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Featured researches published by Hideto Saigusa.


Annals of Otology, Rhinology, and Laryngology | 2001

Morphological and histochemical studies of the genioglossus muscle.

Hideto Saigusa; Seiji Niimi; Tadashi Gotoh; Kazuo Yamashita; Masanobu Kumada

The purpose of this preliminary study was to assess the histoanatomic composition of the genioglossus muscle fibers. The genioglossus muscles were obtained from 4 cadavers and 1 autopsy specimen. On morphological study, the average diameters of the muscle fibers were seen to gradually increase, from the fibers that ran anteriorly to the dorsum of the tongue, to the fibers that ran posteriorly to the root of the tongue. Histochemical study revealed that type II fibers were significantly predominant in the anterior portion; there was no dominant fiber type in the posterior portion. Gradual changes in diameter were independent of fiber type. These findings may suggest that the fibers of the anterior portion are suitable for phasic action, and that the posterior is relatively tonic; and the posterior has larger absolute muscle strength than the anterior. It is thought that the fibers of the posterior portion might contribute to the maintenance of the mesopharyngeal airway and to vowel production, and that the anterior fibers might contribute to some fine movements and to consonant production.


Surgical and Radiologic Anatomy | 2006

Nerve fiber analysis for the lingual nerve of the human adult subjects

Hideto Saigusa; Kumiko Tanuma; Kazuo Yamashita; Makoto Saigusa; Seiji Niimi

The neuro-motor control of the human tongue musculature had not been investigated in detail. This study identified first that the lingual nerve should play the neuro-motor control of some lingual muscles. Six en bloc samples (12 sides), including the tissues from the skull base to the hyoid bone, and three whole tongues were obtained from adult human cadavers. The former samples were used for the study of nerve fiber analysis of the lingual nerve with the aid of binocular stereomicroscope, and the latter samples were used for histological study by serial section method. On nerve fiber analysis of the lingual nerve from the trigeminal ganglion to the tongue musculature, we found that the motor- root of the trigeminal nerve gave off its supply to the lingual nerve and traveled into the lingual nerve, and branched to the superior and the inferior longitudinal muscles. On histological study, it was revealed that in the anterior part of the tongue the superior and the inferior longitudinal muscles surrounded the other lingual musculature and combined with the sub-mucosal connective tissues closely like the cutaneous muscle, for example, the facial muscles. The lingual nerve entered the inner side of the space between the genioglossus and the inferior longitudinal muscles with the lingual artery. These findings suggested that the superior and the inferior longitudinal muscles should be innervated by the motor fibers traveled into the lingual nerve from the motor root of the trigeminal nerve, and do not originate from the myotome originating in occipital somites but branchial muscles.


Acta Oto-laryngologica | 2007

An effective management regimen for laryngeal granuloma caused by gastro-esophageal reflux: combination therapy with suggestions for lifestyle modifications

Koichi Tsunoda; Shin-ichi Ishimoto; Mitsuya Suzuki; Makoto Hara; Hiroya Yamaguchi; Masahiro Sugimoto; Satoshi Takeuchi; Takaharu Nito; Ryuzaburo Higo; Hideto Saigusa; Atsunobu Tsunoda; Niro Tayama

According to our previous study, lifestyle modification in combination with drug therapy is much more effective than drug therapy alone in cases of laryngopharyngeal reflux (LPR). Most patients with LPR will have chronic gastro-esophageal reflux diseases (GERD) and require long-term medical therapy for control, resulting in high total expenditure on pharmacologic agents. We combined pharmacologic management with lifestyle modifications for the management of GERD with successful outcomes in patients with GERD-related laryngeal granulomas. Although further studies are needed, guidance concerning lifestyle modifications in combination with PPI therapy may be not only a clinically effective but also a cost-effective method for the management of laryngeal granulomas caused by gastro-esophageal reflux.


