Kaoru Shimazu

Effect of Oral Moisture on Taste Sensation

Taste disorders can be caused by various factors, including zinc deficiency, adverse drug reactions, cold and xerostomia, and the number of patients seeking medical assistance for such disorders is increasing. However, because taste disorders are often difficult to treat, some medical institutions will not treat these complaints.In the Department of Otolaryngology at Osaka Dental University Hospital, a clinic was opened on September 1, 2004, to treat patients with taste disorders.We treated 1 outpatient who lost one side of parotid gland due to malignancy, then lost the function of the remaining salivary gland due to Sjogrens syndrome.Subjects comprised 17 patients complaining of taste disorders with xerostomia without subjective symptoms of other otolaryngological diseases.In the present study, 4 patients were prescribed zinc by another physician, but only 2 patients actually displayed zinc deficiency. Zinc administration did not improve symptoms in any of the patients.According to the diagnostic criteria for xerostomia in our department, 17 patients had xerostomia, and 4 of these 17 patients were diagnosed with Sjogrens syndrome. These patients were instructed to gargle with cevimeline hydrochloride, and taste sensation improved in 12 patients.We have examined 17 patients to data and consider this number insufficient to draw definitive conclusions but the data we have currently suggests to the following conclusions:1. Latent Sjogrens syndrome should be suspected in patients presenting with taste disorder with xerostomia.2. In taste disorder patients with xerostomia, gargling with cevimeline hydrochloride appears very useful.3. One patient had lost a side of salivary gland, and Sjogrens syndrome caused loss of function of the remaining salivary gland. In this patient, favorable results were also obtained by gargling with cevimeline hydrochloride.

Foreign Bodies of Dental Origin in the Airway and Gastrointestinal Tract.

We treated 109 cases of foreign bodies of dental origin in the airway and gastrointestinal tract in our hospital during the 8 years from 1987 to 1994. A statistical analysis was performed on 109 cases, and the results were as follows:1. Of the 109 cases, 60 were males and 49 were females; 71 patients (65.1%) were over 40 years old.2. Eleven cases involved foreign bodies in the airway and 98 cases involved foreign bodies in the gastrointestinal tract.3. In both the airway and the gastrointestinal tract, crown restorations were the most common foreign objects, followed by dental instruments.4. Gastrointestinal foreign bodies were ejected by defecation in all but 2 cases. In cases of spontaneous ejection, ejection occured within 4 days after misswallowing in 81.2% of patients.5. The accidents occured during dental treatment in 92 cases (84.4%) and while eating in 17 cases (15.6%).We stress the importance of making models of dentures and crown restorations that are misswallowed before removal.

Bacteria in Dental Sinusitis

Antral secretions from 67 patients with dental sinusitis were examined bacteriologically. The results were summerized as follows:1) From the 67 patients, 22 species and 113 strains were isolated.2) Mixed infections with two, three and four species were found in 33 of the total cases. Fourteen of them were a mixture of Staphylococcus aureus and Esherichia coli. Twelve showed a mixture of aerobic and anaerobic bacteria.3) Aerobic bacteria were isolated with higher incidence than anaerobic bacteria. Aerobic bacteria were isolated and composed of 17 species and 94 strains. Staphylococcus aureus was the most frequent species, followed by α-Streptococcus, Esherichia coli and Pseudomonas aeruginosa. In anaerobic bacteria, 5 species and 19 strains were isolated in descending order of Peptococcus, Veillonella and Peptostreptococcus.4) From 49 patients in the acute stage, 19 species and 87 strains were isolated, Staphylococcus aureus was the most frequent species. From 18 patients in the chronic stage, 15 species and 26 strains were isolated, Pseudomonas aeruginosa was the most frequent species and Staphylococcus aureus had a low incidence.5) No difference was found between bacteriological findings in dental sinusitis and nasal sinusitis. In other words, the bacteria participating in this disease are approximately similar to those in nasal sinusitis. No special bacteria are present in this disease.

Re-valuation of X-ray Diagnosis of Sinusitis in Children

小児慢性副鼻腔炎における単純撮影法の診断的価値を再評価することを目的に, 3～14才の小児206例について鼻腔所見とX線所見とを比較検討し次の結果を得た.1) 206例を総括すると, 総合判定から鼻副鼻腔炎と判定されたものは112例 (54.3%) である. 鼻腔所見単独の判定では78例 (37.8%), X線所見単独では102例 (49.5%) で, X線所見からの判定の方が鼻腔所見によるものに比べて総合判定に近い頻度を示した.2) 対象例を幼童期と成童期に分類し比較したが, 8才以下の症例においてもX線診断の意義は大きいと考えられた.3) 148例 (71.8%) は鼻腔所見とX線所見が一致した.4) 所見の不一致は58例 (28.2%) に認められた. 43例は鼻腔所見陰性・X線所見陽性群に属した. 43例中10例は撮影条件の誤りを原因とする誤診例であり, 残る33例は潜伏性副鼻腔炎と考えられた. 15例は鼻腔所見陽性・X線所見陰性群に属した. 15例中5例は撮影条件の誤りを原因とする誤診例と考えられたが, 10例における不一致の原因は不明であった.5) 以上の結果から, 小児慢性副鼻腔炎における単純撮影法の診断的価値は大きいと考えられた.

Clinics of the Radicular Cyst

歯根嚢腫を取扱うにあたり, 臨床上注意すべきことは次の諸点である.1. 本嚢腫の診断は, 原因歯の確認と総合的なX線検査が主体となるが, 犬歯窩における羊皮紙様捻髪音の触知も診断の補助として重要である.2. X線検査において最も注意すべき所見は多房性の陰影である. 多房性の陰影を認める場合には, 癌腫 (腺様嚢胞癌) との鑑別が必要である.3. 本嚢腫の治療上の問題点は, 嚢腫摘出と同時に上顎洞根本手術を施行する必要があるか否かの判定である. その適応の決定には, 排泄機能検査によって洞粘膜病変の程度を調べることも1つの指針であるが, 嚢腫が大きい場合には洞粘膜を保存できると考えられる症例に対しても, 上顎洞根本手術を行って嚢腔と上顎洞を1つの腔洞にして2次的治癒を計る方法が良いと考える.