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Yamada A, Shinomiya H, Uehara N, Iritani K, Tatehara S, Furukawa T, Teshima M, Miyawaki D, Fujita T, Kakigi A, Kiyota N, Sasaki R, Nibu KI. Oncological outcomes of concurrent chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil for locally advanced squamous cell carcinoma of the external auditory canal: A single-center study. Head Neck 2023; 45:2498-2504. [PMID: 37503962 DOI: 10.1002/hed.27461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/30/2023] [Accepted: 06/23/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Squamous cell carcinoma of the external auditory canal (EACSCC) is a rare condition. However, a standard treatment has not yet been established. We retrospectively evaluated the efficacy, adverse events, and feasibility of TPF-CCRT (concomitant chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil) in patients with advanced EACSCC. METHODS Thirty-five consecutive patients with advanced EACSCC (T3, T4) initially treated with TPF-CCRT at Kobe University Hospital were included. T4 diseases with invasion of the brain, internal carotid artery, or internal jugular vein were classified as T4b, and those without these features were classified as T4a. RESULTS Five-year overall survival rates for T3 and T4 were 100% and 64.2%, respectively. A significant difference was observed between T4a and T4b (82.4% vs. 30%, p = 0.007). Five-year progression-free survival rates of T3, T4a, and T4b were 100%, 68%, and 20% (p = 0.022), respectively. CONCLUSIONS TPF-CCRT should be considered as a plausible treatment option for advanced EACSCC.
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Affiliation(s)
- Akihiro Yamada
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Natsumi Uehara
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keisuke Iritani
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shun Tatehara
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuya Furukawa
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Teshima
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Miyawaki
- Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Fujita
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akinobu Kakigi
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naomi Kiyota
- Kobe University Hospital Cancer Center, Kobe, Japan
| | - Ryohei Sasaki
- Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Hashimoto Y, Teshima M, Yui M, Tatehara S, Iritani K, Furukawa T, Shinomiya H, Nibu KI. OK432 sclerotherapy for refractory chylous leakage after neck dissection. J Surg Case Rep 2023; 2023:rjad310. [PMID: 37332664 PMCID: PMC10271211 DOI: 10.1093/jscr/rjad310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/08/2023] [Indexed: 06/20/2023] Open
Abstract
Chylous leakage is a rare but serious postoperative complication of neck dissection (ND). Most chylous leakages are successfully treated either by drainage or ligation of the thoracic duct, but the resolution is occasionally prolonged. OK432 sclerotherapy is used to treat various refractory cystic diseases of the head and neck. Three patients were treated with OK432 sclerotherapy for refractory chylous leakage following ND. Case 1 involved a 77-year-old man with chylous leakage after a total laryngectomy and bilateral ND. Case 2 involved a 71-year-old woman who underwent total thyroidectomy and left ND for thyroid cancer. Case 3 involved a 61-year-old woman who underwent right ND for oropharyngeal cancer. In all patients, chylous leakage rapidly improved after OK432 injection without any complications. Our results suggest the efficacy of OK432 sclerotherapy in patients with refractory chylous leakage after ND.
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Affiliation(s)
- Yuiko Hashimoto
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Masanori Teshima
- Correspondence address. Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo 650-0017, Japan. Tel: +81-78-382-6020; Fax +81-78-382-6039; E-mail
| | - Mitsuko Yui
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Shun Tatehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Keisuke Iritani
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Tatsuya Furukawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Ken-ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
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Tamagawa K, Shinomiya H, Okada T, Tatehara S, Teshima M, Sasaki R, Nibu KI. Ligation of the ethmoid arteries in superselective intra-arterial infusion of cisplatin for advanced maxillary sinus cancer fed by the ophthalmic artery. Head Neck 2023; 45:E16-E24. [PMID: 36891662 DOI: 10.1002/hed.27341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/16/2023] [Accepted: 02/24/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Superselective cisplatin (CDDP) infusion via the external carotid artery system and concomitant radiotherapy (RADPLAT) provides favorable oncological and functional outcomes in patients with maxillary sinus cancer. However, targeted lesions are occasionally fed by the branch of the internal carotid artery. METHODS In RADPLAT for maxillary sinus cancer partly fed by the ophthalmic artery, the ethmoid arteries were ligated in two patients without medial orbital wall involvement. In four patients with that, CDDP was administered via the ophthalmic artery. RESULTS A complete response was obtained in all six patients. Locoregional recurrence was not observed in any cases. However, visual acuity was lost in four patients who received the ophthalmic artery infusion. CONCLUSIONS Ligation of the ethmoid arteries is recommended in RADPLAT for maxillary sinus cancer with lesions fed by the ophthalmic artery. CDDP administered via the ophthalmic artery may be considered if a patient accepts the possibility of visual loss.
