Hitomi Motoshima

Mumps virus infection in adults : Three cases of supraglottic edema

Mumps virus infections primarily involve the parotid glands and most frequently affect school‐aged children. We present three unusual adult cases of mumps with dyspnea secondary to severe swelling of the salivary glands and review previously reported cases in the literature. Dyspnea developed progressively after the onset of salivary gland swelling. Laryngoscopy revealed an advanced edematous change in the supraglottis obstructing the airway. In two cases, tracheotomy was needed because of rapid worsening of the supraglottic edema. Questioning regarding breathing problems and laryngoscopic examination is therefore recommended when one encounters a mumps case with combined parotid and salivary gland swelling.

Influence of a Cold Front upon the Onset of Meniere's Disease in Toyama, Japan

In order to clarify the influence of a cold front (CF) upon the onset of Meniéres disease (MD), major CFs were defined by meteorological observations, and the influence of CFs on MD was evaluated by using the time n method. From our preliminary study it was seen that the onset of MD had its highest incidence exactly on days where a CF passed by. Out of the patients with MD, sudden deafness (SD) and Bells palsy (BP) who visited our neurotological clinic of the Toyama Medical and Pharmaceutical University from 1987 to 1992, 67 MD patients, 70 SD patients and 70 BP patients could clearly define the date of the onset of their disease, and were therefore selected for this epidemiological study. Thirty-six our of the 67 MD patients had the first attack on the day when a CF passed by or on the next day. The results obtained from these studies were as follows. i) The onset of MD was influenced by the passing of a CF, and this influence was more specific in MD than in SD or BP. ii) In the 36 CF influence MD patients, the majority were over the forty years, and their hearing level was worse than that of the other 31 MD patients during the observation periods.

MRI of intranasal pleomorphic adenoma

A pleomorphic adenoma in the nasal cavity constitutes a rarity. A 48-year-old woman presented with intranasal pleomorphic adenoma revealed by unilateral continuous obstruction and occasional epistaxis. Nasal endoscopy showed a mucosa-covered and opalescent polypoidal mass arising from the left nasal septum. Unlike cases affecting the major salivary gland, magnetic resonance image (MRI) revealed that the mass showed a low signal intensity on T1-weighted image and a heterogeneous, intermediate signal intensity on T2-weighted image. MRI findings can aid in diagnosis and help exclude the possibility of other neoplasms that occur at this site.

A Case of Cerebellopontine Angle Metastasis of Renal Cell Carcinoma with Hearing Impairment.

We experienced a rare case of metastatic cerebellopontine (CP) angle tumor, originating from a renal cell carcinoma with hearing impairment. A 61-year-old male was admitted to our hospital complaining of sudden hearing impairment of the left ear. He had been well for six years, after a diagnosis of left renal cell carcinoma two years previously, with lung metastasis and brain metastases in the frontal lobe. Brain tumors had been removed twice. Magnetic resonance imaging (MRI) of the head showed a new lesion at the CP angle with recurrence of the left metastatic tumors.Hearing impairment was achieved by the administration of corticosteroid. The patient showed loss of II -V waves on left ABR, and optokinetic nystagmus test depression on the counterclockwise. Hearing impairment and dizziness progressively worsened during the subsequent two year period, but he was managed as an out-patient until March in 1998.