[Show abstract][Hide abstract] ABSTRACT: Objective
To report a rare case of unilateral cavernous sinus thrombosis caused by contralateral sphenoid sinusitis.
A 33-year-old female visited our hospital for severe, right-sided, temporal headache, chemosis, periorbital edema, and proptosis. These signs were associated with congested erythematous nasal mucosa with purulent discharge from the right superior nasal meatus. Contrast enhanced CT showed dilated left superior ophthalmic vein, suggestive of thrombosis, contrast enhancement of the left cavernous sinuses, and dilation of cavernous sinus, indicating cavernous sinus inflammation. The right maxillary, ethmoid and sphenoid sinuses showed mucosal thickening and retention of purulent material. She was diagnosed with cavernous sinus thrombosis caused by contralateral sphenoid sinusitis. All clinical symptoms and signs improved after endoscopic sphenoidotomy and appropriate medical treatment.
Sphenoiditis can cause contralateral cavernous sinus thrombosis. Early surgical sphenoidotomy and aggressive medical treatment are the cornerstones of successful management of this life-threatening complication.
Head & Face Medicine 03/2013; 9(1):9. DOI:10.1186/1746-160X-9-9 · 0.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Eagle's syndrome is often associated with elongated styloid process or ossified stylohyoid or stylomandibular ligament. Patients with this syndrome present with recurrent cervicofacial pain. Surgical removal of the elongated styloid process is a standard treatment and can be accomplished through either a transoral or extraoral approach. Both approaches have advantages and disadvantages, and the best surgical approach remains controversial. In our case, the elongated styloid process was removed by transoral approach assisted by endoscopy. Endoscopy provides clear surgical view thus lessen the chance of neurovascular injury and other intraoperative complications. Endoscopy-assisted transoral resection is an optional alternative surgical procedure for Eagle's syndrome.
Head & Face Medicine 07/2012; 8(1):21. DOI:10.1186/1746-160X-8-21 · 0.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The present study assessed how to inject a gene into the mouse vestibule and which is the optimum gene to the mouse vestibule adenovirus (AdV) vector or adeno-associated virus (AAV) vector.
Loss of vestibular hair cell is seen in various balance disorder diseases. There have been some reports concerning gene delivery to the mouse vestibule in recent years. To effectively induce transgene expression at the vestibule, we assessed the efficiency of inoculating the mouse inner ear using various methods.
We employed an AdV- and AAV-carrying green fluorescent protein using a semicircular canal approach (via a canalostomy) and round window approach.
AAV injection via canalostomy induced gene expression at the hair cells, supporting cells, and fibrocytes at the vestibular organs without auditory or balance dysfunction, suggesting it was the most suitable transfection method. This method is thus considered to be a promising strategy to prevent balance dysfunction.
AAV injection via canalostomy to the vestibule is the noninvasive and highly efficient transfection method, and this study may have the potential to repair balance disorders in human in the future.
Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 04/2012; 33(4):655-9. DOI:10.1097/MAO.0b013e31825368d1 · 1.79 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Giant cell tumor (GCT) is classified as a benign bone tumor, and it is frequently identified at the epiphysis of long bones and relatively rare in the temporal bone. For orthopedists expert at recognizing bone and soft tissue tumors, the diagnosis of GCT is relatively easy; however, since head and neck surgeons experience few cases of GCT, it may be difficult to diagnose when it occurs in the temporal bone. A 32-year-old man complained of left hearing loss, aural fullness, and tinnitus. Examination of the ear revealed a bulging tumor. Audiologic examination demonstrated conductive hearing loss of the left ear. Computer tomograph of the temporal bone showed a soft-tissue-density specification indicating bone destruction at the left temporal bone. The tumor invaded the skull base. Imaging examinations using magnetic resonance imaging revealed a nonhomogenous isosignal intensity area on T1 at the left temporal bone. After intravenous gadolinium, the mass showed unequal enhancement. This patient subsequently underwent surgery to remove the lesion using transmastoid and middle fossa approach. Pathological examinations from specimens of the tumor revealed characteristic of GCT. No clinical or radiological evidence of tumor recurrence was detected for 4 years.
[Show abstract][Hide abstract] ABSTRACT: GJB2 mutations are responsible not only for deafness but also for the occurrence of vestibular dysfunction. However, vestibular dysfunction tends to be unilateral and less severe in comparison with that of bilateral deafness.
The correlation between the cochlear and vestibular end-organs suggests that some children with congenital deafness may have vestibular impairments. On the other hand, GJB2 gene mutations are the most common cause of nonsyndromic deafness. The vestibular function of patients with congenital deafness (CD), which is related to GJB2 gene mutation, remains to be elucidated. The purpose of this study was to analyze the relationship between GJB2 gene mutation and vestibular dysfunction in adults with CD.
