著者
武田 広誠 中屋 宗雄 甲斐 智朗 堀内 正敏
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.2, pp.181-184, 2002-02-01 (Released:2011-11-04)
参考文献数
13

To investigate the correlation between obstructive sleep apnea syndrome (OSAS) and obesity, 71 OSAS patients whose sites of obstruction were diagnosed based on sleep nasendoscopy findings were studied. The patients were subdivided into three groups by body mass index (BMI) as follows: Group A, 24 patients with BMI less than 25 (kg/m2); Group B, 19patients with BMI between 25 and 28; and Group C, 28 patients with BMI more than 28. Variables examined include the apnea index (AI), 4% O2 desaturation index (DI), nadir SpO2, and cephalometric data (SNA, SNB, PNS-U, MP-H, PAS). AT and cephalometric data were not correlated with BMI, but DI and nadir SpO2 were mutually correlated with BMI. These data suggest that OSAS may be worsened by obesity. Of the 71 patients, 45 were treated with surgery based on sleep nasendoscopy findings, and 33 patients, AI, DI, and nadir SpO2 were evaluated after surgery. There was a 77.4% and 72.7% improvement in the AT and DI respectively, but neither were correlated with BMI. The response rates were slightly better than previous reports. We believe that careful patient selection using sleep nasendoscopy data as well as avoiding surgery for extremely obese patients when possible may contribute to good results of surgical treatments.
著者
藤坂 実千郎 西島 由美 浅井 正嗣 舘野 宏彦 將積 日出夫
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.162, pp.37-43, 2023 (Released:2023-07-01)
参考文献数
12

A 93-year-old man with bilateral mild hearing loss since childhood due to chronic middle ear infections could hear and speak as an adult, but his hearing level had gradually become worse. He started to wear hearing aids when he was 70 years old, but he still found it difficult to hear. Finally, he could not understand the contents of any conversations by 87 years old, even with hearing aids. He accepted to undergo cochlear implantation on the right side at the age of 93 years. The results of the speech recognition test improved after surgery for monosyllables (from 28% to 38%) and single words (from 18% to 38%), but no improvement of sentence recognition was observed. Oldest-old patients have little occasion to speak, and could benefit from special tools, such as an audiobook or DVD, which they can learn by themselves.
著者
阪上 雅史 荻野 敏 土井 勝美 松永 亨 入船 盛弘 尾崎 正義
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.11, pp.1537-1543, 1993-11-01 (Released:2011-11-04)
参考文献数
12

A 63-year-old woman with multiple disturbances of the cranial nerves is reported. She initially complained of bilateral hearing loss and otorrhea, followed by right facial palsy and vertigo and was hospitalized on August 25, 1983. Despite steroid therapy, her condition deteriorated and finally complete bilateral deafness and complete bilateral facial palsy developed.Histologial examination of the mastoid mucosa, obtained by exploratory tympanotomies in both ears, showed non-specific inflammation. Noteworthy findings or laboratory examinations were extremely high levels of ESR and CRP, positive RA test, and negative tuberculin test.Tracheotomy was performed because of recurrent bilateral nerve palsy. Scleritis occurred in March, 1984, and the disturbances of eye movement, ptosis and atrophy of tongue developed in September, 1984. Long-term steroid therapy did not improve cranial palsy. There were no neurological signs such as pathological reflex in the limbs, involuntary movement or meningeal irritation symptom. There were no remarkable findings on CT or MRI.Although treatment by a local hospital continued, the III, IV, VI, VII, VIII, X and XII cranial nerves remained paralyzed. She finally died of systemic weakness in March, 1989.This was a rare case that began with bilateral otitis media and proceeding to paralysis of initially occurred and cranial nerves in order of VII, VIII, X, XII, III, IV and VI nerves. The background of this case included systemic vascular disease, especially Cogan's syndrome, because of otologic and ocular symptoms and multiple disturbances of the cranial nerves.
著者
池田 敦子 池田 元久 小松 崎篤
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.11, pp.1235-1239, 1997-11-01 (Released:2011-11-04)
参考文献数
16
被引用文献数
1 1

