著者

児嶋 剛 庄司 和彦 一色 信彦 中村 一博

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.101, no.1, pp.39-43, 2008-01-01 (Released:2011-10-07)

参考文献数

21

被引用文献数

1 6

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We report a case of GID (gender identity disorder) of the female-to-male type, where her vocal pitch was lowered to her satisfaction by Thyroplasty type 3. The distress of GID patients derives from the contradiction between their sexual physical features and gender self-consciousness. As to the levels of distress and the means patients select to resolve the problems they face, individual variations are great. The present patient did not want either transsexual surgery or hormonal treatment, but merely her vocal pitch lowered. Thyroplasty type 3 successfully lowered her vocal pitch as desired without any complication. Surgical details and key points were described.

著者

児嶋 剛 庄司 和彦 池上 聰 鈴木 慎二 岸本 曜 高橋 淳人

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.98, no.12, pp.969-972, 2005-12-01 (Released:2011-10-07)

参考文献数

11

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Most malignant thyroid nodules are surgically treated. This report reviews changes in size of malignant thyroid nodules; none of them received any medical and surgical treatment. Three hundred and three nodules were diagnosed as malignant using fine needle aspiration biopsy (FNAB) and ultrasonography from 1997 to 2003. In 17 patients (19 nodules), they were observed for more than 6 months. We examined the transition of their major axis by ultrasonography. Large nodules (>10mm) and nodules in younger patients (age<50) tend to increase in size. As compared with benign nodules, malignant nodules tend to increase in large nodules (>10mm).

著者

児嶋 剛 堀 龍介 岡上 雄介 藤村 真太郎 奥山 英晃 北野 正之 庄司 和彦

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.109, no.11, pp.791-795, 2016 (Released:2016-11-01)

参考文献数

20

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There have been reports of cases in which a clicking sound is produced in the neck region upon swallowing. It could occur because of elongation and thickening of the hyoid bone, resulting in its coming in contact with the cervical vertebrae during swallowing, or because of abutting of the thyroid cartilage against the hyoid bone, or even because of ossification of the space between the thyroid cartilage and the greater cornu of the hyoid bone. However, in all of these cases, the causes are different and also very rare. Herein, we report a case that we encountered in which a clicking sound was produced in the neck region because of both the thyroid bone and the hyoid bone coming in contact with the cervical vertebrae. The patient was a 57-year-old man. He visited our clinic, because one-year earlier, he had started to hear a sound when swallowing, which had progressively worsened. The abnormal sound was a click coming from the left neck region, and on CT, we observed elongation and hypertrophy of the left greater cornu of the hyoid bone. It was thought that the overgrowth of the hyoid bone was the principal cause, however, this could not be confirmed prior to the surgery. Surgery was performed under local anesthesia. First, the hypertrophic omohyoid muscle and sternohyoid muscle were cut, but the symptoms did not change. Upon cutting of the left greater cornu of the hyoid bone, which was thickened and slightly elongated, and came in contact the cervical vertebrae upon swallowing, the symptoms resolved somewhat. After cutting the superior cornu of the thyroid cartilage, which interfered with the cervical vertebrae upon swallowing, the symptoms disappeared altogether. This was an extremely rare case where the symptoms were caused by both the thyroid cartilage and the hyoid bone, however, appropriate treatment was given through surgery done under local anesthesia while the symptoms were concurrently assessed.

著者

平野 滋 児嶋 久剛 庄司 和彦 金子 賢一 楯谷 一郎

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.93, no.1, pp.53-60, 2000-01-01 (Released:2011-11-04)

参考文献数

12

被引用文献数

4 2

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We assessed the surgical effects of Isshiki's thyroplasty on 10 functional voice disorder patients including seven with mutational voice disorder, two with spasmodic dysphonia and one with asthenic voice disorder. Our concept is to select and combine proper surgical procedures according to the laryngeal findings of each case. We conveyed thyroplasty type I and III for six patients, and type II and III for one with mutational voice disorder. For spasmodic dysphonia, thyroplasty type II and III was performed in one case with atrophy of the vocal folds accompanied by contraction of false vocal folds during phonation, while type II thyroplasty was selected for the other case without vocal fold atrophy and supraglottic contraction. One asthenic voice disorder was treated with thyroplasty type II and III. We showed the efficiency of framework surgery for functional voice disorders and discussed how to select the type of thyroplasty for each case.

