著者

吉田 正 中村 光士郎 小林 泰輔 富所 雄一

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.96, no.9, pp.783-789, 2003-09-01 (Released:2011-10-07)

参考文献数

27

被引用文献数

1 1

---

Mycosis in the paranasal sinus is commonly found in the maxillary sinus, but rarely in the sphenoid sinus. In this paper, three cases of sphenoid sinus mycosis are reported and the clinical feature are compared with the 25 other cases reported in Japan since 1968. Our three patients had complained of headache and eye pain, which were thought to be characteristic symptoms in the 25 previous cases. One of the three patients had onset with a background of rheumatoid arthritis and needed steroid medication, but the other two patients had no improvement with medication for sinusitis. By CT scanning and MRI, a localized sphenoid sinus lesion was detected as a characteristic findings for paranasal sinus mycosis, showing irregular mosaic contras on CT scanning and low intensity signal on T1 and T2 MRI imaging. The definite diagnosis was made by means of histological examination for a block age in the affected sinus cavity. Endoscopic sphenoidectomy was performed through the parsnaslis of the anterior wall of sphenoid sinus and was usefull for total removal of the lesion.

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

丸山 裕美子 古川 仭

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.95, no.5, pp.513-520, 2002-05-01 (Released:2011-11-04)

参考文献数

13

---

We report 7 cases of acute and recurrent inspiratory dyspnea in which no organic cause could be identified. Patients were from 12 to 68 years old (43.6 in average), consisting of five males and two females. In three of the seven cases, fiberoptic laryngoscopy during an attack of dyspnea revealed laryngospasms following symmetric adduction of the vocal cords. Each patient experienced loud, stridorous noise during inspiration at the beginning of an attack as well as the subsequent inability to inspire. The attacks ranged from several tenths of a second to a few minutes in duration and occurred frequently, several times a day in some cases. Results of physical examinations, lung function tests, roentgenograms of the chest and larynx, and CTs of the lungs and the neck were unremarkable. Laboratory findings including blood gas analysis between attacks were within normal limits. No atopic stigmata were found.Drinking water or swallowing could sometimes relieve the grade of the attack, and the patient could completely prevent attacks once they understood the condition of the dyspnea and mastered a breathing maneuver during the attack. Previous upper respiratory infection, cough, and sleep apnea were suggested to correlate with the episodes. Our patients did not require drastic maneuvers such as tracheostomy or intubation. Administration of Eperisone hydrochloride and Etizolam proved effective in some cases.Laryngospasm as a cause of recurrent inspiratory dyspnea is functional, and we suspect that it is not such a rare occurrence. An awareness of this entity could prevent unnecessary tracheotomies.

著者

城本 修

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.9, pp.697-705, 2007-09-01 (Released:2011-10-07)

参考文献数

27

被引用文献数

4 3

---

This review considers the framework of voice therapy by the SLHT (speech-language-hearing therapist) to otolarngologists using the 5-R concept. The 5-R concept is “Right” client, voice therapy, time, dose, and route. “Right” is used in the sense of “most appropriate”.First, Right client means that the right voice client with “functional” (no visible structural or neurological laryngeal pathology) voice problems must be selected because voice therapy by the SLHT is most effective for functional voice disorders. If the client does not have a functional problem with phonation, voice therapy might not be effective.Second, Right voice therapy means that the SLHT should carefully choose the right therapeutic technique to treat the client's voice symptom. In this review, I will introduce a tube-phonation exercise and vocal hygienic advice, which are evidence-based.Third, Right time refers to when the SLHT should start and stop voice therapy. Voice therapy should be begun as soon as possible after the client is diagnosed with a functional voice disorder. The SLHT must also know when to terminate a series of voice therapy sessions.Fourth, Right dose refers to how many sessions of voice therapy and number of phonatory repetitions are effective. Unfortunately, there is a lack of research data in this area. My recent study shows that more than 1500 phonatory repetitions (50-repetitions per day) may be needed to retain the effect 1-month post-therapy.Fifth, Right route indicates that the SLHT should have extensive knowledge of the motor-learning system because voice therapy is a behavioral modification, which is based on motor-learning theory. Some previous research in speech therapy, which is based on motor-learning therapy has shown that summary-feedback and randomized task exercises are effective to promote retention of new motor behaviors.