Journal of Voice | 2010

A Pathological Study of Bamboo Nodule of the Vocal Fold

Lishu Li; Hideto Saigusa; Yuko Nakazawa; Tsuyoshi Nakamura; Taro Komachi; Satoshi Yamaguchi; Aimin Liu; Yuichi Sugisaki; Eiji Shinya; Hongmei Shen

We examined pathologically a bamboo nodule of the vocal fold by means of immunohistochemical studies and scanning electron microscopic examination. A 38-year-old female showed a high index of antinuclear antibodies without any systemic symptoms but had complained of progressive voice disorder for 9 months. She had used her voice excessively in her occupation and for singing. Hematoxylin and eosin staining showed submucosal edema with lymphocyte and neutrocyte infiltrations and hyaline degeneration. Periodic acid methenamine silver staining showed hypertrophy of the basal lamina of the blood vessels. Immunohistochemical study showed IgG-positive cells in the blood vessel walls. Scanning electron microscopic study demonstrated immune complexes deposited as fine granules of high electrodense materials in the hypertrophic walls of the micro-blood vessels. After surgical resection of the bamboo nodules and advising her to avoid using her voice excessively, her voice improved gradually and the levels of IgG, immune complexes, and antinuclear antibody decreased for 1 year. These findings suggest that the bamboo nodules were not induced by an organ-specific reaction to an autoimmune disease, but mechanical damage to the micro-blood vessels induced by phonation injury of the vocal fold might have caused the deposit of high-molecular weight immune complexes in the damaged micro-blood vessels at the midportion of the vocal folds, which induced secondary inflammatory change at the midportion of the vocal fold.


Laryngoscope | 2005

Bent (head-down) posture and aberrant common carotid arteries of the neck: another new risk factor for stroke?

Koichi Tsunoda; Shin-ichi Ishimoto; Jo Aikawa; Masanobu Shinogami; Ryusuke Murakami; Hideto Saigusa; Kenji Kondou; Seiji Bitou

ver, questioning its reproducibility and validity as predictive tool.3 They argue that assessment with Muller’s maneuver can identify palatal obstruction preoperatively and that elimination of palatal obstruction will increase the airflow postoperatively. Eliminating palatal obstruction may result in increasing negative pressures with subsequent obstruction at a lower level. We fully agree that Muller’s maneuver is not a very valuable test to predict the obstruction site. Remodelling the upper airway does have consequences for its dynamics and airflow patterns, which may result in obstruction at tongue base level rather than at hypopharyngeal level. Changing the architecture of the upper airway might be an additional reason why we cannot predict surgical outcomes preoperatively. Anatomical staging has a large cost-benefit when compared to sleep endoscopy, but we believe that combining the two tests may help improving surgical outcomes even more, since both policies lead to fewer UPPP failures. In case the outcome of both screening tests is equal, there is little reason for concern. In case of conflicting outcome, however, it remains unclear which of the screening modalities is superior. In this respect, more research is mandatory.


Journal of Voice | 2009

A Case of Creutzfeldt-Jacob Disease with Bilateral Vocal Fold Abductor Paralysis

Lishu Li; Hideto Saigusa; Hiroshi Nagayama; Tsuyoshi Nakamura; Iichirou Aino; Taro Komachi; Satoshi Yamaguchi

Bilateral vocal fold abductor paralysis was seen in a patient with Creutzfeldt-Jacob disease. After tracheotomy, the patient showed disappearance of reduced oxygen saturation with high-pitched inspiratory stridor and pulling phenomenon of the supraclavicular region and larynx. Electromyographic examinations of the intrinsic laryngeal muscles, including the thyroarytenoid and posterior cricoarytenoid muscles, demonstrated that there was no apparent action potential in those muscles during spontaneous respiratory movements, and there was no abnormal potential for those muscles at rest. By pushing the infrasternal region of the patient on the expiration, normal motor unit action potential could be seen in the posterior cricoarytenoid muscle on the next inspiration. Based on those findings, we concluded that bilateral vocal fold abductor paralysis in this case of Creutzfeldt-Jacob disease was not induced by disorders of the degeneration of motor nucleus in the ambiguus as in multiple system atrophy, but by a disorder of the upper motor neuron.


Perspectives in Vascular Surgery and Endovascular Therapy | 2013

Vernet's syndrome after carotid endarterectomy.

