著者
市村 恵一 田中 利善 北原 伸郎
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.82, no.9, pp.1209-1219, 1989
被引用文献数
7 2

The masseter muscle, which contributes to mastication, originates on the zygomatic arch and inserts into the lateral surface of the mandible. Although relatively rare, benign masseteric hypertrophy and intramasseteric hemangioma are two important conditions affecting this muscle. Patients with these lesions complain of the cosmetic deformity rather than the functional disorder. Unless desired for cosmetic reasons there is little justification for any operative treatment. However, as no report could be found of the esthetic problem being solved by conservative treatment, surgical correction is advised when the chief complaint is esthetic.<br>Surgical treatment involves resection of the hypertrophied musculature or excision of the tumor with a surrounding margin of normal muscle. We list here the important aspects of surgery of the masseter.<br>1) Careful preoperative planning, including CT and MRI, is indispensable.<br>2) An extraoral approach is preferred in most cases. The masseter muscle is exposed through a curvilinear incision around the angle of the mandible for cosmetic reasons. A postauricular incision extending to the submandibular area is used instead of a routine preauricular parotid skin incision.<br>3) Care should be exercised to identify and preserve the lower branches of the facial nerve. They should either be dissected free and retracted (in case of tumor) or remain on the surface of the muscle (in cases of muscle hypertrophy) to protect them from damage.<br>4) Ligation of the feeding vessels helps to minimize blood loss.<br>5) Oozing from the muscle can be controlled by an infrared contact coagulator.<br>6) Postoperatively continuous suction with a fenestrated polyethylene drain for 2 days and a pressure dressing for 5- to 7-days is recommended to prevent hematoma and resultant scar formation, which causes swelling or trismus.<br>7) Patients should begin chewing early to prevent trismus.
著者
市村 恵一 田中 利善 北原 伸郎
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.82, no.9, pp.1209-1219, 1989-09-01 (Released:2011-11-04)
参考文献数
52
被引用文献数
2 2

The masseter muscle, which contributes to mastication, originates on the zygomatic arch and inserts into the lateral surface of the mandible. Although relatively rare, benign masseteric hypertrophy and intramasseteric hemangioma are two important conditions affecting this muscle. Patients with these lesions complain of the cosmetic deformity rather than the functional disorder. Unless desired for cosmetic reasons there is little justification for any operative treatment. However, as no report could be found of the esthetic problem being solved by conservative treatment, surgical correction is advised when the chief complaint is esthetic.Surgical treatment involves resection of the hypertrophied musculature or excision of the tumor with a surrounding margin of normal muscle. We list here the important aspects of surgery of the masseter.1) Careful preoperative planning, including CT and MRI, is indispensable.2) An extraoral approach is preferred in most cases. The masseter muscle is exposed through a curvilinear incision around the angle of the mandible for cosmetic reasons. A postauricular incision extending to the submandibular area is used instead of a routine preauricular parotid skin incision.3) Care should be exercised to identify and preserve the lower branches of the facial nerve. They should either be dissected free and retracted (in case of tumor) or remain on the surface of the muscle (in cases of muscle hypertrophy) to protect them from damage.4) Ligation of the feeding vessels helps to minimize blood loss.5) Oozing from the muscle can be controlled by an infrared contact coagulator.6) Postoperatively continuous suction with a fenestrated polyethylene drain for 2 days and a pressure dressing for 5- to 7-days is recommended to prevent hematoma and resultant scar formation, which causes swelling or trismus.7) Patients should begin chewing early to prevent trismus.
著者
由井 誠一郎 福喜多 啓三 福家 博史
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.5, pp.1312-1320, 1981
被引用文献数
12

Rhinogenic Intracranial infection is a rare complication. Intracranial complication arising from nasal infections, principally afflictions of the accessory sinuses, is a very grave complication. Since the advent of chemotherapy and various antibiotics, its incidence and morbidity has diminished appreciably.<br>A case of rhinogenic spontaneous Intracranial complication is reported herein. The patient was a 16-year-old man with a swelling around the left eye-lid that had existed for two days. There had been headache and high fever. On examination, the spinal fluid was under pressure with a high cell count, consisting mostly of poly-morphonuclear cells. Four days after admission, he went into coma. Rhinogenic intracranial complication was suspected. A radical ethmoid, antrum and frontal sinus surgery was immediately carried out. Ten grams of SB-PC and 200mg of DKB were administered daily, but 12 days after admission, the careful CT scanning revealed that he had a subdural abscess. Drainage of the subdural abscess was carried out. The patient made a complete recovery 7 weeks after admission.
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

