Takehiro Hanada

Diagnostic and Therapeutic Dilemmas in Rapidly Progressive Sensorineural Hearing Loss and Sudden Deafness a Reappraisal of Immune Reactivity in Inner Ear Disorders

Sera from 76 patients with a clinical diagnosis of idiopathic rapidly progressive sensorineural hearing loss (SNHL) (n = 15), sudden deafness (n = 31) and with other etiologies of their hearing loss (n = 30) were analysed by western blot assay. Seventy-three percent of the cases with rapidly progressive SNHL had cross-reacting antibodies (27, 45, 50, 68 kD). The overall response to immunoprogressive therapy was effective in only 50% of cases. Sixty-five percent of the patients with sudden deafness also had cross-reacting antibodies (27, 45, 50, 80 kD). In these cases steroid therapy was more effective in re-establishing the hearing than no treatment, regardless of the western blot outcome. Spontaneous recovery occurred in approx. 50% of cases, but only in those with a positive assay. The antigenic epitopes detected with immunoblotting were not cochlea specific; they were also found in protein extracts of other organs (cranial nerves, kidney, brain).

Synovial sarcoma in the parapharyngeal space: case report and review of the literature.

We encountered a rare case of synovial sarcoma in the parapharynx of a 47-year-old Japanese man. This patient presented with an enlarging tumor in the right side of his neck that had grown progressively over a 4-week period. Radiological examinations revealed that the tumor arose from the parapharyngeal space. The tumor could not be completely removed at surgery. Metastasis to the lumbar vertebra was detected postoperatively. The patient underwent three courses of chemotherapy and the delivery of palliative radiation to the lumbar vertebra without success. The patient died of lung metastasis 7 months after surgery.

Unusual Case of Myoepithelioma Associated with Adenoid Cystic Carcinoma of the Parotid Gland

Tumors of the salivary glands comprise less than 3% of all neoplasms of the head and neck, with synchronous parotid tumors of differing histologic types being extremely rare. We present a 71-year-old woman with a myoepithelioma associated with an adenoid cystic carcinoma of the left parotid gland. The 48 previously reported cases of synchronous occurring parotid gland tumors of differing histologic types are reviewed.

Acinic cell carcinoma originating in the nasal cavity.

SummaryThe nasal cavity is a rare site for an acinic cell carcinoma. We have treated one such tumor in a 68-year-old man. He underwent a Denkers operation under general anesthesia and then received postoperative irradiation at 50Gy. He has been kept asymptomatic for the past 2 years. To the best of our knowledge, this case is the third report on the acinic cell tumor in the nasal cavity. A brief literature review is also presented.

Laser-assisted uvulopalatoplasty with Nd : YAG laser for sleep disorders

We evaluated the apnea index (AI), the oxygen saturation above 95% (SA95), the lowest oxygen saturation (LSAT), and snoring before and after laser‐assisted uvulopalatoplasty (LAUP) in 106 patients with obstructive sleep apnea syndrome (n=59) or snoring (n=47). Type 1 LAUP was performed in 42 patients and type 2 LAUP in 64 patients. A 50% or greater reduction in AI was observed in 15 patients (35.7%) who underwent type 1 LAUP and 37 patients(57.8%) who underwent type 2 LAUP. Snoring was diminished in 18 (51.4%) of 35 patients who underwent type 1 LAUP and 30 (55.6%) of 54 patients who underwent type 2 LAUP. SA95 and LSAT showed no difference. No serious complications such as significant bleeding, postoperative episodes of asphyxia, nasopharyngeal stenosis, or nasal regurgitation were observed. LAUP was an effective outpatient treatment.