Kunio Yanohara

The localization of motoneurons innervating the canine pharyngeal constrictor muscles in the posterior larynx by the fluorescent double-labeling technique

SummaryThe localization of motoneurons innervating the canine pharyngeal constrictor muscles in the posterior larynx, i.e., the hyopharyngeal muscle (HP), the thyropharyngeal muscle (TP) and the cricopharyngeal muscle (CP), was investigated by the fluorescent labeling technique. Labeled cells were found in the rostral portion of the ipsilateral nucleus ambiguus. The rostral ends of these cell columns were located at nearly the same level. The caudal ends of the HP cell column and the TP cell column were also located at nearly the same level. However, the CP cell column was elongated a little more caudally. The HP cells and the TP cells were intermingled in the dorsal part of the nucleus. The CP cells were mainly located in the ventral part of the nucleus. No double-labeled cells were detected.

Echo-Guided Aspiration Biopsy Cytology of Thyroid.

Echo-guided aspiration biopsy cytology (EGABC) performed for nodular goiter in the past 3 years was evaluated in 605 cases. A correlation of cytologic findings with histologic findings was possible in 127 patients who underwent surgery. Fifty-two of 62 cancers diagnosed histologically were cytologically positive (83.9%), 4 were suspicious (6.5%) and 6 were negative (9.7%). EGABC of the thyroid is an excellent method for eliminating unnecessary operations in patients with thyroid nodules.

Statistical study of ear surgery from 1977 to 1989.

Surgery, primarily tympanoplasty, was performed on 1051 ears from April 1977 to March 1989. Two-thirds of the patients were aged 30 to 60. There was no sex difference in any age group. Chronic otitis media was observed in 45.2% and cholesteatomatous otitis media in 33.7%. Including the ears that needed reoperation or secondary operation, 931 ears (88.6%) were operated on for problems related to chronic otitis media; tympanoplasty was performed in 885 of them. In the ears with chronic otitis media, operation was type I in 60.8% and modified type III in 16.5%. In ears with cholesteatomatous otitis media, operation was type Tin 30.7% and modified type III in 30.4%.Hearing was good in 86.9% after type I operation, in 77.2% after modified type III operation, and in 45.3% after modified type IV operation. No difference was observed in the columellae used other than the cartilage and auditory ossicles. Recurrence was observed frequently in the ears followed for a long time after posterior walll preserving operations for cholesteatomatous otitis media.

Ultrasonographic Examination of Thyroid Tumor in Human Dry Dock

過去1年間の人間ドック受診者2103名にたいして, 超音波を用いた甲状腺腫瘍スクリーニングを行った。超音波検査にて異常所見を認めたもののうち, 一定の条件を満たすものについて, 穿刺吸引細胞診を行い, 手術適応を決定した。その結果甲状腺癌を14例発見した。ドック全受診者に占める甲状腺癌患者の割合は0.67%である。また全女性受診者に占める割合は1.28%であり, これは過去のどの報告よりも高率である。甲状腺腫瘍を耳鼻咽喉科疾患として内外に認知させるための1つの手段として, われわれ耳鼻科医もこのような甲状腺腫瘍検診に係わっていくことが将来的見地からも必要であろう。

Clinical study of cefixime in the treatment of otitis media and paranasal sinusitis.

Cefixime (CFIX) was administered to 22 patients with acute otitis media, 43 patients with acute exacerbation of chronic otitis media, 27 patients with acute paranasal sinusitis and 14 patients with acute exacerbation of chronic paranasal sinusitis.1. It was effective in 81.0 00 of those with acute otitis media, in 54.

Long-standing foreign body in the esophagus - A case report.

% of those with acute exacerbation of chronic otitis media, in 65.400 of those with acute paranasal sinusitis, and in 100.0 % of those with acute exacerbation of chronic paranasal sinusitis.2. Bacteriological studies showed an elimination rate of 59.5% (47/79).3. No side effect was noted.4. The above results indicate that CFIX is a very useful antibiotic in the treatment of otitis media and paranasal sinusitis.

A case of otosclerosis of sudden onset.

The patient was a congenitally deaf and dumb 23-year-old female with cerebral palsy and hyperthyroidism. She had had occasional slight oral bleeding and difficulty swallowing for about 7 months. A foreign body in the esophagus was detected by chance when she visited the pediatrics department of our hospital for follow up of hyperthyroidism. The foreign body (a curtain hook) was removed by lateral esophagotomy.

Functional Restoration in Gases of Laryngeal Nerve Paralysis

The patient was a 33-year-old female who noted sudden hearing loss of her left ear while she was listening to her stereo. She was treated first as a case of sudden deafness because of its sudden onset.Afterward detailed examinations revealed otosclerosis. Patients with otosclerosis usually lose their hearing ability slowly in over a long period. This case is a rare one of otosclerosis with sudden hearing loss.

Clinical Aspect of Recurrent Laryngeal Nerve Palsy

Historical investigations of the functional restoration for recurrent laryngeal nerve paralysis were reviewed and recent studies introduced.Preliminary experiments are reported in which the Ansa hypoglossi and sternothyroid muscle pedicle were implanted into the denervated posterior cricoarytenoid muscle (abductor), and a new functional combination technique with the selective severance of the abductor branch after neurorrhaphy of the recurrent laryngeal nerve was employed.The preliminary experiments were carried out on three adults dogs. Under deep intravenously administered anesthesia, the left recurrent laryngeal nerve was transected at the level of the third tracheal ring and each cut end was folded back and tied. After exposing the posterior cricoarytenoid muscle on the left side, the Ansa hypoglossi and sternothyroid mascle pedicle, which was prepared beforehand, was implanted and sutured into the small cut wound of the denervated posterior cricoarytenoid muscle. After three months postoperatively, the abductor on the affected vocal cord was active simultaneously during inspiration and was markingly active during dyspnea in these experimental animals. The results demonstrated that implantation of the Ansa hypoglossi and sternothyroid muscle pedicle into the denervated abductor offer sufficient abductor function.The new functional combination technique was designed to relieve an inspiratory dyspnea and to maintain a good voice. After 10 months postoperatively, the recovery of satisfactory abductor function during inspiration, dyspnea and deflation of the lung was 67%, and the recovery of satisfactory adductor function during phonation was 89%.The rapid return of abductor function without special training in all cases suggests that the pedicle nerve muscle grafting technique is the best and that the sternothyroid muscle is available as a substitute for the abductor. The significance of these experimental observations concerning this approach to bilateral vocal cord paralysis is that the operation can be applied to humans quite successfully.