Yoshihiro Shibahara

Histopathologic Study of Eustachian Tube in Cleft Palate Patients

We studied eight temporal bones from eight individuals with cleft palates (CPs) and eight age-matched control temporal bone specimens from our collection. We used the eustachian tube (ET) and its surrounding structures in serial vertical histologic sections. The findings observed in CP specimens were as follows: 1) the angle between axial lines through the tensor veli palatini (TVP) muscle and the superior portion of the ET lumen was narrow, 2) the angle between axial lines through the lateral lamina and the medial lamina of the cartilage was wide, 3) the angle between axial lines through the TVP muscle and the lateral lamina of the cartilage was narrow, and 4) the angle between axial lines through the superior part and the inferior part of the ET lumen was wide. From these findings, we assume that the ET dysfunction that occurs in individuals with CP is the result of abnormalities of the ET and its cartilage and of abnormal anatomic relationships of these structures to the TVP muscle.

Bone destruction due to the rupture of a cholesteatoma sac. A pathogenesis of bone destruction in aural cholesteatoma

Severe bone destruction in a cholesteatoma is one of the characteristic clinical features. To clarify the mechanism of bone destruction in cholesteatoma, the matrix of cholesteatoma and the attached bone, obtained during middle ear surgery, was observed by light microscope. Rupture of the epithelial lining in a cholesteatoma and the escaping contents (keratin), which gave rise to intense characteristic granulations in subepithelial tissue, were found. Furthermore bone destruction was always found at the site of subepithelial tissue of cholesteatoma. From these facts, the escape of contents from the sac of cholesteatoma into the subepithelial layer is considered to be an important factor in the mechanism of bone destruction.

A Morphological Study of the Vestibular Sensory Epithelia in the Rabbit

Surface preparations were made of the vestibular sensory end-organs of the rabbit. The total sensory cell counts and surface area measurements were made from the composite photographic reconstructions. The general topographical and cytoarchitectural arrangements were found to be similar to those previously described for guinea pigs, squirrel monkeys and humans. The sensory cell counts of the maculae are about 50% larger in the rabbit than in the guinea pig, while those of the cristae remained almost unchanged in both species of animals despite a large difference in both size and weight. The body size of the species does not seem to play a decisive role in determining the sensory cell population of the vestibular sensory end-organs. The growth of the maculae is compared with that of the cristae or vice versa seems to vary from one species to another, probably depending upon a physiological need of the species.

Treatment of Esophageal Stenosis in the Neck after Sungical Reconstruction

58才, 女性. 下咽頭腫瘍による咽頭喉頭頸部食道摘出例にをける再建頸部食道術後狭窄の治療経験をのべた.(1) 局所皮弁及び一部遊離植皮を用いる方法による食道再建であるが, 4年3ヶ月で狭窄を生じた.(2) 食道再建術後長期間を経て生じた瘻孔形成, 食道は狭小に起因する可能性をチェックする必要がある.(3) 狭窄部瘢痕を摘出したのち粘膜縫合を行い, 経鼻胃管のみを留置していても, いづれ抜管後に再狭窄を生ずる可能性がある.(4) 狭窄部の処置は, DP皮弁にて新しく食道を作り変える等の, 根本的方法をとる方がよいように思われる.(5) 症例によっては, 食物の経口摂取を可ならしめながら, 食道持続拡張プロテーゼを長期間留置 (本例では5ヶ月) する方法も考慮されてよいと思う.