Ichio Inuzuka

A Case of Blood-Transfusion-Associated Graft-Versus-Host Disease Following Total Laryngectomy

We present a rare case of post-trasfusion Graft Versus Host Disease (GVHD) that developed in a patient treated for laryngeal cancer. A 65-year-old man with laryngeal cancer (T2N1Mo) underwent total laryngectomy with right radical neck dissection after 30 Gy irradiation and chemotherapy with CBDCA and 5-FU. Blood loss volume during surgery was 890 ml and he was transfused with 3 U of packed red blood cells. On the fifth day after blood transfusion, high fever (39.0°C) developed. On the 7th day, erythema appeared over the whole body. Thereafter, liver dysfunction and pancytopenia developed. The patient died of heart failure on the 34th day. Prevention of transfusion-associated GVHD is very important because the mortality rate is more than 90%. Therefore, should be treated products with gamma radiation before transfusion or autologous blood should be used as a safety precaution.

Surgical Results for Middle Ear Cholesteatoma in 392 New Cases

We evaluated surgical results for middle ear cholesteatoma in new cases treated between 1983 and 1992. Hearing improved in 131 of 211 (62%) ears treated by single stage tympanoplasty and 22 of 48 (45.8%) ears treated by two-stage tympanoplasty. Better results were shown after single stage tympanoplasty. These results were associated with pathological deficits of the stapes. In the two-stage tympanoplasty group, supperstructural defects of the stapes were observed in 21 ears and footplate defects of the stapes in 7 ears. The closed method was performed in 84.5% of all cases ; Residual cholesteatoma was found in 3.0% during single stage tympanoplasty and 6.3% during two-stage tympanoplasty. The incidence of recurrent cholesteatoma was 8.5% after single stage tympanoplasty and 14.6% after two-stage tympanoplasty. Since two-stage tympanoplasty was used in children and advanced cases, surgical results may have been poorer.

Histological Changes in the Inner Ear of Senile Mice

Age-related changes in the inner ear were investigated histopathologically in senile mice. Histological changes with age were first observed after 12 months of age. In mice, loss of outer hair cells was greater than that of inner hair cells. The characteristics of aging observed in the inner ear included a diminishing number of cells in Cortis organ, stria vascularis and spiral ganglions as well as a decrease in supporting cells. However, we could not classify the age-related changes into sensory, neural, strial and/or cochlear conductive presbycusis.

Surgery for Chronic Ear Disease in Children

This paper describes a retrospective study of 44 children (50 ears) whose first ear operation was performed during the past four years.The most common disease was acquired cholesteatoma (27 cases), followed by 15 ears with simple chronic infection and 6 with cholesterol granulomas.On the basis of the analysis of cholesteatomas, the authors emphasize that cholesteatomas in children under the age of six years are more progressive and destructive, so early diagnosis and early operation are essential.The operative procedures for each disease and the postoperative results are discussed briefly.

Statistical Analysis of Inpatient at Aichi Medical University

The authors analysed statistically 2, 514 inpatients treated from 1978 to 1983 in this department. Diseases of the ear predominated as did operations on the ear: tympanoplasty, auriculoplasty for microtia, decompression to the facial nerve for Ramsay Hunts syndrome, Bells palsy and traumatic facial palsy.

Experimental Study and Clinical Application of Hydroxyapatite in Middle Ear Surgery

Recently, hydroxyapatite (H. A.) has often been used to reconstruct the bony defect in middle ear surgery. We used H. A. in 30 clinical cases: in 10 cases to reconstruct the posterior canal, in 16 cases (6 cases overlap with others) to obliterate the mastoid cavity, and in 10 cases to separate the mastoid and the attic. In 3 cases H. A. was later removed because infection, which led to circulatory failure in the skin over the mastoid. The other 27 are contented with H. A. Thus H. A. seems to be useful as a middle ear implant.To evaluate the safety of H. A, we embedded it in a hole drilled in the bullae of adult guinea pigs. One month later, these animals were sacrificed under ether anesthesia, and the bullae were examined histologically by light microscope.1) The embedded H. A. was tightly surrounded by soft tissue, in which no giant cells were observed. Therefore, it seems that no foreign body reaction occurred.2) There was no evidence of bone formation on any surface of the embedded H. A., but bone induction was accelerated by H. A..

A Case Report of Harada's Disease with Equilibrium Disorder

Haradas disease is well known as a systemic disorder of pigment cells especially in the uveal tract, retina and meninges. Signs of integumentary (vitiligo, poliosis and alopecia) and auditory involvement (dysacousia, tinnitus and vertigo) are common.The authors report a case of Haradas disease with equilibrium disorder.The patient was a 36-year-old man, who complained of hyperemia of his eye balls and deterioration of his visual acuity and was admitted to the department of ophthalmology of our hospital. A diagnosis of Haradas disease was made, and he was treated with steroid therapy. His visual acuity improved, but he suffered from a sudden onset of vertigo 13 days after admission.Several neuro-otological findings and some therapeutic features are discussed.