著者
長山 郁生
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.76, no.11special, pp.3136-3140, 1983-11-20 (Released:2011-11-04)
参考文献数
9

The body sway of patients in a position standing was recorded by a stabilometer. Each subject stood on a platform with feet together and looked straight ahead at a small spot on a wall 1.5m away. The test was done for 35 seconds with eyes open and another 35 seconds with eyes closed.The total distance of body sway and the shift of the center of the stabilogram were measured. The test was performed on normal subjects and patients with vestibular disorders.(1) In patients with vestibular disorders, the total distance of body sway was greater than in normal subjects, and its ratio with eyes closed and eyes open was larger than normal.(2) Normal subjects shifted forward with eyes closed, but the patients tended to shift backward.These two indicators, the total distance of body sway and the shift of the center of the stabilogram provide useful information in observing the clinical course of patients with vestibular disorders.
著者
村井 紀彦 佐藤 宏昭
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.87, no.7, pp.909-912, 1994-07-01 (Released:2011-11-04)
参考文献数
13
被引用文献数
1 5

A 42-year-old man was referred to our hospital because of left nasal obstruction. Anterior rhinoscopy disclosed a mass in the left nostril attached to the nasal septum. CT scanning showed a well-demarcated soft tissue density mass in the anterior part of the left nasal cavity. Biopsy revealed that the mass comprised spindle cells without atypia. Under local anesthesia the tumor was removed by the transnasal approach. The histopathological diagnosis was neurilemmoma.
著者
山根 英雄
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.98, no.12, pp.907-914, 2005-12-01 (Released:2011-10-07)
参考文献数
29

Surgery for congenital aural atresia is among the most difficult and challenging procedures for both ear surgeons and patients. Some previous reports have not recommended this type of surgery with confidence, because of the difficulty of the surgery itself and because postoperative hearing gain has not been as good as was expected, while postoperative complications such as middle ear infection sometimes occur. How then should the otolaryngologist approach this disease? When microtia coexists with aural atresia, the otolaryngologist sometimes hesitates to decide how to treat atresia because of excessive attention to microtia. The difficulty of atresia surgery should be considered apart from microtia because the microtia itself is not a crucial factor in such surgery. At present, it is hoped that otolaryngologists will develop several strategies such as reliable surgery with good postoperative hearing results without postoperative complications and new devices such as BAHA.
著者
生井 明浩 池田 稔 吉川 拓磨 工藤 逸大 小野田 恵子 木田 亮紀
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.801-804, 1999-07-01 (Released:2011-11-04)
参考文献数
10
被引用文献数
2 1

Polaprezinc is an anti-ulcerative drug that contains zinc. We used this drug for the treatment of 41 taste disorder patients (21 to 76 years). The rates of improvement were 80.0% in drug-induced, 100.0% in zinc deficient, and 62.5% in idiopathic taste disorders. The overall rate of improvement in all patients was 73.2% (30 cases). These results revealed that polaprezinc is useful for taste disorder patients lacking zinc.
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
水越 文和 出島 健司 竹中 洋 齊藤 憲治 河田 了 高木 伸夫 安田 範夫 村上 泰 松岡 秀樹 日向 美知 立本 圭吾 任 書熹 大島 渉 寺薗 富朗 日向 誠 松本 真吏子 竹上 永佑 土井 玲子 三牧 三郎 西嶋 信雄 牛島 千久 伊達 敬一 園田 隆朗 大槻 晃直 木村 隆保 八木 正人 中井 茂 昌子 均 豊田 健司
出版者
耳鼻咽喉科臨床学会
雑誌
耳鼻咽喉科臨床. 補冊 = Practica otologica. Suppl. (ISSN:09121870)
巻号頁・発行日
vol.76, pp.56-66, 1995-03-20
被引用文献数
6 2

The effect of Oxatomide in the initial treatment of Japanese cedar pollinosis was examined in 11facilities in Kyoto prefecture. This study examined the most appropriate starting time and period of administration for the highest effect of the initial treatment. The following results were confirmed by administre ring Oxatomide during the initial treatment for Japanese cedar pollinosis on 1991.<BR>The effect of Oxatomide was obtained after administering for one week or more, including the highest effect after two weeks for sneezing and three weeks for nasal discharge. However, no effect on sniffling. These results suggest that two to three weeks is the best administration period for Oxatomide in the treatment of Japanese cedar pollinosis.<BR>In addition, a close relation between pollen information facilities and practical medicine in the region, is necessary for the initial treatment of pollinosis.
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
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
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
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.
著者
深澤 達也 藤村 英一 加納 直行 牧本 一男
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.74, no.8, pp.1761-1766, 1981-08-01 (Released:2011-11-04)
参考文献数
6

Differentiated thyroid cancer is regarded to be of low grade malignancy with a good prognosis. We made statistical analyses of 138 cases of differentiated thyroid cancer treated in Kyoto University during the past ten years.Our study proved the propriety of the standard surgical procedures for thyroid cancer. These established indications of surgical procedure for various stages of the cancer were found to have been properly followed in our series. This could conceivably be related to a lower recurrence rate in our series.
著者
山中 昇
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.5, pp.407-412, 2012 (Released:2012-04-27)
参考文献数
18

Currently, the evidence-based medicine, EBM, has become essential in every field of medicine and many clinical guidelines have been developed based on the high-quality evidence. Such evidence has usually classified into 6 levels according to the quality of the studies. A meta-analysis of randomized controlled trials is considered as the highest level of evidence. The meta-analysis, however, has several pit-falls that we should keep in mind. The pit-falls are Simpson’s paradox, the selection bias, the publication bias, and the geographical bias. In the clinical setting of otolaryngology, it is not always possible to obtain a high level of evidence for conventional clinical treatments such as myringotomy, sinus puncture and aspiration, aeration of the Eustachian tube for the treatment of otitis media with effusion, and so on. Since these treatment modalities have no high-level of evidence, should we therefore stop performing them? No. We should have a further look at these treatments as “good practice points (GPP)”. Otolaryngological specialists should play an important role in combining high-quality evidence and GPP to seek the optimum treatment approach for each patient.