Michitoshi Araki

Prognosis for Bell's palsy: a comparison of diabetic and nondiabetic patients

Conclusion. The present study indicates that recovery from Bells palsy in a diabetic group (DG) is delayed, and the facial movement score remains low in comparison with a nondiabetic group (NDG). More aggressive treatments, such as higher-dose corticosteroid administration and/or facial nerve decompression surgery, might be considered in diabetic patients with severe Bells palsy. Objectives. The purpose of this study was to reveal prognostic differences for Bells palsy in the DG and NDG. Patients and methods. The grades of facial palsy in 19 diabetic and 57 nondiabetic patients with Bells palsy were assessed using the House-Brackmann grading system (HB system). Recovery was defined as grade I. The average of HB system grades and recovery rates were compared in the DG and NDG at the start of the treatment, and 1 month, 3 months, and 6 months after onset. Results. There were no differences in the HB system between the DG and NDG at the start of treatment and at 1 month after onset. However, facial movement in the DG was poorer than that in the NDG at 3 months and 6 months after onset. In terms of the recovery rate, the rate in the DG (52.6%) was much lower than that in the NDG (82.5%) at 6 months after onset.

Effect of Lidocaine Injection on EOAE in Patients with Tinnitus

In the present study, evoked otoacoustic emissions (EOAEs) were measured in 30 patients with tinnitus before and after intravenous lidocaine injection (1 mg/kg). For EOAE recordings, 1 kHz tone burst stimuli were used. Intravenous lidocaine injection resulted in suppression of tinnitus in 22 (73%) ears, and changes of EOAE amplitude (increase or decrease) in 18 (60%) ears. Of the 18 ears with EOAE amplitude changes, tinnitus disappeared or decreased in 17 (94%) ears. In 12 ears without changes of EOAE amplitude, tinnitus was suppressed in only 5 (42%). Changes in latency were not detected in any of the ears. These results indicate that there is a relationship between the effect of lidocaine in tinnitus suppression and changes in cochlear micromechanics caused by lidocaine.

Basal cell adenoma of the parotid gland: a clinicopathological study of nine cases—basal cell adenoma versus pleomorphic adenoma and Warthin’s tumor

The aim of this study is to investigate the clinical and pathological characteristics of basal cell adenoma (BCA) and to compare the diagnosis/treatment of BCA with those of Warthin’s tumor (WT) and pleomorphic adenoma (PA). Among 192 patients with benign tumors of the parotid gland who underwent surgery, 9 had BCA. All of these tumors showed a benign pattern on computed tomography and magnetic resonance imaging. The accuracy of fine needle aspiration biopsy (FNAB) for diagnosis of BCA was slightly lower than for PA and WT. Most PA and BCA lesions developed in the upper part of the parotid gland. Considering the gender difference, tumor site, and age, it is necessary to differentiate BCA from PA rather than from WT. There were no significant differences in the duration of surgery, the blood loss, and the incidence of transient facial paralysis between surgical resection of BCA and surgery for PA or WT. BCA is the third most common of the benign parotid tumors, following WT and PA, although its incidence is low. When PA and WT are ruled out by FNAB after a tentative diagnosis of benign tumor has been based on imaging findings, BCA should be considered.

Expression of cyclooxygenase-2 and microsomal prostagalandin E synthase-1 in head and neck squamous cell carcinoma

OBJECTIVE Our aim was to examine the expression of COX-2 and microsomal prostaglandin E synthase-1 (mPGES-1), and compare the results with clinical data. PATIENTS AND METHODS Expression of COX-1, COX-2, and mPGS-1 was evaluated by immunohistochemistry in head and neck squamous cell carcinoma (HNSCC) from 25 patients and mRNA levels were determined by the quantitative reverse transcription polymerase chain reaction. RESULTS COX-2 overexpression was noted in tumor cells from 19 of the 25 carcinoma patients and mPGES was expressed by tumor cells from 21 patients. Localization of COX-2 and mPGES-1 was very similar, and well-differentiated tumors showed stronger expression than poorly/moderately differentiated tumors. The COX-2/GAPDH and mPGES/GAPDH mRNA ratios were significantly higher in well-differentiated carcinomas and N0 patients. CONCLUSIONS There was overexpression of COX-2 and its downstream enzyme mPGES-1, and their localization in tumor cells was similar, suggesting that these enzymes play both an important role in the development and proliferation of HNSCC. Furthermore, COX-2 and mPGES-1 were strongly expressed by well-differentiated carcinomas, suggesting their involvement in the differentiation of cancer.

Safety and usefulness of an electric knife during surgery for parotid benign tumor: postoperative facial paresis and its risk factors

Conclusion The incidence of facial nerve paresis was not high compared with previously reported incidences using conventional operative techniques, showing the safety of the use of an electric knife in this operative technique. An electric knife is provided in almost all operating rooms and no special apparatus is necessary for this technique. Background Since the glandular tissue of the parotid gland is rich in blood flow, safe and accurate protection of the nerve is often made difficult due to bleeding during parotid surgery. Therefore, we developed a technique in which glandular tissue is cut using an electric knife, which is provided in almost all operating rooms. Patients and methods In this study, the safety and usefulness of an electric knife in parotid surgery were confirmed by evaluating patients with parotid benign tumor who underwent surgery using an electric knife. The subjects were 135 patients with parotid benign tumors. Results Postoperative facial nerve paresis developed in 36 (26.6%) of the 135 patients but was transient in all cases. Depending on the tumor site, transient paresis was observed in 8 of the 13 patients with tumors in the deep lobe but in 28 (22.9%) of the 122 patients with tumors in the superficial lobe. The mean recovery time from facial nerve paresis was 6.1 weeks.

Planned fractionated boron neutron capture therapy using epithermal neutrons for a patient with recurrent squamous cell carcinoma in the temporal bone: a case report.

We describe the first case of extensive squamous cell carcinoma in the temporal bone recurring after surgery, conventional radiotherapy, and chemotherapy, which was treated using planned fractionated boron neutron capture therapy (BNCT).

Spontaneous Otoacoustic Emissions in Humans With Endolymphatic Hydrops

Objective/Methods The origin and clinical implications of spontaneous otoacoustic emissions (SOAEs) have not been well revealed. To investigate the relationship between the ear with endolymphatic hydrops and SOAE, SOAEs were measured in 31 patients with unilateral endolymphatic hydrops and 10 volunteers with normal hearing levels that had less than 25 dB hearing level (HL) on average for five frequencies (0.25, 0.5, 1, 2, and 4 kHz).