Toshi Naito

The effect of eye-closure upon nystagmus.

Influence of closure of eye and mental arithmetic on nystagmus was studied. Influences on nystagmus during horizontal pendular rotation (Amp. 45d` Period 5) : in cases of the normal and central lesion. Nystagmus is inhibited by closure of eye and this inhibition is removed by mental arithmetic.Closure of eye makes caloric nystagmus larger in the normal persons and the patients with the peripheral lesion, and smaller in the patients with the central lesion.Spontaneous or positional nystagmus is inhibited by closure of eye in cases with central lesion such as brain tumor, but not in cases with the peripheral lesion such as MBniGres disease.Nystagmus inhibited by closure of eye becomes apparent by mental arithmetic.The data may be useful to identify the lesion whether it is central or peripheral.

Meatotympanoplasty with Special Reference to the Postoperative Hearing

We introduce our experience in “meatotympanoplasty”, a tympanoplastic operation with the preservation of the ear canal. The outline of the procedure is elevation of the skin of the ear canal from the bony wall as a pedicule tube, retrograde removal of the bridge portion as needed, excentration of the mastoid pathology by retroauricular approach, re-establishment of middle ear conductive system, covering the ossicles with the connective tissue flap, and repositioning the skin of ear canal over the flap. Postoperative drying of the ear canal is attained early and the after care is unnecessary. It is also emphasized that the preservation of the normal ear canal is the method of choice from the standpoint of hearing gain. A favorable effect of the preservation of the normal ear canal upon the postoperative hearing was substantiated by clinical and experimental studies. Clinically, the hearing was compared before and after packing the posterior fossa of the tympanoplastically operated ear canal. Experimentally...

Surgical Experience of Auricle Formation For Microtia

The authors have experiences of surgical auricle formation for microtia by costocartilage frame method on 22 cases in the period covering 1968 to 1979, which we are reporting hereunder.The operation was done in Fukudas procedure, which is presently done in three stages. The first stage operation consists of downward turning of the existing portion of lobule, formation of a subcutaneous pocket in the location for the auricle formation, removing of autocostocartilage from the patients chest for transplant-use, formation of an auricle with the costocartilage and transplantation of the costocartilage auricle frame into the subcutaneous pocket, and thus the present operation method includes the external auditory meatus formation. The second stage operation consists of decollement of the lower two thirds of the transplanted costocartilage frame to raise it, the process of so-called “ear raising”, as well as the full thickness skin grafting to cover the exposed raw surface. The third stage operation consists of decollement and fixing of the upper one third of the costocartilage frame and the full thickness skin grafting to cover the exposed raw surface.Besides the above, two or three times of trimming of various parts of the auricle are done.The above-method operation was completed on 17 cases. Both the patients and the surgeons were more than satisfied in 6 cases; the surgeons were extremely satisfied while the patients were fairly satisfied in 5 cases; both the patients and the surgeons were not quite satisfied in 2 cases, and both the surgeons and the patients were unsatisfied in 4 cases.Retrospectively from these experiences, we conclude that this operation method should be applied starting at the patients age of 8 to 9 years; that the frame work should be done excellently, that decollement of the subcutaneal tissues should be sufficiently done; that subcutaneal tissue steel should be formed; that the frame should be covered with subcutaneal tissues; that the mattress suture should be relaxed; that the method of raising the auricle be improved, etc. in order to perform better and more satisfactory auricle formation.

Clinical Application of Evoked Electromyography (Frequency Depression Curve) in the Diagnosis and Treatment of Vertigo

For the purpose of determining how abnormal myogenic tonus of the skeletal muscles is involved in the mechanism of vertigo and equilibrium disturbances and investigating whether the classification of antivertigo agents would be possible electro myographically, evoked electromyography by H-reflex of the gastrocnemius muscle was applied to the cases complaining of vertigo and equilibrium disturbances and their frequency depression curves (hereinafter referred to as FDC) were investigated. Two hundred and twenty nine patients who visited the Otolaryngological Department of Osaka University during the period from June 1971 to November 1975, complaining of vertigo and equilibrium disturbances were examined. In the cases of vertigo, FDCs of rigid, rigospastic or spastic type, reflecting hypertonic myogenic tonus of the gastrocnemius muscle, or FDCs of cerebellar type reflecting hypotonic myogenic tonus were seen, and both FDCs of the right and left gastrocnemius muscle were found to be widely different. In the patients complaining of body sway, the rigid type of FDC was recognized and in the cases of equilibrium disturbances, the cerebellar type of FDC was observed. In 80 % of the cases having attacks of vertigo, abnormal types of FDC were observed, differing between right and left legs. On the other hand, in the remission period of attacks, the normal type of FDCs with less difference between legs was observed. There were found correlations between the type of FDCs showing the myogenic tonus abnormality of the gastrocnemius muscle and the results of body deviation tests. It was assumed that the classification of types of FDCs will be of use for the search for suitable antivertigo drugs effective in the treatment of various vertiginous conditions and equilibrium disturbances.

Motion Sickness and Nasal Allergy among Preschool and School-age Children

A survey of 7, 200 preschool and children between ages 6 and 15, for motion sickness and nasal allergy showed that 2, 600 (35.7%) habitually experienced motion sickness, with the incidence being higher among females, and that 1, 000 (13.7%) had symptoms of nasal allergy with its predilection for males.Comparison of these data with the data in 1963 showed that the incidence of motion sickness has increased tenfold during this 14 year period probably due to increased utilization of cars and buses.

Anti-Vertigo Agents and Experimental Measurement of Inner Ear Temperature (Thermister Method)

The influence of an anti-vertigo agent upon inner ear temperature was studied using an experimental inner ear temperature measuring method that utilizes a thermister. An injection needle-type thermister was inserted into inner ear of 34 normal rabbits through fossa fenestra rotunda by an inner ear fenestration operation ( Honjo , 1954 ), and inner ear temperature was measured. Various anti-vertigo agents were administered and the time change of temperature was observed. At the same time the temperature of rectum was also measured by the same method as a control. Some anti-vertigo agents caused increases in inner ear temperature (7 % sodium bicarbonate, diphenidol, etc.), while others acted to reduce the temperature (pilocarpine, furosemide, etc.). Some showed only temporary action while others showed a sustained effect. The change of rectal temperature measured simultaneously roughly parallelled the fluctuation of inner ear temperature but the slope of the change of temperature was less sharp than that of the inner ear. To classify drugs according to the change of inner ear temperature may be a useful clue to judging the pharmacological action of anti-vertigo agents.