Muneo Nakaya
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View article: A Case of Severe Recurrent Epistaxis in a Patient with Hereditary Hemorrhagic Telangiectasia who was Treated by Thalidomide and Embolization
A Case of Severe Recurrent Epistaxis in a Patient with Hereditary Hemorrhagic Telangiectasia who was Treated by Thalidomide and Embolization Open
頻回に輸血を要した難治性鼻出血に対し, 外鼻孔閉鎖術を施行するも著効せず, サリドマイド投与および血管塞栓術を施行したオスラー病例を経験したので報告する. 症例は68歳女性. 平均1.5回／月の頻度で大量鼻出血による出血性ショックのため搬送, 輸血を繰り返し, 10カ月で赤血球濃厚液計60単位を投与した. 難治性鼻出血に対し, サリドマイド50mg/日投与および血管塞栓術を4回施行し, 出血量・頻度は減少した. サリドマイドは出血量・頻度の減少, QOL 改善が期待されるが…
View article: A Study on 14 Cases of Tracheostomy in COVID-19 Patients
A Study on 14 Cases of Tracheostomy in COVID-19 Patients Open
The number of infected and critically ill patients rose to a record high between July and September 2021 in Japan, with rampant transmission of the delta variant of the SARS-CoV-2 virus during the fifth wave of the coronavirus disease 2019…
View article: A case of acquired hemophilia diagnosed after thyroid tumor surgery
A case of acquired hemophilia diagnosed after thyroid tumor surgery Open
後天性血友病Aとは,血液凝固第Ⅷ因子に対する自己抗体が様々な要因により出現し,出血症状を呈する自己免疫性疾患である。われわれは甲状腺腫瘍手術を契機に判明した後天性血友病Aの1例を経験した。症例は65歳,女性。甲状腺腫瘍手術後に腹直筋内血腫を認め,精査の結果,後天性血友病Aと診断された。本疾患は,出血により致命的な経過をたどる可能性もあり,早期診断・早期治療介入が望ましい。耳鼻咽喉科・頭頸部外科医にとってはまだ馴染みが薄い疾患であるが,出血性素因のない患者で,血小板数およびP…
View article: Efficacy of High-Dose Corticosteroid Therapy in Acute Stage Severe Facial Palsy in Children
Efficacy of High-Dose Corticosteroid Therapy in Acute Stage Severe Facial Palsy in Children Open
Objectives To evaluate the efficacy of high-dose corticosteroid for severe acute facial paralysis in children. Methods The present study enrolled 10 pediatric patients with House-Brackmann (H-B) Grade VI facial paralysis who received predn…
View article: Relationship between cleft palate width and otitis media
Relationship between cleft palate width and otitis media Open
Objectives To investigate the relationship between cleft width and otitis media (OM) and to determine whether a wide cleft palate (CP) is a risk factor of the incidence, type, amount of middle ear effusion, and prolonged morbidity in OM. S…
View article: A Case of Acquired Factor V Inhibitor Following Nivolumab Administration
A Case of Acquired Factor V Inhibitor Following Nivolumab Administration Open
Acquired factor V inhibitor (AFVI) is a very rare disease. We presented herein a case of hypopharyngeal cancer in which AFVI developed after nivolumab administration. Blood test findings two weeks after the first dose of nivolumab showed a…
View article: A Case of Parotid Gland Facial Nerve Schwannoma Reconstructed by Facial Nerve End-to-Side Anastomosis with the Great Auricular Nerve
A Case of Parotid Gland Facial Nerve Schwannoma Reconstructed by Facial Nerve End-to-Side Anastomosis with the Great Auricular Nerve Open
Intraparotid facial nerve schwannoma is rare. During the process of resection of the parotid gland tumor with sacrifice or intracapsular enucleation of the facial nerve, the postoperative facial nerve function is expected to become worse, …
View article: A Case of Malignant Otitis Externa with Facial Nerve Palsy
A Case of Malignant Otitis Externa with Facial Nerve Palsy Open
Malignant otitis externa (MOE), an invasive infection of the external auditory canal and skull base, typically occurs in elderly patients with diabetes mellitus. The most common causative agent is said to be Pseudomonas aeruginosa, but oth…
View article: A Case of Lightning-Induced Injury of the Tympanic Membrane