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Affiliation(s)
- Kotaro Tamagawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takuya Okada
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shun Tatehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryohei Sasaki
- Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Furukawa T, Tatehara S, Teshima M, Shinomiya H, Inokuchi G, Komatsu M, Hara S, Zen Y, Nibu KI. Expressions of NeuroD and GAP43 as diagnostic markers for olfactory neuroblastoma. Auris Nasus Larynx 2022; 50:358-364. [PMID: 35999123 DOI: 10.1016/j.anl.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/30/2022] [Accepted: 08/03/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Olfactory neuroblastoma (ONB) is often difficult to pathologically distinguish from other small round cell tumors (SRCTs) arising in the nasal cavities. Although there are several diagnostic markers used for differential diagnosis of ONB, these molecules are also expressed in various neuronal derived tumors. Here, we examined the expression of NeuroD, GAP43, and olfactory marker protein (OMP) in ONB and non-ONB SRCT to determine their utility in the differential diagnosis of ONB. METHODS Twenty-six patients diagnosed with and treated for ONB at Kobe University Hospital between 1997 and 2017 with formalin-fixed, paraffin-embedded biopsy or surgical resection specimens were included. The expressions of NeuroD, GAP43, and OMP were immunohistochemically examined in these 26 ONB specimens and specimens from 13 SRCTs arising in the nasal cavities for reference. RESULTS Among the 26 ONB samples, focal, patchy, and marked staining for NeuroD was observed in 4, 3, and 9 samples, respectively. Focal, patchy, and marked GAP43 staining was observed in 5, 3, and 11 samples, respectively. Consequently, marked positive staining for either NeuroD or GAP43 was observed in 54% (14/26) of ONBs. Among the 13 SRCTs, marked staining for NeuroD was observed in two small cell carcinomas, one undifferentiated carcinoma, and one neuroendocrine carcinoma, whereas marked positive staining for GAP43 was observed only in one undifferentiated carcinoma. No specimen in this study exhibited OMP staining. CONCLUSIONS Our results suggest possible roles of GAP43 immunostaining in the differential diagnosis of ONB.
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Affiliation(s)
- Tatsuya Furukawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Shun Tatehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Go Inokuchi
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masato Komatsu
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shigeo Hara
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan; Kobe City Medical Center General Hospital, Department of Pathology, Kobe, Japan
| | - Yoh Zen
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan; Institute of Liver Studies, King's College Hospital & King's College London, London, UK
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Kamikonya T, Inokuchi G, Tatehara S, Yui M, Nibu KI. Surgical treatment of bony nasal airway stenosis in a patient with adult Crouzon’s syndrome. J Surg Case Rep 2022; 2022:rjac358. [PMID: 35919695 PMCID: PMC9341303 DOI: 10.1093/jscr/rjac358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/17/2022] [Indexed: 11/13/2022] Open
Abstract
Crouzon’s syndrome is associated with the respiratory impairment of the upper airway due to mid-facial hypoplasia. We managed an adult Crouzon patient who wanted us to treat his choanal and nasopharyngeal stenosis for obstructive sleep apnea relief and tracheostomy tube extubation. We drilled out the abnormal maxillary bone and created a new nasal passage to the pharynx. Epithelialization of the new nasal cavity was completed within a month, and the patient was able to breathe through the nose and his sense of smell improved somewhat after the surgery. Although the apnea-hypopnea index had decreased, sleep apnea remained.
