著者

安藤 一郎 新井 顕 渡辺 道隆 加納 昭彦

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.88, no.12, pp.1625-1632, 1995-12-01 (Released:2011-12-12)

参考文献数

36

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Over the past 9 years, we studied 1090 cases of ABC (aspiration biopsy cytology) and 258 cases of malignant tumor. There were 3 false positive cases (1.2%) and 6 cases (2.3%) of histological misdiagnosis. Although we have not experienced fatal complications yet, we have recognized tuberuculous change in the needle tract after postoperative histology as a case of lymphoadenitis tuberuculosa.A search of the literature has revealed 4 cases of needle tract seeding after large needle biopsy and a case of embolism in the cerebral artery after ABC of head and neck lesions. Fatal complications of ABC were reported in 7 cases.Although the incidence of complication after ABC is not obvious, fatal complications of ABC are very rare in comparison with large needle biopsy and we consider that ABC is a safe method of clinical diagnosis.ABC imposes less burden on patients and differentiation of benign from malignant and identification of the presumable histological type are possible. Therefore, we conclude that ABC can be applied clinically in oto-rhino-laryngology.

著者

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.93, no.1, pp.1-6, 2000-01-01 (Released:2011-11-04)

参考文献数

8

---

Characteristics of hearing disorders due to retro-cochlear lesions have been recognized as disproportionally poor discrimination of speech to the hearing level in pure tone audiometry and disturbances in tone decay test, Bekesy audiometry and binaural hearing test. There have been numerous patients whom we diagnosed as having retro-cochlear hearing loss because they had these characteristic. However, we have encountered quite a few individuals who failed to obtain speech understanding after cochlear implantation (CI) in spite of poor speech discrimination before surgery.From these clinical observations and review of recent literature, it appears that true retro-coc-hlear hearing disorder is far less frequent than we thought and that the retro-cochlear pathway may not have an important role in the process of speech recognition, although the cochlea plays an important role in transforming speech sound into electric signals. The main function of the retrocochlear tract may be to detect the direction of the sound source, as the vestibular tract contributes to equilibrium of the body in a reflex manner.Thus, in perception of speech, the cochlea and the auditory cortex play more important roles than the retro-cochlear pathway does. From the clinical points of view, cochlear implantation can be indicated even for patients who have any discrepancy between the result of pure tone audiometry and speech discrimination test.

著者

北野 仁 斎藤 春雄 北嶋 和智 竹田 泰三 矢沢 代四郎 松原 秀春 北野 眞由美 北野 博也 児玉 章 水上 千佳司

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.74, no.10special, pp.2370-2378, 1981-10-25 (Released:2011-11-04)

参考文献数

7

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Meniere's disease is represented by episodic vertigo (vestibular symptom), tinnitis and hearing loss (cochlear symptom). It is possible to devide patients with Meniere's disease into three groups; those with cochlear and vestibular symptoms starting at the same time, and those with the vestibular symptoms starting before or after cochlear symptoms: In this presentation, we studied the clinical differences of these three groups. The following results were obtained.1. In the case of cochlear Meniere's disease, the cochlear symptom is slight and it is easy to acquire the vestibular symptom. The cause of cochlear Meniere's disease was considered to be the existence of endolymphatic hydrops. Compared with frequency of bilateral Meniere's disease, bilateral cochlear Meniere's disease was more found.2. In the case of vestibular Meniere's disease, the vestibular symptom is slight and it is difficult to acquire the cochlear symptom. The cause of vestibular Meniere's disease, in all cases was not considered to be the existence of endolymphatic hydrops.3. In the case of Meniere's disease with vestibular symptoms starting after the cochlear symptoms, both the vestibular symptoms and cochlear symptoms are heavy. In the case of Meniere's disease with vestibular symptoms starting before the cochlear symptoms, both symptoms are slight.

著者

梶川 泰造

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.30, no.3, pp.343-380, 1935

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.

