Nobuo Kitahara

Polypoid type of laryngeal sarcoidosis--case report and review of the literature.

Abstract A 45-year-old mentally retarded woman was discovered to produce a stridor upon inhalation. Fiberoptic laryngoscopic study revealed a smooth-surfaced, wide, and pedunculated tumor on the right arytenoid and the right aryepiglottic fold. Histopathological study revealed that the tumor was characterized by granulomatous inflammation. The condition was diagnosed as laryngeal sarcoidosis. The tumor was resected surgically. Surgical resection of the tumor and injection of corticosteroid should be performed for polypoid-type laryngeal sarcoidosis. The case is discussed in detail, along with a review of the literature pertaining to sarcoidosis of the larynx.

Differential diagnosis of proptosis: Report of 2 cases

We rarely encounter patients with proptosis, however, it is known that inflammation and extension of paranasal sinus tumors may cause this condition. We should consider the diseases that may cause proptosis to facilitate the diagnosis. Recently, we treated proptosis in 2 cases, one with inflammatory myofibroblastic tumor (IMT) and the other with malignant lymphoma. As these 2 diseases show various clinical features and these features frequently overlap, it is difficult to differentiate between IMT and malignant lymphoma without pathological examinations. In this study, we review the relevant literature reports and discuss the difficulties in establishing a clinicopathological diagnosis and present a slight distinction in magnetic resonance imaging.

Vocal cord abductor paralysis in multiple system atrophy: a case report

Multiple system atrophy (MSA) is a progressive neurodegenerative disease that is characterized by varying degrees of parkinsonism and cerebellar, corticospinal, and autonomic dysfunction. Vocal cord abductor paralysis (VCAP) is considered a sign of a poor prognosis in MSA, because it is a life-threatening complication that may cause nocturnal sudden death. This case report presents a patient who was treated for Parkinsons disease, and complained of dizziness and sleep apnea. We examined VCAP using fiberoptic laryngoscopy as the possible cause of sleep apnea. VCAP usually occurs in the advanced stages of MSA and is accompanied by a worsening of other symptoms. Optokinetic nystagmus was severely impaired and the caloric test response was bilaterally absent. Objective findings such as VCAP and abnormal neuro-otological results led to the diagnosis of MSA.

Spontaneous external auditory canal cholesteatoma complicated by rheumatoid arthritis—case report and review of the literature

A 63-year-old woman with rheumatoid arthritis sought medical assistance for dull and chronic pain in her left ear two and half years after her initial diagnostic examination. Otoscopic examination revealed that the posteroinferior wall of the bony external ear canal was eroded and that the small cavity was filled with squamous debris. The condition was diagnosed as external auditory canal cholesteatoma (EACC). The existence of EACC might suggest complications of bone disease, aging cerumen gland, or a low migratory rate of the epithelium.

Auditory Brainstem Responses in Leptomeningeal Metastatic Spread

Auditory brainstem responses (ABRs) were recorded in 2 patients with hearing loss caused by leptomeningeal metastatic spread. These recordings showed similar characteristic findings. The absolute latencies of wave V and interwave latencies I-V were exceedingly increased. Definite effects on the wave morphology and latency of wave V were observed with the use of high repetition rates. It is surmised that the hearing loss caused by leptomeningeal metastatic spread is mainly an effect on the auditory nerve and/or the cochlear nucleus. ABR examination is of clinical value in detecting functional abnormalities resulting from leptomeningeal metastatic spread.

Congenital Stapedial Tendon Ossification; A Case Report.

A ten-year-old girl with right conductive hearing loss was found to have unilateral congenital stapedial tendon ossification. Exploratory tympanotomy revealed absence of the incus long crus, anomaly of the stapes superstructure and a stapedial tendon ossification. After excision of the tendon and insertion of the cartilage piece between the malleus neck and the superstructure, her hearing was almost normal.