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Affiliation(s)
- Tatsuhiko Kamikonya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine , Kobe , Japan
| | - Go Inokuchi
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine , Kobe , Japan
| | - Shun Tatehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine , Kobe , Japan
| | - Mitsuko Yui
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine , Kobe , Japan
| | - Ken-ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine , Kobe , Japan
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Yamaoka M, Kanzawa Y, Tatehara S, Sasaki K, Mizuki S, Ohnishi J, Nakajima T, Ishimaru N, Kinami S. Recurrent erysipelas led to diagnosis of hereditary hemorrhagic telangiectasia. Infez Med 2022; 30:129-133. [PMID: 35350259 PMCID: PMC8929743 DOI: 10.53854/liim-3001-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
Hereditary hemorrhagic telangiectasia (HHT) is a risk of infection, such as by brain abscess associated with pulmonary arteriovenous malformations. However, association between HHT and recurrent erysipelas is not well described. HHT can cause vessel malformations in organs, leading to various serious outcomes. Prophylactic treatment is effective, but many people with HHT are undiagnosed. HHT is not described as a risk factor for soft tissue infection, but may increase the risk of serious infections requiring hospitalization. Our 72-year-old female patient was admitted for recurrent erysipelas. Pulmonary nodules indicated pulmonary arteriovenous fistula on chest computed tomography. By recognizing this combination, although seemingly unrelated problems, we could diagnose HHT and the patient could receive adequate treatment to prevent life-threatening events. The recurrent erysipelas was likely associated with HHT. Recurrent erysipelas is an important presentation which may facilitate early diagnosis of HHT.
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Affiliation(s)
- Mari Yamaoka
- Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan
| | - Yohei Kanzawa
- Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan
| | - Shun Tatehara
- Department of Otorhinolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Koji Sasaki
- Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Hyogo, Japan
| | - Shimpei Mizuki
- Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan
| | - Jun Ohnishi
- Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan
| | - Takahiro Nakajima
- Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan
| | - Naoto Ishimaru
- Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan
| | - Saori Kinami
- Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan
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Hayama M, Maeda Y, Shikina T, Tatehara S, Inokuchi G, Hoag JB, Sato T, Obata S, Nakatani A, Amano Y, Hida E, Nibu KI, Inohara H. Validation of epistaxis severity score for hereditary hemorrhagic telangiectasia in Japan. Auris Nasus Larynx 2021; 49:415-420. [PMID: 34857410 DOI: 10.1016/j.anl.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/21/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aimed to assess the health-related QoL (HR-QoL) of patients with hereditary hemorrhagic telangiectasia (HHT), with emphasis on the role/social aspects, and validate the Japanese version of the epistaxis severity score (ESS) in these patients. METHODS The Japanese version of the ESS was created through forward and reverse translation, and consultation with the original author. A validation analysis was performed by comparing ESS severity with the invasiveness of previous treatments for epistaxis and assessing the correlation between the ESS and HR-QoL. Medical history forms, ESS questionnaires, and the Medical Outcomes Study Short Form 36 (SF-36) were distributed to participants with HHT in August 2020. The relation between the ESS and summary scores of SF-36 was assessed by performing analysis of variance and Spearman's correlation. RESULTS In total, 73 participants were included in this study. The average ESS was 5.02; there were mild (32.9%), moderate (45.2%), and severe (21.9%) epistaxis groups. Patients with higher ESS received a significantly more invasive treatment (Fisher's exact test, p < 0.05). The ESS was also negatively correlated with the physical component score (PCS) (r = -0.489, p < 0.001). Comorbid liver and gastrointestinal arteriovenous malformations significantly reduced the PCS (p < 0.05). Multiple regression analysis revealed that the ESS was a significant variable (p < 0.01). The role/social component score was significantly lower in the severe ESS group than in the mild or moderate group. CONCLUSION The Japanese version of the ESS was considered valid and may be useful as an outcome measure of future HHT-associated epistaxis trials in Japan.