著者

松永 亨 武田 憲昭

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.81, no.8, pp.1095-1120, 1988-08-01 (Released:2011-11-04)

参考文献数

109

被引用文献数

5 2

---

Motion sickness occurs when man is expected to certain types of real or apparent motion. The signs and symptoms are malaise, pallor, cold sweating, nausea and vomiting. According to the sensory conflict theory, neural mismatch among the actual sensory input from the eyes, the vestibular apparatus and the somatosensory receptors and the signals expected to be received in the central nervous system causes motion sickness.We developed a rat model and examined the roles of histamine, acetylcholine and noradrenaline in the development of motion sickness. We conclude that 1) histamine plays a role in the onset of the disorder; 2) acetylcholine is involved in the sensory conflict mechanisms; 3) noradrenaline modulates the sensory information.Space motion sickness is generally regarded as a variation of the common type of motion sickness. Here, we introduce three hypothese of space motion sickness and explain the results of space vestibular experiments on space motion sickness in the Skylab mission and Spacelab-1 mission.

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

3 3

---

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

広戸 幾一郎 平野 実 荻尾 良介 末吉 楠雄 大野 敏二

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.57, no.2, pp.98-103, 1964-02-01 (Released:2011-10-14)

参考文献数

13

---

Massive dosage alinamin F (thiamine tetrahydrof uryl sulfide) therapy (150mg/day) was performed on 267 ears suffering from various type of perceptive deafness. Therapeutic effect was found in 34.5% of the series. It must be emphasized that the earlier the patient began to undergo this treatment, the more favorable result was obtained. 79.2% of the patients who began to undergo the treatmant within one week from the onset of the disease proved effective, and in the cases that were treated within one month from the beginning of deafness 74.3% benefited from the treatment. To our regret, nearly half of the series had began to undergo the treatment in more than half years from the onset of deafness with satisfactory result only in less than 30% of them.The therapeutic effect was most markedly observed when the treatment was continued during two or three months.

著者

杉田 俊明 森 敏裕 稲木 匠子 丘村 煕

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.85, no.2, pp.261-266, 1992-02-01 (Released:2011-11-04)

参考文献数

5

被引用文献数

2 1

---

The authors describe a case of clicking larynx, which is characterized by a clicking sound and pain in the neck on swallowing. A 58-year-old woman complained of pain and clicking on both sides of her neck on swallowing. Examination and fluoroscopy showed that on swallowing, the thyroid cartilage entered between the greater hyoid cornua. The thyroid cartilage and hyoid bone were locked together until they reached the end of their downward course, when the sterno-thyroid muscle contracted strongly to separate the locked structures. At the moment of this separation, a click was produced. Both superior cornua of the thyroid cartilage were surgically removed, and the click and pain on swallowing disappeared.

著者

大八木 章博

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.83, no.2, pp.309-318, 1990-02-01 (Released:2011-11-04)

参考文献数

28

---

Autonomic innervations of the mucosa in the middle ear, Eustachian tube and pharynx were investigated by retrograde labelling of the autonomic ganglia with horseradish peroxidase (HRP). Of the sympathetic ganglia, the superior cervical ganglion (SCG), middle cervical ganglion (MCG) and stellate ganglion (StG) were examined, and of the parasympathetic ganglia, the pterygopalatine ganglion (PpG) and the otic ganglion (OtG) were examined.1. The sympathetic innervation of the middle ear mucosa was by fibers originating in the ipsilateral SCG, but not by those originating in the MCG or StG. The parasympathetic innervation was by fibers originating in the ipsilateral PpG, but not by those originating in the OtG.2. The sympathetic innervation of the Eustachian tube mucosa was by fibers originating in the ipsilateral SCG and MCG, but not by those from the StG; parasympathetic innervation was by fibers originating in the ipsilateral PpG, but not by those from the OtG.3. The epipharynx received sympathetic innervation from the ipsilateral SCG, but not from the MCG or StG. Its parasympathetic innervation was from the PpGs bilaterally, but not from the OtG.4. The sympathetic innervation of the mesopharynx was from the SCG, MCG and StG, but the parasympathetic supply was from neither the PpG nor the OtG. Sympathetic innervation was bilateral, but predominantly from the ipsilateral side.5. The hypopharynx resembled the mesopharynx, but had more innervation from the MCG and StG.

