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1.
J Voice ; 32(3): 374-380, 2018 May.
Article in English | MEDLINE | ID: mdl-28687381

ABSTRACT

OBJECTIVE: We reviewed the clinical anatomy of the anterior commissure and examined the effectiveness of a specialized spreader developed for optimal, efficient spreading of the thyroid cartilage in type II thyroplasty. STUDY DESIGN AND METHODS: The present study was a multicenter retrospective study of patients with spasmodic dysphonia who underwent a primary operation either before or after the introduction of a specialized spreader (in 2008 or 2014, respectively). In these patients, we examined the size of the titanium bridge used, the presence of perforation of the mucosa directly superior to the anterior commissure, and postoperative glottic findings. RESULTS: The sample comprised 39 and 40 patients who underwent surgery in 2008 and 2014, respectively. The mean size of the titanium bridge used during surgery was significantly smaller in 2014 (2.9 mm) than in 2008 (3.81 mm). Perforation of the laryngeal mucosa occurred in 13 patients in 2008 but occurred in only one patient in 2014. Based on glottic findings, spreading the thyroid cartilage using the specialized spreader was deemed to yield an effective glottic gap. CONCLUSIONS: In type II thyroplasty, the handling of the anterior commissure is the most important point. It is necessary to split the tendon and to spread the glottis while the tendon is joined with the cartilage. For this purpose, a specialized spreader was made. The use of a specialized spreader renders separation around the anterior commissure unnecessary, enabling minimally invasive spreading of the thyroid cartilage and thereby improving phonation.


Subject(s)
Dysphonia/surgery , Glottis/surgery , Laryngoplasty/methods , Tendons/surgery , Thyroid Cartilage/surgery , Adult , Dysphonia/diagnosis , Dysphonia/physiopathology , Equipment Design , Female , Glottis/physiopathology , Humans , Japan , Laryngeal Mucosa/injuries , Laryngoplasty/adverse effects , Laryngoplasty/instrumentation , Male , Phonation , Recovery of Function , Retrospective Studies , Surgical Instruments , Tendons/physiopathology , Thyroid Cartilage/physiopathology , Titanium , Treatment Outcome , Voice Quality
2.
Nihon Shokakibyo Gakkai Zasshi ; 110(5): 846-51, 2013 May.
Article in Japanese | MEDLINE | ID: mdl-23648541

ABSTRACT

A 38-year-old man was given a diagnosis of as sigmoid colon cancer and underwent sigmoid colectomy. Post-operative pathological staging was stage IIIb. He then underwent adjuvant chemotherapy. One year and 4 months after the surgery, CT scans revealed multiple liver and lung metastases. He was given mFOLFOX6+bevacizumab, which was changed later to FOLFIRI+bevacizumab. After these chemotherapies, he was admitted to the hospital due to sudden abdominal pain and high grade fever. Obstructive jaundice was initially diagnosed, but detailed study of initial CT revealed intragastric wall abscess. After the drainage of the abscess, his conditions improved. We speculated that the abscess formation was caused by mucosal damage due to bevacizumab.


Subject(s)
Abscess/chemically induced , Angiogenesis Inhibitors/administration & dosage , Angiogenesis Inhibitors/adverse effects , Antibodies, Monoclonal, Humanized/adverse effects , Stomach Diseases/chemically induced , Adult , Antibodies, Monoclonal, Humanized/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Bevacizumab , Chemotherapy, Adjuvant/adverse effects , Gastric Mucosa/drug effects , Humans , Male , Sigmoid Neoplasms/therapy
3.
Int J Pediatr Otorhinolaryngol ; 73(10): 1368-72, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19631395

ABSTRACT

OBJECTIVES: Abnormal cortical responses in patients with functional hearing loss were evaluated by magnetoencephalography, which can better separate bihemispherical activity than electroencephalography. METHODS: Auditory evoked fields in response to 1 kHz or 2 kHz tone bursts at 80 dB sound pressure level were measured by a helmet-shaped magnetoencephalography system in 22 patients with functional hearing loss (18 females, mean age 13.2 years) as well as 5 control subjects under 10 years old. Waveform, latency, and equivalent current dipole of N100m responses were used to evaluate activity in the bilateral auditory cortices. RESULTS: Abnormal N100m of the contralateral response to the stimulated ear, either absence or delayed latency in comparison to normal adult subjects, was found in 6 of the 7 patients with functional hearing loss aged 9 years or younger, but in only 3 of the 15 patients aged 10 years or older. However, such abnormalities were also observed in younger control subjects. CONCLUSION: Auditory evoked field may be applied to objectively evaluate cortical auditory function in patients with functional hearing loss, but the normal findings for young children have not yet been established.


Subject(s)
Evoked Potentials, Auditory/physiology , Hearing Loss, Functional/diagnosis , Hearing Loss, Sensorineural/diagnosis , Magnetoencephalography , Adolescent , Age Distribution , Audiometry, Pure-Tone/methods , Auditory Cortex/physiopathology , Case-Control Studies , Child , Early Diagnosis , Female , Follow-Up Studies , Hearing Loss, Functional/epidemiology , Hearing Loss, Sensorineural/epidemiology , Humans , Male , Reference Values , Risk Assessment , Sensitivity and Specificity , Sex Distribution , Young Adult
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