In an attempt to study the distribution pattern and correlation between maxillary, frontal and sphenoid sinus volume, sinus volumes were measured by coronal CT scans of the paranasal sinus. Two hundred and four maxillary sinuses of 102 patients, the frontal sinuses of 62 patients and the sphenoid sinuses of 68 patients with no inflammatory changes detectable on CT scans of the each paranasal sinus and nasal cavity were analyzed. The volumes of the maxillary sinus showed a normal distribution, and its mean volume and standard deviation were 20.5±9.2cm3. The logarithms of both frontal and sphenoid sinus volumes exhibited a normal distribution. The mean volume of the frontal sinus and the sphenoid sinus, which were calculated using logarithms of the sinus volumes statistically, were 8.3cm3 and 9.6cm3 respectively. The correlation coefficient was 0.134 between the maxillary and frontal sinus, 0.445 between the maxillary and sphenoid sinus and 0.315 between the frontal and sphenoid sinus. It is suggested that differences in the volume distribution pattern between the maxillary sinus and frontal or sphenoid sinus might be caused by differences in the growing process of each sinus.
著者
林 熊男
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.37, no.4, pp.287-301_3, 1942-04-20 (Released:2011-10-14)
参考文献数
5
著者
平野 滋 児嶋 久剛 庄司 和彦 金子 賢一 楯谷 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.93, no.1, pp.53-60, 2000-01-01 (Released:2011-11-04)
参考文献数
12
被引用文献数
4 2

We assessed the surgical effects of Isshiki's thyroplasty on 10 functional voice disorder patients including seven with mutational voice disorder, two with spasmodic dysphonia and one with asthenic voice disorder. Our concept is to select and combine proper surgical procedures according to the laryngeal findings of each case. We conveyed thyroplasty type I and III for six patients, and type II and III for one with mutational voice disorder. For spasmodic dysphonia, thyroplasty type II and III was performed in one case with atrophy of the vocal folds accompanied by contraction of false vocal folds during phonation, while type II thyroplasty was selected for the other case without vocal fold atrophy and supraglottic contraction. One asthenic voice disorder was treated with thyroplasty type II and III. We showed the efficiency of framework surgery for functional voice disorders and discussed how to select the type of thyroplasty for each case.
著者
廣瀬 肇
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.80, no.9, pp.1334-1338, 1987-09-01 (Released:2011-11-04)
参考文献数
9
被引用文献数
2 1

1 0 0 0 OA 舌骨症候群例

著者
里見 文男 西村 善彦 森 裕司 雲井 健雄
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.3, pp.359-362, 1991-03-01 (Released:2011-11-04)
参考文献数
7
被引用文献数
5 3

A 21-year-old female complained that the right greater cornu of her hyoid bone often slid out and projected to the side of her neck and caused pain on speaking. The projecting tip of the cornu could be returned manually to the original position, and the pain was instantly relieved. A plain radiogram of the neck revealed that the right greater cornu of the hyoid bone was elongated and had a much wider curvature than normal. Good symptomatic relief was obtained with surgical extirpation of the elongated greater cornu. There are various clinical features in the hyoid bone syndrome, including this case. The authors add a review of the literature.
著者
小宅 大輔 岡田 智幸 深澤 雅彦 佐藤 成樹 肥塚 泉
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.8, pp.617-620, 2008-08-01 (Released:2011-10-07)
参考文献数
10

