File： Modified Killian法が診断に有用であった下咽頭梨状陥凹瘻の一症例.pdf

DOI： 10.5106/jjshns.30.229

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Language：English   Publishing type：Research paper (scientific journal)  

Aims/objectives: To examine the effects of surgery for unilateral sinonasal lesions on sleep-disordered breathing (SDB). Material and methods: Oxygen desaturation index (3%ODI) as a marker of SDB and bilateral/unilateral nasal resistance were measured before and after surgery for 18 patients with unilateral sinonasal lesions. Various parameters were compared between those who achieved 60% or less decrease of 3%ODI and those who did not. Results: Bilateral nasal resistance as well as that of the surgical side five days after surgery was significantly lower than those of pre-operative value. Preoperative 3%ODI (times/hour) was 10.08 ± 7.32, which significantly decreased to 7.67 ± 5.79 five days after surgery. Even in unilateral patients, sinonasal surgery could reduce the bilateral nasal resistance, resulting in a decrease in 3%ODI. Age was younger and postoperative nasal resistance of the surgical side was significantly lower in the group who achieved 60% or less decrease in 3%ODI than those who did not. Conclusions and significance: SDB is influenced by even unilateral nasal obstruction. Surgery for unilateral lesion can improve the respiration during sleep as well as bilateral nasal resistance. Favorable outcome by surgery could be brought about in younger patients and those for whom sufficient improvement of nasal resistance was expected by surgery.

DOI： 10.1080/00016489.2019.1632481

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.anl.2019.01.012

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Language：Japanese   Publisher：THE JAPANESE UROLOGICAL ASSOCIATION  

<p> (Background) The standard treatment for recurrent immunoglobulin A nephropathy (rIgAN) after kidney transplantation (KTx) has not been established.</p><p> (Methods) The results of treatment consisting of tonsillectomy and steroid pulse therapy in 20 recipients who were diagnosed as rIgAN were retrospectively analyzed.</p><p> (Results) The level of proteinuria significantly decreased from 0.84±0.81 g/day to 0.27±0.31 g/day after treatment (P=0.007). Microscopic hematuria disappeared or improved in 58.3% and 66.6% of recipients 6 and 12 months after treatment, respectively. Serum creatinine levels remained stable for 5 years by the treatment, except for 3 cases of graft loss. Sixteen recipients received renal graft biopsies before and after treatment. Mesangial IgA deposition were dramatically decreased in 7 recipients (43.75%). The degree of mesangial hypercellularity, endocapillary hypercellularity, and crescents formation improved in 3 (18.8%), 6 (37.5%), and 4 (25%) recipients after treatment.</p><p> (Conclusion) Steroid pulse therapy combined with tonsillectomy may be clinically and histopathologically effective treatment for rIgAN after KTx.</p>

File： 腎移植後再発性 IgA 腎症に対する扁桃腺摘出術とステロイドパルス併用療法の 20 例の解析.pdf

DOI： 10.5980/jpnjurol.110.92

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Oto-Rhino-Laryngological Society of Japan, Inc.  

File： 水痘帯状疱疹ウイルスによる急性下位脳神経麻痺についての検討.pdf

DOI： 10.3950/jibiinkoka.121.1279

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

File： Surgical treatment of enterovirus D68 brainstem encephalitis-induced dysphagia.pdf

DOI： 10.1016/j.anl.2017.12.004

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

OBJECTIVE: Globus sensation, a feeling of lump or something stuck in the throat, could be caused by structural, functional, and psychogenic diseases. Due to a possible multifactorial nature of the disease, neither diagnosing test battery nor standard treatment for globus sensation has been established. Therefore, a questionnaire to accurately identify globus patients and evaluate the severity of the disease is desired. Glasgow Edinburgh Throat Scale (GETS) is a 10-item questionnaire about the throat symptoms consisting of three subscales relating to dysphagia, globus sensation, and pain/swelling in the throat. It was reported that globus patients marked high scores specifically for the globus scale among three scales, indicating that GETS can be used as a valid symptom scale for globus sensation. Aims of this study were to translate GETS into Japanese and to test its reliability and validity. METHODS: Fifty-five patients complaining of globus sensation without abnormal endoscopic and CT findings were enrolled into the study. They were asked to answer the questions of GETS translated into Japanese (GETS-J). Reliability (internal consistency) of the questionnaire was tested using Cronbach's coefficient alpha. To test the validity, principal components analysis was used to identify the factorial structure of the questionnaire and GETS-J data were compared with those reported in the original GETS. Contribution of psychiatric comorbidities to globus sensation was also investigated by examining the correlation between Hospital Anxiety and Depression Scale (HADS) and GETS-J. RESULTS: Reliability of the questionnaire examined by the Cronbach's coefficient alpha was satisfactory and all higher than 0.75. Principal components analysis identified following three questions as the globus scale: Q1, Feeling something stuck in the throat; Q5, Throat closing off; Q9, Want to swallow all the time. Somatic distress, i.e., patients' reaction to throat symptoms, was significantly correlated with globus scale (r=0.680). Anxiety component of HADS was significantly correlated with somatic distress but not with globus scale. These results were consistent with those of the original GETS except for the replacement of Q3 (discomfort/irritation in the throat) to Q5 (throat closing off) for globus scale in GETS-J. CONCLUSION: Translation of GETS into Japanese showed high reliability and validity, suggesting that translation and cross-cultural adaptation were not problematic. High correlation of globus scale of GETS-J with somatic distress indicated that GETS-J could be a useful questionnaire to identify the globus patients and evaluate the severity of the disease. Anxiety may complicate the somatic distress in patients with globus sensation.

