Hiroyuki Wakisaka

Ehime Prefectural University of Health Science

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

A Study of Cases of Cervical Neurinoma Surgery

Nippon Jibiinkoka Gakkai Kaiho (2018)

Sohei Mitani Toru Ugumori Hinako Kawamoto Tomoyoshi Sanada Junpei Nota

頸部神経鞘腫に対する手術は, 神経温存を目指した被膜間摘出術など, そのほかの一般的な頸部腫瘍に対する術式とは異なった手技を要する. 今回, 2000～2016年の間に当科で手術を施行した頸部神経鞘腫の12例について臨床的検討を行い報告する. 男性, 女性それぞれ6例ずつで, 平均年齢は46歳 (14～81歳) であった. 起源神経は, 迷走神経が4例と最多で, 交感神経, 腕神経叢がそれぞれ2例, 舌下神経, 鎖骨上神経がそれぞれ1例, 不明が2例であった. 当科では, 術後 QOL に重要と考えられる神経については, 被膜間摘出術を基本とし, 温存を試みている. 頸部神経鞘腫は比較的まれな腫瘍であり術前に確定診断を得られないことが多いが, 術前の画像検査での腫瘍の形状や部位は, 神経鞘腫を疑う上で重要な所見であると考えられた. 被膜間摘出術を施行した9例中5例 (56%) に術後神経脱落症状を生じた (永続性麻痺4例, 一過性麻痺1例) が, 特に腫瘍が舌骨より高位である副咽頭間隙に存在した症例で80% (4/5例) と高率であった. 舌骨より高位に存在する神経鞘腫では, 術後神経脱落症状を生じる可能性が高いことを考慮した上で, 慎重に手術適応を検討する必要がある. また, 神経温存を目指して被膜間摘出術を行う際には, 神経上膜の切開部位に注意を要する.

10.3950/jibiinkoka.121.673

Cite

Citations (0)

An Experimental Study of Facial Nerve Paralysis Induced by Reactivation of Herpes Simplex Virus Type-1

Otology & Neurotology (2002)

Hisanobu Kisaki Hirotaka Takahashi Nobumitsu Honda Hiroyuki Wakisaka Naohito Hato

Kisaki, Hisanobu; Takahashi, Hirotaka; Honda, Nobumitsu; Wakisaka, Hiroyuki; Hato, Naohito; Murakami, Shingo; Gyo, Kiyofumi; Yanagihara, Naoaki Author Information

Facial paralysis

10.1097/00129492-200200001-00042

Cite

Citations (1)

Efficacy of Early Treatment of Bell's Palsy With Oral Acyclovir and Prednisolone

Otology & Neurotology (2003)

Naohito Hato Shuichi Matsumoto Hisanobu Kisaki Hirotaka Takahashi Hiroyuki Wakisaka

To investigate the therapeutic effects of acyclovir and prednisolone in relation to the timing of treatment in Bell's palsy.This was a retrospective study of 480 Bell's palsy patients who were treated with oral acyclovir and prednisolone (94 cases) or prednisolone alone (386 cases).Patients met the after criteria: (1) severe or complete Bell's palsy with a score lower than 20 on the 40-point Yanagihara facial score and (2) treatment started within 7 days after onset. The patients were treated with oral prednisolone (60-40 mg/day) with or without oral acyclovir (2,000 mg/day).Rate of recovery, which was defined as a facial score of 36 or more, and the absence of contracture with synkinesis.The overall recovery rate of patients treated with acyclovir and prednisolone was 95.7 percent, which was better than that of patients treated with prednisolone alone (88.6%). The recovery rate in patients who began the combined therapy within 3 days of the onset of palsy was 100 percent and early treatment resulted in early remission. In contrast, the recovery rate in patients who started the combined therapy more than 4 days after onset was 86.2 percent.These results suggest that early diagnosis and treatment within 3 days of the onset of paralysis are necessary for maximal efficacy of combined acyclovir and prednisolone therapy for Bell's palsy.