Tomonori Tamaki; Yoji Node; Norihiro Saitoum; Hideto Saigusa; Michio Yamazaki; Akio Morita

Unilateral paresis of cranial nerves IX to XI is defined as Vernets syndrome. We retrospectively assessed cranial nerve symptoms from the clinical records of 143 carotid endarterectomy patients. A flexible nasolaryngoscope was used to examine vocal fold movements in 73 patients. If vocal fold paresis (VFP) was confirmed, the patient also underwent magnifying laryngoscopy (for correct diagnosis of injury to the glossopharyngeal and vagus nerves). It was found from clinical records that 8 patients (6%) were confirmed to have cranial nerve symptoms corresponding to Vernets syndrome; 7 patients (9 %) had VFP on nasolaryngoscopy. In 2 patients, magnifying laryngoscopy confirmed ipsilateral VFP, pharyngeal paresis, pharyngeal wall hypesthesia, and ipsilateral pharyngeal wall swelling. These 2 patients also had symptoms of injury to the accessory nerve. Damage to cranial nerves IX to XI probably occurred in the parapharyngeal space, based on the existence of posterior pharyngeal wall edema or swelling after carotid endarterectomy.


Journal of Anesthesia and Clinical Research | 2013

Clinical Study of the Incidence of Arytenoid Cartilage Dislocation for the Patients after General Anesthesia with Tracheal Intubation

Hideto Saigusa; Norihito Suzuki; Satoshi Yamaguchi; Taro Komachi; Osamu Kadosono; Takashi Hongou; Hidetaka Onodera; Iichirou Aino; Takashi Nakamura; Chiharu Matsuoka; Makoto Saigusa; Hiroyuki Ito

Incidence of arytenoid cartilage dislocation for patients treated or examined under general anesthesia with tracheal intubaion in one hospital had not been reported. And true incidence and mechanism of arytenoid cartilage dislocation after tracheal intubation are not investigated yet. Here, we examined retrospectively the incidence of arytenoid cartilage dislocation for patients after general anesthesia with tracheal intubaion in the Central Surgical Center of Nippon Medical School Main Hospital for two years from 2004 until 2005. The incidence of arytenoid cartilage dislocation for patients after general anesthesia with tracheal intubaion was 0.2%, and patients received cardiovasucular surgeries were the most common. The mean age of the patients with arytenoid cartilage dislocation was 70 years. It could be considered that additional medical instrumentation of the esophagus including transesophageal echocaridiography probe or upper gastrointestinal endoscopy, and prolonged tracheal intubation for more than two days should be the risk factors causing arytenoid cartilage dislocation. And calcification of the laryngeal cartilage and morphological changes of the cervical vertebrae along with aging might also contribute to dislocate the arytenoid cartilage.


Practica oto-rhino-laryngologica | 1995

Congenital Cholesteatoma of the Petrous Pyramid; A Case Report.

Kazuhiko Yokoshima; Hideto Saigusa; Shunkichi Baba; Toshiaki Yagi

A congenital cholesteatoma arising from the petrous pyramid is very rare. Only 22 cases have been reported in Japan. We treated a 34-year-old male with congenital cholesteatoma of the petrous pyramid. He complained of weakness of the left half of the face, and examination revealed left peripheral facial nerve palsy. His audiogram showed mixed hearing loss, computed tomography (CT) and magnetic resonance imaging (MRI) showed an abnormal shadow, originating from the petrous pyramid and extending along the facial canal to the internal acoustic meatus, tympanic cavity and mastoid cells. This cholesteatoma was removed successfully by a trans-mastoidal and middle cranial fossa approach. After surgery, the hearing loss and facial palsy worsened. Facial palsy is now less marked than before surgery, but severe sensorineural hearing loss continues. One year after surgery there are no signs of recurrence of cholesteatoma.We discuss the problems of diagnosis and treatment of congenital cholesteatoma of the petrous pyramid.


Clinical Anatomy | 2004

Morphological studies for retrusive movement of the human adult tongue

Hideto Saigusa; Kazuo Yamashita; Kumiko Tanuma; Makoto Saigusa; Seiji Niimi

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