Masaki Ogura

Sendai City Hospital, Sendai, Kagoshima, Japan

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Publications (10)16.39 Total impact

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    ABSTRACT: A novel narrow-field laryngectomy procedure known as central-part laryngectomy (CPL) for less invasive laryngeal diversion in patients with intractable aspiration is introduced. We conducted retrospective case reviews of 15 patients who underwent CPL. In this procedure, an area of the glottis including the mid-part of the thyroid cartilage and cricoid cartilage is removed to separate the digestive tract from the air way. The lateral part of the thyroid cartilage, the entire hypopharyngeal mucosa and epiglottis are preserved. The superior laryngeal vessels and nerve are not invaded. All fifteen patients were relieved of aspiration without major complications. In good accordance with cutting of the cricopharyngeal muscles and removal of the cricoid cartilage, postoperative videofluoroscopy demonstrated smooth passages of barium. Ten of 12 patients who had hoped to resume oral food intake became able to do so after CPL and two others also achieved partial oral deglutition. CPL is a useful procedure for treatment of intractable aspiration and offers considerable advantages over other laryngotracheal diversion procedures from the view point of oral food intake.
    Archives of Oto-Rhino-Laryngology 10/2013; · 1.29 Impact Factor
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    ABSTRACT: A fairly quite rare case of osseous tumor arising from the Eustachian tube (ET) is described. A 56-year-old man presented with a smooth bulky mass in the nasopharynx and secretory otitis media in the right ear. Computed tomography and magnetic resonance imaging indicated a solid tumor-like region occupying the nasopharynx with apparent extension to the right ET. Transnasal endoscopic surgery demonstrated that the tumor had originated from the ET, and the tumor was partially removed in the area where it had expanded into the nasopharynx. The pathological diagnosis was an osseous hamartoma consisting of bony tissue, fat cells and fibroblasts. To our knowledge, this is the first reported case of osseous hamartoma arising from the ET in the world literature. The patient presented symptoms of nasal obstruction and unilateral aural fullness. Reduction surgery and tympanostomy tube insertion were useful for accurate diagnosis and resolution of the symptoms.
    Clinics and practice. 08/2013; 3(2):e25.
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    ABSTRACT: Juvenile xanthogranuloma (JXG) is a benign manifestation of non-Langerhans cell histiocytosis characterized by yellowish cutaneous nodules. Its occurrence in the larynx is very rare, but laryngeal JXG may cause severe respiratory distress. We report a patient with isolated laryngeal JXG treated by laryngomicrosurgery, and this is the first report of JXG extending to vocal fold. A 3-year-old girl presented with hoarseness and inspiration stridor. A bulky tumor was found in right glottic to subglottic region. Subtotal resection of the tumor was carried out by laryngomicrosurgery, and airway distress was diminished after the operation. In pathological examination, the resected specimen showed proliferation of histiocytic cells and spindle cells with Touton giant cells that are characterized by polynuclei or wreath nuclei and are known to appear in JXG but not in LCH. Immunohistochemistry of histiocytic cell markers demonstrated positivity for CD68, lysozyme, alpha1-anti-chymotrypsin, factor XIIIa and vimentin, and negativity for CD1a and S-100, leading to diagnosis of JXG, but not LCH. The patient was thus expected with benign prognosis, and additional resection of the tumor including vocal fold was not indicated in the initial treatment. Six weeks later, the JXG recurred and a second procedure using CO2 laser was needed. The tumor did not re-grow thereafter, and there was no residual voice handicap. Because of its favorable prognosis and tendency for spontaneous regression, JXG in the larynx needs to be considered carefully with regard to whether reduction surgery and/or tracheotomy are necessary, and thus precise diagnosis is required.
    The Tohoku Journal of Experimental Medicine 01/2013; 230(2):123-127. · 1.37 Impact Factor
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    ABSTRACT: Laryngomalacia is the most common cause of stridor in neonates and infants, where the soft cartilages and tissues surrounding the upper larynx collapse inward during respiration. On the other hand, acquired idiopathic laryngomalacia in adults is quite rare, but should be borne in mind for differential diagnosis of upper airway distress. Allergic factors may cause airway distress, but have not been highlighted previously as the background of laryngomalacia. In this report, we describe two patients with acquired idiopathic laryngomalacia with reference to allergic rhinitis and high serum levels of immunoglobulin E. The first patient was a 16-year-old female who presented with inspiratory stridor and dyspnea due to attachment between the epiglottis and bilateral arytenoids, and the second patient was an 18-year-old male who also presented with inspiratory stridor due to attachment between the epiglottis and posterior pharyngeal wall. The respiratory function of both patients was within the normal range but the inspiratory stridor interfered with daily life. Laryngomicrosurgery was performed in both patients using a CO2 laser to remove the arytenoid mucosa in the first patient, and to remove the tip of the epiglottis in the second. Both patients were followed up while receiving oral anti-allergic agents. Laser supraglottic laryngoplasty to remove the vibrating excess tissue was effective for resolving the symptoms. However, recurrence occurred three times in the first patient, and inferior turbinotomy to improve nasal respiration was useful for diminishing the symptoms.
