著者

佐久間 仁 大河内 幸男 馬場 陽子 大谷 巌 平山 和美 佐藤 正憲 児玉 南海男

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1991, no.Supplement43, pp.70-76, 1991-04-25 (Released:2012-11-27)

参考文献数

25

---

A case of brainstem cavernous angioma associated with hearing loss and dizziness is reported. A 25-year-old female initially complained of hearing loss in the leftear and dizziness. Six months thereafter she suddenly developed additional symptoms, and was diagnosed as having hemorrhage in the brainstem on the basis of CT scan and MRI findings. Otological examination revealed low- and high-frequency hearing loss and abnormal ABR consisting of only wave I in the left ear. Follow-up MRI showed cavernous angioma, which was surgically removed.

著者

角田 保雄 尾股 丈夫 大谷 巌

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1995, no.Supplement83, pp.53-67, 1995-08-01 (Released:2012-11-27)

参考文献数

41

被引用文献数

1

---

Correlations were made between audiometric pattern (especially flat and gradual high tone loss)and speech discrimination score (SDS) in 255 ears with sensorineural hearing loss that were tested at the Department of Otolaryngology of Shirakawa Kousei General Hospital during the past 6 years.First, the audiometric pattern was defined on all frequencies (0.125 k-8 kHz). SDS of each audiometric pattern resembled that in all similarly affected ears, but in younger ears (under 75 years old, the average value of pure tone hearing level subtracted from speech reception threshold was under 10 dB), SDS of patients with flat audiogram or abrupt high tone loss (mainly 8 kHz) maintained a good score (over 70%) at 10 dB intervals below 70 dB, then sharply decreased at 70 dB. However, SDS of patients with gradual high tone loss decreased in proportion to hearing loss. This fact supports Schuknecht's classification of hearing loss in presbycusis. Furthermore, this suggests that there is a boundary of good SDS at the 60 dB level, at which SDS was marked by deafness and a flat audiometric pattern caused by atrophy of the stria vascularis.Second, the audiometric pattern was defined by the slope of the audiogram (value of 2 kHz loss subtracted from 0.5 kHz loss, and 4 kHz loss from 0.5 kHz loss). The gradual high tone loss group had a good SDS (over 70%) under 50 dB. In cases involving hearing loss reaching and exceeding 50 dB, SDS declined abruptly. Good SDS almost disappeared and poor SDS (under 50%) increased suddenly. This suggests that not only that the decrease in neurons reached the minimum necessary to maintain a good SDS, but also that the neurons which transfer information under 50 dB exerted great influence on SDS.Differences were analyzed, between each audiometric pattern and between the group before abrupt deccrease in SDS and the group after the abrupt decrease in the flat audiogram or gradual high tone loss group.

著者

野中 聡 海野 徳二

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1987, no.Supplement15, pp.160-166, 1987-08-10 (Released:2012-11-27)

参考文献数

17

被引用文献数

1 1

---

We examined the neuronal mechanisms of sneezing in precollicular postmammillary decerebrate cats. Mechanical stimulation (duration; 5 s, frequency; 20 Hz, amplitude; 500μm) of the nasal membrane by means of a spring coil vibrator evoked sneezes. In the same preparation, electrical stimulation (0.2 ms,10 Hz,10-40 μA) of a certain area within the lower brainstem evoked sneezes. The sequences of EMG activation and the accompanying change in the subglottic pressure were almost the same for mechanically and electrically induced sneezes. The sneeze evoking region was located ventromedial to the spinal trigeminal nucleus, and extended rostrocaudally from P4.0 to 12.0 according to Horsley-Clarke coordinates. A microlesion made at a caudal portion of this region diminished the effects of rostral stimulation, but a microlesion made at the rostral portion had no effect on caudal stimulation.These results suggest that the sneeze evoking region is located in the medulla oblongata, with no regional differences from the rostral region to the caudal region. This region appears to control the respiratory, intrinsic laryngeal, epipharyngeal muscles. The integrated activity of these muscles evokes sneezes.

