著者

吉田 正 中村 光士郎 小林 泰輔 富所 雄一

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.96, no.9, pp.783-789, 2003-09-01 (Released:2011-10-07)

参考文献数

27

被引用文献数

1 1

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Mycosis in the paranasal sinus is commonly found in the maxillary sinus, but rarely in the sphenoid sinus. In this paper, three cases of sphenoid sinus mycosis are reported and the clinical feature are compared with the 25 other cases reported in Japan since 1968. Our three patients had complained of headache and eye pain, which were thought to be characteristic symptoms in the 25 previous cases. One of the three patients had onset with a background of rheumatoid arthritis and needed steroid medication, but the other two patients had no improvement with medication for sinusitis. By CT scanning and MRI, a localized sphenoid sinus lesion was detected as a characteristic findings for paranasal sinus mycosis, showing irregular mosaic contras on CT scanning and low intensity signal on T1 and T2 MRI imaging. The definite diagnosis was made by means of histological examination for a block age in the affected sinus cavity. Endoscopic sphenoidectomy was performed through the parsnaslis of the anterior wall of sphenoid sinus and was usefull for total removal of the lesion.

著者

小林 泰輔 岡田 昌浩 寺岡 正人 中村 光士郎

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.65, no.6, pp.453-459, 2006 (Released:2009-06-05)

参考文献数

15

被引用文献数

1

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Cogan's syndrome is primarily diagnosed based on subsequent episodes of an inflammatory eye disease and rapidly progressive, usually sequential bilateral loss of audiovestibular function. Since there are still no specific tests for the syndrome, it is difficult to diagnose Cogan's syndrome in the early stage before the emergence of both eye and audiovestiubular symptoms. We present a case of a 34-year-old woman who complained of vertigo and bilateral hearing loss. Magnetic resonance imaging (MRI) of the inner ear was performed before the emergence of keratitis. MRI on the 23rd day after onset of hearing loss revealed a slightly high intensity on TI-weighted images in the right vestibule, which showed profound hearing loss. On the 54th day after onset, high signal intensity was noted in the right cochlea, the vestibule, and lateral semicircular canal on Tl-weighted images, but no enhancement. The high signal intensity disappeared seven months after onset, but there was no defect of inner ear signs on the T2-weighted images. A high signal of the inner ear on T1-weighted images is not a specific sign of MRI in Cogan's syndrome, since it is sometimes encountered in the inner ear of labyrinthitis, bleeding in patients with leukemia, and intralabyrinthine schwanoma. However, MRI could be a possible method for the early diagnosis of Cogan's syndrome because this finding might be recognized before the onset of eye symptoms.

著者

岡田 昌浩 小林 泰輔 中村 光士郎

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.102, no.3, pp.219-223, 2009 (Released:2010-12-03)

参考文献数

20

被引用文献数

9 10

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Hemorrhage following tonsillectomy is still a major complication despite the development of new hot knives. In this study, a retrospective review of 242 adult patients who underwent tonsillectomy in the Department of Otolaryngology, Ehime Prefectual Central Hospital between January 2000 and March 2007 was conducted. Post-tonsillectomy hemorrhage occurring in 56 patients (23.1%); four of these patients experienced hemorrhage during the first 24 hours postoperatively, and the remaining 52 had delayed bleeding. Nine of 56 patients (3.7%) required a procedure to control their bleeding under general anesthesia. The hemorrhage rate in males was significantly higher than in females. There was no statistically significant difference in hemorrhage rates based on age, body mass index (BMI), duration of surgery and smoking. Patients who received antibiotics postoperatively experienced less secondary hemorrhage than those without antibiotics. In 99 patients who were administered antibiotics, patients who used cephalosporins experienced less secondary hemorrhage than those who received penicillins. These results indicate that antibiotics after tonsillectomy are effective to reduce post-tonsillectomy hemorrhage rates.

著者

中村 光士郎 松本 康 柳原 尚明

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.73, no.11, pp.1673-1678, 1980-11-01 (Released:2011-11-04)

参考文献数

19

被引用文献数

1

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Bilateral or recurrent facial palsies were found in 70 patients (3.8%) among the 1856 patients with facial palsy whom we treated during the last fifteen years. According to the clinical course, these 70 patients were classified into the following four groups.1) Bilateral simultaneous facial palsy (15 patients, 0.8%)2) Bilateral recurrent facial palsy (3 patients, 0.2%)3) Bilateral alternating facial palsy (24 patients, 1.3%)4) Unilateral recurrent facial palsy (28 patients, 1.5%)The bilateral simultaneous facial palsies were caused by Bell's palsy in five patients, head trauma in three, the Melkerson-Rosenthal syndrome in one, otitis media in two, myasthenia gravis in two, polyneuritis in two. The etiologies of four other patients were unknown. In contrast to multiple etiologies of the bilateral simultaneous facial palsies, bilateral alternating and recurrent palsies were caused mostly by Bell's palsy (22 patients) and the Melkerson-Rosenthal syndrome (3 patients). Although the majority of unilateral recurrent facial palsies were caused by Bell's palsy (22 cases) and the Melkerson-Rosenthal syndrome (2 cases), it is noteworthy that intratemporal tumors such as neurinoma of the facial nerve (1 patient) and cholesteatoma in the petrous apex (2 cases) could be the cause of recurrence.