File： Reliability and validity of the Japanese version of the Glasgow Edinburgh Throat Scale.pdf

DOI： 10.1016/j.anl.2018.02.001

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Language：Japanese   Publisher：日本嚥下医学会  

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File： 口蓋扁桃摘出術の手術機器と術後疼痛管理.pdf

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications  

Postoperative pain is a remaining issue in tonsillectomy. Polyglycolic acid (PGA) is a biocompatible material used for absorbent suture reinforcement, and its sheet has been applied for covering defects after resection of oral carcinoma. The aim of this study is to examine whether the attachment of a PGA sheet to surgical wounds would reduce posttonsillectomy pain. In this prospective single-blind study, 17 consecutive adult patients were recruited who needed to undergo tonsillectomy, mainly due to habitual tonsillitis. Following bilateral tonsillectomies, a PGA sheet was attached with fibrin glue to only 1 side, without notification to patients of which side. Postoperative pain of each side was separately evaluated with a visual analog scale at 4 time points: before each meal and before sleep. Postoperative pain of both the PGA sheet–attached and nonattached sides was most severe before breakfast among 4 time points. Postoperative pain measured before breakfast was significantly more severe in the PGA sheet–attached side than the nonattached side. As such, this study provided solid data on the negative effects of PGA sheeting on posttonsillectomy pain.

DOI： 10.1177/0194599816660072

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Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/0194599816660072

Publishing type：Research paper (scientific journal)   Publisher：Informa UK Limited  

DOI： 10.1080/23772484.2016.1244470

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Other Link： http://www.tandfonline.com/doi/pdf/10.1080/23772484.2016.1244470

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Oto-Rhino-Laryngological Society of Japan, Inc.  

File： 小児の口蓋扁桃細菌叢 16S rRNA 解析を用いた検討.pdf

DOI： 10.3950/jibiinkoka.119.29

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Language：Japanese   Publisher：Japan Society of Stomato-pharyngology  

<p> We report herein on an infant with respiratory and feeding disorders due to severe unilateral palatine tonsillar hypertrophy. A female infant at the age of 1.5 month presented with inspiratiory stridor and retractive breathing. Poor weight gain and right palatine tonsillar hypertrophy were noticed in a health examination at the age of three month. The patient was referred to our department at the age of four month, and chronic respiratory and feeding disorders were diagnosed. Tracheostomy was performed at the age of five months, since the respiratory condition had severely deteriorated and the poor body weight gain was persistent. Respiratory symptoms disappeared and weight gain was achieved after the tracheostomy. However, the right palatine tonsillar hypertrophy gradually enlarged and upper airway stenosis developed. The tracheostomy orifice could not be closed. A right palatine tonsillectomy to improve the upper airway and respiratory condition was undertaken at the age of 13 months. The tracheostomy orifice could be closed without any trouble after the tonsillectomy. in infancy, it is rare that tonsillar hypertrophy causes chronic respiratory and feeding disorders. We deliberate the course of the treatment and discuss the case with a review of the literature.</p>

File： 著明な口蓋扁桃肥大により呼吸障害・哺乳障害を呈した乳児の1例.pdf

DOI： 10.14821/stomatopharyngology.29.163

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Language：Japanese   Publisher：金原出版(株)  

2013年2月〜2014年6月の8例(男7例、女1例、48〜85歳)を対象とした。セツキシマブは初回400mg/m2、2回目以降は放射線治療とともに週1回250mg/m2を投与した。放射線治療には三次元放射線治療計画を用い、病変部の総線量は70Gyを基本とした。セツキシマブ・放射線治療とも完遂できたのは6例であり、治療の1次効果は完全寛解(CR)が5例、部分寛解(PR)が3例であった。CRの5例中4例が再発なく生存し(観察期間21〜26ヵ月)、1例は治療後4ヵ月で肺転移を認めたが、観察期間29ヵ月で担癌生存中である。PRの3例のうち1例は原病死、1例は治療に関連する肺障害により死亡、1例は、17ヵ月間、担癌生存中である。有害事象はGrade 5の肺障害を1例、Grade 3の嚥下障害を5例に認めた。粘膜炎による疼痛に対し全例にオピオイド鎮痛薬の使用を要した。全例に皮膚障害を認めたが、治療完遂に影響を及ぼさなかった。

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Authorship：Lead author   Language：Japanese   Publisher：Japan Society of Stomato-pharyngology  

It has been reported that antileukotriene therapy improves breathing during sleep for children with mild sleep-disordered breathing (SDB). The expression of the cysteinyl leukotriene1 receptor (CysLT1-R) from dissociated adenoids harvested intraoperatively was investigated through the procedure of immunohistological examination. In 70% of 20 cases, CysLT1-R was expression on vascular endothelial cells and/or interstitial cells. It was revealed in particular that 88.9% of children with house dust mite allergy showed CysLT1-R expression, occurring at a higher rate compared to that of children without house dust mite allergy, of whom 54.5% showed CysLT1-R expression. Therefore, it is considered that antileukotriene therapy could be more effective for children with house dust mite allergy based on the immunohistochemistry findings.