著者

伊藤 彰紀 坂田 英治

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.1221-1228, 1989-09-01 (Released:2011-11-04)

参考文献数

12

---

Four cases of typical “Patulous Canal” are presented. Two of the patients had von Recklinghausen's disease. Patulous canal is defined as bilateral dilatation of the internal auditory canal without an accompanying acoustic neurinoma.Bilateral perceptive deafness may rarely accompany this syndrome.Etiologies of bone changes of von Recklinghausen's disease may be summarized as:1. Changes in the bone secondary to mass effect of neurofibromas.2. Intrinsic factors in the initial stage of ontogenesis.Among the latter, abnormalities of mesodermal tissues are found frequently.Ontogenitically the skull, especially the temporal bone including the internal auditory canal, are derived from the peri-otic capsule of the cartilaginous neurocranium which is of mesenchymal origin.The inner ear is derived from the otic vesicle which separates from the epidermal ectoderm.The presence of bone changes such as dilatation of the internal auditory canal in von Recklinghausen's disease and in other illnesses may suggest that bony changes are accompanied by mesenchymal abnormalities ontogenetically.The rarity of the complication of deafness may be explained by the low incidence of coincidental involvement of both mesenchymal and ectodermal tissues in congenital and intrinsic abnormalities.Attention has been focused on the occurrence of similar bony changes, such as dilatation of the internal auditory canal in von Recklinghausen's disease. The possible mechanisms causing these changes are discussed from the embryological viewpoint.

著者

青柳 優

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.95, no.10, pp.985-995, 2002-10-01 (Released:2011-11-04)

参考文献数

17

被引用文献数

2 2

---

Electrical examinations for the diagnosis of facial palsies are reviewed. Because the recovery of nerve function is prescribed by the degree of wallerian degeneration and the degenerated nerve fibers are not responsive to stimulation, the examinations using electrical stimulation are important for the accurate prognostic diagnosis of facial palsy.Because of its simplicity and convenience, the nerve excitability test (NET) is the most popular in clinical use. But its reliability is insufficient. Electroneurography (ENoG) is more reliable either than NET or the maximal stimulation test. However, when a facial nerve is stimulated peripheral to the injury site, the prognosis cannot be estimated correctly until the degenerations are completed in the stimulus site. Thus, NET and ENoG are not significant within 7-10 days after the onset for prognostic diagnosis.Using transcranial magnetic stimulation (TMS), the facial nerve can be stimulated around the fundus of the internal auditory meatus, which is central to the injury site in most facial palsies. Patients having a good prognosis can be identified using TMS in the early stage of palsy. Though the examination technique developed by Saito et al. (1992) is a bit complicated, antidromic facial nerve-evoked potential provides accurate information about nerve degeneration in the early stage of palsy.For bilateral facial palsy, the measurement of facial nerve conduction velocity is useful for the prognostic diagnosis (Tojima, 1988). The measurement of the distribution of facial nerve conduction velocity using Hopf's collision method (Saito, 1991) contributed to the analysis of the pathophysiology of Bell's pal-sy, which is thought to be a compression neuropathy.Blink reflex is useful in the prognostic diagnosis and also in the estimation of synkinesis as a sequela of palsy. F-waves caused by neuronal recurrent discharge due to antidromic impulse have recently been used in the estimation of recovery of damaged nerves.

