[Show abstract][Hide abstract] ABSTRACT: To estimate parotitis caused by fine-needle aspiration (FNA) in parotid Warthin tumor.
Case series with chart review.
Hospital records were reviewed for 104 parotid tumors (103 patients) including 35 Warthin tumors, which underwent FNA within our department.
Three patients with four Warthin tumors among them noticed parotid pain, swelling, and abscess formation as a consequence of acute parotitis after FNA. Examinations of the materials obtained from tumor puncture or drainage before the start of antibiotic therapy showed no bacterial association in any patient. Two of the patients with Warthin tumor underwent parotidectomy, and the surgical specimens indicated histopathological changes with necrosis, abscess, granuloma, and the infiltration of inflammatory cells including Langhans-type multinucleated giant cells.
It is conceivable that Warthin tumor bears the characteristics of inflammation induced by the FNA procedure without any relation to infection. Therefore, it may be better to avoid routine FNA and give priority to diagnostic imagings over FNA in the diagnosis of tumors strongly suspected as Warthin tumor.
No preview · Article · Sep 2009 · Otolaryngology Head and Neck Surgery
[Show abstract][Hide abstract] ABSTRACT: Assessment of the efficacy of ossicular reconstruction using a cartilage-connecting hydroxyapatite prosthesis designed with a spearhead to reduce extrusion and dislocation of the implant.
All patients undergoing ossicular reconstruction after chronic ear surgery, connecting the cartilage to the prosthesis, with a minimum of 1 year of postoperative follow-up.
Postoperative change in pure-tone averages. Air-bone gap closures, and implant extrusion rates.
Overall mean pure-tone averages improved by 12.2 dB (ranged between -40 and 60 dB). In total, 68.4% of the patients achieved an air-bone gap less than 20 dB. Gains in the mean air conduction thresholds were 9.5 dB in cases of partial ossicular reconstruction and 14.9 dB in cases with total ossicular reconstruction (p < 0.05). The overall extrusion rate was 4.21%.
The cartilage-connecting hydroxyapatite prosthesis with a spearhead was found to restore hearing to a satisfactory level. The extrusion rate was relatively low. The cartilage-connecting hydroxyapatite prosthesis with a spearhead is an effective ossicular implant and offers an attractive alternative for ossicular reconstruction, particularly for total ossicular reconstructions.
No preview · Article · Jan 2008 · Otology & Neurotology
[Show abstract][Hide abstract] ABSTRACT: To establish a preoperative diagnostic system and examine prognostic factors for Kimura disease.
Hospital records were reviewed for nine cases of Kimura disease treated in our department. Preoperative eosinophil counts for 74 cases with untreated malignancy in the parotid gland were also examined.
Parotid swelling with inhomogeneities and subcutaneous invasion on magnetic resonance imaging and eosinophils > 10.5 percent in Asian patients clearly indicates Kimura disease. Eosinophils > 50 percent, serum IgE levels > 10,000 IU/mL, and multifocal lesions outside salivary glands are prognostic factors suggesting disease recurrence.
A preoperative decision based on our diagnostic criteria and prognostic factors should lead to better therapeutic outcomes for Kimura disease, for which a definitive treatment policy has never been determined.
No preview · Article · Aug 2007 · Otolaryngology Head and Neck Surgery
[Show abstract][Hide abstract] ABSTRACT: Tracheoesophageal phonation appears to participate in early acquisition of esophageal phonation, which remains the preferred method of voice restoration among patients. Further studies into factors predicting and mechanisms underlying acquisition of esophageal phonation among alaryngeal patients may provide information facilitating superior quality of life.
The aim of this study was to examine early acquisition of esophageal phonation following tracheoesophageal phonation, and underlying mechanisms and preferred phonatory methods for alaryngeal patients who master both tracheoesophageal and esophageal phonation.
Subjects comprised 44 alaryngeal patients and were divided into three groups: group A (n=13), esophageal phonation alone; group B (n=21), tracheoesophageal phonation alone; and group C (n=10), patients who acquired esophageal phonation after learning tracheoesophageal phonation.
