著者
河野 敏朗 石戸谷 淳一 遠藤 亮 佃 守
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.100, no.11, pp.899-903, 2007-11-01 (Released:2011-10-07)
参考文献数
19
被引用文献数
1 1

We sometimes experience infant cases leading to unexpected deaths due to foreign bodies. It is often difficult to identify the cause or foreign body invasion by asking questions directly to a child. We experienced an infant case of a chopstick passing through the soft palate, reaching the parapharyngeal space near the inner carotid artery circumference. At the first medical examination, we could not detect the tip of the chopstick, in the pharynx. Using 3-directional-CT images, we could locate the tip of the chopstick in the parapharyngeal space near the inner carotid artery circumference. Under general anesthesia, we could remove the tip of the chopstick from the parapharyngeal space near the inner carotid artery with an endoscope trans-orally.It is important to investigate positional conditions between a foreign body and the vessels in the parapharyngeal space. Images such as enhancing 3-directional-CT before the operation is useful.Furthermore, we have to be careful of the late neurosis by pencil-injury in the region and pay close attention to respiratory tract management.
著者
平賀 幸弘 黄 淳一
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.106, no.4, pp.341-346, 2013 (Released:2013-04-01)
参考文献数
21

Anaplastic thyroid carcinoma is a rare and lethal human malignancy. In this paper, we report on a case of a 55-year-old man who had undergone radiation therapy on the cervical region for malignant lymphoma at 14 years of age, and had been consulting our hospital for 19 years. He underwent a left hemithyroidectomy for papillary thyroid carcinoma at the age of 35, and 11 years after that a total thyroidectomy was performed for cervical nodal disease. After the operation he underwent radioiodine therapy twice. Five years after radiotherapy, anaplastic carcinomas arose in the left cervix and the cranium. Soon after complete resections of the tumors, systemic metastases were detected with FDG-PET. Finally, 11 months after the operation, he died in our palliative care unit at the age of 55 due to frequent bleeding from a palatal carcinoma. A review of the literature showed that the age at which the tumor arose, namely the peak of the patient’s life, was earlier than was usually reported. The survival time of 11 months observed in our patient was more than that generally observed in patients with anaplastic carcinoma.
著者
篠原 尚吾 山本 悦生 田辺 牧人 辻 純 宗田 由紀 坂本 達則 金 泰秀 寺下 健洋
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.92, no.7, pp.779-783, 1999-07-01 (Released:2011-11-04)
参考文献数
19
被引用文献数
2 1

Papillary microcarcinomas (PMCs) which are 1.0cm or less in diameter are a specific subgroup of thyroid cancer. As the prevalence of these tumors found in autopsy cases was reported to be 10 to 28.4% in Japan, the necessity of surgical treatment of PMCs has been questioned. However, PMCs are often found in conjunction with advanced metastases in cervical lymph nodes, lung, etc..We reviewed eight cases with PMCs revealed by the presence of cervical metastases over the past 10 years. Five cases were revealed by manifest cervical lymph node metastases. Two of the other three cases were operated on for treatment of metastatic lesions subsequent to other diagnoses, notably a parotid tumor and lateral cervical cyst. The PMCs were revealed in a postoperative histological study of these two cases. The remaining case was discovered incidentally during neck dissection for laryngeal cancer. Preoperative ultrasonography was undertaken in seven cases. Two cases showed multif ocal small high echoic spots without tumors and one case showed no abnormal findings in the thyroid.In all cases, total thyroidectomy, unilateral or bilateral neck dissection and postoperative radioiodine scintigraphy were performed. Multifocal tumors in the thyroid were proven histologically in four cases. In one case, the primary lesion was not found even in a postoperative histological study.In accordance with these observations, PMCs revealed by cervical metastases shoul be treated as advanced thyroid carcinomas.
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

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 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 1

