著者
安藤 一郎 新井 顕 渡辺 道隆 加納 昭彦
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.88, no.12, pp.1625-1632, 1995-12-01 (Released:2011-12-12)
参考文献数
36

Over the past 9 years, we studied 1090 cases of ABC (aspiration biopsy cytology) and 258 cases of malignant tumor. There were 3 false positive cases (1.2%) and 6 cases (2.3%) of histological misdiagnosis. Although we have not experienced fatal complications yet, we have recognized tuberuculous change in the needle tract after postoperative histology as a case of lymphoadenitis tuberuculosa.A search of the literature has revealed 4 cases of needle tract seeding after large needle biopsy and a case of embolism in the cerebral artery after ABC of head and neck lesions. Fatal complications of ABC were reported in 7 cases.Although the incidence of complication after ABC is not obvious, fatal complications of ABC are very rare in comparison with large needle biopsy and we consider that ABC is a safe method of clinical diagnosis.ABC imposes less burden on patients and differentiation of benign from malignant and identification of the presumable histological type are possible. Therefore, we conclude that ABC can be applied clinically in oto-rhino-laryngology.
著者
本庄 巖
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.1-6, 2000-01-01 (Released:2011-11-04)
参考文献数
8

Characteristics of hearing disorders due to retro-cochlear lesions have been recognized as disproportionally poor discrimination of speech to the hearing level in pure tone audiometry and disturbances in tone decay test, Bekesy audiometry and binaural hearing test. There have been numerous patients whom we diagnosed as having retro-cochlear hearing loss because they had these characteristic. However, we have encountered quite a few individuals who failed to obtain speech understanding after cochlear implantation (CI) in spite of poor speech discrimination before surgery.From these clinical observations and review of recent literature, it appears that true retro-coc-hlear hearing disorder is far less frequent than we thought and that the retro-cochlear pathway may not have an important role in the process of speech recognition, although the cochlea plays an important role in transforming speech sound into electric signals. The main function of the retrocochlear tract may be to detect the direction of the sound source, as the vestibular tract contributes to equilibrium of the body in a reflex manner.Thus, in perception of speech, the cochlea and the auditory cortex play more important roles than the retro-cochlear pathway does. From the clinical points of view, cochlear implantation can be indicated even for patients who have any discrepancy between the result of pure tone audiometry and speech discrimination test.
著者
北野 仁 斎藤 春雄 北嶋 和智 竹田 泰三 矢沢 代四郎 松原 秀春 北野 眞由美 北野 博也 児玉 章 水上 千佳司
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.74, no.10special, pp.2370-2378, 1981-10-25 (Released:2011-11-04)
参考文献数
7

Meniere's disease is represented by episodic vertigo (vestibular symptom), tinnitis and hearing loss (cochlear symptom). It is possible to devide patients with Meniere's disease into three groups; those with cochlear and vestibular symptoms starting at the same time, and those with the vestibular symptoms starting before or after cochlear symptoms: In this presentation, we studied the clinical differences of these three groups. The following results were obtained.1. In the case of cochlear Meniere's disease, the cochlear symptom is slight and it is easy to acquire the vestibular symptom. The cause of cochlear Meniere's disease was considered to be the existence of endolymphatic hydrops. Compared with frequency of bilateral Meniere's disease, bilateral cochlear Meniere's disease was more found.2. In the case of vestibular Meniere's disease, the vestibular symptom is slight and it is difficult to acquire the cochlear symptom. The cause of vestibular Meniere's disease, in all cases was not considered to be the existence of endolymphatic hydrops.3. In the case of Meniere's disease with vestibular symptoms starting after the cochlear symptoms, both the vestibular symptoms and cochlear symptoms are heavy. In the case of Meniere's disease with vestibular symptoms starting before the cochlear symptoms, both symptoms are slight.
著者
大木 孝一 和田 公平 山本 祐三 牧本 一男 高橋 宏明
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.12, pp.1757-1762, 1993-12-01 (Released:2011-11-04)
参考文献数
6
被引用文献数
2 2