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.
著者
東辻 英郎 北村 溥之 齋藤 春雄 岸本 誠司 宮本 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.74, no.4, pp.698-705, 1981
被引用文献数
2

Sixteen patients with progressive bilateral perceptive deafness due to unknown causes were examined using various hearing tests and equilibrium tests with the following results.<br>1. Among the 11 patients examined 11 showed inner ear deafness and 3 showed inner ear deafness combined with retrocochlear one.<br>2. With reference to the appearance and progress of deafness, the deafness of this type was divided into the following two:<br>One was frequently observed in younger patients under twenty and was characterized by the tendency that bilateral deafness which appeared simultaneously and deteriorated equally, showed gradual, high-tone hearing loss. Thus, the hearing loss in these patients tended to be similar in pattern. i) between the first and the last examinations and ii) between the right and the left ears. Furthermore, the deafness of this type was rarely accompanied by vertiginous attacks.<br>The other was frequently found in older patients, of above twenty and was characterized by the tendency that deafness of both ears did not appear simultaneously and did not deteriorate equally. Furthermore, the deafness of this type was sometimes accompanied by vertiginous attacks in anamnesis.<br>3. Among the 16 patients examined, 4 showed fluctuating hearingloss. Furthermore, one of the 3 patients who underwent the glycerol test showed a positive sign. From the above mentioned findings the following conclusions were drawn:<br>(1) There may be differences between the 2 groups of patients, younger and older with regard to the etiological factors of the progressive bilateral perceptive deafness due to unknown causes, although both groups showed inner ear deafness. The deafness in the former group may be induced by congenital factors and may be regarded as a kind of premature presbyacusis. In contrast, the deafness in the later may be induced, at least partly, by acquired factors.<br>(2) Some patients showed findings suggestive of the existence of labyrinthine hydrops. These are valuable in considering the mechanism and treatment of the deafness of this type.
著者
三輪 高喜
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.103, no.12, pp.1073-1081, 2010-12-01

Remarkable progress has been made in basic research on the sense of smell during the last few decades. This progress has been accelerated by the discovery made by Axel and Buck of the genes that encode olfactory receptors. These rescarchers won the Nobel Prize in Physiology or Medicine in 2004. The detection and discrimination of odor molecules in humans is mediated by 388 olfactory receptors that are expressed on olfactory sensory neurons. A basic understanding of the mechanism of odor reception is crucial to an understanding of olfactory dysfunction. Olfactory disorders can be classified as quantitative or qualitative disorders. The former category includes the deterioration or total loss of olfactory sensation, while the latter category includes distortions of the sense of smell. Quantitative olfactory disorders can be classified by the area affected by the disease into four major groups: (1) sino-nasal, (2) olfactory mucosa, (3) olfactory fila, and (4) central pathway. Chronic rhinosinusitis, which is the most frequent cause of olfactory disorders, is caused by the conductive loss of odor molecules. The second most common cause is postviral olfactory disorders occurring after an upper respiratory tract infection. The prognosis for olfactory function in individuals affected by these causes is relatively good. However, olfactory loss caused by neural disorders, such as posttraumatic olfactory loss, has a poor prognosis. Dysosmia, or a distorted sense of smell, is mainly caused secondary to postviral or posttraumatic olfactory disorders. Dysosmia is classified as either parosmia or phantosmia. Parosomia occurs in patients who are unable to correctly identify odors, while phantosmia involves the smelling of odors that are not derived from any physical stimulus. The mechanism of dysosmia has been clarified by basic research on olfactory reception and conduction.<br>
著者
北原 糺 村田 潤子 小畠 小畠 奥村 新一 江崎 光彦
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.91, no.8, pp.845-849, 1998-08-01 (Released:2011-11-04)
参考文献数
11

