Michiaki Yokoyama

67Ga citrate and99mTc(v)-DMSA scintigraphy in a case of maxillary sinus liposarcoma

Scintigraphic images with67Ga citrate and99mTc(v)-dimercaptosuccinic acid and MR image of a 16-year-old male with maxillary sinus liposarcoma (predominantly myxoid type) are reported. The MR image clearly indicated the exact location, size and anatomical relationship of the tumor. Scintigraphic evaluation was useful in suggesting the malignant nature of the tumor and showed no distant metastasis. Both examinations were effective in treating this case.

Carcinoid Tumor Originating in Oropharynx; A Case Report.

Carcinoid tumors are rare in the otorhinolaryngeal area. There have been no reports of oropharyngeal carcinoid, as far as we know. Recently we treated a patient with this tumor.A 68-year-old woman visited our hospital because of a mass on her hard palate. A biopsy was performed. The histological diagnosis was atypical carcinoid. Partial maxillectomy, including the soft and hard palate, was done. No further treatment, such as radiation therapy or chemotherapy, was given. There has been no sign of recurrence for over one year after surgery.

Synchronous reconstruction of the face and hard plate after total maxillectomy in two patients.

Synchronous reconstruction of the defect of the face and hard palate afterr maxillectomy was performed with free myocutaneous flaps. A 58-year-old male and a 65-year-old male were treated for maxillary cancer (T4N0) with total maxillectomy and resection of facial skin (include the orbital contents in the latter case). The defects were reconstructed synchronously with two types of free myocutaneous flap: rectus abdominis (the former case), latissimus dorsi (the latter case). They were able to eat two weeks after surgery and did not suffer from speech disturbance. The greatest advantage of using free myocutaneous flaps for such reconstruction is the availability of enough muscle to fill the dead space and sufficient skin and the chief disadvantage is the risk of herniation after removal of the rectus abdominis.

Concentration of cefuzonam in otorrhea discharge.

The level of cefuzonam (CZON) in otorrhea discharge was measured to evaluate the clinical effectiveness of this drug in the treatment of middle ear infection. The concentration of CZON ranged from 1, μg/g to 2μg/g for 4 hours after 1g single i. v. injection (SIV), 2μg /g to 6μg/g for 3 hours after 2g SIV, 1μg/g to 2μg/g for 2 hours after 1g i. v. drip infusion (IVD) over 30 minutes, and 2μg/g to 5μg/g for 2 hours after 2g IVD over 30 minutes. In the cases of chronic otitis media including cholesteatoma, the most commonly isolated bacteria were Staphylococcus aureus (25.6%) and Pseudomonas aeruginosa (25.6%), followed by Staphylococcus epidermidis (8.5%). In the literature, the MICgo of CZON is reported to be ≤ 1.56μg/ml for Staphylococcus aureusexcept MRSA and 6.25μg/ml for Staphylococcus epidermidis. CZON is effective against all these bacteria except Pseudomonas aeruginoa.

Schwannoma of cervical vagus nerve; A case report.

Schwannoma of the cervical vagus nerve is rare, and only 65 cases, including our case, have been reported in Japan since 1926.A 28-year-old man with an asymptomatic tumor on the right side of his neck visited our outpatient clinic. He had no other symptom.At operation, it was found that the tumor originated from the vagus nerve. It was removed together with the vagus nerve.After operation, hoarseness occurred. We treated this by injecting of atelocollagen into the paralyzed vocal cord, and his hoarseness disappeared almost completely. This is the first report in Japan of this new treatment for hoarseness following resection of a tumor of the vagus nerve.

Pleomorphic adenoma of nasal septum; A report of two cases.

Pleomorphic adenoma (so-called mixed tumor) is only rarely seen arising from the nasal septum. Recently we treated two patients with pleomorphic adenoma arising from the nasal septum. The first was a 67-year-old woman who complained of nasal stuffiness; a tumor was found on the right side of the nasal septum. The second was a 33-year-old woman who had noted a mass in the nasal cavity; a tumor was found on the left side of nasal septum. Biopsies on their first visit to the clinic showed pleomorphic adenoma. The patients were admitted and the tumors were resected en bloc through the nostril. There have been no signs of recurrence.So far 35 cases of pleomorphic adenoma arising from the nasal septum have been reported in Japan. The literature was reviewed with respect to the age and sex of the patients, the chief complaint, side of lesion, treatment, etc.

Two cases of malignant lymphoma of the frontal sinus.

Case 1. A 30-year-old male complained of swelling of the forehead and exophthalmus. He was treated with irradiation and chemotherapy, but died 18 months later.Cpse 2. A 60-year-old male complained of swelling of the forehead. He was succesfully treated with surgical excision, irradiation and chemotherapy and is living and well with no recurrence or metastasis 18 months later.The authors reviewed six cases of malingant lymphoma of the frontal sinus reported in Japan during the past 51 years. The mortality of malingant lymphoma of the parasinuses has been very high in Japan.Case 2 was treated with combined therapy with good results. It is thought that combined therapy is effective for malignant lymphoma of the frontal sinus.