Yoshihisa Kawasaki

Displacement of the Ventricular Fold Following Cordectomy

In order to avoid radiation and its undesirable side effects, we have employed surgical techniques for treatment of early glottic cancer when the lesion is confined to one membranous cord (Fukuda, Saito, Sato, and Kitahara: J. Jpn. Bronchoesophagol. Soc. 30: 7-14, 1979; Fukuda and Saito: Otologica 26: 434-436, 1980; Fukuda, Kawaida, Ohki, Kawasaki, Kita, and Tatehara: J. Jpn. Bronchoesophagaol. Soc. 39: 139-144, 1988). Laser is one of the most popular techniques and it has been accepted as the first choice by many authors (Annyas, Overbeek, Escajadillo, and Hoeksema: Laryngoscope 94: 836-838, 1984; Mcguirt and Koufman: Arch. Otolaryngol. Head Neck Surg. 113: 501-505, 1987; Tsuji, Fukuda, Kawaskai, Kawaida, and Kanzaki: Keio J. Med. 38: 413-418, 1989). However, some cases are difficult to approach by direct laryngoscopy, requiring an external way to expose the lesion. In these cases, cordectomy by laryngofissure is the method of choice, but the function of the glottis could be improved by replacing the excised cord displacing the ventricular fold. This technique, designed by the authors, was carried out in 22 patients and the results from the viewpoint of phonodynamics, voice quality, and cure rate are discussed in this study. The results are encouraging and we believe that this method is a very reasonable alternative to the laser when such equipment is not available. We also believe that late side effects and oncogenic problems associated with radiation are important points to be considered, especially in patients of relatively younger age.

Surgical Treatment of Large Epiglottic Cysts with a Side-Opened Direct Laryngoscope and Snare

Two cases of large epiglottic cysts are reported. Histopathological examination revealed a retention cyst in one case and an epidermoid cyst in the other. We designed a side-opened direct larngoscope and snare for treating epiglottic cysts. This direct laryngoscope is characterized by an opening from the anterior tip to the posterior end of the right side. The removal of the cysts was accomplished by using this direct laryngoscope and a snare under inhalation anesthesia by fiber optic guided endotracheal intubation. The side-opened direct laryngoscope enabled easy insertion of the snare through the right side opening.

Conservative Therapy for Nonspecific Granuloma of the Larynx Using a Beclomethasone Dipropionate Inhaler

Nonspecific granuloma of the larynx is a benign tumor that usually occurs on the posterior glottis. Conventional treatment for this laryngeal lesion has consisted of surgical resection. However, this lesion has a strong tendency to recur postoperatively and may require multiple repeated operative procedures. Conservative treatment, consisting mainly of beclomethasone dipropionate inhalation therapy, was instituted in 20 cases with good results. We discussed the effect of beclomethasone dipropionate on this lesion as well as the etiology of this disease.

Long-Term Results of Ventilation Tube for Otitis Media with Effusion in Children

The treatment of otitis media with effusion (OME) in children by insertion of a ventilation tube has been widely employed ( Armstrong , 1954; Richards et al ., 1972; Kowata et al., 1979; Yokoyama , 1979), and information thus gathered has been abundant ( Mawson and Fagan , 1972; Richards et al ., 1972; Adkins, 1977). A study of long-term results on ventilation tubes used as therapy was conducted on children (ages 3–14) during a 6-year span covering the years from 1978 to 1983. They had undergone treatment for OME at the Department of Otorhinolaryngology, Kawasaki Municipal Hospital.

A case of epiglottic cyst with pendulous appearance.

A case of epiglottic cyst with pendulous appearance is reported. A 53-year-old man suffered from abnormal sensation of the throat and visited our clinic. At the initial examination, a pale yellow cystic lesion was observed on the left side of the lingual surface of the epiglottis. At the next examination, a cystic lesion was observed on the right aryepiglottic fold, and the location of the cystic lesion was different on all subsequent visits. Laryngomicrosurgery through a direct laryngoscope was performed to remove the cystic lesion. The excised lesion had a long stalk and a pendulous appearance. The histopathological diagnosis was epidermoid cyst. The histopathological findings of the stalk were similar to those seen in the stalk portion of pendulous tonsils, suggesting a common etiology of this lesion and pendulous tonsil.

Clinical Experience with Cefoperazone in the Field of Otorhinolaryngology

The clinical usefulness of Cefoperazone for the treatment of post-operative infections or prophylaxis was studied in patients with head and neck tumors. In some cases in which local application of an antibiotic was considered to be useful, Polymyxin B Sulfate was used concomitantly. Cefoperazone administration was clinically useful in 17 of the 18 patients enrolled in this study (very useful in 10, useful in 7) and only one patient failed to respond to Cefoperazone therapy. Adverse reactions or laboratory abnormalities possibly related to the therapy were seen in three patients. However, in one case, the adverse reaction could be attributed to the concomitantly administered anticancer agent, and in the other two cases, reactions were mild and transient.