In this paper, a very rare case of vasculo (angio)-Behcet's disease initiated with hoarseness due to inflammatory aortic aneurysm, is presented. A 35 year-old male with persistent hoarseness for half a month was revealed to have left recurrent laryngeal nerve palsy. Chest X-ray films showed slight enlargement of the aortic arch. CT demonstrated direct evidence of a saccular type aortic aneurysm at the branched area of the left subclavian artery. Aortic angiography demonstrated two additional aortic aneurysms at the right subclavian artery and in the lower abdominal area. The patient subsequently underwent emergency surgery for treatment of these aneurysms. The histopathological characteristics of the representative aortic aneurysmal lesions suggested a diagnosis of “vasculo-Behcet's disease”. Behcet's disease is usually characterized by oral and genital ulceration, folliculitis and uveitis. This patient, however, displayed no previous evidence of these symptoms. We would like to emphasize that some cases of left recurrent laryngeal nerve palsy require urgent management.
著者
近藤 律男 榎本 浩幸 田口 享秀 長原 太郎 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.98, no.4, pp.309-313, 2005-04-01 (Released:2011-10-07)
参考文献数
21
被引用文献数
1

Behçet's Disease is a systemic disease characterized by mucosa, dermis and eye lesions. Otolaryngologists sometimes examine patients of this disease who complain of inveterate aphthae. Patients with Behçet's Disease often have histories of tonsillitis and many caries of the tooth. Based on these facts, streptococcus in the oral cavity is suspected to be closely related to this disease.We report a case of Behçet's Disease whose first symptom was acute tonsillitis.A 33-year-old male complaining of sore throat and elevated fever was referred to our hospital. Oral aphthae was seen and the bilateral palatine tonsils were swollen, reddish and coated with fur. We diagnosed acute tonsillitis and treated him with antibiotics. However, elevated fever, inflammation and oral aphthae were not remitted and a pudendal ulcer appeared. We suspected Behçet's Disease and consulted with doctors of internal medicine, dermatology and ophthalmology. Fourteen days after admission, folliculitis and arthritis appeared and finally he was diagnosed with incomplete type Behçet's Disease.This case suggests that tonsillitis is closely related with the appearance of Behçet's Disease. Furthermore, oral aphthae and tonsillitis are very important symptoms regarding Behçet's Disease, in patients with oral aphthae.
著者
岩崎 久藏
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.35, no.5, pp.425-434, 1940-05-20 (Released:2011-10-14)
参考文献数
15
著者
川端 五十鈴 佐藤 恒正
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.83, no.7, pp.1099-1110, 1990

The lateralization of tinnitus on the cranium was measured by a directional hearing device, which can generate binaural time or intensity differences for various sound sources. Tracings of sound locomotion are recorded as sawteeth-like waves by repetition of the dial operation in the right and left directions.<br>First, the central and lateral sound images on the cranium were measured by method of adjustment for subjects with normal hearing. The range of the values was determined after three measurements per day for three days. The regions of these locations of sound impression were in close agreement, and 67% of 20 normal control subjects showed stable results.<br>Next, 30 subjects with normal hearing ability and monaural tinnitus were tested. The location of tinnitus on the cranium was determined after localization of the sound impression in the central and lateral positions by the method described above. The results were as follows: in 53% of the subjects the results were stable; 46% showed agreement between the positions of tinnitus and the lateral side, and 27% showed a more medial impression of tinnitus than the lateral position.<br>This method has no restrictions as a clinical test. The fact that the position of tinnitus may disagree with the lateral impression on the cranium was clarified by these experiments.
著者
菊地 茂 洲崎 春海 青木 彰彦 伊藤 修 野村 恭也
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.84, no.1, pp.41-47, 1991
被引用文献数
41 24

Twenty six adult patients with chronic sinusitis who had undergone Caldwell-Luc operation and received conservative therapy for a long time, but still complained of nasal symptoms, were treated with 400-600mg of erythromycin (EM) per day for 7.9 months on the average.<br>1) Rhinorrhea was reduced in 60.0%, postnasal drip in 50.0%, nasal obstruction in 60.0%, hyposmia in 11.8% and sense of dullness in the head in 100%.<br>2) Rhinoscopy showed reduced mucosal swelling in 10.5%, lower volume of rhinorrhea in 80.0%, better quality of rhinorrhea in 70.0% and reduced postnasal drip in 85.7%.<br>3) This therapy was effective even when EM-resistant bacteria such as Hemophilus influenzae were present.<br>4) No significant side effects were noted in any of the patients during this therapy. Long-term low-dose EM therapy is useful in the treatment of chronic sinusitis. We consider that its effect is not due to its antibacterial activity but to some as yet unknown mechanism.
著者
中江 進 水田 康雄 八木 美知 平杉 嘉昭 水越 治
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.72, no.11, pp.1469-1477, 1979