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Affiliation(s)
- Masaki Hayama
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita city, Osaka, Japan.
| | - Yohei Maeda
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita city, Osaka, Japan
| | | | - Shun Tatehara
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe city, Hyogo, Japan
| | - Go Inokuchi
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe city, Hyogo, Japan
| | - Jeffrey B Hoag
- Department of Pulmonary, Allergy and Critical Care Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A
| | - Tomoharu Sato
- Department of Biostatistics and Data Science, Osaka University Graduate School of Medicine, Suita city, Osaka, Japan
| | - Sho Obata
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita city, Osaka, Japan
| | - Ayaka Nakatani
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita city, Osaka, Japan
| | - Yuta Amano
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita city, Osaka, Japan
| | - Eisuke Hida
- Department of Biostatistics and Data Science, Osaka University Graduate School of Medicine, Suita city, Osaka, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe city, Hyogo, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita city, Osaka, Japan
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Komatsu H, Furukawa T, Iritani K, Tatehara S, Takahashi M, Iwaki S, Kakei Y, Hasegawa T, Teshima M, Shinomiya H, Otsuki N, Hashikawa K, Kiyota N, Sasaki R, Akashi M, Nibu KI. Blowing time ratio and high-resolution manometry to evaluate swallowing function of patients with oral and oropharyngeal cancer. Auris Nasus Larynx 2021; 49:477-483. [PMID: 34789391 DOI: 10.1016/j.anl.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 10/07/2021] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The blowing time ratio, which is the ratio of the blowing time when the nostrils are open and closed, is significantly correlated with velopharyngeal pressure, not only during speech but also during swallowing. This study aimed to further evaluate the usefulness of the blowing time ratio as a screening tool to evaluate the swallowing pressure of patients treated for oral and oropharyngeal cancers using high-resolution manometery (HRM). METHODS Ten patients treated for oral or oropharyngeal cancer were recruited for this study. Swallowing pressures at the velopharynx, oropharynx, and upper esophageal sphincter (UES) were measured using HRM. Their correlations with the blowing time ratio were analyzed. RESULTS The blowing time ratio was significantly correlated with the swallowing pressures of the oropharynx (CC = 0.815, p = 0.004) and the velopharynx (CC = 0.657, p = 0.039), but not of the UES. CONCLUSIONS The present results further support our previous finding that the blowing time ratio is a useful screening tool to evaluate velopharyngeal and oropharyngeal swallowing pressures in patients treated for oral and oropharyngeal cancer.
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Affiliation(s)
- Hirokazu Komatsu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuya Furukawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Keisuke Iritani
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shun Tatehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Shinobu Iwaki
- Department of Rehabilitation, Kobe University Hospital
| | - Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoki Otsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazunobu Hashikawa
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naomi Kiyota
- Department of Medical Oncology/Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryohei Sasaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Furukawa T, Otsuki N, Tomotsu M, Tatehara S, Morita N, Kojima Y, Teshima M, Shinomiya H, Nibu KI. Left non-recurrent inferior laryngeal nerve in a patient with right-sided aortic arch and aberrant left subclavian artery. Auris Nasus Larynx 2020; 48:317-321. [PMID: 32178945 DOI: 10.1016/j.anl.2020.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/08/2020] [Accepted: 02/18/2020] [Indexed: 11/19/2022]
Abstract
Non-recurrent inferior laryngeal nerve (NRILN) is rare but one of the important anatomical variations in thyroid and parathyroid surgery. Almost all cases were observed on the right side with aberrant right subclavian artery and left NRILN have been reported in only five cases so far. Here, we reported a 38 year-old Japanese male with left NRILN accompanying adenomatous goiter. He was referred to our hospital for the surgical treatment of left thyroid goiter. Preoperative computed tomography revealed right-sided aortic arch and aberrant left subclavian artery with no signs of complete situs inversus viscerum, suggesting possible left NRLN. Left hemithyroidectomy was performed using nerve monitoring system. Intraoperatively, left recurrent laryngeal nerve was not identified along tracheoesophageal groove, but directly originated from vagal nerve and was running horizontally to larynx. Mobility of vocal cords were not impaired and postoperative course was uneventful. During thyroid surgery for the patients with right-sided aortic arch, meticulous care should be taken using nerve monitoring system to avoid nerve injury.
