Nihon Jibiinkoka Gakkai kaiho
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Nippon Jibiinkoka Gakkai Kaiho · Jul 1999
Clinical Trial[The efficiency of magnetic resonance angiography (MRA) in the diagnosis and vertigo--prediction of vertebrobasilar insufficiency (VBI) and atherosclerosis].
Major causes of vertigo in patients who attend Otolaryngology clinics are peripheral vestibular disorders (PVD) and vertebrobasilar insufficiency (VBI). The purpose of this study was to see whether MRA findings can distinguish VBI from PVD to evaluate the efficiency of MRA in the diagnosis of vertigo. A total of 185 vertigo patients were examined by MRA with the 3D-Phase Contrast method. ⋯ The appearance of type III was restricted to type III's view was only meandering and type IV-1 showed severe stenotic changes in the union area. These data show that MRA findings in the diagnosis of vertigo patients are very effective in distinguishing VBI and cerebellar and brainstem infarction from PVD and that some pattern of MRA may correspond to atherosclerosis of the vertebrobasilar artery. We think MRA examination of vertigo patients is useful not only to assist in the diagnosis of the etiology but also to predict the stage of atherosclerosis in each patient.
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Nippon Jibiinkoka Gakkai Kaiho · Jul 1997
Case Reports[En bloc resection of the temporal bone for middle ear carcinoma extending to the cranial base].
En bloc resection of the temporal bone for squamous cell carcinoma of the middle ear was performed by the postauricular transtemporal and retromastoid approaches. The patient was a 70-year-old woman whose tumor extended to the middle and posterior cranial fossae. Temporal and retromastoid craniotomies were carried out, then the temporal dura and the cerebellar dura, and the transverse and sigmoid sinuses were exposed. ⋯ The patient has shown no evidence of recurrence for the 28 months since the surgical treatment, and has not complained of any problems with swallowing or conducting conversations in daily life. With the contribution of recent developments in skull base and reconstruction surgery, more aggressive en bloc resection of the temporal bone can be carried out on patients with advanced middle ear carcinoma. These developments will also make it possible for patients whose prognosis was previously thought to be poor to have a chance for a cure.
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Nippon Jibiinkoka Gakkai Kaiho · Sep 1995
Comparative Study Clinical Trial[Clinical investigation of transcranial magnetic stimulation of the facial nerve--an early prognostic diagnosis of patients with peripheral facial palsy and the facial nerve magnetic stimulation site].
To obtain an early prognostic diagnosis of patients with peripheral facial palsy, a magnetic stimulator (Dantec Mag 2) was used to directly stimulate the intracranial portion of the facial nerve in 15 normal subjects and 108 patients with peripheral facial palsy. In normal subjects and patients with facial palsy, compound muscle action potentials (CMAPs) of the orbicularis oris muscle elicited by transcranial magnetic stimulation were compared with CMAPs elicited by electrical stimulation at a peripheral site of the stylomastoid foramen. This technique is similar to electroneurography (ENoG) and is regularly used in our department. ⋯ In patients with peripheral facial palsy, recovery of the stapedial reflex, blink reflex and magnetically evoked CMAPs were examined to investigate the site of magnetic stimulation. From the clinical perspective, the facial nerve is thought to be magnetically stimulated near the meatal foramen that Fisch reported the site of damage in Bell's palsy. This stimulation site was almost the same point as that calculated from the mean latency difference between magnetically evoked CMAPs and ENoG in normal controls.
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Nippon Jibiinkoka Gakkai Kaiho · Aug 1995
Case Reports[Measurement of cochlear blood flow during exploratory tympanotomy in patients suspected of having perilymphatic fistulas].
Since impairment of cochlear blood flow is one of the factors implicated in the pathophysiology of sudden deafness, we measured cochlear blood flow in nine patients suspected of having perilymphatic fistulas. All but one patient had sudden sensorineural hearing loss. The exceptional case had experienced rotatory vertigo immediately after nose-blowing. ⋯ Pulsatory movement of the laser-Doppler output was observed in all 9 patients even after the middle ear mucosa had been removed. We attempted to measure the effects of carbon dioxide on cochlear blood flow, using methods such as inhalation of carbogen and cessation of respiration. In most cases, however, no significant change in cochlear blood flow was observed with these procedures.
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Nippon Jibiinkoka Gakkai Kaiho · Aug 1994
[Pliability of vocal fold mucosa in relation to the location of subglottic mucosal upheaval during phonation].
Mucosal pliability was measured in 23 excised larynges, 19 canine and four human, at the three portions of the vocal fold, namely the midline, the anterior 1/4 and the posterior 1/4. The pliability at the midline showed a greater value than those at the other two portions. The free edge of the vocal fold showed a maximum pliability which gradually diminished toward the tracheal side and reached a minimum 3mm from the free edge of the fold. ⋯ At this point, the muscle layer approximated the epithelial layer with disappearance of the deep layer of the lamina propria. The point shifted to the oral side following an increment in vocal fold tension, while the point moved toward the tracheal side following contraction of the TA. Pliability of the vocal fold is minimal at the point around which the deep layer of the lamina propria disappears and the mucosal upheaval occurs.