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
高橋 昭
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.8special, pp.1404-1421, 1980-08-20 (Released:2011-11-04)
参考文献数
70
著者
本田 圭司 鎌田 知子 田崎 彰久 畑中 章生
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.105, no.7, pp.681-685, 2012-07-01

We report a case of burns of the larynx caused by hot food in which emergency airway management was required.<br> A 36-year old male came to the hospital with a sore throat 14 hours after ingesting hot food (takoyaki, a Japanese dumpling containing octopus). Fiberscopic examination revealed mild edema of the aryepiglotic fold. The patient refused hospitalization against medical advice and went home after a corticosteroid injection, but returned to the hospital by ambulance with severe dyspnea the next day (44 hours after the injury). A considerably swollen epiglottis were seen on fiberscopy. Since endotracheal intubation was expected to be difficult, surgical cricothyroidotomy was performed for the relief of the airway obstruction. If a laryngeal burn is suspected, the patient should be hospitalized and observed carefully for 24-48 hours.<br>
著者
北尻 真一郎 田渕 圭作 平海 晴一
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.94, no.1, pp.17-20, 2001-01-01 (Released:2011-11-04)
参考文献数
19

A case of fracture of the stapes footplate with ossicular disruption and perilymph fistula caused by earpick-induced trauma is reported. A 51-year-old female was presented with hearing loss and vertigo just after sticking an ear pick into her left ear. Pure tone audiometry showed a mixed hearing loss of 67.5dB. Nystagmus was not observed, and vertigo improved in a week. On exploratory tympanotomy, the fracture of the stapes footplate accompanying a dislocation of the incudo-stapedial joint and perilymphatic leakage from the oval window were found. The perilymph fistula was sealed with temporal fascia, and ossicular chain continuity was reconstructed by type N tympanoplasty. After the operation, the cochlear and vestibular symptoms improved.
著者
中出 捨次郎
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.21, no.2, pp.347-370_1, 1927