This study retrospectively investigated the value of both endoscopically visible oropharyngeal secretions in the hypopharynx and miss-swallowing frequency in the prediction of food and liquid aspiration. Videoendoscopy was performed in Fourty-three patients. A four-level rating scale was employed to determine the severity of accumulated oropharyngeal secretions. On this secretion scale patients graded 0 and 1 could eat, but those graded 3 could not. It was found that the accumulation of endoscopically visible oropharyngeal secretions located within the laryngeal vestibule was highly predictive of the aspiration of food or liquid. The Results are discussed in terms of integrating this information with clinical bedside examinations.
著者
眞田 友明 田中 信三 佐藤 公則 平野 実
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.1993, no.Supplement62, pp.27-32, 1993-06-15 (Released:2012-11-27)
参考文献数
10

One hundred ninety eight patients with Reinke's edema who visited our clinic between 1981 and 1990 were retrospectively studied. One hundred twenty four were males and 74were females. Ninety percent of the patients were between 30 and 69 years old. Brinkman's index was 400 or more in 78% of patients. This suggests that smoking was the most important etiological factor. Surgery was performed for 73 cases and the hoarseness improved in 63 cases. Thirty one patients stopped smoking for more than a month without surgery, and 16 cases showed vocal improvement. Surgery was effective regardless of the size of the lesion, while prohibition of smoking was effective only for slight edema. Voice therapy without surgery or prohibition of smoking had no effect on hoarseness.
著者
中野 淳 稲福 繁 呉 孟達 中山 明峰 石神 寛通
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.2000, no.Supplement104, pp.37-41, 2000-10-31 (Released:2012-11-27)
参考文献数
11

We report a patient with traumatic perilymphatic fistula caused by an earpick. Exploratory tympanotomy was performed via endoaural incision. The patient was found to have a dislocated stapes in the vestibule. The stapes was removed, and no perilymphatic leakage from the oval window was seen. Jugular pressure was also performed with no lymphatic leakage. We then injected physiological salt solution at 37°C into the oval window. Lastly, stapes surgery was perfomed and a piece of fascia was placed over the perforation in the tympanic membrane using fibrin glue. The patient's operation was performed 3 days after trauma and improvement of vertigo and hearing (sensory and air-bone gap) was obtained after surgery.
著者
高野 信也 荒牧 元 岡村 由美子 信貴 宏治
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.89, no.12, pp.1487-1491, 1996-12-01 (Released:2011-11-04)
参考文献数
11

The association between the symptoms of various conditions was investigated in patients first presenting with a sore throat (n=613) and pain when swallowing (n=109).This study was performed at the Department of Otorhinolaryngology of the Tokyo Women's Medical College Daini Hospital.1) Many patients with lesions of the palatine tonsils complained of a sore throat.2) Lesions of the nasopharynx were detected in 4.6% of those patients presenting with a sore throat.3) Many patients with lesions involving the lateral pharyngeal wall complained of pain when swallowing.4) Many patients with lesions of the epiglottis or when pyriform fossa complained of pain when swallowing.5) Some patients with cancer of the thoracic esophagus complained of pain when swallowing.6) When a patient presents with a complaint of pain when swallowing, the site of the pain and its association with food intake should be fully clarified by a careful history.
著者
本多 徳行 斎藤 等 山田 武千代 野田 一郎 大坪 俊雄
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.1993, no.Supplement63, pp.154-157, 1993-07-25 (Released:2012-11-27)
参考文献数
15
被引用文献数
2 2

We encountered a case of hyoid bone elongation characterized by a clicking sound on swallowing. A 32-year-old man complained of a foreign body sensation and painless clicking sound on the left side of his neck when swallowing. CT scan of the neck revealed that the left greater cornu of the hyoid bone was elongated. Both greater cornu were surgically removed, and his symptoms disappeared.
著者
中野 勇治 朝倉 光司
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.83, no.9, pp.1429-1434, 1990-09-01 (Released:2011-11-04)
参考文献数
18
被引用文献数
2 1