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Affiliation(s)
- Tatsuya Furukawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe,7-5-2 Kusunoki-Cho, Chuo-ku, Kobe 650-0017, Japan
| | - Naoki Otsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe,7-5-2 Kusunoki-Cho, Chuo-ku, Kobe 650-0017, Japan.
| | - Masahiro Tomotsu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe,7-5-2 Kusunoki-Cho, Chuo-ku, Kobe 650-0017, Japan
| | - Shun Tatehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe,7-5-2 Kusunoki-Cho, Chuo-ku, Kobe 650-0017, Japan
| | - Naruhiko Morita
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe,7-5-2 Kusunoki-Cho, Chuo-ku, Kobe 650-0017, Japan
| | - Yasutaka Kojima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe,7-5-2 Kusunoki-Cho, Chuo-ku, Kobe 650-0017, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe,7-5-2 Kusunoki-Cho, Chuo-ku, Kobe 650-0017, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe,7-5-2 Kusunoki-Cho, Chuo-ku, Kobe 650-0017, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe,7-5-2 Kusunoki-Cho, Chuo-ku, Kobe 650-0017, Japan
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Tatehara S, Inokuchi G, Takeda H, Kuroki S, Fujio H, Azumi A, Nibu KI. Frontal sinusitis associated with orbital decompression for Graves' orbitopathy. Auris Nasus Larynx 2020; 47:1079-1082. [PMID: 32088015 DOI: 10.1016/j.anl.2020.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/22/2020] [Accepted: 01/30/2020] [Indexed: 10/25/2022]
Abstract
Orbital decompression (OD) for Graves' orbitopathy usually includes removal of orbital medial wall. While OD occasionally cause or worsen chronic sinusitis because of the obstructed sinus drainage by prolapsed orbital fat, to date few reports have been published on the management or prevention of sinusitis associated with OD. Here, we present two patients (three sides) with newly developed and one patient (one side) with worsening obstructive frontal sinusitis following OD. These three patients had OD including the removal of the superior attachment of uncinated process to lamina papyracea. Endoscopic modified Lothrop procedure (EMLP) was useful to relieve symptoms and keep an enough access to frontal sinuses for all cases. We also performed EMLP for another two patients (four sides) with pre-existing sinusitis before OD. Worsening of sinusitis could be avoided by EMLP before OD. EMLP was useful approach for both treatment and prevention of sinusitis related to OD. The superior attachment site of uncinated process and the pattern of frontal sinus drainage might predict the occurrence of obstructive frontal sinusitis following OD.
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Affiliation(s)
- Shun Tatehara
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Go Inokuchi
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Hiroko Takeda
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Shunsuke Kuroki
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Hisami Fujio
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Atsushi Azumi
- Kobe Kaisei Hospital, Department of Ophthalmology, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
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Fujio H, Inokuchi G, Kuroki S, Tatehara S, Katsunuma S, Kowa H, Nibu KI. Three-year prospective study on olfaction of patients with Parkinson's disease. Auris Nasus Larynx 2019; 47:899-904. [PMID: 31506174 DOI: 10.1016/j.anl.2019.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 08/03/2019] [Accepted: 08/21/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We conducted a 3-year prospective study on olfaction of patients with Parkinson's disease (PD) in order to examine the severity and frequency of smell disorder in PD using odor identification test, Open Essence (OE) and to verify the validity of olfactory tests as a predictor of cognitive symptom onset of PD. PATIENTS AND METHODS We conducted a prospective study by performing an annual examination over a 3-year period. For 56 cases diagnosed with PD by the Department of Neurology at our hospital, OE and Jet Stream Olfactometry (JSO) were performed to assess the olfactory function, and Mini-Mental-State Examination (MMSE) was conducted to measure cognitive impairment. RESULTS At the beginning, 56 cases were examined, of which 42 remained to be followed up for 3 years. Based on the results of baseline, we found a correlation between OE and the average cognitive thresholds of JSO, but did not find any correlation between OE and MMSE. OE (median 4.0→4.0) and the average cognitive thresholds of JSO (median 2.2→1.6) decreased after 3 years, and MMSE (median 29→29) also declined, but not significantly. At the 3rd year, 6 cases with MMSE score of 23 or less were identified as suspected dementia and 36 cases with more than 24 points were defined as an invariant group. In order to distinguish these two groups, OE scores of baselines were evaluated with a combination of 12 odors. Sensitivity 1.0 and specificity 0.722 were obtained and the sensitivity+specificity value (1.722) was the highest when the number of correct answers was 4 or less using an odor combination of lumber, menthol, Japanese orange, gas for household use, Hinoki cypress and condensed milk. CONCLUSION When the number of correct answers of 6 odors (lumber, menthol, Japanese orange, gas for household use, Hinoki cypress and condensed milk) is 4 or less in patients with PD, there is a possibility that MMSE declines in 3 years.