1. 口蓋扁桃腺ニ於ケル格子状纖維ハ胎生第三ヶ月初期ニ於テ既ニ發生シ, 規則正シキ網羅状ヲナシテ實質中平等ニ存在シ, 實質組織ヲ多數ノ小部分ニ分チ, ソノ各部ニハ一個若クハ數個ノ細胞ヲ容ル.<br>該纖維網眼ハ更ニ之ヨリ分岐シテ樹枝状又ハ不規則ナル網状ヲナセル甚ダ纖細ナル多數ル細纖維ニヨリテ充タサレ, 此等細纖維ハ前述ノ細胞間ニモ入リ, 之等ヲ纒絡スルモノノ如シ.<br>2. 口蓋扁桃腺ノ格子状纖維ハ胎生第三ヶ月初期ニ於テ既ニ主副纖維ノ別明瞭ナリ. 即, 該時期ニ於テハ主纖維ハ多數細纖維ノ集リテ成レルコト恰モ絹絲ノ多數細纖維ヨリ成ルニ酷似シ, 其後次第ニ成育スルニ從ヒ該細纖維ノ一部ハ尚依然之ヲ認メ得ルモ一部ハ融合シテ太キ一本ノ纖維トナリ胎生第六ヶ月ニ至レバ此ノ融合セル纖維部ハ甚ダ強靱トナル.<br>3. 胎生時ニ於ケル格子状纖維ハ胎生初期ニ於テハ尚甚ダ纖細ナリト雖モ網羅状ニ黒染シ, 成人ニ於ケルモノト全ク同一ナリ.<br>4. 格子状纖維ハ膠基纖維ト明ニ區別ス可キモノニシテ胎生期ニ於ケル口蓋扁桃腺ニ於テハ前者ノ後者ニ變性移行スルヲ認メズ.<br>5. 口蓋扁桃腺ニ於ケル格子状纖維ハ胎生第三ヶ月末期以後ニ於テ濾胞ニ一致シテ圓形, 紡〓形若クハ不整形ニ全ク缺如スルカ, 或ハ著シク乏少ニシテ僅ニ斷片状ニ存在スルニ過ギズ. 而テ該格子状纖維缺如部 (即, 濾胞) ハ胎生初期 (第三・四ヶ月) ニ於テハ紡〓形若クハ不整形ヲ呈スルモ, 漸次發育スルト共ニ類圓形ヲ呈シ, 第六ヶ月ニ至レバ生後ニ於ケルモノト大差ナキニ至ル.<br>6. 胎生第三ヶ月ニ於テ扁桃腺上皮組織下ニ之ニ沿ヒテ稍太キ格子状纖維ノ走行スルヲ認ムルモ扁桃腺被嚢内ニハ全ク之ヲ認メズ. 其後扁桃腺ノ發育ト共ニ該纖維モ亦, 發育増殖スト雖モ, 被嚢内ニハ特ニ強靱ナル該纖維ヲ認ムル事ナシ. 即, 格子状纖維ハ被嚢ノ形成ニ關與スル事少シ.<br>7. 彈力纖維ハ胎生第三ヶ月ニ於テ既ニ扁桃腺上皮組織下ニ, 第四ヶ月ニ於テ皮嚢内ニ, 實質ヲ包ミテ走行スルヲ認メ, 其後次第ニ發育スルモ, 第六ヶ月ニ至レバ甚ダ著明ナル發育ヲ遂ゲ強靭ナル該纖維ハ屈曲蛇行シテ扁桃腺組織ヲ包ムニ至ル.<br>8. 扁桃腺實質内ニ於テハ彈力纖維ハ甚ダ纖細ナレ共, 胎生第三ヶ月ニ於テ血管壁ノ外, 上皮組織ニ接近セル極メテ小部分ニ略, 之ニ並行シテ線状ニ走行シ, 第四ヶ月ニ於テハ被嚢ニ近キ部ニ於テモ同樣, 該纖維ヲ認メ,上皮組織ニ近キ部ニ於ケルモノハ互ニ吻合ヲ作リテ網状ヲナシ, 稍之ニ遠ザカリテ扁桃腺深部ニ入レノバ未ダ吻合ヲ作ルニ至ラズシテ線状ヲナシテ存ス. 