Actinomycosis is a chronic purulent granulomatous disease caused by actinomyces, an organism which is often present in man. Patients with a chronic clinical course have been on the increase in recent years, and differentiating this disease from tumor is often necessary when the mass is in facial and cervical regions other than the oral cavity and jaw. We report two cases of actinomycosis in the face and neck.Case 1: A 54-year-old man complained of a swelling in the anterior part of the neck. A mass 65 × 70 mm with redness of the skin was noted at his first visit. The mass was of platelike consistency with a smooth surface closely adherent to the surrounding tissue. The tuberculin test was negative. A malignant tumor was considered, so percutaneous needle biopsy was performed, but no significant abnormality was found. Antibiotics were given by drip infusion, and the mass disintegrated. Yellow viscous pus containing light gray granules was discharged to form a fistula.Case 2: A 40-year-old man developed a swelling in the left cheek. A ping pong ball-sized mass of plate-like consistency with redness was noticed at his first visit. A fistula formed in the oral cavity on the left, and pus was discharged from it. Plain CT revealed an isodense lesion in the left cheek, with no connection to the maxillary sinus.Actinomyces is anaerobic, so it was not detected by culture in either case. Histopathological examinations of actinomycotic granules was useful in the diagnosis.The treatment consists mainly of drainage by incision of the lesion and administration of antibiotics, especially penicillin.
著者
石川 敏夫 市村 恵一
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.97, no.4, pp.285-290, 2004-04-01 (Released:2011-10-07)
参考文献数
20

The clinical features of 14 patients with deafness due to mumps who underwent treatment in Jichi Medical School Hospital from April 1993 to March 2003 were reviewed. The diagnosis was made according to the criteria for diagnosis of mumps deafness determined by the Acute Profound Deafness Committee set up by the Ministry of Health and Welfare, Japan.The number of patients with mumps has gradually increased since 2000, and the number of patients in 2002 was about 3 times greater than that in 2000.The age distribution of the patients in our hospital was 3 to 34 years old and half of the patients were 5 to 9 years old. The onset time of hearing loss in 10 cases was within 8 days after the appearance of parotid swelling. All 14 patients had unilateral total deafness or profound sensorineural hearing loss. Nine were treated with corticosteroids. Hearing loss did not improve after treatment in any patient. The importance of mumps vaccination should be reconsidered.
著者
大屋 耕子
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.96, no.6, pp.499-502, 2003-06-01 (Released:2011-10-07)
参考文献数
15

Natural mumps virus infection is believed to induce lifelong immunity and rarely cause unilateral severe sensorineural hearing loss with sudden onset. Unilateral deafness due to mumps virus reinfection had rarely been reported in the Japanese literature. I present a case of unilateral deafness due to mumps virus reinfection.
著者
五島 史行 矢部 はる奈 小川 郁
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.102, no.4, pp.315-320, 2009 (Released:2010-12-04)
参考文献数
15
被引用文献数
1

Introduction: Treatments for acute peripheral vertigo have not been well investigated. The most suitable drug for controlling acute vertigo should suppress both vertigo and accompanying nausea. The purpose of this study was to evaluate the effect of four different drugs on acute peripheral vertigo: (A) hydroxyzine hydrochloride (25 mg, i.v.); (B) 0.5% metoclopramide (2 ml, i.v.); (C) sodium bicarbonate (40 ml, i.v.); and (D) a cocktail of diphenhydramine hydrochloride (30 mg) and dyprophylline (26 mg) (both i.m.). Methods: Forty-two patients with acute peripheral vertigo (average age: 59.5±18.1 years) with spontaneous nystagmus were assigned to four treatment groups (A-D, above). Patients with central vertigo and vestibular neuritis were excluded. The number of patients in each group was as follows: A, n=11; B, n=11; C, n=11; and D, n=9. Patients were instructed to evaluate their subjective symptoms of nausea and vertigo before and 30 minutes after drug treatment. They rated the severity of their symptoms on a 0-to-10 scale, with 10 representing the most severe symptoms and 0 a lack of symptoms. Results: Group A patients (hydroxyzine hydrochloride; 25 mg, i.v.) reported the highest level of relief from vertigo and nausea after drug treatment, whereas group C (sodium bicarbonate; 40 ml, i.v.) and D (diphenhydramine hydrochloride (30 mg)-dyprophylline (26 mg) cocktail; i.m.) patients reported only the slight relief of these symptoms. Group B patients (0.5% metoclopramide; 2 ml, i.v.) experienced partial symptom relief; their vertigo remained unchanged. Thus, hydroxyzine hydrochloride (A) was the most effective in controlling both nausea and vertigo, whereas sodium bicarbonate (C) and diphenhydramine hydrochloride and dyprophylline (D) only slightly suppressed vertigo and nausea. Metoclopramide (B) only suppressed nausea. Conclusions: Hydroxyzine hydrochloride (A) was the most suitable for treating acute peripheral vertigo. Doctors should be familiar with the contraindications of these drugs. Some of these drugs may potentially be used in combination to control the symptoms of acute vertigo more effectively.
著者
岡田 昌浩 小林 泰輔 中村 光士郎
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.102, no.3, pp.219-223, 2009 (Released:2010-12-03)
参考文献数
20
被引用文献数
9 3

