Yoshihiro Tsuruta

Clinical Study of Combined Use of Ofloxacin and Pronase.

Tissue concentrations of ofloxacin (OFLX) and pronase were determined in 58 tonsils and 43 maxillary sinus mucosal biopsies collected surgically after a single oral dose of 200mg of OFLX with or without a daily dose of 54, 000 units of pronase given for the previous 4 days. In tonsils the tissue concentration of OFLX 90 minutes after administration was 2.37μg/g in the OFLX group and 3.72μg/g in the combined group. In maxillary sinus mucosa the tissue OFLX concentration 90 minutes after administration was 1.29μg/g in the OFLX group and 1.79μg/g in the combined group. In both specimens penetration in the combined group was higher than in the OFLX group.The clinical effectiveness, safety and utility were evaluated in 39 patients with paranasal sinusitis who were given OFLX in a daily dose of 600mg for 14 to 28 days with or without pronase in a daily dose of 54, 000 units. In the combined group the clinical efficacy, defined as percentage of patients with exellent or good responses, was 42.9% in those with chronic sinusitis and 83.3% in those with acute exacerbation of chronic sinusitis. On the other hand, in the OFLX group the efficacy was 40% and 50%, respectively. No clinical side effects were observed in the combined group.The results indicate that OFLX with pronase is useful in the treatment of chronic sinusitis and tonsillitis.

Augmentation of Paralyzed Vocal Cord with Autologous Fat Injection.

A 68-year-old male had vocal cord paralysis after extripation of a cervical vagus nerve neurilemoma. Autologous fat was injected into the vocal cord to medialize it. His voice showed both subjective and objective improvement. Although slight intermittent failure of glottic closure persisted, the vibratory margin was almost normal.The use of autologous fat injection for medialization of the vocal cord offers many theoretical advantages over other materials. 1) The graft is autolognous. 2) Fat is easy to obtain. 3) There is no immune reaction. 4) The process can be repeated as many times as necessary. 5) It is relatively inexpensive. 6) There is good preservation of sound waves on phonation.However, it is too early to evaluate the long-term effects of fat injection, and follow-up studies of more patients are needed.