DOI： 10.14821/stomatopharyngology.28.193

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Authorship：Lead author   Language：Japanese   Publisher：Japan Society of Stomato-pharyngology  

Objectives: Adenoid vegetation and palatine tonsil hypertrophy mainly cause sleep disordered-breathing (SDB) in children. Pediatric SDB is highly improved by adenotonsillectomy. We studied the outcome of adenotonsillecomy using the pre and post-surgery polysomnography (PSG).<br>Methods: An adenotonsillectomy was carried out on a total of 39 children with SDB from February 2009 to September 2012. All patients were under 12 years of age at surgery. In accordance with the AASM2007 scoring manual, the obstructive apnea-hypopnea index (OAHI), cummulative percentage at an SpO₂ below 90% (CT90%) and Lowest SpO₂ (Low-SpO₂) were measured, and the outcome of adenotonsillectomy was determined by comparison of the preoperative and postoperative results of PSG.<br>Result : The average value of OAHI was preoperatively 22.5±2.63/h, and postoperatively 1.3±0.17/h. There were 17 cases of "healed", 21 cases of "improved", and 1 case of "exacerbated". Over 90% of children with SDB were healed or improved by adenotonsillectomy. However, adenoid regrowth caused a recurrence of SDB in one case, in which adenoidectomy was performed again one year after adnotonsillectomy. PSG after the second surgery showed "healed".<br>Conclusions : It was thought that adenotonsillectomy for children with SDB could mostly improve the breathing during sleep with the exclusion of maxillofacial anomalies and obesity. However, adenoid re-growth could occur in some of children with SDB after adenoidectomy. The follow-up of one year after surgery should be considered.

File： 小児睡眠呼吸障害に対するアデノイド口蓋扁桃摘出術の成績 手術前後の PSG による検討.pdf

DOI： 10.14821/stomatopharyngology.28.205

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Society for Head and Neck Surgery  

A retrospective review was performed on 20 patients with primary hyperparathyroidism who were initially treated at our hospital between 2007 and 2013. The 20 patients (6 men and 14 women) ranged in age from 41 to 84 years (average: 60.6). Histological examinations revealed 18 parathyroid adenoma, 1 parathyroid carcinoma and one case was not searched. Ultrasonography, CT scan and ^99mTcMIBI scintigraphy in almost cases were found to be the most useful modalities for a localized diagnosis. The serum calcium levels were normalized in 19 cases, and not normalized in one case. This case was complicated with a thyroidal nodule, and it was difficult to diagnose the localization. Even if a localized diagnosis technology is developed, it might not be possible to operate by a focused approach, and so a bilateral neck exploration should always be considered.

File： 当科における原発性副甲状腺機能亢進症手術例の検討.pdf

DOI： 10.5106/jjshns.24.323

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Other Link： http://search.jamas.or.jp/link/ui/2015172831

Authorship：Lead author   Language：Japanese   Publisher：Japan Society of Stomato-pharyngology  

Ranine tumors are a common cystic disease of the floor of the mouth but, a differential diagnosis between cystic lymphangiomas, dermoid cysts and epidermoid cysts is important. Generally, epidermoid cysts have fluid attenuation on CT scans and demonstrate a low intensity area on T1-weighted images and a high intensity area on T2-weighted images, following the signal intensity of the fluid. We experienced a case of an epidermoid cyst of the floor of the mouth which showed characteristic findings on both imaging and, pathology. We describe herein the case of a 35-year-old man with a slowly enlarging mass in the left submandibular region. MRI demonstrated the sack-of-marbles appearance, which is coalescence of fat into small nodules within the fluid matrix. This finding was also potentially diagnostic of a dermoid or epidermoid cyst, which should be considered in the differential diagnosis.

File： 特徴的な画像, 病理所見を呈した口腔底表皮嚢腫の症例.pdf

DOI： 10.14821/stomatopharyngology.27.179

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Language：Japanese   Publisher：日本口腔・咽頭科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：日本音声言語医学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

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Language：Japanese   Publisher：日本口腔・咽頭科学会  

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Language：Japanese   Publisher：日本口腔・咽頭科学会  

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Language：Japanese   Publisher：Japan Audiological Society  

DOI： 10.4295/audiology.55.575

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Other Link： http://search.jamas.or.jp/link/ui/2012370281

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