A total of 31 subjects, including 10 healthy volunteers and 21 patients with CD, were enrolled in the study. A hearing test and genetic analysis were performed. The vestibular evoked myogenic potentials (VEMPs) were measured and a caloric test was performed to assess the vestibular function. The percentage of vestibular dysfunction was then statistically analyzed.
The hearing level of all CD patients demonstrated a severe to profound impairment. In seven CD patients, their hearing impairment was related to GJB2 mutation. Five of the seven patients with CD related to GJB2 mutation demonstrated abnormalities in one or both of the two tests. The percentage of vestibular dysfunction of the patients with CD related to GJB2 mutation was statistically higher than in patients with CD unrelated to GJB2 mutation and in healthy controls.
[Show abstract][Hide abstract] ABSTRACT: We investigated the effectiveness of Lipo-prostaglandin El (Lipo-PGEl) into patients with idiopathic sudden hearing loss. Thirty three patients were treated with steroids only (steroids group) and 40 patients were treated with steroids plus Lipo-PGEl (steroids plus Lipo-PGEl group). There was no significant difference in sex, age, initial hearing level, and period between the onset of the disease and the start of the treatment between the two groups. The rate of complete recovery and marked improvement was 45. 4% in the steroids group and 65. 0% in the steroids plus Lipo-PGEl group at the final examination. There was no significant difference in the rate between the two groups. For patients under 60 years of age and those with vertigo in the steroids and Lipo-PGEl group a significantly better outcome was seen in the rate of complete recovery and marked improvement. These results suggest that the Lipo-PGEl may be effective as a concomitant drug with the steroids regardless of the age and hearing level of the patient for the treatment of idiopathic sudden hearing loss.
[Show abstract][Hide abstract] ABSTRACT: Resection of the posterior nasal nerve is often performed in the patients with intractable and severe chronic rhinitis. However, massive nasal bleeding has been pointed out as a serious postoperative complication. We report here 3 patients with postoperative bleeding, who were successfully treated with prompt hemostasis. From the basis of the perioperative findings, the bleeding point was derived from the central part of the resected trunk or major branches of the sphenopalatine artery. It was concluded that careful attention should be paid during and after surgery involving resection of the posterior nasal nerve.
[Show abstract][Hide abstract] ABSTRACT: Paragangliomas are highly vascular, slow growing neoplasms that can occur within the temporal bone, as well as other sites in the head and neck. Preoperative angiography showed no feeding artery of the tumor in our case, but Zellenballen and hypervasularity were observed histologically. Tympanic paragangliomas confined to the middle ear cavity do not need preoperative embolization.
[Show abstract][Hide abstract] ABSTRACT: Before performing transnasal fiberscopy to observe the nasal cavity, pharynx and larynx in outpatient clinics, nasal anesthetics and vasoconstrictive agents are routinely sprayed into the nares in order to improve patients' comfort. Bacterial contamination of the nozzles of Venturi principle atomizer barrels and their solutions after being used for multiple patients over a long-term period without cleaning is controversial. We evaluated the potential risk of atomizer-associated cross-infection by using atomizers commonly available in Japan that use compressed air to atomize medication. Eighteen of the 23 samples (78.3%) from the external nozzle tips of the atomizers resulted in positive bacterial cultures. These detected bacteria are suggested to be colonized in the nares and to cause bacterial contamination of the atomizer. Of the 25 samples obtained from the spray of the drug solutions, 11 samples showed positive bacterial culture, whereas 16 control samples produced no growth of bacteria. The present study demonstrated that the atomizer widely used in the outpatient ENT clinics in Japan has a potential risk of causing cross-infection of patients.
Indian Journal of Otolaryngology and Head & Neck Surgery 09/2009; 61(3):193-6. DOI:10.1007/s12070-009-0064-y · 0.05 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We herein describe a case of 44-year old female who presented with a chief complaint of gustatory rhinorrhea from childhood, in which gustatory stimuli caused bilateral excessive, watery nasal secretion. No abnormality of taste acuity was observed. This disorder was presumably caused by faulty regenerated parasympathetic nerve fibers reaching the nasal mucosa or possibly, by a congenital condition. Nasal pretreatment with an anti-cholinergic drug clinically blocked the positive sugar-induced rhinorrhea, thus indicating that the gustatory rhinitis in this case was produced by foods that stimulate muscarinic receptors sensitive to atropine (probably on submucosal nasal glands). Although this syndrome can be treated prophylactically by the use of topical atropine, the patient preferred to undergo radical therapy and a resection of the posterior nasal nerve was performed through the middle meatus under endoscopic control. The resection of the nerve on both sides resulted in an almost complete inhibition of the sugar-induced rhinorrhea without serious complications. Although this disease is not life-threatening, it is socially embarrassing and troublesome to patients and surgical therapy is one of the accepted modalities.
The Tohoku Journal of Experimental Medicine 11/2006; 210(2):165-8. DOI:10.1620/tjem.210.165 · 1.35 Impact Factor