著者

李 汝培

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.66, no.1, pp.85-112, 1973 (Released:2011-12-12)

参考文献数

74

被引用文献数

1 1

著者

田辺 正博 上原 範子

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.73, no.4, pp.673-677, 1980

被引用文献数

2 1

---

Evidence of a foreign body in the esophagus is not rare. When characteristics of the foreign body are unknown and are non-contrasted with x-ray, the diagnosis is often difficult.<br>We report a case of a foreign body which was overlooked for more than two months.<br>A 47-year-old woman experienced severe pain in her throat when she swallowed a piece of sponge cake. A foreign body lodged in the throat was ruled out by two otolaryngologists.<br>Five weeks later, she developed retrosternal pain and epigastralgia and an esophagogram was done.<br>She was sent to our clinic as there was an abnormal shadow detected on the esophagogram.<br>Flexible fibro-optic esophagoscopy revealed a foreign body lodged in the esophagus.<br>Under general anesthesia, a piece of quadrilateral plastic film with sharp corners was removed using a rigid esophagoscope.<br>The patient had a good postoperative course and esophagogram done five months after removal of the foreign body showed no stenosis of the esophagus due to scar formation.

著者

大木 孝一 和田 公平 山本 祐三 牧本 一男 高橋 宏明

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.86, no.12, pp.1757-1762, 1993-12-01 (Released:2011-11-04)

参考文献数

6

被引用文献数

2 4

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Actinomycosis is a chronic purulent granulomatous disease caused by actinomyces, an organism which is often present in man. Patients with a chronic clinical course have been on the increase in recent years, and differentiating this disease from tumor is often necessary when the mass is in facial and cervical regions other than the oral cavity and jaw. We report two cases of actinomycosis in the face and neck.Case 1: A 54-year-old man complained of a swelling in the anterior part of the neck. A mass 65 × 70 mm with redness of the skin was noted at his first visit. The mass was of platelike consistency with a smooth surface closely adherent to the surrounding tissue. The tuberculin test was negative. A malignant tumor was considered, so percutaneous needle biopsy was performed, but no significant abnormality was found. Antibiotics were given by drip infusion, and the mass disintegrated. Yellow viscous pus containing light gray granules was discharged to form a fistula.Case 2: A 40-year-old man developed a swelling in the left cheek. A ping pong ball-sized mass of plate-like consistency with redness was noticed at his first visit. A fistula formed in the oral cavity on the left, and pus was discharged from it. Plain CT revealed an isodense lesion in the left cheek, with no connection to the maxillary sinus.Actinomyces is anaerobic, so it was not detected by culture in either case. Histopathological examinations of actinomycotic granules was useful in the diagnosis.The treatment consists mainly of drainage by incision of the lesion and administration of antibiotics, especially penicillin.

著者

石川 敏夫 市村 恵一

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.97, no.4, pp.285-290, 2004-04-01 (Released:2011-10-07)

参考文献数

20

---

The clinical features of 14 patients with deafness due to mumps who underwent treatment in Jichi Medical School Hospital from April 1993 to March 2003 were reviewed. The diagnosis was made according to the criteria for diagnosis of mumps deafness determined by the Acute Profound Deafness Committee set up by the Ministry of Health and Welfare, Japan.The number of patients with mumps has gradually increased since 2000, and the number of patients in 2002 was about 3 times greater than that in 2000.The age distribution of the patients in our hospital was 3 to 34 years old and half of the patients were 5 to 9 years old. The onset time of hearing loss in 10 cases was within 8 days after the appearance of parotid swelling. All 14 patients had unilateral total deafness or profound sensorineural hearing loss. Nine were treated with corticosteroids. Hearing loss did not improve after treatment in any patient. The importance of mumps vaccination should be reconsidered.

著者

大屋 耕子

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.6, pp.499-502, 2003-06-01 (Released:2011-10-07)

参考文献数

15

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Natural mumps virus infection is believed to induce lifelong immunity and rarely cause unilateral severe sensorineural hearing loss with sudden onset. Unilateral deafness due to mumps virus reinfection had rarely been reported in the Japanese literature. I present a case of unilateral deafness due to mumps virus reinfection.

著者

五島 史行 矢部 はる奈 小川 郁

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.4, pp.315-320, 2009 (Released:2010-12-04)