著者

菅原 康介 岡村 純 下平 有希 足守 直樹 峯田 周幸

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.156, pp.171-176, 2021 (Released:2021-03-11)

参考文献数

17

---

All penetrating neck wounds are potentially dangerous and require emergency treatment, because there are important vessels, nerves, and organs in the neck. We report the rare case of a 71-year-old man with neck injury caused by a glass fragment that penetrated into the floor of the mouth from the submandibular region. The patient had accidentally fallen through a glass door and sustained a 15-cm long incised wound in his neck. He was initially transferred to a district hospital, where he was diagnosed as having arterial bleeding and a neck injury penetrating into the oral cavity; ENT surgeons at the hospital performed temporary hemostasis and tracheotomy under local anesthesia, and the patient was urgently transported to our hospital by ambulance. On admission, he was conscious, and his general condition was good. CT showed no damage to the major vessels, but revealed free air around the sublingual region. Therefore, emergency surgery was performed to repair the perforation from the neck into the oral cavity under general anesthesia. We found the facial artery and facial vein and ligated them during the operation, and the opening into the oral cavity was closed with absorbable sutures. The postoperative course was good, the patient resumed oral intake on day 4 after the surgery, and he was discharged from the hospital on day 9 after the surgery, with the only postoperative complication of palsy of the marginal mandibular branch of the facial nerve. In this report, we review nine cases of neck injury penetrating into the floor of the mouth and 11 cases of neck injury caused by a glass fragment reported in the literature and discuss their clinical findings.

著者

Hisayoshi Ishizaki

出版者

The Society of Practical Otolaryngology

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.156, pp.26-33, 2021 (Released:2021-03-11)

参考文献数

30

---

Intratympanic gentamicin is used to control episodic vertigo in patients with the severe form of Meniere’s disease, but it may also cause hearing loss. The purpose of this study was to investigate gentamicin-induced changes in hearing in such patients.In this study, a total of 38 patients (mean age 55.4 y, range 23–86 y, male 16, female 22, side rt 17, lt 21) who received intratympanic gentamicin administration were monitored by pure-tone audiogram (PTA) and click-evoked extratympanic electrocochleography (ECoG) over a period of five years. Hearing detection thresholds were measured by PTA, and the summating potential (SP), action potential (AP) and SP/AP ratio were determined by ECoG. The patients received dilute gentamicin solution with sodium bicarbonate administration into the middle ear 1 or 2 times.The mean hearing level at mid frequencies (500–2000 Hz) was 47 dB before the treatment and 40 dB after the treatment. The mean hearing gains at the frequencies of 125, 250, 500 Hz, and 1 kHz were 12.6, 12.1, 10.5, and 6.2 dB, respectively. The differences in the hearing levels at the frequencies of 125, 250, and 500 Hz recorded before and after treatment were statistically significant (p<0.001).The longitudinal follow-up conducted after the treatment did not show any worsening of the hearing levels or relapse of the vestibular symptoms. The SP/AP ratio (0.49 before and 0.34 after treatment) seemed to return to normal in the long term after gentamicin treatment. Normalized SP/AP resulted in hearing gain at the frequencies of 250 and 500 Hz. The amplitudes of the SP (0.59 before and 0.3 after treatment), and especially of the AP (1.23 before and 0.86 after treatment), decreased after gentamicin treatment, indicating hearing loss. The hearing was better in 16 cases (42%) and showed no change in 18 cases (47%), while hearing loss occurred in 4 cases (11%) because of gentamicin.Intratympanic gentamicin treatment alleviated hearing loss and reduced vertigo. It also normalized the SP/AP ratio, and the consequent hearing gain may reflect a reduction in endolymphatic hydrops. Long-term observation after gentamicin treatment revealed stable hearing.

著者

涌谷 治夫 稲守 徹 森 裕司 町塚 博文 雲井 健雄

出版者

The Society of Practical Otolaryngology

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1986, no.4, pp.9-14, 1986

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Thirty-five normal subjects were stabirographically studied using a force plate on the rolling platform. The rolling was controled manually between 0 and 0.6 Hz applied at random. The upper limit of power spectrum and phase shif between rolling and body movements were measured.<BR>These parameters were similar to the results of constant rolling of above 0.2 Hz and were influenced by the rolling of above 0.2 Hz in the random rolling.<BR>As the rolling was controled manually, the power spectrum of rolling was not stable and the content of random rolling changed at every measurment. The motor of rolling platform made noise during acceleration and deceleration allowing the subjects know the rythm of rolling.<BR>These problem indicated that this technique was not adequate for the prevention of forecasting behavior.

