Katsura Yamamoto

Reliability and validity of late vertex-evoked response audiometry.

In order to evaluate the current visual scoring technique in the late vertex-evoked response audiometry (ERA), the detectability of the response, errors in judgment, consistency between scorers and test-retest reliability were studied in adults and young children in waking and sleeping states. In waking adults, ERA proved to be a quite reliable and valid method for testing hearing objectively. On the contrary, a marked inconsistency was found in the appearance of the response in children during sleep. From a clinical standpoint, ERA in waking adults and sleeping children should be regarded as two substantially different methods.

Facial reconstruction with latissimus dorsi myocutaneous island flap following total maxillectomy

Following total maxillectomy for maxillary cancer, facial reconstruction was performed using a latissimus dorsi myocutaneous island flap. Postreconstructive deformity was studied in 10 patients. In 5 patients, after simple total maxillectomy the inner raw surface of the facial skin and orbito was covered by the flap, and the other extended total maxillectomy patients where the orbital contents and facial skin were involved, reconstruction was by means of the folded flap. In the patients with simple total maxillectomy, cicatricial contracture of the facial skin and cicatricial ectropion of the lower eyelid were quite small, and in the patients with extended total maxillectomy, reconstructed facial skin did not give rise to cicatricial contracture.

Intraoral Reconstruction with Latissimus Dorsi Myocutaneous Island Flap

SummaryIntraoral reconstruction for large defects using a latissimus dorsi myocutaneous island flap in ten patients is presented. All flaps were transferred successfully in one stage and provided adequate flap tissue for the intraoral defect. Five cases involved hemiglossectomy. The postoperative atrophy of the flap was minor and the intraoral defects were adequately resurfaced. The postoperative function of the remaining tongue was satisfactory. The latissimus dorsai myocutaneous flap was found to be reliable and useful for intraoral reconstruction.

Reconstruction of late laryngo-tracheal stenosis in a one stage operation by cervical flap and cartilage transplantation

SummaryAn operation has been devised to produce a one stage correction of cases with stenosis of the larynx and trachea. The scar tissue of the stenotic area is resected. To reconstruct the inner lining of the lumen, a cervical pedicle flap is inserted. To insure a stable structural framework, costal cartilage is usually used. A stent is inserted into the lumen by using a rubber glove finger packed with silicon sponge to maintain an adequate air passage for about four weeks. The external covering is achieved by direct closure. The tracheostome should remain open for four to six months. In ten cases, all obtained satisfactory results by this method.