Shin-ya Ohtsu

Relationship between Clinically Diagnosed Tinnitis and Serum Zinc Level

A questionnaire concerning the loudness and continuity of tinnitis was administered to 194 patients who had been diagnosed with tinnitis. These patients also underwent pitch match and loudness balance tests. Zinc levels were measured in 22 of the 194 patients. Serum zinc level was less than 70 pg/dl in 15 of these patients. Zinc (polaplesing 150 mg/day) was administered to these 15 patients daily for at least 1 month. The serum zinc level was subsequently measured in 10 patients. Zinc levels had recovered in all of the patients. The influence of zinc on tinnitis was then examined with the questionnaire and loudness balance test in these 10 patients. Tinnitis decreased in 4 patients according to their score on the loudness balance test, suggesting that zinc exerts a positive effect on tinnitis in some patients.

Clinical Studies on Roxithromycin Treatment of Chronic Sinusitis.

Roxithromycin (RXM) was administered to 191 patients with chronic paranasal sinusitis. The overall rate of excellent and good clinical response was 58.1% as judged by the attending otolaryngologists and 56.0% as judged by the committee.In bacteriological examinations performed on 39 patients before administration 52 organisms were isolated, and 25 (83.3%) of the 30 cultures examined showed sensitivities to RXM. Among patients infected with sensitive organisms the clinical efficacy rate (CER) was 81.0%.X-ray examinations were performed on 59 patients with an CER of 66.1%. The rates for excellent and good results were 75.9% for maxillary sinusitis and 78.3% for ethmoid sinusitis.Side effects, in the form of mild digestive symptoms, were noted in only 3 patients (1.6%), but no treatment was required even though RXM was administered for a long period of time, up to 178 days.These results indicate that RXM is effective in the treatment of chronic paranasal sinusitis.

A Study on Cricothyroid Muscle Activities During Carbon Dioxide Inhalation

Hirofumi Kihara, Shin-ya Ohtsu, Yoshizumi Wada, Jiro Udaka, Tatsuya Ishida and Yasuo Koike Several studies of the activity of human cricothyroid muscles during sleep have been reported. Eight adults in good health aged 36 to 61 years were subjected in this study. The activity of the cricothyroid muscle was investigated during sleep and the influence of carbon dioxide inhalation upon the cricothyroid activity was electromyographically determined. During sleep, a slight degree of cricothyroid activity was observed for inspiration. Carbon dioxide inhalation caused an increase in the cricothyroid activity during inspiratory phases.

The Efficacy of Hemitonsillectomy and Adenotomy in Treatment of Upper Airway Obstruction in Children

Adenotonsillectomy is frequently performed on children with upper airway obstruction, since the most common cause is adenotonsillar hypertrophy. Removal of a minimal amount of tonsil tissue may be immunologically better, however, removal of a wider area may be necessary to enlarge the airway sufficiently. Based on the foregoing, removal of the palatine tonsil on only one side and adenotomy (hemitonsillectomy and adenotomy: HTA) was performed in 6 cases of upper airway obstruction in patients under 5 years old. Five of these cases underwent nocternal polygraphic recordings before and one week after HTA. Airflow, thoracic movement, mesopharyngeal pressure and oxygen saturation were simultaneously monitored and the following results were obtained: the maximum amplitude of mesopharyngeal pressure remarkably decreased, and the minimum oxygen saturation increased to a normal range postoperatively. Although all cases had good long term courses, two, both 5 years old, complained of snoring and sleep apnea again 30 or 37 months after HTA. On physical examination, the remaining palatine tonsils had hypertrophied while pharyngeal lymph follicles had not hypertrophied. Funnel chest, which had been observed in one of the 2 cases before HTA, had already completely disappeared. On polysomnographic examination, recurrence of upper airway obstruction was demonstrated. The remaining palatine tonsils were removed and thereafter the 2 cases improved both clinically and on the polygraphic test. The remaining 4 cases were investigated by questionnaires, which showed that they had no recurrence 5 to 39 months postoperatively. Pigeon chest, which had been observed in one of the 4 cases before HTA, had slightly improved. These results suggest that HTA is valuable for preservation of immunological function,