著者

市川 良之 井本 祥子 中島 築 海野 徳二 白戸 勝 川堀 真一 高橋 光明 中村 晃 熊井 恵美 野中 聡 長島 泰行 金井 直樹

出版者

The Society of Practical Otolaryngology

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1987, no.15, pp.86-94, 1987

被引用文献数

1

---

A clinical evaluation was conducted on 107 patients with laryngeal cancer treated in our department between 1976 and 1985. Their mean age was 64.0 years, and the male to female ratio was 12: 1. Histopathologically, squamous cell carcinoma was the most common malignant tumor constituting 97.2% of all the cases, whereas there were only 3 cases of verrucous carcinoma. There were 52 cases of glottis,52of supraglottis and 3 of subglottis. The overall five-year survival rate was 62.7%. The five-year survival rates for Stages I to IV were 74.6%,84.9%,54.2% and 31.1%, respectively. As the five-year survival rate of T4 cases was 0%, more aggresive therapies such as combinations of extended operation, irradiation and chemotherapy appear to be required in such cases. In our clinic, the patients with metastases to the cervical lymph nodes at preoperation were treated with radical neck dissection combined with the total laryngectomy in most cases. Radical neck dissection for such patients decreases the number of death due to uncontrolled metastases to the cervical lymph nodes. In the cases of the advanced stage, careful postoperative examination is required.

著者

田中 久哉

出版者

The Society of Practical Otolaryngology

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1994, no.71, pp.1-20, 1994

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The scoring system is widely accepted as a simple and useful method for evaluating the degree of facial palsy, but there have been some problems in objectivity and reproducibility. This study investigated a new objective method of analyzing facial movements and examined the physiological range of asymmetry and differences between genders.<BR>Facial expression data input to an Apple Computer using Quick Tim e was analyzed by applying digital image editing techniques.<BR>Forty-six healthy volunteer subjects were analyzed utilizing this method. To quantify facial movements, several points on the face were identified to accurately monitor their movements. Twenty-four white marks were placed on the face, and 10 pictures in a series from resting to maximum movements were imported. The movements of each marker were expressed on a coordinate axis. Four voluntary facial movements (forehead wrinkling, eye closing, grinning and whistling) were examined.<BR>The trajectory of the marks were expressed n umerically and changes in an area within a polygon produced by connecting all marked points with a line were measured. The ratio of the area of maximum movement to the area at rest was obtained and used for comparative investigation.<BR>The differences in the ratio between the left and right sides were less than 6% in any area and any movement. There were no significant differences due to gender. Some areas obtained by subdividing showed larger changes with facial movements than other areas.

著者

伊藤 博隆 馬場 駿吉 高木 一平 大屋 靖彦 横田 明 伊藤 弘美 稲垣 光昭 小山 賢吾 北條 郷明 丸尾 猛 東内 朗 杉山 和子 河合 〓 森部 一穂 鈴木 賢二 柘植 勇人 板谷 純孝 鈴木 康夫

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1991, no.Supplement52, pp.107-118, 1991-12-25 (Released:2012-11-27)

参考文献数

17

被引用文献数

1 1

---

Mao-bushi-saishin-to extract capsules (6 caps. /day) were administered orally to 61 perennial nasal allergy patients presenting with nasal obstruction for 4 consecutive weeks to assess the overall efficacy, safety and utility of the drug. In the doctor's evaluation, the overall efficacy rate covering excellent and good responses was 38.3% at week 2 of treatment and 54.7% at week 4 of treatment. The utility rate covering useful and higher ratings was 60.7%.Nasal symptoms, viz, sneezing attack, nasal discharge, nasal obstruction, dysosmia and interference with daily living were all improved. Nasal obstruction, in particular, disappeared in many cases, thus generating a high improvement rate. Nasal mucosal findings, viz, swelling of inferior turbinal mucosa, watery secretion in nasal cavity, and nasal discharge eosinophil count showed good improvements.The time course of each nasal symptom i n terms of the average score according to allergy diaries, revealed significant reduction in nasal obstruction, dysosmia and interference with daily life in severity at and after week 2 and sneezing and nasal discharge were significantly alleviated at week 4 as compared with the findings obtained during the baseline period.As side effects, headache was reported in one case and stomachache in one case. These symptoms were relieved after discontinuation of treatment.