A Case of Lightning-Induced Injury of the Tympanic Membrane Open
Lightning strikes, though rare, are associated with a mortality rate of 30%; but even when they are not fatal, they can cause lasting damage. The most commonly reported lightning-induced injury of the ear is tympanic membrane perforation. …
View article: A Case of Relapsing Polychondritis with Bilateral Deafness in a Month
A Case of Relapsing Polychondritis with Bilateral Deafness in a Month Open
Relapsing polychondritis (RP), which is a multisystem, inflammatory, autoimmune disease affecting the cartilage, is relatively rare. RP is characterized by swelling of the auricles, audiovestibular disorders, and airway chondritis. Symptom…
View article: Smoking‐induced radiation laryngeal necrosis after definitive radiotherapy alone for T1a glottic squamous cell carcinoma: A case report
Smoking‐induced radiation laryngeal necrosis after definitive radiotherapy alone for T1a glottic squamous cell carcinoma: A case report Open
Background We report the case of a patient with smoking‐induced radiation laryngeal necrosis (RLN) after undergoing definitive radiotherapy (RT) alone for T1a glottic squamous cell carcinoma. Case The patient was a 63‐year‐old man who had …
View article: A case of paraneoplastic neurological syndrome with dizziness and bilateral progressive sensorineural hearing loss
A case of paraneoplastic neurological syndrome with dizziness and bilateral progressive sensorineural hearing loss Open
Paraneoplastic neurological syndrome (PNS) is a rare syndrome representing the remote effect of a cancer, that is often associated with the presence of specific serum antibodies. PNS can affect the central, peripheral, and autonomic nervou…
View article: A clinical study of parotid surgery: 8 year review of 224 patients at a single institution
A clinical study of parotid surgery: 8 year review of 224 patients at a single institution Open
2012年1月-2019年12月に耳下腺病変に手術を施行した224例を検討した。良性病変192例,悪性腫瘍32例であった。悪性腫瘍の良悪性正診率は高悪性症例で75.0%,低中悪性症例で27.3%であった。良性病変の顔面神経へのアプローチは中枢アプローチ130例,末梢アプローチ56例で,術後顔面神経麻痺は25.0%であった。末梢アプローチは中枢アプローチと比べて,手術時間と術後入院日数が有意差をもって短く,術後顔面神経麻痺の出現率が高い結果となったが有意差は認められなかった。…
View article: A case of destructive thyroiditis with a huge adenomatous goiter cured by thyroidectomy
A case of destructive thyroiditis with a huge adenomatous goiter cured by thyroidectomy Open
今回，保存的治療に抵抗性の，巨大甲状腺腫を伴う破壊性甲状腺炎に対し，外科的治療で改善を得たので報告する。症例は56歳男性，急性心不全の診断で前医に入院した。心不全の原因精査で甲状腺中毒症の関与が疑われ，精査目的で当院内分泌内科を受診した。精査の結果，巨大甲状腺腫を伴った破壊性甲状腺炎が疑われた。症状が出現してから3か月以上経過するも甲状腺中毒症は改善せず手術目的で当科紹介受診し，甲状腺全摘術を施行した。術後，甲状腺ホルモン値は安定し，甲状腺中毒症の症状も消失した。破壊性甲状…
View article: Clinical Experience with a Varicella Zoster Virus Antigen Detection Kit
Clinical Experience with a Varicella Zoster Virus Antigen Detection Kit Open
Diseases caused by varicella zoster virus (VZV) infection, such as Ramsay Hunt syndrome and pharyngolaryngeal herpes zoster, are commonly encountered in clinical practice.
View article: A case of aggressive follicular thyroid carcinoma in pregnancy
A case of aggressive follicular thyroid carcinoma in pregnancy Open
今回，われわれは妊娠中に急速進行した甲状腺濾胞癌遠隔転移例を経験したので報告する。症例は46歳女性。甲状腺濾胞癌遠隔転移に対し，放射性ヨウ素治療中であった。病状進行の可能性があったが，挙児希望があり，不妊治療を経て妊娠に至った。無事，健康な女児を出産したが，妊娠中，原病は急速に進行し，ADLは低下した。適切に治療されている進行分化型甲状腺癌であれば，妊娠は禁忌とはならないが，妊娠に伴うホルモン変化の影響で急速に進行する可能性があることを認識しておく必要があると考えられた。
View article: A Case of Impalement Wound Through the Auricle to the Contralateral Submandibular Region
A Case of Impalement Wound Through the Auricle to the Contralateral Submandibular Region Open