著者

庄司 和彦 藤田 修治 大森 孝一 辻 純 伊藤 壽一 本庄 巖

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.81, no.12, pp.1709-1713, 1988-12-01 (Released:2011-11-04)

参考文献数

4

被引用文献数

1 1

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Patients with multi-electrode cochlear implants can distinguish vowels well, but the ‘sounds’ they hear through this device are unknown. In order to simulate vowels through multielectrode cochlear implants, we synthesized waves which have translated formant frequencies using a computer and reverse fourier transformation .Through a digital-analog converter, we heard the synthesized sounds. Each sound is quite different from each vowel, but we can easily distinguish them from each other. With the use of this procedure, cochlear implants can be expected to be improved.

著者

長谷部 孝毅 堀 龍介 児嶋 剛 岡上 雄介 藤村 真太郎 鹿子島 大貴 田口 敦士 庄司 和彦

出版者

公益財団法人 天理よろづ相談所 医学研究所

雑誌

天理医学紀要 (ISSN:13441817)

巻号頁・発行日

vol.23, no.1, pp.50-51, 2020-12-25 (Released:2020-07-17)

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【目的】顔面神経麻痺疾患において,予後予測,治療効果判定のために正確な評価が必要である.誘発筋電図(electroneurography; ENoG)などの電気生理学的評価方法の他に,柳原法などに代表される顔面各部位の動きを評価し,その合計で麻痺程度を評価する主観的評価方法が簡便であり広く使われている.しかしながら,顔面表情の動きを見た目で評価する方法は複数あるものの,いずれにも共通する欠点として,あくまで主観的評価のため検者間で差異が生じる可能性がある他,各部位は3 段階評価のため,わずかな改善などを点数では評価しきれないという点が挙げられる.それらを解決する方法として,画像解析による評価方法はいくつか報告されているが,解析の手間や装置の問題などから広くは使われていない.一方で,近年米Apple 社の販売するスマートフォン(iPhone X 以降) は,その認証方式として顔認証を用いており,顔面運動を正確に捉えることが可能である.そこで我々は,顔面神経麻痺に対する客観的かつ簡便な評価方法を確立することを試みた. 【方法】iPhone XS を用いて検証した.各顔面の部位の動きを係数化し最大値を取得し,左右の比較を行うことで顔面神経麻痺を評価するアプリを作成した.それを用いて外来受診した顔面神経麻痺患者の評価を行い,主観的評価法との比較,及びENoG,積分筋電図との比較を行った. 【結果】アプリでの評価は既存の主観的評価方法と相関しており,特に頬,鼻翼,口角では強い相関が見られた.また,ENoG では相関関係が見られなかったものの,積分筋電図でも相関が見られた. 【結論】デバイスは一般に普及しているため,臨床応用に向けての素地は整っており,目的としていた客観的かつ簡便な評価アプリは開発出来た.顔面の動きの捉え方は,病態生理に基づきさらなる検証およびアップデートが必要ではあるが,非耳鼻科医,さらに言えば患者本人でも現状評価を行うことができるようになることが期待される.

著者

平野 滋 篠原 尚吾 庄司 和彦 児嶋 久剛

出版者

The Society of Practical Otolaryngology

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.89, no.1, pp.75-80, 1996-01-01

被引用文献数

14 2

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Intracapsular enucleation is thought to be a suitable method for preserving post-operative function of the original nerve following treatment for cervical neurilemmomas. In previous studies, however, post-operative palsy occurred in most cases and there have been seen several cases in which nerve funtions did not recover. In the present study, we performed a modified method of Intracapsular enucleation for two cervical neurilemmomas, the first case involved the facial nerve, the second the hypoglossal nerve. In these cases, post-operative palsy has not been observed since immediately after surgery. Important points in this procedure include (1) making the incision line at a point on the capsule where few nerve fibers exist, (2)ablating the capsule from the tumor as gently as possible, (3) monitoring nerve function using a nerve stimulator throughout the procedure.