Ryuichi Aibara

Effect of sinus surgery on visual disturbance caused by spheno-ethmoid mucoceles

Fifteen patients suffering from visual disturbance of varying degrees caused by a mucocele of the posterior ethmoid and/or sphenoid sinuses underwent marsupialization of a mucocele into the nasal cavity. Five of the eight patients with severe visual loss worse than 20/200 showed recovery of measurable vision. Two of these five were operated on within 24 hours after the onset of visual loss and showed marked recovery to 20/25 and 20/15. The other seven patients who had relatively mild visual disturbance experienced improvement of visual acuity or remission of subjective complaints such as blurred vision postoperatively. During operation partial bony defect was found in the optic canal in 12 patients and in the skull base in 12 patients. A good understanding of this disease by ophthalmologists and otolaryngologists is essential for early diagnosis and prompt surgical treatment to avoid permanent visual dysfunction and operative sequelae.

Histochemical Study of the Canine Inferior Pharyngeal Constrictor Muscle: Implications for its Function

The inferior pharyngeal constrictor muscle (IPC), which consists of the thyropharyngeal (TP) and cricopharyngeal (CP) muscles. plays an important role during deglutition. The histochemical properties of the canine IPC muscle were investigated. The motor endplates of the TP muscle clustered at the midlength of the muscle, while those of the CP muscle were scattered diffusely. The glycogen depletion technique suggested that most of the CP muscle fibers terminated into the belly of the muscle and fiber lengths varied. With ATPase stain, type II fibers were shown to be predominant in the TP muscle, while type I fibers were predominant in the CP muscle. The diameter of the TP muscle fibers was significantly larger than that of the CP muscle. Although the histochemical characteristics of these two muscles were markedly different, they gradually changed, resulting in their coordinated physiological movements.

Motor Innervation of the Guinea Pig Interarytenoid Muscle: Reinnervation Process Following Unilateral Denervation

The authors investigated the process of denervation and reinnervation of the interarytenoid (IA) muscle in the guinea pig using transmission electron microscopy and glycogen depletion technique after unilateral transection of the recurrent laryngeal nerve (RLN) and superior laryngeal nerve to clarify the innervation pattern of the unpaired IA muscle. Anastomosis between the bilateral arytenoid branches was confirmed in the belly of the IA muscle. Five weeks after transection, all of the IA muscle fibers appeared to have been reinnervated by the contralateral RLN. As the arytenoid branch of the RLN runs together with that of the contralateral RLN in a single intramuscular nerve funiculus, it is possible that collateral sprouting branches grow and extend into the adjacent denervated Schwanns sheaths. The authors conclude that the unpaired IA muscle, as a whole, receives specific motor nerve supply from the bilateral RLNs, although each muscle fiber is innervated unilaterally.

Motor Innervation of the Arytenoid Muscle Viewed from

Seij i Kawakita ), Ryuichi Aibara 2 ), Masamitsu Hyodo ), Yuji Kawamura 3) and Eiji Yumoto 1) Using 38 guinea pigs with unpaired arytenoid muscle (AR) , the innervation pattern of the AR was studied viewed from reinnervation process following unilateral (left) recurrent laryngeal nerve (RLN) transection. Light and electron microscopic observation, glycogen depletion experiment, and histochemical study using the adenosine triphosphatase (ATPase) stain were carried out. Seven days after transection, both myelinated and unmyelinated fibers were noted in the intramuscular nerve funiculus. Thus, the anastomosis of the arytenoid branches between both RLNs was found in the belly of AR. Three types of the neuromuscular junctions (NMJs) were observed; normal, degenerated, and regenerated NMJs. Five weeks after transection, however, neither degeneration nor regeneration of the NMJ were seen. Until three weeks after transection, half of the AR fibers were stained with PAS staining following electrical stimulation of the contra lateral (right) RLN. Five weeks after transection, all the AR fibers were unstained. Therefore, all the AR fibers were considered to have been reinnervated by the contra lateral RLN. ATP stain of the AR showed that type 2 fibers were predominant regardless of the period following unilateral denervation. The present study indicates that transection of the unilateral RLN facilitates collateral sprouting from the contra lateral RLN, and that these collateral sprouting reinnervated the denervated muscle fibers before degeneration occurs. Therefore the AR, as a whole, receives a specific motor innervation from the bilateral RLNs, although each muscle fiber is innervated by the unilateral RLN.