Five patients with a congenital deafness caused by maternal rubella infection during pregnancy visited our clinic in 1977. The ages ranged from 3 to 11 months. The diagnosis of deafness was made mainly by Brain Stem Response, partly startle response and C. O. R.<br>Case 1 was diagnosed as a typical congenital rubella syndrome, because of the high HI titer, congenital deafness, PDA+ASD, retinochoroidal degeneration, thrombocytopenia, and hepatosplenomegaly. Case 4 whose HI titer was high was accompanied by microphthalamia and anophthalamia with a positive response at 40dBSL in BSR the left ear and 50dBSL in the right ear.<br>We conclude that congenital deafness should be determined by Brain Stem Response as early as possible so that an early diagnosis of hearing impairment can be made.
著者
西村 宏子 山本 悦生 山内 盛雄 岩永 迪孝 藤田 佳代子 岩崎 博 佐藤 宏昭 竹内 俊二 鶴原 秀晃
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.76, no.2special, pp.328-337, 1983 (Released:2011-11-04)
参考文献数
31

昭和52年1月から昭和57年9月までの6年9ヵ月間, 京大病院耳鼻咽喉科を訪れた顔神麻痺患者662名について統計的観察を行い以下の結果が得られた.(1) 顔神麻痺患者は, 外来新患数の1.8%を占めていた.(2) 年度別発生件数では, 各年ともベル麻痺が1番多く, 62.0~80.5%を占め, その他の頻度はまちまちであった.(3) 診断別分類では, ベル麻痺が1番多く, 447例 (67.5%), 以下, ハント症候群59例 (8.9%), 手術損傷性45例 (6.8%), 頭部外傷性45例 (6.8%), 先天性23例 (3.5%), 耳炎性15例 (2.3%), 中枢性6例 (0.9%), 側頭骨外疾患4例 (0.6%), 聴神経腫瘍2例 (0.3%), その他16例 (2.4%) であった.(4) ベル麻痺, ハント症候群における男女の差は著明でなかった.(5) ベル麻痺, ハント症候群とも左側にわずかに多かった.(6) ベル麻痺, ハント症候群の月別発生頻度は, 前者は11月に少なくなっている他は著明な差は見られなかった. 後者も季節的な一定の結論を出すのは困難であった.(7) ベル麻痺, ハント症候群とも青壮年が多く罹患していた.(8) 再発性麻痺は40例あり, 一側反復性麻痺14例, 両側交代性麻痺25例, 両側同時性麻痺1例を含んでいた.(9) ウイルス感染については, 検索を行った73例のうち, 感染ベルは21.3%で, ハント症候群では75%に帯状疱疹ウィルスに感染が認められた.
著者
堀 龍介 安里 亮 田中 信子 嘉田 真平 平塚 康之 金子 賢一 児嶋 久剛 赤水 尚史 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.95, no.8, pp.825-829, 2002-08-01
被引用文献数
8 1

Congenital piriform sinus fistula, which is usually unilateral, is recognized as a cause of acute suppurative thyroiditis. We have encountered a rare case of bilateral piriform sinus fistulae. The patient, a 53-year-old female, was referred to our hospital because of right neck swelling, which improved after conservative treat. Three months later, an abscess of the left thyroid lobe was presented and was improved after incision and drainage. The diagnosis of bilateral piriform sinus fistulae was made by hypopharyngeal enhancement radiography. Total fistulectomies were performed. There was no recurrence observed six months after surgery.
著者
岩塚 和子
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.98, no.6, pp.447-452, 2005-06-01 (Released:2011-10-07)
参考文献数
11
被引用文献数
2