参考文献数

15

被引用文献数

1 1

---

Introduction: Treatments for acute peripheral vertigo have not been well investigated. The most suitable drug for controlling acute vertigo should suppress both vertigo and accompanying nausea. The purpose of this study was to evaluate the effect of four different drugs on acute peripheral vertigo: (A) hydroxyzine hydrochloride (25 mg, i.v.); (B) 0.5% metoclopramide (2 ml, i.v.); (C) sodium bicarbonate (40 ml, i.v.); and (D) a cocktail of diphenhydramine hydrochloride (30 mg) and dyprophylline (26 mg) (both i.m.). Methods: Forty-two patients with acute peripheral vertigo (average age: 59.5±18.1 years) with spontaneous nystagmus were assigned to four treatment groups (A-D, above). Patients with central vertigo and vestibular neuritis were excluded. The number of patients in each group was as follows: A, n=11; B, n=11; C, n=11; and D, n=9. Patients were instructed to evaluate their subjective symptoms of nausea and vertigo before and 30 minutes after drug treatment. They rated the severity of their symptoms on a 0-to-10 scale, with 10 representing the most severe symptoms and 0 a lack of symptoms. Results: Group A patients (hydroxyzine hydrochloride; 25 mg, i.v.) reported the highest level of relief from vertigo and nausea after drug treatment, whereas group C (sodium bicarbonate; 40 ml, i.v.) and D (diphenhydramine hydrochloride (30 mg)-dyprophylline (26 mg) cocktail; i.m.) patients reported only the slight relief of these symptoms. Group B patients (0.5% metoclopramide; 2 ml, i.v.) experienced partial symptom relief; their vertigo remained unchanged. Thus, hydroxyzine hydrochloride (A) was the most effective in controlling both nausea and vertigo, whereas sodium bicarbonate (C) and diphenhydramine hydrochloride and dyprophylline (D) only slightly suppressed vertigo and nausea. Metoclopramide (B) only suppressed nausea. Conclusions: Hydroxyzine hydrochloride (A) was the most suitable for treating acute peripheral vertigo. Doctors should be familiar with the contraindications of these drugs. Some of these drugs may potentially be used in combination to control the symptoms of acute vertigo more effectively.

著者

多湖 千晃 柳田 則之 成内 秀雄 落久 保文子 倉田 毅

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.84, no.11, pp.1625-1631, 1991

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We investigated the role of immunological mechanisms in sensorineural hearing disorders and the relationship between inner ear and renal pathologies.<br>Controls, and NZB/kl and MRL/lpr strain mice, in which autoimmune disease can be spontaneously induced, were used in this study. The mice were tested for acoustic brain stem response (ABR), cochlear and renal pathology and circulating immune-complexes (CIC) serology, using enzyme immunoassay (ETA). For ABR, click and high frequency tone bursts were used as stimuli. Pathological studies consisted of tissue changes observed following hematoxylin-eosin (HE) and indirect immunofluorescent staining under light microscopy.<br>Compared to controls, hearing was impaired in NZB/kl mice while hearing remained unaffected in MRL/lpr mice. On HE staining, no histological changes were observed in the cochleae of either strain of mice. However, indirect fluorescent staining showed IgG deposits in the stria vascularis in both strains of mice. In both strains, renal pathology consisted of an immune-complex glomerulonephritis. CIC values were significantly higher in MRL/lpr mice, but were not correlated to stria vascular lesions. The lesions in the stria vascularis in the two strains were different, which probably explains the discrepancy in hearing impairment, whereas the lesions in the kidney were similar. NZB/kl mice that had hearing impairment showed severe stria vascular lesions and there was a correlation between the degree of hearing impairment and the severity of stria vascular lesions. However, no correlation was seen between stria vascular and renal lesions and CIC values.<br>These findings suggest that autoimmune mechanisms exist yin the cochlea, mainly in stria vascularis. The NZB/kl mouse can be a useful model of sensorineural hearing disorder secondary to immunological disorders.

著者

竹田 泰三 柿木 章伸 竹内 俊二 齋藤 齋藤

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.85, no.12, pp.1893-1901, 1992

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Recent advances in imaging technique, including high resolution thin section computed tomography scanning and magnetic resonance imaging (MRI), permit the easy diagnosis of congenital malformations of the osseous labyrinth, which have so far been lumped together as "Mondini dysplasia". In the present study the anatomic patterns from the radiographic appearance and the clinical manifestation were examined in 18 patients (23 ears) with radiographic abnormalities of the inner ear. The most common abnormal configuration was a large vestibule (20 of 23 ears). This anomaly of the vestibule often involved the lateral semicircular canal, revealed as a round high signal zone on T2-weighted MRI. However, a large vestibule was not always associated with an abnormal cochlea. Abnormal cochleas were found in 8 of the 20 ears with a large vestibule, and most of these 8 ears had total or profound deafness. But 4 of the 10 ears with residual hearing had low tone deafness and 6 had fluctuating hearing loss, which was frequently associated with attacks of dizziness. These clinical manifestations of Mondini dysplasia are similar to those of patients with endolymphatic hydrops.

