Hisato Motai

Bilateral middle ear squamous cell carcinoma and clinical review of an additional 5 cases of middle ear carcinomas.

We reported a retrospective review of the clinical records for a 64 year old male patient with bilateral middle ear squamous cell carcinoma (MESCC), and for the five other patients with MESCC treated at our institution during the last 20 years. The patient with bilateral MESCC has survived and remained tumor free for more than 1.5 years after extended radical resection of the secondary tumor combined with intra-arterial and systemic chemotherapy, radiotherapy and immunotherapy. Four patients with unilateral MESCC were treated with multidisciplinary treatment (induction chemotherapy, surgery and radiotherapy), and the remaining patient was treated with radiotherapy and mastoidectomy. Five of the six patients are alive with no evidence of disease. The patient treated with radiotherapy and radical mastoidectomy died of local recurrence 3 years after diagnosis. We suggest that MESCC should be considered when refractory granulation, long-standing otorrhea, otalgia and facial paralysis are observed. Multidisciplinary treatment, including intra-arterial chemotherapy and en bloc resection of the temporal tumor is useful for the treatment of MESCC and will improve the prognosis of patients with this disease.

Enterued as an Elemental Diet for Patients with Head and Neck Cancers.

Twenty eight patients were given an elemental diet (Enterued®) containing small peptides through a nasal feeding tube. Oral alimentation was difficult for these patients because of head and neck cancer itself or the therapy, surgery and/or irradiation. In 23 of the patients (82.1%) the nutritional status was improved. Diarrhea occurred as a side effect in 5 of them (17.9%), 3 of whom stopped using Enterued®. The speed of administration should be carefully controlled to prevent diarrehea.

Clinical Evaluation of a Helium-Neon Laser in Otolaryngeal Fields

To investigate the effects of the low powered laser in otolaryngeal fields, we conducted clinical studies. The laser used in this study was a He-Ne laser with a 632.8 nm wavelength and 8.5 mw power (Model PDT, Senko Medical Instrument Co, Tokyo). Eight patients were irradiated by the laser for 3 or 6 minutes per day, every day or every other day. The sites irradiated were skin defects, fistula, failure of suture, stomatitis, pharyngeal ulcer, and oral mucosal ulcer. Six cases showed improvement, and 2 of them showed prominent improvement.