第六ヶ月ニ至レバ該纖維ハ實質中平等ニ網状ヲナシテ存在スルニ至リソノ走行ハ上皮組織並ニ被嚢ニ近キ部ニ於テハ略, 之ニ並行シテ走行シ, 互ニ吻合ヲ作リテ網状ヲ呈シ, 稍, 之ヲ遠ザカリテ扁桃腺深部ニ入レバカクノ如ク一定セズシテ不規則ニ網羅状ヲナス. 其後益々發育スト雖, 扁桃腺被嚢或ハ周圍組織ニ於ケルモノニ比シ一般ニ甚ダ纖細ナリ.<br>9. 彈力纖維ハ腺窩ニ近接セル扁桃腺實質部ニ於テハ, 腺窩ヲ色ミテ之ト略並行ニ輪状ニ走行セル太キ纖維ト, 上皮組織ト略, 垂直ニ放線状ニ走行セルモノト及ビ腺窩上皮組織ニ並行ニ縦走セルモノトル略三種ヨリ成リ, 互ニ吻合シテ網羅状ヲナシ, 籠状ニ腺窩ヲ包ム.<br>10. 口蓋扁桃腺ニ於テハ彈力纖維ハ濾胞ニ一致セル部ニ略圓形ヲナシテ全ク缺如スルカ, 或ハ著シク乏少ナリ.<br>11. 膠基纖維ハ胎生第三ヶ月ニ於テ扁桃腺被嚢部並ニ上皮組織下ニ之ニ沿ヒ纖細ナル纖維トシテ走行シ, 其後次第ニ發育スト雖, 扁桃腺被嚢部ニ於ケルモノ特ニ著明ニシテ, 胎生第六ヶ月ニ至レバ強靱ナル該纖維ハ屈曲蛇行シテ扁桃腺實質ヲ包ム. 上皮組織下ニ於ケルモノハ胎生第十ヶ月ニ至レバ再ビ甚ダ纖細トナル.<br>12. 膠基纖維ハ扁桃腺實質中ニ於テハ胎生第三ヶ月, 第四ヶ月ニ於テ極メテ纖細且, 淡染セルモノ線状或ハ粗鬆ナル網状ヲナシテ細胞間ニ少量存シ, 第六ヶ月以後ニ於テハヨク發育シテ濃染シ, 全實質中ニ分布ス. 然レドモ濾胞ニ於テハ之ヲ缺如スルカ, 或ハ甚ダ乏少ナリ.<br>13. 胎生期ニ於テハ扁桃腺被嚢ハ主トシテ膠基纖維並ニ彈力纖維ヨリ成リ, 格子状纖維ハ之ニ與ル事少シ. 然ルニ扁桃腺實質組織内ニ於テハ間質組織ハ主トシテ格子状纖維ヨリ成リ, 膠基纖維, 彈力纖維亦存在スト雖, 彼ニ比スレバ甚ダ纖細ニシテ間質組織トシテハ前者ニ比シ意義少シ.<br>14. 胎兒口蓋扁桃腺ニ於テハ扁桃腺實質部タルト被嚢部タルトヲ問ハズ一般ニ格子状纖維ハ胎生初期 (第三ヶ月) ニ於テ既ニヨク發育分布セルニ反シ, 彈力纖維, 膠基纖維ハ胎生初期ニ於テ既ニ發生スレ共, 其發育極メテ微々タルノ顯著ナル相違アリ. 而テ胎生中期 (第五, 六ヶ月) 以後ニ至レバヨク發育分布サルルニ至ル.<br>15. 口蓋扁桃腺實質部ニ於ケル各纖維ハ, 扁桃腺周圍組織ニ於ケルモノニ比スレバ甚ダ繊細ニシテ, 彈力纖維, 膠基纖維ニ於テ殊ニ顯著ナリ.<br>16. 扁桃腺被嚢ハ胎生第三ヶ月ニ於テ既ニ其
著者
国吉 京子 井上 幸 中島 誠 川野 通夫 澤田 正樹 一色 信彦
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.82, no.11, pp.1587-1592, 1989-11-01 (Released:2011-11-04)
参考文献数
20