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Affiliation(s)
- Hisami Fujio
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Go Inokuchi
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Shunsuke Kuroki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shun Tatehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sayaka Katsunuma
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hisamoto Kowa
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Fujio H, Inokuchi G, Tatehara S, Kuroki S, Fukuda Y, Kowa H, Nibu KI. Characteristics of Smell Identification Test in Patients With Parkinson Disease. Clin Exp Otorhinolaryngol 2018; 12:206-211. [PMID: 30586953 PMCID: PMC6453781 DOI: 10.21053/ceo.2018.01116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 11/01/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Parkinson disease (PD) is frequently associated with olfactory disorder at early stage, which is caused by deposition of Lewy bodies emerging from the olfactory bulb to higher olfactory centers. Early detection of olfactory disorder in the patients with PD may lead to the early diagnosis and treatment for this refractory disease. METHODS Visual analog scale (VAS), Jet Stream Olfactometry, and Japanese smell identification test, Open Essence (OE), were carried out on 39 patients with PD. Thirty-one patients with postviral olfactory disorder (PVOD), which was caused by the olfactory mucosal dysfunction, were also enrolled in this study as control. RESULTS There were no significant differences in detection thresholds (2.2 vs. 1.4, P=0.13), recognition thresholds (3.9 vs. 3.5, P=0.39) and OE (4.8 vs. 4.2, P=0.47) between PVOD and PD, while VAS scores of PVOD and PD were significantly different (2.0 and 6.2, P<0.01). In OE, significant differences were observed in the accuracy rates of menthol (68% vs. 44%, P=0.04) and Indian ink (42% vs. 15%, P=0.01) between PVOD and PD. Of particular interest, patients with PVOD tended to select "no detectable," while patients with PD tended to select wrong alternative other than "no smell detected." CONCLUSION Discrepancy between VAS and OE, and high selected rates of wrong alternative other than "undetectable" in OE might be significant signs of olfactory dysfunction associated with PD.
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Affiliation(s)
- Hisami Fujio
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Go Inokuchi
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shun Tatehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shunsuke Kuroki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuriko Fukuda
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hisamoto Kowa
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Tatehara S, Sato T, Terada T, Kataoka S, Ida H, Kimura M, Satomura K. Development of compact PDD system for early detection of oral carcinoma. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Satomura K, Kon M, Tokuyama R, Tomonari M, Takechi M, Yuasa T, Tatehara S, Nagayama M. Osteopetrosis complicated by osteomyelitis of the mandible: a case report including characterization of the osteopetrotic bone. Int J Oral Maxillofac Surg 2006; 36:86-93. [PMID: 17011167 DOI: 10.1016/j.ijom.2006.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2005] [Revised: 03/23/2006] [Accepted: 06/26/2006] [Indexed: 11/17/2022]
Abstract
A case of a 53-year-old Japanese man with osteopetrosis complicated by osteomyelitis of the mandible is presented. The patient experienced frequent exacerbations and remissions of osteomyelitis of the mandible, despite undergoing several surgical debridements and sequesterectomies with appropriate antimicrobial therapy, for 3 years. Finally, the patient underwent mandibular segmental resection followed by reconstruction with a titanium reconstruction plate. Fifty-one months after surgery there is no evidence of recurrent osteomyelitis of the mandible, suggesting that a more radical surgical approach is preferable for patients with severe complications resulting from osteopetrosis. Also presented here are the histopathological and biochemical features of the osteopetrotic bone. The osteopetrotic cortical bone was morbidly sclerotic with compact and irregular laminations. Degradation of osteocytes in the osteopetrotic bone was due to hypoxia and lack of nutrition resulting from osteosclerosis. There were no significant differences between osteopetrotic and normal bone according to X-ray diffraction, Fourier transform infrared spectroscopy, collagen content or mineral content. Micro-Vickers hardness measurements showed that osteopetrotic bone was significantly harder than normal bone, and the standard deviation of hardness was greater in osteopetrotic bone. Such a loss of integrity in osteopetrotic bone is considered to be a primary reason for the greater risk of a variety of complications such as pathological fracture and refractory osteomyelitis.
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Affiliation(s)
- K Satomura
- Department of Oral and Maxillofacial Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
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