Makito Tanabe

Effect of Estrogen Replacement Therapy on Salivary Flow Dysfunction.

Changes in salivary flow rate were evaluated after administration of oral estrogen medication to 4 female patients with menopausal syndrome accompanied by various oral symptoms. Four patients showed symptoms including glossodynia (3 cases) and problems with taste (1 case). All patients were diagnosed with menopausal syndrome by a gynecologist and were administered oral estrogen medication. Salivary flow rate was evaluated by analysis of the time-activity curve of 99mTc-pertechnetate scintigraphy. Before treatment, 2 patients showed salivary flow hypofunction while the other 2 patients showed normal function. Complaints of each patient were resolved completely a few months after medication was prescribed. The uptake and secretion rates of the parotid glands in all patients increased after medication, but that of the submandibular gland did not change with medication. Thus, there appears to be a difference in the effect of estrogen on salivary flow rates between the parotid and submandibular gland. The results suggested that estrogen replacement therapy could be effective for salivary gland hypof unction.

Differential Diagnosis of Middle Ear Inflammatory Diseases by MRI Findings.

Although computed tomography can reveal a soft tissue mass in middle ear diseases as an area of increased density, it cannot differentiate cholesteatoma from other inflammatory tissue. We prospectively studied 30 patients with various middle ear inflammatory diseases, including inflammatory granulation tissue, cholesteatoma and cholesterin granuloma with magnetic resonance imaging (MRI) with or without Gd-DTPA enhancement. Cholesteatoma and inflammatory granulation tissue showed intensity ranging from low to high on Ti-weighted images and from high to very high on T2-weighted images. However, cholesteatoma showed either no enhancement or ring enhancement on MR imagings with Gd-DTPA, and it could be differentiated from the Gd-DTPA-enhanced inflammatory granulation tissue. Cholesterin granuloma showed very high intensity on both T1 and T2-weighted images. Therefore, MRI with Gd-DTPA is considered to be useful in the differential diagnosis of these middle ear diseases.