    The Tohoku Journal of Experimental Medicine 01/2013; 230(1):43-47. · 1.37 Impact Factor
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    ABSTRACT: Diplacusis is defined as the phenomenon of hearing the same tone at different pitches in the two ears. Although binaural pitch-matching using method-of-adjustment has been employed in most studies, it is sometimes hard for subjects with impaired hearing to judge ‘equal pitch’ as one frequency. To resolve this problem, a modified pitch-matching test, in which the relation of pitch sensation between the two ears was assessed as a matched frequency ‘range’ using the randomized maximum likelihood sequential procedure, was developed. Eight subjects with unilaterally impaired hearing, as well as eight normal subjects, were examined to evaluate this new test procedure. In the present method, matched frequency is assessed as a frequency range, in which subjects cannot judge whether the pitch of the signal in one ear is higher or lower than that in the opposite ear. This method appeared to be useful for assessing the characteristics of diplacusis in subjects with impaired hearing as well as in normal subjects. Sumario La diploacusia se define como el fenómeno de percibir un mismo tono como frecuencias diferentes en los dos oídos. Aunque se ha utilizado en muchos estudios la equiparación binaural del tono por el método del ajuste, a veces es difícil que los sujetos con trastornos auditivos juzguen un “tono igual” como una misma frecuencia. Para solucionar este problema, se desarrolló una prueba modificada de equiparación de tonos, en la cuál la relación de sensación tonal entre los dos oídos se evaluó como un rango de frecuencias, utilizando procedimientos secuenciales aleatorios de máxima similitud. Se examinaron ocho sujetos con hipoacusia unilateral y ocho con audición normal para evaluar este nuevo procedimiento. Con este método, la equiparación de la frecuencia se evalúa como un rango de frecuencias, en el que los sujetos no pueden juzgar si el tono de la señal en un oído es más alto o más bajo que en el oído opuesto. Este método parece ser útil para evaluarlas características de la diploacusia en sujetos con trastornos auditivos, así como en sujetos normales.
    07/2009; 42(6):297-302.
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    ABSTRACT: The pterygoid venous plexus (PVP) is an important factor in the mechanism of eustachian tube (ET) closure under conditions that can cause increased venous pressure in the head, such as during neck compression and postural change from the sitting/standing to the recumbent position. The symptoms of patulous ET are usually improved by neck compression or postural change (from sitting/standing to recumbent position). Venous congestion around the ET and/or gravitational change may be involved in the changing degree of symptoms, but its mechanism is not understood. This study investigated whether the PVP is involved. The dimensions of soft tissues surrounding ET were measured on magnetic resonance images before and after neck compression. The lateral pterygoid muscle became enlarged after neck compression. Simultaneously, the volume of venous plexus observed between the medial pterygoid muscle and tensor veli palatini muscle was increased. Such enlargement was probably due to blood pooling in the PVP, resulting in protrusion of the ET anterior wall to the luminal side, and decreased ET patency.
    Acta Oto-Laryngologica 08/2007; 127(7):693-9. · 1.11 Impact Factor
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    ABSTRACT: Computed tomography (CT) in the sitting position was useful for detecting patulous Eustachian tube (ET). Retrospective. Tertiary referral center. Eighty-seven patients divided into two groups. The patulous ET group consisted of 111 ears of 67 patients with patulous ET. The control group consisted of 30 ears of 20 patients without symptoms characteristic of patulous ET or abnormal findings in ET function tests. CT was performed under the resting condition and during Valsalva maneuver (Valsalva condition). The multiplanar reconstruction technique was used to reconstruct 1-mm-thick gapless images parallel to and perpendicular to the ET long axis. The open tubal distance (OTD) and average ET-gram were examined. The OTD was significantly longer in the patulous ET group than in the control group under both resting and Valsalva conditions (both p < 0.001). The OTD was also significantly longer under the Valsalva condition than under the resting condition in both groups (p < 0.01 in the patulous ET group, p < 0.001 in the control group). The average ET-gram showed an occlusive zone in the cartilaginous portion medial to the isthmus under both the resting and Valsalva conditions in the control group (n = 30). However, the occlusive zone could not be observed under either the resting or Valsalva conditions in the patulous ET group (n = 111). Completely patent (open) ET was observed with continuous hyperlucency from the pharyngeal to the tympanic orifices in 88 of 111 patients in the patulous ET group, but in none of the control group, indicative of 100% specificity. Computed tomography in the sitting position employing Valsalva maneuver is useful for the diagnosis of patulous ET.