Prednisolone

Facial paralysis

10.1097/00129492-200311000-00022

Cite

Citations (117)

Facial synkinesis after experimental compression of the facial nerve comparing intratemporal and extratemporal lesions

The Laryngoscope (2010)

Hiroyuki Yamada Naohito Hato Shingo Murakami Nobumitsu Honda Hiroyuki Wakisaka

The anatomical configuration of the facial nerve differs greatly between the intratemporal and extratemporal portions. The purpose of this study was to investigate the incidence of facial synkinesis and misdirection on clamping the facial nerve at the intratemporal or extratemporal portion of the facial nerve in guinea pigs.Experimental study.In 16 guinea pigs, the facial nerve was clamped with microsurgical needle forceps at either the extratemporal (group A) or intratemporal (group B) segment. Facial nerve function was evaluated 1 week postoperatively using electroneurography (ENoG), and the incidence of facial synkinesis was evaluated 15 weeks postoperatively using an evoked blink reflex test. Fifteen weeks postoperatively, two retrograde fluorescent tracers (Dil [1-1'-dioctodecyl-3,3,3',3'-tetramethyl-indocarbocyanine perchlorate] and True Blue) were injected into the facial muscles to observe reorganization of the facial nucleus.No significant difference in the ENoG threshold was observed between groups A and B. In group A, none of the animals developed facial synkinesis and the somatotopic organization of the facial nucleus was not disturbed. In contrast, synkinesis occurred and the somatotopic organization was disturbed in group B.A lack of funicular structure within the intratemporal facial nerve increases the possibility of misdirected regenerating axons and synkinesis.

Synkinesis

Electroneuronography

Facial muscles

10.1002/lary.20840

Cite

Citations (22)

Lectin histochemical study on the olfactory organ of the newt, Cynops pyrrhogaster, revealed heterogeneous mucous environments in a single nasal cavity

Anatomy and Embryology (2003)

Shouichiro Saito Toshiyasu Matsui Naoto Kobayashi Hiroyuki Wakisaka Katsumi Mominoki

Vomeronasal organ

Nasal glands

Submucosal glands

Olfactory mucosa

Jacalin

10.1007/s00429-002-0306-1

Cite

Citations (26)

One-step nucleic acid amplification for detecting lymph node metastasis of head and neck cancer

Journal of Clinical Oncology (2009)

Hiroyuki Goda Koh‐ichi Nakashiro Teizo Yoshimura Tomomi Sumida Hiroyuki Wakisaka

6028 Background: Lymph node stage is an important prognostic factor in squamous cell carcinoma of the head and neck (SCCHN). We previously reported the clinical usefulness of sentinel lymph node (SLN) biopsy diagnosed by concurrently performing histological examination using semiserial sections and genetic analysis by quantitative RT-PCR. However, these methods took about 3 hours. In this study, we have attempted to develop a more efficient method for intraoperative genetic detection of lymph node metastasis in SCCHN. Methods: A total of 291 lymph nodes (59 patients) resected on SLN biopsy for cN0 SCCHN or neck dissection for cN1/2 SCCHN were diagnosed by one-step nucleic acid amplification (OSNA) method using GD-100. The primary site was tongue, gingiva, oral floor, buccal mucosa, and pharynx in 44% (26), 37% (22), 10% (6), 5% (3), and 3% (2), respectively. OSNA consists of a short homogenization step followed by amplification of cytokeratin 19 (CK19) mRNA directly from the lysate. It is characterized by the use of 4 different primers specifically designed to recognize 6 distinct regions, so the CK19 primers do not amplify the known CK19 pseudogenes. The reaction process proceeds at a constant temperature (65°C) during strand displacement reaction. Amplification and detection of CK19 mRNA can be completed in a single step. Each lymph node was divided into two halves to diagnose metastasis. An alternative half was used for the OSNA assay with cytokeratin 19 (CK19) mRNA, and the remaining block was subjected to semiserial sectioning, sliced at 200-μm intervals and then examined by H&E and cytokeratin AE1/AE3 immunohistochemical staining. Results: Fifty-four of 291 lymph nodes were pathologically metastasis-positive. The optimal cut-off for the copy number of CK19 mRNA in assessing lymph node metastasis was 300 copies/μl, which had the highest diagnostic accuracy. The sensitivity and specificity of OSNA assay with CK19 mRNA was 92.6% (50/54) and 97% (230/237), respectively. An overall concordance rate between the OSNA assay and histopathology was 96.2%. The OSNA assay could be completed within 30 minutes. Conclusions: The OSNA assay showing high sensitivity and specificity can be used as a novel genetic detection tool of lymph node metastasis in SCCHN patients. No significant financial relationships to disclose.

Neck dissection

10.1200/jco.2009.27.15_suppl.6028

Cite

Citations (4)

THE RELATIONSHIP BETWEEN BELL'S PALSY AND HIV, HTLV-1 INFECTION

Facial nerve research (1999)

Nobumitsu Honda Hisanobu Kisaki Hirotaka Takahashi Hiroyuki Wakisaka Shingo Murakami

Source

Cite

Citations (0)

Gastric scirrhous carcinoma as a rare cause of aggressive fibromatosis in the neck

American Journal of Otolaryngology (2001)