Motor innervation of the arytenoid muscle in Guinea Pig

tetrasodium salt, nitroblue tetrazolium in phosphate-buffered saline. Before this reaction, some sections were provided for immunohistochemistry with use of anti-VIP or CGRP sera. A small number of NADPH-d nerve fibers could be detected in the epithelium. Most of these fibers with varicosities reached the surface of the epithelium and appeared to be free-ended. The NADPH-d nerve fibers associated with blood vessels were found in the lamina propria, submucosa, and inferior costrictor muscle. The distribution of NADPH-d nerve fibers in the submucosal gland region was different from that in the region of the hypopharynx. The submucosal glands at the level of the thyropharyngeal muscle were richly supplied with NADPH-d nerve fibers. On the contrary, the submucosal glands at the level of the cricopharyngeal muscle (CPM) were poorly supplied with NADPH-d nerve fibers. In the inferior costrictor muscle the quantity of NADPH-d nerve fibers were more abundant in the CPM than in the thyropharyngeal muscle. A cluster of cells, presumably parasympathetic ganglia, were found in the submucosa and muscle layer of the CPM. Most of these cells were NADPH-d positive. VIP and CGRP were co-localized with some of the NADPH-d fibers. VIP was more frequently co-localized with NADPH-d than CGRP. In the ganglia, most of the cells were co-localized with VIP and no cells were co-localized with CGRP. The present findings indicate that NO is involved in the regulation of blood supply and glandular secretion in the canine hypopharynx in coordination with intrinsic VIP or extrinsic CGRP.

Olfactory Neuroblastoma; A Case Report.

A 49-year-old female consulted our clinic with a complaint of righ trecurrent epistaxis on December 2, 1989. A tumor was found in the right nasal cavity. Radiographic study failed to disclose the extent of the tumor, because of associated paranasal sinusitis. MRI (magnetic resonance imaging) studies suggested that the tumor was limited to the right nasal cavity. Right lateral rhinotomy was performed and the tumor was totally removed on December 27, 1989. The tumor was confirmed to be neurogenic by the findings of intracytoplasmic neurosecretory granules and neuritic processes in the tumor cells examined by electron microscopy. It was diagnosed as olfactory neuroblastoma because of its location and the normal value of urine VMA (vanillyl mandelic acid). There was no evidencel of recurrence during 18 months of follow up. The authors confirmed the usefulness of MRI in the evaluation of the extent of the tumor and the necessity of electron microscopy to diagnose olfactory neuroblastoma.

Tissue transfer concentration of cefminox in tonsil.

Tissue transfer concentration of cefminox (CMNX) in the tonsil was measured in 10 adults and 8 children after tonsillectomy. One gram of CMNX was injected intravenously before tonsillectomy, and its concentrations in the tonsil and in the serum were measured after tonsil had been removed.1. In adults, mean CMNX concentration in the tonsil was 15.8μg/mg 40 to 120 minutes after administration. Tonsillar concentration was 33.1% of serum concentration.2. In children, mean CMNX concentration in the tonsil was 20.9μg/mg 25 to 100 minutes after sdministration. Tonsillar concentration was 17.4% of serum concentration.3. The half-life of CMNX in the serum was 115 minutes in adults and 83 minutes in children.CMNX is effective against a variety of bacteria. The present study proved that the administration of one gram of CMNX was sufficient to treat tonsillitis and peritonsillar abscess, since its concentration in the tonsil was above the MIC80 of most bacterial.