Total nasal resistance measurements in 40 patients with obstructive sleep apnea syndrome (OSA) and 31 non-snorers were performed.Active anterior rhinomanometry was performed with a Nippon Kohden MPR-2100 rhinomanometer to measure inspiratory and expiratory total nasal resistance in both the upright and the supine positions.Nasal resistance values of each nostril were measured at a fixed pressure gradient sample point of 1.0cm H2O. Total nasal resistance values were calculated by a formula.Of the 40 OSA patients 24 were treated surgically, two with tonsillectomy, one with uvuloplasty, and 21 with uvulopalatopharyngoplasty (UPPP).The mean total nasal resistance values were compared between the 40 OSA patients and the 31 non-snorers, and before and two months after operation in 24 OSA patients treated surgically.The mean expiratory and inspiratory total nasal resistance values of the 40 OSA patients were significantly higher than those of the 31 non-snorers in both the upright and the supine positions.There was no correlation between the apnea index and the nasal resistance values in the 40 OSA patients.In the 24 OSA patients treated surgically there was no significant difference in nasal resistance before and two months after the operation.
著者
臼井 信郎
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.74, no.3, pp.357-365, 1981 (Released:2011-11-04)
参考文献数
6

A number of procedures are available for objective evaluation of nasal passage. Our knowledge is still limited, however, with respect to the transition of ventilation from nasal to mouth breathing caused by increasing nasal obstruction.We selected seven patients who had to breathe through the mouth besides the nose in unilateral nasal breathing because of severe nasal obstruction, measured nasal resistance, total and unilateral (right, left), as well as pulmonary resistance in nasal and mouth breathing among them, and analyzed the obtained data with Rohrer's formula.The results were as follows:1) The patient breathed through the nose when nasal resistance was equal to pulmonary resistance consistent with mouth breathing.2) The patient complained of a suffocating sensation when unilateral nasal resistance exceeded pulmonary resistance consistent with bilateral nasal breathing, and began to breathe through the mouth.3) In concomitant mouth breathing initiated to remove the suffocating sensation due to unilateral nasal breathing, pulmonary resistance was lower than that in bilateral nasal breathing.4) Pulmonary resistance in simultaneous unilateral nasal and mouth breathings fell to 1.8 times that in mouth breathing.The above findings indicate that the point of transition from nasal to mouth breathing lies where pulmonary resistance in nasal breathing becomes roughly twice as high as nasal resistance in that or pulmonary resistance in mouth breathing.
著者
中川 雅文 小川 郁男
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.111, no.7, pp.445-455, 2018 (Released:2018-07-01)
参考文献数
34

PURPOSE: The hearing level and cognitive function were examined in 174 elderly persons admitted to a nursing care facility using the Auditory Checker (JB electronics.inc, Japan). The Auditory Checker is a screening tool that can evaluate pure-tone hearing level up to 1000 Hz and speech discrimination and sentence understanding; the results are expressed in terms of the auditory cognitive score. The baseline score and the score after one year were compared using a statistical approach. The background factors of the subjects, such as the age, sex, degree of disability, and MMSE-J scores were also evaluated by statistical methods.RESULTS: The results revealed a significant positive correlation between the auditory cognitive score and the MMSE-J score. Factors such as the age, gender, degree of need for long-term care, presence/absence of brain disease, etc., had no significant influence on the auditory perception.CONCLUSION: It was useful for the functional screening of hearing acuity and cognitive function in case that had the hearing loss conducted prior to cognito-psycho test batteries. It is useful to conduct functional screening of the hearing acuity and cognitive functions prior to administration of cognito-psycho test batteries in patients with hearing loss. The Auditory Checker is useful for evaluating the hearing ability and auditory perception of elderly people who need long-term care. When evaluating hearing-impaired elderly people whose cognitive function is significantly reduced, it is useful to use the MMSE-J, Barthel Index, motivation score, etc. (VI) It is also desirable to use internationally recognized test batteries. An outline of the test batteries and their application method are outlined. It is an urgent need to establish a screening system for hearing and auditory perception in elderly people.