A 31-year old woman with Churg-Strauss Syndrome (CSS) including eosinophilic otitis media is presented. Other manifestations included an 11-year history of nasal allergy followed by bronchial asthma, sinusitis with nasal polyps, eosinophilic pneumonia accompanied by peripheral eosinophilia (34% of 6, 600/μl leukocytes), and erythema in both legs. Repeated episodes of painless right otitis media occurred without fever during the first stage of CSS characterized by an allergic state. This progressed to bilateral otitis media with gelatinous mucoid fluid accumulations shortly before the second stage of CSS characterized additionally by peripheral eosinophilia and eosinophilic pneumonia. Numerous eosinophils were found in gelatinous fluid within the tympanic cavity.The patient was diagnosed with bilateral eosinophilic otitis media, which was controlled by nebulizer therapy with 2% fosfomycin and 0.2% betamethasone solution directed into the Eustachian tube and tympanic cavity. Hearing loss and vertigo have been avoided. This case strongly suggests that eosinophilic otitis media can be a manifestation of CSS.

1 0 0 0 OA 内耳硬化症

著者
立木 孝
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.75, no.2, pp.305-315, 1982 (Released:2011-11-04)
参考文献数
58

The idea that sensorineural hearing loss without an associated conductive loss due to stapes fixation can be attributed to otosclerosis is presented.The literature on sensorineural hearing loss in otosclerosis is reviewed. Although a considerable number of related findings seems to support this idea, no confirming evidence has been found.It has been believed that otosclerosis is rare in Japan and many otologists are uninterested in the idea of inner ear otosclerosis. Recently, however, some investigators reported a considerable number of patients with clinical and/or histological otosclerosis.There are many cases of sensorineural hearing loss of unknown cause and its etiology has been a matter of concern.As inner ear otosclerosis is clinically characterised by sensorineural hearing loss of unknown origin, it should be included in differential diagnosis when evaluating the etiology of sensorineural hearing loss in general.
著者
楊光宗
雑誌
耳鼻咽喉科臨床
巻号頁・発行日
vol.76, pp.2911-2916, 1983
被引用文献数
2
著者
近松 一朗 増山 敬祐
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.105, no.2, pp.87-94, 2012 (Released:2012-02-01)
参考文献数
32
被引用文献数
1

Cancer immunotherapy is designed to activate and up-regulate the host immune responses against tumor cells and is currently in use or under investigation for cancer treatments. Although tumor cells can use a variety of mechanisms to create an immunosuppressive environment, many agents and strategies to reduce or eliminate tumor-induced immune suppression are either being developed or already in clinical trials. This review deals with recent advances in cancer immunotherapy, focusing on new strategies to enhance antitumor immunity. Numerous approaches have been tested for the development of therapeutic cancer vaccines. Recently, several promising reports suggest that clinical benefit has been shown in randomized phase III trials for vaccines against prostate cancer, follicular lymphoma, and melanoma. Moreover, in 2010, the first patient-specific immunotherapy (sipuleucel-T) was approved by the FDA for the treatment of prostate cancer. On the other hand, some chemotherapeutic agents such as cyclophosphamide and docetaxel, have direct effects on the immune system that is likely to contribute to an improved antitumor immunity. Therefore, cancer immunotherapy combined with chemotherapy may represent one approach for breaking tumor-induced immune suppression. To date, a number of monoclonal antibodies are in use or under evaluation. Among these antibodies, blocking negative immunoregulatory receptors, CTLA-4 and PD-1, also represent a new strategy to induce antitumor immunity by manipulation of the immune system. In clinical trials, these antibodies could increase anti-tumor T-cell immunity and result in objective tumor regression in some patients. Thus, accumulating data from recent cancer vaccine trials, the manipulation of immune suppression using chemotherapeutic agents, and the use of immune-stimulatory antibodies raise the hope that immunotherapy could become the fourth modality of cancer treatment. Based on these new findings, in our hospital, a clinical trial using dendritic cells combined with low dose cyclophosphamide and docetaxel in patients with relapsed and refractory head and neck squamous cell carcinoma is under way (UMIN000003725, ClinicalTrials.gov identifier, NCT01149902). In the near future, various immunotherapeutic modalities will most probably be applied as novel approaches in the treatment of head and neck cancer.