[in Japanese]

View full abstract

Epipharyngeal abrasive therapy in the treatment of chronic epipharyngitis includes a transnasal method and a transoral method, each of which is a method that is blindly performed, and a method performed under an endoscope. Endoscopic epipharyngeal abrasive therapy（E-EAT）is categorized into endoscopic transnasal epipharyngeal abrasive therapy（E-TN-EAT）and endoscopic transnasal epipharyngeal abrasive therapy（E-TN-EAT）by the method used to approach the epipharynx. Both E-TN-EAT and E-TO-EAT have advantages and disadvantages, it is important to understand their characteristics and use the methods appropriately according to the case to improve the clinical effect. For cotton swabs used for the transnasal method, there are straight swabs and curved swabs, which are used according to the situation. There is a usage method corresponding to each part of the epipharynx that scrubs even the cotton applicator used in the transoral method. The basic usage of both transnasal cotton swabs and transoral cotton applicators is outlined.

View full abstract

[in Japanese]

View full abstract

Mammary analogue secretory carcinoma （MASC） is a mammary secretory carcinoma like salivary gland tumor which was reported in 2010 by Skalova et al. Its histopathological features vary, but it displays similarities to acinic cell carcinoma. Around 30％ of acinic cell carcinoma cases diagnosed before the disease concept was established are now considered to be MASC. The main feature of MASC is the expression of ETV6-NTRK3 gene fusion. With a review of the literature, we report two surgical cases which were diagnosed as MASC after histopathological examination.

View full abstract

We focused on salivary secretion, which is one of the mucosal protective mechanisms. We resected the bilateral submandibular glands from a rat model of gastroesophageal disease（GERD）to cause a disturbance of salivary secretion, and observed the pathological changes in the laryngopharyngeal and esophageal mucosae. Marked inflammatory changes were observed in the laryngopharyngeal and esophageal mucosae of the rats with disturbance of salivary secretion compared with the mucosae in the GERD model. Disturbance of salivary secretion might lead to induction and exacerbation of GERD and LPRD.

View full abstract

It is well known that one of the causes of deep neck abscesses is an odontogenic infection. However, temporal abscesses are rarely caused by an odontogenic infection. Here we report a rare case of a 63-year-old female with a temporal and infratemporal fossa abscess that was caused by dental infection. She had a left temporal headache, jaw-opening pain and trismus. Enhanced computed tomography findings showed an abscess in the left side of the head, and revealed a radiolucent shadow in the left fifth tooth of the mandible. We diagnosed a left temporal and infratemporal fossa abscess caused by periodontitis. We performed surgical drainage of the incision on the left temporal region and she received an antibiotics medication. CT findings showed the abscess had improved in the temporal and infratemporal fossa. After 14 days she was discharged. It is important to perform adequate abscess drainage. The otolaryngologist should be aware that temporal and infratemporal fossa abscesses may be caused by an odontogenic infection.

View full abstract

We report a case of myoepithelioma in the hard palate. The patient was a 69-year-old woman with a mass in the hard palate. The hard elastic mass was covered with normal mucosa and located on the right side of the hard palate. We diagnosed myoepithelioma by biopsy and surgically removed the tumor. An epithelioid organization was the main histopathology finding, and multiple histology was mixed. Actin, αSMA, and S-100 protein, which is a marker of the myoepithelium system, and GFAP were positive by immunostaining. The MIB-1 index, which is an index of malignancy, was 5％, suggesting the mass was benign. A diagnosis of myoepithelioma（mixed type）was made. Postoperative observation revealed no recurrence as of 10 months after the operation, but there are reports of recurrence and malignant transformation, so careful follow-up is necessary.

View full abstract

Stevens-Johnson syndrome （SJS） is a disease which presents symptoms of fever, enanthem all over the body including mouth and external genitals, and ocular conjunctivitis. We report a case of SJS experienced by a 50-year-old man without skin lesions. One week before hospitalization, the patient had a high fever and cough, and was treated by the attending physician with medication. However, pain due to mucosal erosion in the oral cavity gradually worsened, so the patient visited this hospital. At the initial visit, conjunctivitis in both eyes and significant swelling and erosion of the nasal oro-pharyngolaryngeal mucosa were observed, however, rash was not observed. SJS was suspected according to eye and mucosal lesions. DLST results of the suspected drug were slightly positive, but a patch test was negative. In addition, antibody levels for mycoplasma were positive, and the LAMP method was also positive. Based on these results, SJS due to mycoplasma infection was diagnosed. We treated the case by steroid infusion and the patient healed without subsequent complications. Cases of SJS caused by medicine are said to be common in adults, however, cases caused by mycoplasma infection usually occur in children. In addition, most SJS cases with only mucosal symptoms are reported in patients less than 18 years old. We report this rare case of adult SJS caused by mycoplasma infection where only mucosal symptoms appeared at onset.

View full abstract