Cases of impalement injuries in the head and neck region, such as injuries caused by toothbrush penetration of the oropharyngeal area, are often encountered in the field of pediatric medicine, although facial injuries are relatively rare. …
View article: A Case of Intratemporal Facial Nerve Schwannoma Observed over the Long Term
A Case of Intratemporal Facial Nerve Schwannoma Observed over the Long Term Open
Surgery is indicated for intratemporal facial nerve schwannoma with severe facial palsy, but even if nerve transplantation or a hypoglossal-facial nerve anastomosis is performed after complete tumor resection, only insufficient resolution …
View article: Caldwell-Luc Operation for an Aneurysmal Bone Cyst in the Maxillary Sinus of a 5-year-old Child: The Three-year Healing Process of the Maxillary Sinus
Caldwell-Luc Operation for an Aneurysmal Bone Cyst in the Maxillary Sinus of a 5-year-old Child: The Three-year Healing Process of the Maxillary Sinus Open
We present herein a case of a 5-year-old female patient with a maxillary aneurysmal bone cyst that was removed using a Caldwell-Luc operation.After three years of follow-up, flattening deformation of the sinus in the inferolateral directio…
View article: A Case of Difficult to Treat Orbital Subperiosteal Abscess
A Case of Difficult to Treat Orbital Subperiosteal Abscess Open
鼻性眼窩合併症の一つである眼窩骨膜下膿瘍に対して3回の膿瘍切開術を施行し,治療に難渋した症例を経験した。症例は20歳女性で,当院受診2日前より左眼痛を自覚し,副鼻腔炎の波及による眼窩蜂窩織炎が疑われ当科紹介となった。CTより左急性副鼻腔炎,左眼窩骨膜下膿瘍及び左眼瞼蜂窩織炎の診断で,緊急で左内視鏡下鼻副鼻腔手術(Endoscopic Sinus Surgery; ESS)および経鼻的左眼窩骨膜下膿瘍切開術を施行した。眼窩上外側を複数回洗浄したが壊死組織は除去しきれなかった。…
View article: A case of thyroid cancer with a non-recurrent inferior laryngeal nerve which preoperatively left vocal cord is paralyzed
A case of thyroid cancer with a non-recurrent inferior laryngeal nerve which preoperatively left vocal cord is paralyzed Open
甲状腺および副甲状腺の手術において反回神経の処理は重要であり，手術による神経損傷を防ぐためにも，その走行を熟知しておく必要がある。しかし，反回神経の走行にはいくつかの亜型があり，非反回下喉頭神経（non-recurrent inferior laryngeal nerve：NRILN）は必ず知っておかなければならない亜型である。症例は52歳男性。嗄声を主訴に受診し，左反回神経麻痺を認め，エコー・細胞診・CT検査にて甲状腺乳頭癌両側頸部リンパ節転移の診断にて手術を行った。術中…
View article: Ocular Adnexa MALT Lymphoma in a 77-year-old Female Controlled by Surgical Resection Alone: A Case Report
Ocular Adnexa MALT Lymphoma in a 77-year-old Female Controlled by Surgical Resection Alone: A Case Report Open
【はじめに】
View article: Clinical Consideration of Odontogenic Maxillary Sinusitis
Clinical Consideration of Odontogenic Maxillary Sinusitis Open
近年,歯性上顎洞炎の原因歯は未治療の齲歯であることは少なく,根管治療後の臼歯が多い。原因歯に対する治療は,抜歯するか保存するかについては明確な方針が定まっていない状況である。2017年4月から2018年3月までに歯性上顎洞炎の診断で内視鏡下鼻内副鼻腔手術を行った29例について検討した。平均年齢55歳(21~87歳),男性16例 女性13例であった。原因歯が根尖性歯周炎であった症例が13例,根尖性歯周炎に辺縁性歯周炎を合併していた症例が8例,原因歯が残根であった症例が2例,そ…
View article: Four cases of extracranial abscess caused by sinusitis exacerbated by a foreign body
Four cases of extracranial abscess caused by sinusitis exacerbated by a foreign body Open
Background: Foreign bodies in the paranasal sinus is a relatively rare. Furthermore, most of foreign bodies in the paranasal sinuses occur in the maxillary sinus, and reports of foreign bodies in frontal sinus are few. Extracranial abscess…
View article: Clinical Consideration of Fungal Rhinosinusitis
Clinical Consideration of Fungal Rhinosinusitis Open
近年,副鼻腔真菌症は増加傾向にあり,その背景には糖尿病患者の増加や経口ステロイド薬使用の増加が指摘されている。加えてCT・MRIなどの画像検査の普及により偶発的に見つかるケースも増加している。2010年1月から2016年12月までに当科で内視鏡下鼻内副鼻腔手術を行い病理組織学的に副鼻腔真菌症と診断された82例を対象に,分類,年齢,性別,患側,主訴,基礎疾患,鼻内所見,罹患洞,画像所見,術前診断,治療・予後について検討した。病型は非浸潤性真菌症が75例,アレルギー性鼻真菌性副…
View article: Paranasal Tuberculosis
Paranasal Tuberculosis Open
sinus surgery, ESS)を他院で施行された。ESSで上顎洞に肉芽病変を認め，術後の再生検でZiehl-Neelsen染色陽性・液体培 養陽性で副鼻腔結核の診断となった。肺に陰影があり， 喀痰塗抹検査でもZiehl-Neelsen染色陽性であったので，