著者

泰地 秀信 小川 美弥子 鳥谷部 郁子 小川 茂雄 大塚 護 岡本 健

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1996, no.Supplement89, pp.37-38, 1996-12-01 (Released:2012-11-27)

被引用文献数

1

著者

田口 喜一郎 菊川 正人 石山 哲也 伊藤 和也 上條 豊

出版者

耳鼻臨床

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1990, no.38, pp.1-6, 1990

被引用文献数

1

---

We devised a series of tasks as therapy for some types of vertigo. The task are as follows: 1) keeping the head in a position that elicits vertigo,2) head movements beginning in the sitting position,3) a short rest,4) body trunk movements,5) clockwise and counterclockwise body rotations while standing with eyes closed,7) walking forwards and backwards with eyes closed.<BR>We obtained favo r able results with this therapy in one of ten patients with Meniere's disease, all seven patients with benign paroxysmal positional vertigo and six of ten patients with vertebro-basilar artery insufficiency. Our home therapy is recommended for all patients with benign paroxysmal positional vertigo and selected patients with vertebrobasilar artery insufficiency.

著者

新関 泰夫 渡辺 勇 大久保 仁 石田 博義 山本 修三 水越 鉄理 渡辺 行雄

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1986, no.Supplement8, pp.104-115, 1986-12-05 (Released:2012-11-27)

参考文献数

8

被引用文献数

1 1

---

Registered cases of Ménière's Disease collected by the Committee members were studied and classified according to the age of onset and the duration of the disease. The influence of each factors on the vestibular symptoms and hearing impairment was analyzed. Next, the influence of these two factors on the hearing loss of the affected side was studied in 120 cases of definite Ménière's Disease.The results of this study were as follows:1) The hearing impairment of the affected side increased gradually with the age of onset and the duration of the disease.2) The vestibular symptoms of Ménière's disease were not significantly affected by these two factors.

著者

渡辺 健一 土肥 二三夫 冨田 寛 竹本 律子 村上 弦

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1995, no.Supplement78, pp.53-62, 1995-04-30 (Released:2012-11-27)

参考文献数

38

被引用文献数

2

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The topographical anatomy of the chorda tympani nerve (CTn) was investigated macroscopically in 45 ears of Japanese adult cadavers, aged 38-88 yr, with special reference to its topographical relationship to critical structures encountered in otorhinolaryngological practice such as the auditory tube and Wharton's duct. Fifteen cases of the “separated type” of CTn running independently along the posterior margin of the lingual nerve, which were noted in our previous study, were included among the 45 specimens. Major findings considered relevant to clinical practice are described below.1. The course of the CTn, passing inferiorly and medially in the petrotympanic fissure, was classified into 2 types: that traveling immediately anterior to and parallel with the auditory tube, and the becoming progressively more distant (inferior and anterior) to the auditory tube.2. Immediately after emerging from the petrotympanic fissure, the CTn cons istently communicated with the sympathetic plexus around the middle meningeal artery, and often issued twigs reaching the otic ganglion area.3. In cases where the CT n was trapped by tendinous tissue around the lateral pterygoid muscle (17.8%), the nerve merged into the lingual nerve from the medial or anterior aspect, and not from the usual posterior aspect, at the level of the mandibular notch.4. The lingual nerve sometimes (20.0%) showed a strongl y curved sigmoid course behind the mandibular ramus. Several buccal branches innervating the oral lining, without containing the CTn element, were issued at the anterior projecting protion of the sigmoid course.5. At the base of the oral cavity, the major CTn element traveled al ong the superior margin of the lingual nerve, therefore the CTn element was located away from the submandibular ganglion.6. A thick communicating branch on both sides of the lingual nerve was rarely observ ed under the mucous lining or in the mucous layers at the tip of the tongue. These findings suggest that morphological variations of the CTn should be considered during surgical procedures and for understanding the nature of related clinical symptoms.