Hemorrhage following tonsillectomy is still a major complication despite the development of new hot knives. In this study, a retrospective review of 242 adult patients who underwent tonsillectomy in the Department of Otolaryngology, Ehime Prefectual Central Hospital between January 2000 and March 2007 was conducted. Post-tonsillectomy hemorrhage occurring in 56 patients (23.1%); four of these patients experienced hemorrhage during the first 24 hours postoperatively, and the remaining 52 had delayed bleeding. Nine of 56 patients (3.7%) required a procedure to control their bleeding under general anesthesia. The hemorrhage rate in males was significantly higher than in females. There was no statistically significant difference in hemorrhage rates based on age, body mass index (BMI), duration of surgery and smoking. Patients who received antibiotics postoperatively experienced less secondary hemorrhage than those without antibiotics. In 99 patients who were administered antibiotics, patients who used cephalosporins experienced less secondary hemorrhage than those who received penicillins. These results indicate that antibiotics after tonsillectomy are effective to reduce post-tonsillectomy hemorrhage rates.
著者
小林 丈二 佐伯 忠彦 竹田 一彦 上甲 英生
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.89, no.11, pp.1365-1369, 1996-11-01 (Released:2011-11-04)
参考文献数
14
被引用文献数
1

The authors investigated the clinical course of 49 patients with peritonsillar abscesses treated at Uwajima City Hospital between January 1983 and December 1995. The cohort consisted of 36 males and 13 females, aged 15 to 68 (mean age, 37.2 years old). Along with administration of antibiotics, removal of the abscess was performed by needle aspiration in 25 cases, and incision for drainage in 24 cases, respectively. There were no statistical differences in clinical stage and course between the group under 40 years old and the group over 40 years old. There was also no difference between the group treated with needle aspiration and the group treated with incision, except for the length of hospital stay healing time. Interval tonsillectomy was carried out in 10 cases. Recurrence of the peritonsillar abscess occurred in only one case. Therefore, we recommend needle aspiration as the first choice for treatment of peritonsillar abscesses. In cases of peritonsillar abscess with no past history of habitual angina, tonsillectomy is not indicated because recurrence of peritonsillar abscesses is rare.
著者
石島 健 野々村 光栄 藤木 暢也
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.88, no.6, pp.739-742, 1995-06-01 (Released:2011-11-04)
参考文献数
12
被引用文献数
2 2 4

A patient with right exophthalmus due to exacerbation of relapsing sinusitis who had undergone bilateral radical paranasal sinus surgery in our hospital 6 months earlier visited us and was diagnosed with acquired immunodeficiency syndrome (AIDS) after many tests. The patient was a 36-year-old male who had consorted with prostitutes. Esophageal candiditis and tumors of the liver and the colon were found. Blood tests showed a reduction in lymphocytes, particularly in T-cells and an CD4/CD8 ratio of 0.2. HIV (human immunodeficiency virus) antibody titer was increased. Remission of exophthalmus came after therapy with steroids and antibiotics.
著者
中村 光士郎 松本 康 柳原 尚明
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.73, no.11, pp.1673-1678, 1980-11-01 (Released:2011-11-04)
参考文献数
19

Bilateral or recurrent facial palsies were found in 70 patients (3.8%) among the 1856 patients with facial palsy whom we treated during the last fifteen years. According to the clinical course, these 70 patients were classified into the following four groups.1) Bilateral simultaneous facial palsy (15 patients, 0.8%)2) Bilateral recurrent facial palsy (3 patients, 0.2%)3) Bilateral alternating facial palsy (24 patients, 1.3%)4) Unilateral recurrent facial palsy (28 patients, 1.5%)The bilateral simultaneous facial palsies were caused by Bell's palsy in five patients, head trauma in three, the Melkerson-Rosenthal syndrome in one, otitis media in two, myasthenia gravis in two, polyneuritis in two. The etiologies of four other patients were unknown. In contrast to multiple etiologies of the bilateral simultaneous facial palsies, bilateral alternating and recurrent palsies were caused mostly by Bell's palsy (22 patients) and the Melkerson-Rosenthal syndrome (3 patients). Although the majority of unilateral recurrent facial palsies were caused by Bell's palsy (22 cases) and the Melkerson-Rosenthal syndrome (2 cases), it is noteworthy that intratemporal tumors such as neurinoma of the facial nerve (1 patient) and cholesteatoma in the petrous apex (2 cases) could be the cause of recurrence.
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.