Jun Yamanaka

Autologous transplantation of fascia into the vocal fold as a treatment for recurrent nerve paralysis

Objectives To apply the technique of autologous transplantation of fascia graft into the vocal fold for glottal insufficiency due to recurrent nerve paralysis and to evaluate the results in eight patients who underwent the procedure.

A comparative study of suturing techniques in microlaryngosurgery.

Different types of suturing device for microlaryngosurgery were compared. A new device was developed based on the results of this comparison, and proved to be very useful.

Sclerosing inflammatory pseudotumor arising from the carotid artery region

We report a 42-year-old female patient with sclerosing inflammatory pseudotumor. She had found a mass in her left neck after she caught a cold. An elastic hard mass (25 x 15 mm), unaccompanied by any other symptoms, was palpated adjacent to the left carotid bifurcation. The mass extended vertically along the common carotid artery, partially adhering to the pulsating artery. Under ultrasonography, the mass was characterized by a homogenized low echoic shadow surrounding the left common carotid artery. Angiography revealed a slight narrowing of the common carotid artery with a surrounding hypovascular mass. Computerized tomography (CT) and magnetic resonance imaging (MRI) both showed a mass enclosing the carotid artery; a Ga scintigram also showed a highly concentrated mass. Surgical removal of the mass included removing part of the carotid artery, internal and external carotid arteries and sympathetic trunk. The left internal jugular vein was transplanted to connect the common carotid artery to the internal carotid artery. Although the hypoglossal and vagus nerves adhered to the mass, they were preserved by sharp dissection with the scalpel. Although hypoglossal and vagus nerve dysfunction were observed temporarily after the surgery, Horners syndrome appeared and persisted. Histological examination revealed markedly fibrotic tissues surrounding the carotid artery with extensive lymphocyte and plasmacyte infiltration and a diagnosis of sclerosing inflammatory pseudotumor was made.

Hypopharyngeal neurinoma: report of two cases.

Hypopharyngeal neurinoma is a very rare disease and we found reports of only seven cases in the literature. Laryngomicrosurgery (LMS) and lateral neck exploration are two operating methods for hypopharyngeal neurinoma. Of the seven reported cases, the operating method was mentioned in six: two were operated on using LMS and four using the neck exploration method. It is necessary to select the operating method based on the size of the tumor, the existence of a stem, the risk of bleeding, etc. It is difficult to trace the original nerve of the tumor and this could not be done conclusively in the previous reports.