Junji Koda

Stenosis of the Internal AuditoryCanal with VIIth and VIIIth Cranial Nerve Dysfunctions

We report the case of a 37-year-old woman with a history of long-standing right-sided sensorineural hearing loss who presented with an acute onset of vertigo and ipsilateral facial palsy. A computed tomographic scan study showed a stenosis of the right internal auditory canal (IAC). Neither generalized skeletal disease nor bony tumors, which may cause the IAC stenosis, were evident. The IAC stenosis found in this patient may be due to congenital malformation. Inflammation, compression or ischemia in the stenosed IAC may have resulted in the vertigo and facial palsy. This is the only case that we are aware of in which IAC stenosis is accompanied by vertigo and facial palsy.

Relationship between Clinically Diagnosed Tinnitis and Serum Zinc Level

A questionnaire concerning the loudness and continuity of tinnitis was administered to 194 patients who had been diagnosed with tinnitis. These patients also underwent pitch match and loudness balance tests. Zinc levels were measured in 22 of the 194 patients. Serum zinc level was less than 70 pg/dl in 15 of these patients. Zinc (polaplesing 150 mg/day) was administered to these 15 patients daily for at least 1 month. The serum zinc level was subsequently measured in 10 patients. Zinc levels had recovered in all of the patients. The influence of zinc on tinnitis was then examined with the questionnaire and loudness balance test in these 10 patients. Tinnitis decreased in 4 patients according to their score on the loudness balance test, suggesting that zinc exerts a positive effect on tinnitis in some patients.

Two Cases of Parapharyngeal Space Tumor

A midline mandibulotomy was performed on two patients in order to resect parapharyngeal space tumors. One patient was a 65 year-old woman diagnosed as with a monomorphic adenoma, and the other was a 48 year-old man diagnosed as with a carcinoma in pleomorphic adenoma. Despite the disadvantages associated with a midline mandibulotomy, including the esthetics and postoperative occlusion disorders, this procedure was indicated for both patients because this is a useful technique for removing large, highly-vascularized, and malignant tumors due to the large surgical field of this method.

Clinical Studies on Roxithromycin Treatment of Chronic Sinusitis.

Roxithromycin (RXM) was administered to 191 patients with chronic paranasal sinusitis. The overall rate of excellent and good clinical response was 58.1% as judged by the attending otolaryngologists and 56.0% as judged by the committee.In bacteriological examinations performed on 39 patients before administration 52 organisms were isolated, and 25 (83.3%) of the 30 cultures examined showed sensitivities to RXM. Among patients infected with sensitive organisms the clinical efficacy rate (CER) was 81.0%.X-ray examinations were performed on 59 patients with an CER of 66.1%. The rates for excellent and good results were 75.9% for maxillary sinusitis and 78.3% for ethmoid sinusitis.Side effects, in the form of mild digestive symptoms, were noted in only 3 patients (1.6%), but no treatment was required even though RXM was administered for a long period of time, up to 178 days.These results indicate that RXM is effective in the treatment of chronic paranasal sinusitis.