    Ontology & Neurotology 03/2007; 28(2):199-203. · 2.01 Impact Factor
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    ABSTRACT: Binaural unmasking refers to the improvement in intelligibility under conditions of masking when a tone is presented out of phase rather than in phase. In the present study, binaural unmasking was evaluated using auditory-evoked magnetoencephalography (MEG) in eight healthy right-handed volunteers (7 males and 1 female, mean age 25.9 years). Peak latency and amplitude of the N1m response to tone bursts of 250 Hz (n = 8), 1000 Hz (n = 3), and 4000 Hz (n = 3) were measured under S0N0 (binaural phase difference was zero radian (in phase) for both stimulus sound and masker noise) and SpiN0 (binaural phase difference was pi radian (out of phase) for stimulus sound and zero radian for masker noise) conditions. The level of tone bursts was swept by 5 or 10 dB steps from the level of 20 dB above the psychophysical threshold under the S0N0 condition until no significant auditory-evoked field could be observed. Identical background noise was presented to both ears continuously at 50 dB SPL. N1m responses to stimuli at or above the psychophysical threshold were found bilaterally in all subjects except one who had only right hemispheric N1m. N1m response for the SpiN0 stimulus had larger amplitude and shorter latency than that for the S0N0 stimulus in each hemisphere and at each sound level. Neuromagnetic binaural unmasking was greatest around the threshold level, corresponding to psychophysical binaural unmasking; became smaller with greater stimuli, indicating the suprathreshold unmasking effect; and disappeared at around 15-20 dB above the threshold. Psychophysical binaural unmasking can be quantitatively evaluated by MEG in the auditory cortex level of the bilateral hemispheres.
    NeuroImage 05/2005; 25(3):684-9. · 6.25 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Diplacusis is defined as the phenomenon of hearing the same tone at different pitches in the two ears. Although binaural pitch-matching using method-of-adjustment has been employed in most studies, it is sometimes hard for subjects with impaired hearing to judge 'equal pitch' as one frequency. To resolve this problem. a modified pitch-matching test, in which the relation of pitch sensation between the two ears was assessed as a matched frequency 'range' using the randomized maximum likelihood sequential procedure, was developed. Eight subjects with unilaterally impaired hearing, as well as eight normal subjects, were examined to evaluate this new test procedure. In the present method, matched frequency is assessed as a frequency range, in which subjects cannot judge whether the pitch of the signal in one ear is higher or lower than that in the opposite ear. This method appeared to be useful for assessing the characteristics of diplacusis in subjects with impaired hearing as well as in normal subjects.
    International Journal of Audiology 09/2003; 42(6):297-302. · 1.63 Impact Factor
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    ABSTRACT: It is well known that sound presented in the contralateral ear can elicit the activity of the olivocochlear (OC) efferent. In the present study, the effects of the addition of contralateral noise on the psychophysical measurements of auditory thresholds were investigated in human subjects with normal hearing. The results obtained in the present study indicate that the addition of contralateral noise at a level of only 20 or 30 dB sound pressure level (SPL) may cause a significant elevation of the auditory threshold in the mid-frequency area (usually 2-3 dB). When the level of contralateral noise was elevated, the elevation of the auditory threshold tended to be larger and the affected frequency area became wider. Although other factors that elevate the auditory thresholds, such as cross-talk effects and the acoustic reflex of the middle ear muscles, may be involved in the above-mentioned paradigm, especially when higher levels of contralateral noise are used, it is important to know the degree of OC-mediated threshold elevation in usual audiometric measurement.
    The Tohoku Journal of Experimental Medicine 08/2003; 200(3):129-35. · 1.37 Impact Factor

Publication Stats

19 Citations
16.39 Total Impact Points

Institutions

  • 2005–2013
    • Sendai City Hospital
      Sendai, Kagoshima, Japan
  • 2009
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia
  • 2003–2007
    • Tohoku University
      • Department of Otorhinolaryngology
      Sendai, Kagoshima-ken, Japan