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

小林 丈二 佐伯 忠彦 竹田 一彦 上甲 英生

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.89, no.11, pp.1365-1369, 1996-11-01 (Released:2011-11-04)

参考文献数

14

被引用文献数

1 2

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The authors investigated the clinical course of 49 patients with peritonsillar abscesses treated at Uwajima City Hospital between January 1983 and December 1995. The cohort consisted of 36 males and 13 females, aged 15 to 68 (mean age, 37.2 years old). Along with administration of antibiotics, removal of the abscess was performed by needle aspiration in 25 cases, and incision for drainage in 24 cases, respectively. There were no statistical differences in clinical stage and course between the group under 40 years old and the group over 40 years old. There was also no difference between the group treated with needle aspiration and the group treated with incision, except for the length of hospital stay healing time. Interval tonsillectomy was carried out in 10 cases. Recurrence of the peritonsillar abscess occurred in only one case. Therefore, we recommend needle aspiration as the first choice for treatment of peritonsillar abscesses. In cases of peritonsillar abscess with no past history of habitual angina, tonsillectomy is not indicated because recurrence of peritonsillar abscesses is rare.

著者

仁保 正次 濱谷 松夫

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.38, no.4, pp.212-221_3, 1943-04-20 (Released:2011-10-14)

参考文献数

29

著者

奥園 達也

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.76, no.10, pp.2565-2580, 1983

被引用文献数

7 2

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著者は, 身体重心動揺の方向性を重視し, 新たに動揺の各規定方向毎の動揺量を表示できるベクトル動揺図 (命名, Vector Statokinesigram; V-Skg. と略) を考案した. V-Skg. は, 重心動揺計の左右及び前後への身体動揺記録 (Statokinesigram; Skg. と略) を用い, 特製プログラムを有するマイクロコンピューターにより作成する, 即ちV-Skg. 上の動揺方向は, Skg. 上単位時間毎移動点, 2点間のΔy/Δxの逆正接より求め, 併せて動揺量は同2点間の距離より求めた. 動揺方向の一計測単位を5度とし, 360度を72分割すれば, 動揺方向毎動揺量の計測値は72個得られる. これを, 極座標上72本の放射状線分として, CRT上に描出した.<br>1) 本法により健康成人29名のV-Skg. を記録した. 動揺の型別は, 求心型, びまん型, 前後型, 多中心型, 左右型の他, 閉眼安定型を加えた. 各型別の総軌跡長, 20度毎18方向別の平均値と標準偏差を求めた. これを健常者の型別, 対照値とした.<br>2) 健康高令者65名のSkg. とV-Skg. を記録した. この型別分類, 総軌跡長及び18方向別の動揺量を求め, 健康成人群と比較した. 身体動揺は加令により増加した. 型別分類では左右型と閉眼安定型の増加が注目された.<br>3) 一側性末梢前庭障害例では左右型の動揺を示す. 動揺量は健康成人群の左右型より有意に大きい.<br>4) 小脳脳幹障害例では前後型の動揺を示すが, 健常群の前後型に比し動揺量は大きい.<br>5) 体平衡障害の代表例2例を呈示した. 本V-Skg. は, 変動する動揺の方向性を明示し, その動揺量を計量し得る方法である.

著者

田端 敏秀 斎藤 載 西村 新 園田 裕 池田 昌生 島田 忠雄 岡本 進 大台 道夫 葛原 敏捷 桜井 〓士 岩間 紀行 釘貫 依子 小向 美奈子

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.61, no.7, pp.849-850, 1968

著者

田端 敏秀 西村 新 大台 道夫 斎藤 載 島田 忠雄 園田 裕 葛原 敏捷 池田 昌生 岡本 進 桜井 禎士 岩間 紀行 小向 美奈子

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.60, no.9, pp.699-704, 1967

著者

玉城 進 齋藤 春雄 村田 清高

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.74, no.4, pp.746-752, 1981

被引用文献数

2 3

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A huge cholesteatoma in a 50-year-old female involving the petrous apex was reported. The prominent features of the case were recurrent attacks of very slowly progressing facial paralysis with a 11-year interval and insidious destruction of labyrinthine function.<br>The cholesteatoma extended into all the air cell tracts up to the petrous apex, and to the retro- and infralabyrinthine-areas.<br>The cholestoma destroyed the otic capsule at the crus commune and resolved the dura mater to such an extent that the cerebellum could be seen through it. As she had experienced acute otitis media on only one occasion at the age of 4 and only had a small dry attic perforation, the possibility of a congenital cholesteatoma of the petrous apex was considered in addition to her clinical course.