Yutaka Furukawa

Schwannoma of the skull base with intracranial extension

A case is reported of solitary schwannoma involving the skull base with extension into the middle cranial fossa and parasellar region. The patient presented with an exophthalmos and ipsilateral facial numbness. The tumor was successfully excised via a two-stage procedure involving an initial intracranial and subsequent transmaxillary approach. The relevant literature on the presentation and treatment of schwannomas of the skull base with intracranial extension is also reviewed.

Changes in Gastric EMG Resulting from Differences in Direction of Linear Acceleration in Rabbits

The role of direction of linear acceleration in stimulation of the otolith organ, which leads to alteration of autonomic activities in the form of inhibition of gastric motility, has not been fully studied. With a view to elucidating this problem, we placed healthy adult rabbits unanesthetized and unrestrained in individual cages, and subjected them to the three different linear acclerations to study changes in gastric EMG. As a result, the forward-and-backward movement was found to inhibit the EMG activity most potently, and was followed in decreasing order by side-to-side movement and up-and-down movement. These findings, when viewed from the standpoint of the accepted concept that optimum stimulation to the otolith organ constitutes the shearing force, account well for the supposition that forward-and-backward movement stimulates both the sacculi and utriculi, while up-and-down movement stimulates the sacculi alone.

Peripheral Facial Palsy Accompanied with the Systemic Disease

In the entity of the peripheral facial palsies, there are idiopathic, otitic, traumatic palsy, Ramsay Hunts syndrome, and others. The causes of the facial palsies were due to the disturbance of microcirculation and the bleeding in Fallopian canal, infection of bacteria and virus, the direct damage of the facial nerve and etc..Some of them occur accompanying with the systemic disease. We reported 8 cases of the facial palsies which were accompanied with the systemic disease. These systemic disease were diabetes mellitus, sarcoidosis, aseptic and carcinomatous meningitis, systemic lupus erythematosus, aplastic anemia, and pregnancy. The facial palsies accompanied with diabetes mellitus and pregnancy are due to the disturbance of microcirculation (anoxia, ischemia, microembolism). As sarcoidosis sometimes involves in degeneration of myelin, and aseptic meningitis and infectious mononucleosis are viral infection of seventh nerve, these cause probably a neuritis or a ganglionitis. The palsy of carcinomatous meningitis is rare, but if initial symptom is only facial palsy, this palsy should be differentiated from idiopathic facial palsy (Bells palsy).As aplastic anemia causes the tendency of bleeding, this palsy occurs from the bleeding in Fallopian canal. One case of the facial palsy accompanying the aplasic anemia revealed the bleeding in Fallopian canal by autopsy. The importance of systemic disease as a possible cause of idiopathic facial palsy was emphasized.

A Foreign Body in the Parotid Gland and Facial Palsy

2歳小児の耳下腺内異物による晩発性顔面神経麻痺症例を報告した. 診断は非常に困難であり, 試験切除術時にたまたま異物がみつかり, はじめて診断がえられた.どの疾患でもそうであるが, 既往歴, 現症歴の重要性を痛感させられた. とくに小児では充分な情報が得られないので, 家族および関係者から事情を充分に聴取することが大切である.疾患が極めて珍しい種類のものであったため, 耳下腺内に異物を113日もの間, 長期滞在させ, 診断上種々反省させられた症例であった.