The results indicated that acquisition of tracheoesophageal phonation significantly accelerated acquisition of esophageal phonation to 59.3 days from 184.6 days. Patients in group C stopped tracheoesophageal phonation and predominantly used esophageal phonation. No factors predicting acquisition of esophageal phonation were identified among patients who had mastered tracheoesophageal phonation, including age at time of surgery, irradiation, neck dissection, acquisition time of tracheoesophageal phonation, and maximum phonation time of tracheoesophageal phonation. No evidence of air leakage through the shunt during esophageal phonation was noted in group C.
No preview · Article · Aug 2006 · Acta Oto-Laryngologica
[Show abstract][Hide abstract] ABSTRACT: In cases of isolated congenital stapes superstructure fixation, a bony bar between the stapes and the pyramidal eminence and a normal stapedius tendon is unusual.(1) Hearing loss, however, rarely seems to occur as a result; to our knowledge, only 3 cases have been reported to date.(2,3) Kinsella and Kerr(3) reported 2 of these cases, in which removal of the bony bar resulted in normal hearing for 2 family members. We also report familial cases spanning 3 generations.
No preview · Article · May 2005 · Archives of Otolaryngology - Head and Neck Surgery
[Show abstract][Hide abstract] ABSTRACT: gamma-Aminobutyric acid (GABA)ergic neurons play important tropic and modulatory roles in the auditory pathway, especially in the early stage between postnatal Days 0 and 5. The effects of GABA and GABAa receptor antagonist were observed in this experimental study. Numerous histological and electrophysiological studies have been performed on the contribution of GABA to the auditory pathway; however, the spatio-temporal patterns of excitatory propagation and the relationships between GABA receptor and excitatory propagation have yet to be reported. Using an optical recording technique and a voltage-sensitive dye, the spatio-temporal patterns of excitatory propagation were observed in the auditory brainstem slices of early postnatal mice. A bath containing 50 microM GABA was applied, which largely inhibited the excitatory activities along the vestibulocochlear pathway. Bicuculline methiodide (BMI), a competitive antagonist against GABAa receptor, partially reversed the effects of GABA on the optical signals. Bath application of BMI alone helped to facilitate the depolarization course and its effect was apparent as an enlargement of the depolarized region from the cochlear nucleus and vestibular nucleus to some adjacent brainstem nuclei, as well as enhancing the amplitude of changes in the optical signals. The experimental results seem to suggest that GABAa receptors are widely distributed in an early postnatal auditory brainstem. GABA exhibited a greater modulating effect in the adjacent brainstem nuclei, which are involved in complex information processes, than that observed in the modulating primary auditory pathway. In the present experiment, significant GABAergic contributions to the optical recordings in the auditory brainstem were observed.
[Show abstract][Hide abstract] ABSTRACT: Using multiple-site optical recording techniques, the spatiotemporal activity was observed in both the cochlear and vestibular nucleus in newborn mice. The optical responses were obviously enhanced by bath-applied strychnine. A quantitative analysis showed higher enhancements to occur in the cochlear nucleus than in the vestibular nucleus. Optical imaging enables us to visualize the spatiotemporal extent of the inhibitory receptive field after the application of strychnine.
[Show abstract][Hide abstract] ABSTRACT: Cochlear inner hair cells (IHCs) and outer hair cells (OHCs) show distinctive morphological features that are usually sufficient to distinguish these two species in vitro. However, OHCs may sometimes resemble IHCs when they are mechanically distorted or begin swelling at their basal end. As a result, accurately discriminating the cells based on morphology was thought to be problematic. An objective method that allows us to clearly and unambiguously distinguish these two cell types is therefore of continued interest. We describe a protocol in which solitary IHCs were harvested from guinea pig cochlea using a manual microsurgical dissection.
[Show abstract][Hide abstract] ABSTRACT: We used optical imaging to investigate the mouse cochlear and vestibular nucleus in brainstem slices using a voltage-sensitive dye, RH 155. As a result, the spatiotemporal patterns of excitatory propagation were shown. These optical signals consisted of two components consisting of a spike-like fast signal and a long-lasting slow signal. All responses were abolished by tetrodotoxin. The slow signals were eliminated under a Ca(2+)-free solution. In addition, synaptic fatigue was also observed. The present study indicated the feasibility of optical recording for visually revealing the synaptic transmission in both the vestibular and cochlear nucleus.