著者

周 莉新 佃 守 古川 政樹 池間 陽子 澤木 修二

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1997, no.Supplement92, pp.61-63, 1997-06-27 (Released:2012-11-27)

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There are more patients with vocal cord nodules in China than in Japan. The occupation of these patients consists mainly of female singers or teachers. On the basis of the etiology and pathology of Chinese traditional medicine, there are three different treatment modalities for this disease. Shikunshi-to, Toninsibutsu-to and Zoueki-to. These Chinese traditional medicine treatment modalities have been characterized by the combined use of Chinese medical herbs according to each individual patient's status.

著者

清田 隆二

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1988, no.Supplement26, pp.32-37, 1988-09-30 (Released:2012-11-27)

参考文献数

19

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It has been reported that healthy persons with normal hearing and without complain of tinnitus have perceivable tinnitus, when the ambient noise level is low. Such tinnitus was observed in 44 (72.1%) of 61 healthy adults with normal hearing in a sound-proof room. In most (91%) of them, tinnitus resembled pure tone, and was composed of middle or high pitch tone.Since their frequency was conce n trated in some ranges relating to each other as multiples, it is suggested that some resonance mechanism in the body is involved in the generation of this type of tinnitus.

著者

桂 周良

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1988, no.Supplement24, pp.10-19, 1988-09-05 (Released:2012-11-27)

参考文献数

15

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Subglottal pressure signals during phonation were evaluated by linear prediction analysis in fifteen normal adults.The first subglottal resonance frequencies, exhibited individual variation, ranging from 420 Hz to 720 Hz. The change in fundamental frequency affected resonance spectra, also suggesting individual variation of subglottal resonance. Moreover, spectrum differences among vowels indicated coupling between the supraglottal and subglottal systems during the closed phase.

著者

宮原 伸之 白根 誠 上田 勉

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.2006, no.117, pp.126-129, 2006

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Varicella-zoster virus often causes not only vesicles, but also facial and vestibular nerve paralysis (Ramsay Hunt syndrome). This syndrome can affect other cranial nerves. We report a case of unilateral palsy of the V, VII, IX, and X cranial nerves due to varicella-zoster virus infection.

著者

石井 歓 竹沢 裕之 小島 正 児玉 広幸 浜本 誠 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 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1995, no.Supplement84, pp.30-35, 1995-10-15 (Released:2012-11-27)

参考文献数

11

被引用文献数

1

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Thirty-two handicapped children with hearing impairment were fitted with hearing aids. Hearing aids were effective in 28 of these caces, but were effective for all children less than 1 year old. Hearing aids could not be fitted in 4 caces.The results of this study showed the importance of early diagnosis of hearing impairment and early fitting of hearing aids in handicapped children.

著者

坂倉 淳

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1989, no.29, pp.1-33, 1989

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The vibration of the body wall during phonation was measured using accelerationtype pick-ups attached to five different points on the body wall. The voice was recorded simultaneously. The test subjects were 18 amateur singers. Each subject was asked to phonate five Japanese vowels /a/, /i/, /u/, /e/ and /o/ in both trained singing voice (trained voice) and untrained singing voice (untrained voice). This distinction was possible for all subjects after some practice.<BR>Spectral analysis of the body wall vibration was performed. The intensities of the vibration were also analysed with respect to the vibration proportion (VP), which is the ratio of the body wall vibration (G) to the sound pressure level. 'Singing formant'was found not only in the spectral structure of the voice sound but also in that of body wall vibration. The VP of the cheek was greatest with the trained head voice, but it was not so great during the production of trained chest voice. With the untrained voice, there was no difference in the VP among the five locations of the body wall. The VP at the cheek in music students was greater than that of members of a glee club. The difference of VP among five vowels was smaller with the trained voice than with the untrained voice. These results suggest the important role of the vibration of the cheek and great resonance of oral cavity in the trained voice.<BR>Listening tests were also performed. Five vowels of voice sound that had been recorded simultaneously with the vibration of body wall were presented to a group of 18 listeners for identification. Articulation score for trained voices was lower than that for untrained voices. The difference of articulation score among five Japanese vowels was smaller with the trained voice.<BR>These results suggest that the difficulty in perceiving sung vowels arises from 'covering'.