In order to study the development of speech in infants with cleft palate, we investigated the development of consonant articulation in two cases (A, B) with cleft soft palate and in two cases (C, D) with cleft lip and palate before and after palatoplasty. We taperecorded their consonants in meaningful speech sounds and transcribed them.We made the following observations: (1) The frequency of consonants in meaningful speech sounds did not vary with the type of cleft or the timing of palatoplasty, and increased radically in the latter half of the second year and the first half of the third year. (2) Glottal stops occurred in the pre-palatoplasty periods but had almost disappeared three to ten months after palatoplasty in cases A, B, and C, whose velopharyngeal function was competent. (3) The speech sounds of these three cases were judged to be intelligible when the numbers of glottal stops decreased, the numbers of voiceless stops accounted for over 50% of all stops, and bilabial voiceless stops [p] appeared.
著者
森山 寛
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.88, no.8, pp.980-982, 1995-08-01
参考文献数
1
被引用文献数
1
著者
大村 咲 北村 守正 平野 滋 楯谷 一郎 嘉田 真平 古田 一郎 三浦 誠 伊藤 壽一
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.107, no.8, pp.639-643, 2014

We report herein on a case of minocycline-induced black thyroid with papillary thyroid carcinoma. A 60-year-old female, who had taken oral minocycline intermittently for osteomyelitis of the mandible for two years, noticed a palpable thyroid nodule. Fine needle aspiration of the nodule revealed atypical cells and the serum thyroglobulin level was high. Under the diagnosis of suspected thyroid carcinoma, a hemithyroidectomy with central compartment neck dissection was performed. The color of the tumor, which was diagnosed as a papillary carcinoma, was white. On the other hand, the color of the normal thyroid gland was dark red to black with minocycline pigmentation. Minocycline therapy may induce headache, nausea, vomiting, liver dysfunction and dental hyperpigmentation in children. But a minocycline-induced black thyroid is uncommon. Recently, there have been some reports that the risk of malignancy in black thyroid glands is higher than in non-black thyroids.
著者
若島 純一 原渕 保明 山口 治浩 形浦 昭克
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.90, no.6, pp.693-697, 1997-06-01 (Released:2011-11-04)
参考文献数
14

Ulcerative colitis is an idiopathic, non-specific inflammatory disorder of the colon, and its etiology remains unknown. We present a case of ulcerative colitis in which clinical symptoms were remarkably improved by palatine tonsillectomy. The patient was diagnosed with severe ulcerative colitis and treated with internal medicine. When pharyngitis and aphthous stomatitis developed, his bowel symptoms worsened. A tonsillar provocation test was performed, and the result was positive. Moreover, bowel symptoms worsened after the tonsillar provocation test and the patient developed a sore throat and fever. Therefore, we suspected tonsillar focal infection and carried out palatine tonsillectomy. In the early postoperative period, bloody diarrhea recovered despite the interruption of sulfasalazopiridine and lymphocyte afferesis. In addition, recurrent pharyngitis and aphtous stomatitis were resolved entirely.
著者
梅田 悦生
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.100, no.6, pp.497-504, 2007-06-01 (Released:2011-10-07)
参考文献数
53

Infectious gastroenteritis caused by Norovirus which broke out in November 2006 has infected more than three million patients within a two-month periode. Their symptoms varied from severe diarrhea, vomiting and fever to digestive disorders due to a slight flu. The author, an otolaryngologist, has examined numerous flu patients who complain of various symptoms and always bears in mind that digestive disorders might result from Norovirus. Warnings of this kind are found in some clinical reports. The present paper suggests that otolaryngologists should be aware that their patients with flu symptoms might have gastroenteritis caused by Norovirus.
著者
家根 旦有
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.486-487, 2003-06-01 (Released:2011-10-07)
参考文献数
2
著者
稲垣 千果夫 沖田 容一 折田 洋造
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.76, no.6, pp.1603-1610, 1983

新生仔ゴールデンハムスターにおける蓋膜辺縁のコルチ器表面との接続形態について, 特に marginal pillar (MP) をスチレン樹脂割断法を併用してSEMで観察し, 次のような結果を得た.<br>1) MPは生後4-6日目の下方回転より出現し, 生後10-14日目にも顕著となり, 生後16日目には消失していた.<br>2) MPの出現部位は Deiters 細胞第三列目の細胞表面であり, 蓋膜下面への付着部位は辺縁よりもやや内側 (蝸牛軸側) であった.<br>3) 生後5-10日目頃では, Deiters 細胞第一列目, 二列目の細胞表面にもMPと同様の構造物を認めた.<br>ハムスターでは, MPの消失するのは聴毛の形態が完成した直後であり, 他の動物による諸家の報告を考え合わせれば, MPはコルチ器が完成するまでの間, 蓋膜を固定, 保持する作用を持つことは間違いないものと思われ, MPの消失がコルチ器の発達完了を示す指標になるものと考えられた.
著者
加藤 寛 田中 佐代子 由端 敏秀
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.77, no.6, pp.1367-1373, 1984-06-01 (Released:2011-11-04)
参考文献数
8

その主な周波数領域が1/3オクターブバンド400Hzから4kHzの胎内音を152名の新生児に聴かせ, その鎮静効果を観察した. そのうちの69名にABRを実施し胎内音の反応と比較した.その結果, 胎内音の鎮静効果とABRの反応とはよく一致した. 胎内音に反応の認められない高度難聴児2名が発見された.これらのことから, 本法は, 新生児聴覚スクリーニング検査として有用であるという確信を深めた.
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

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.