著者

神田 智子 高橋 晴雄 長谷部 誠司 船曳 和雄

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.92, no.3, pp.239-243, 1999-03-01

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A case with a primary mastoid cholesterol cyst accompanying massive bone destruction is reported. The patient was a 43-year-old male, who visited our clinic because of vertigo. Otoneurological examination revealed the patient' s hearing and vestibular function to be nearly normal. A temporal bone CT showed a soft tissue mass in the left mastoid with large bone defects in the posterior and middle cranial fossae, and fistulas in all of the semicircular canals. MRI revealed a huge mass in the mastoid cavity apparently compressing the temporal lobe of the brain. The patient refused surgical treatment, and during the subsequent 4 year follow-up period the mass developed further and a cholesterol cyst was suspected based on the results of another MRI. Surgery revealed a huge cholesterol cyst located in the mastoid cavity with large bone defects and an exposed dura. Histological examination showed cholesterol granuloma accompanied by inflammation and bleeding and surrounded by thick scar tissue.<br>Obstructive and persistent inflammation in the mastoid was considered to be related to development of the mastoid cholesterol cyst.

著者

折田 頼尚 山藤 勇 長谷部 誠司 三浦 誠 西崎 和則

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.13, no.4, 2003-09-12

著者

梅田 裕生 船曳 和雄 高橋 晴雄 長谷部 誠司

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.92, no.1, pp.27-30, 1999-01-01

被引用文献数

4 5

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A case with post-traumatic cholesteatoma of the external auditory meatus extending into the mastoid is reported. A 27-year-old male visited our clinic with complaints of left otorrhea and hearing impairment lasting six months. He had suffered ahead injury three years previously. The left external auditory meatus was filled with otorrhea and debris, and an audiogram revealed slight conductive hearing loss. Computed tomography revealed a fracture line on the bony external auditory meatus and bone resorption at the medial part of the fracture near the eardrum. A soft tissue density mass was observed from the site of bone resorption to the mastoid antrum. During surgery, we found a temporal bone fracture filled with scar tissue, to which the external auditory meatus adhered. At the posterior part of the external auditory meatus medial to the fracture, the epithelium of the external auditory meatus had intruded into the antrum to form a cholesteatoma, which had extended into the whole mastoid cavity. Constriction of scar tissue at the fracture site during healing and a loss of ventilation at the mastoid were suggested to be involved in the pathogenesis of this cholesteatoma.

著者

隈部 洋平 田村 芳寛 中井 麻佐子 長谷部 誠司

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.959-964, 2005-12-01 (Released:2011-10-07)

参考文献数

15

被引用文献数

1

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Spontaneous regression of any malignant tumor is a rare event, occurring in about 1 per 60, 000-100, 000 among the total number of cases of malignant tumor. We report a case of the spontaneous regression of the hypopharyngeal carcinoma with multiple pulmonary metastases.The patient was a 75-year-old man who complained of dysphagia. He was found to have squamous cell carcinoma of the hypopharynx with multiple pulmonary metastases. Since his airway was almost occluded by the tumor, tracheostomy was performed urgently. About two weeks later, while preparing for chemotherapy for the tumor, the primary tumor began to reduce without any treatment. Subsequently not only the primary tumor but also metastatic lesion continued to reduce spontaneously, and about four months later, they disappeared completely.It is thought that elucidation of the mechanisms of spontaneous regression of malignant tumors could possibly lead to a more effective therapy for cancer.

著者

須藤 正治 高橋 晴雄 田邊 牧人 長谷部 誠司

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.91, no.1, pp.23-27, 1998-01-01

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Although impairment of middle ear ventilation and subsequent middle ear negative pressure have been regarded as important pathogenetic factors in middle ear diseases, impairment of middle ear ventilation has not been proven to necessarily cause progressive negative middle ear pressure. Toynbee phenomenon is another possible cause of active production of negative middle ear pressure. Accordingly, we investigated the incidence and pathophysiology of Toynbee phenomenon in various middle ear diseases.<br>The incidence of positive Toynbee phenomenon was 75% (18124) in controls. Whereas, the incidence was 14% (8/59) in cases of otitis media with effusion (OME), 50% (13126) in cases of chronic otitis media (COM), 38% (5/13) in cases of adhesive otitis media (Adh), and 30% (3/10) in patients with cholesteatoma. However, the negative pressure induced by the Toynbee maneuver was significantly more profound in cases of Adh (- 116.0±58.6 mmH₂O) than in normal ears (-8.05±53.9 mmH₂O, p<0.005). Also the average induced negative pressures in the other diseased ears tended to be more profound than in normal ears; -23.6±37.1 mmH₂O in OME, -23.1±55.1 mmH₂O in COM, -45.0±18.0 mmH₂O in cholesteatoma. Considering that middle ear diseases often accompany nasal diseases and are also often induced or aggravated by upper respiratory infections or nasal allergies (when the nose is congested), and that the eustachian tubes in diseased ears often cannot equalize negative middle ear pressure, Toynbee phenomenon may be related to the pathogenesis of these ear diseases.