著者

横山 恒夫

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.51, no.10, pp.776-805, 1958 (Released:2011-10-14)

参考文献数

39

著者

佐々木 優子 荒川 圭三 林 振堂 森 朗子 馬場 廣太郎 筏津 裕美

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.1994, no.Supplement70, pp.94-99, 1994-04-20 (Released:2012-11-27)

参考文献数

25

---

We encountered two cases of otomyiasis. The first case involved left external auditory meatus myiasis due to Sarcophaga peregrina (Robineau-Desvoidy,1830) in a baby girly approximately two months old. The second case was right external auditory meatus myiasis due to Sarcophaga similis Meade,1876, in a six-year-old girl. Both cases occurred in September 1993.Previously myiasis was more common. Antimicrobial therapy and amelioration of public health has resulted in a decrease in the number of myiasis cases. Today, it is quite rare.Recently, twelve cases of genuine myiasis have been reported in Japan. We report two cases of otomyiasis.

著者

山下 敏夫 北尻 雅則 友田 幸一 熊沢 忠躬 西川 正治

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.5, pp.873-879, 1981 (Released:2011-11-04)

参考文献数

15

---

The innervation of cholinergic nerves in the Eustachian tube was light- and electron-microscopically observed using a histochemical technique. Acetylcholinesterase -positive nerves were seen just beneath the epithelial layer all along the tubal wall, around the blood vessels of the subepithelial space, and especially around the tubal glands. It is suggested from these findings that the cholinergic nerve plays an important role in controlling the blood flow in the subepithelial space and also in regulating the secretion of the tubal gland.

著者

宮崎 総一郎

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.99, no.6, pp.427-434, 2006-06-01 (Released:2011-10-07)

参考文献数

13

被引用文献数

1

---

The most frequent sleep problems are sleep-related breathing disorders, insomnia, excessive daytime sleepiness, and circadian rhythm disorder. In 2004, we treated 468 sleep disorder patients, at the Sleep Disorder Center, Shiga University of Medical Science Hospital. Forty-nine percent of the subjects were diagnosed as having sleep related breathing disorders, 22% as insomnia, 10% as rhythm disorders and 5% as having excessive daytime sleepiness. Insomnia is a common sleep-wake-related complaint, and sleeping pills are among the most commonly prescribed drugs in clinical practice. However, insomnia is a symptom that can be caused by various disorder's, many of which require specific therapies. One specific cause of insomnia in older adults is restless legs syndrome. This condition, characterized by an urge to move the legs, which is usually accompanied by sensations of discomfort and aggravations of symptoms by rest. Daytime sleepiness is a common complaint. Snoring, the use of hypnotic agents, sleep difficulties, irregular sleep-wake schedule and sleep deprivation are related to daytime sleepiness. Circadian rhythm sleep disorders have intrinsic and extrinsic subtypes: delayed sleep phase syndrome, advanced sleep phase syndrome and non-24-h sleep-wake syndrome. The underlying problem of circadian rhythm sleep disorders is that the patient cannot sleep when sleep is desired. Waking episodes may occur at inappropriate times; therefore, the patient may complain of insomnia or excessive sleepiness.

著者

吉本 裕

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.65, no.8, pp.987-993, 1972 (Released:2011-11-04)

参考文献数

6

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

山下 敏夫 北尻 雅則 友田 幸一 熊沢 忠躬

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.12, pp.2567-2574, 1982-12-01 (Released:2011-11-04)

参考文献数

11

---

自然再生鼓膜を持つ側頭骨26耳の観察を行った. 従来, 耳鏡所見より自然再生鼓膜は皮膚層と粘膜層の2層のみで中間層はないとされていたが, そのほとんどの例において中間層の存在する事が確認され, 従来の考えの誤まりを指摘した.又, 移行部の観察より穿孔閉鎖機序には皮膚層が先行するとの印象を持った.一方保存的又は手術的閉鎖法によって再生された鼓膜の電顕的像を含めた組織学的観察により, 保存的閉鎖法により再生された鼓膜は, 正常鼓膜に近い構造を持つ事が判明された.

著者

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 (ISSN:00326313)

巻号頁・発行日

vol.92, no.2, pp.115-117, 1999-02-01 (Released:2011-11-04)

参考文献数

6

被引用文献数

1

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.