Yuji Kanazawa

Shizuoka General Hospital

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Masahiro Kikuchi

Tokai University Hospital

Shogo Shinohara

Kobe City Medical Center General Hospital

Yasushi Naito

Kobe City Medical Center General Hospital

Keizo Fujiwara

Kobe City Medical Center General Hospital

Hiroshi Yamazaki

Kobe City Medical Center General Hospital

Ippei Kishimoto

Kyoto University

Risa Tona

National Institute on Deafness and Other Communication Disorders

Risa Kurihara

Tokyo University of Pharmacy and Life Sciences

Hiroyuki Harada

Tokyo Medical and Dental University

Koichi Omori

Kyoto University

Cooperative Institutions

Kyoto University

Kobe City Medical Center General Hospital

University of Toyama

Shizuoka General Hospital

Kyoto University Hospital

Kanazawa University

The University of Tokyo

Tohoku Medical and Pharmaceutical University

National Institute of Infectious Diseases

Fujita Health University

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A Case of Glomus Tympanicum Tumor

Practica oto-rhino-laryngologica Suppl (2012)

Yuji Kanazawa Hideo Shojaku Yukio Watanabe

We report a case of glomus tympanicum tumor. A 65-year-old woman seen for right ear pain was found to have a dull red mass behind her right eardrum on otoscopic examination. The tumor was diagnosed as a glomus tympanicum tumor by computed tomography (CT) and magnetic resonance imaging (MRI). Preoperative angiographic findings revealed that this tumor was fed by the middle meningeal artery, which we embolized, and by more than one artery. The tumor was completely removed by transcanal tympanoplasty with only a small amount of bleeding. Bipolar coagulation can coagulate blood vessels and offers better visualization of the surgical field.

Glomus tumor

10.5631/jibirinsuppl.134.58

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A Suspected Case of Lemierre^|^rsquo;s Syndrome with Neck Abscess

Practica Oto-Rhino-Laryngologica (2014)

Ippei Kishimoto Masahiro Kikuchi Shogo Shinohara Keizo Fujiwara Yuji Kanazawa

We report a suspected case of Lemierre’s syndrome with a neck abscess. A 27-year-old man without any significant past medical history visited our hospital with a complaint of right neck pain which had lasted for three days. His tonsils were mildly infected and the uvula was shifted a bit toward the left side. He complained about severe pain in his right neck, which is not usually seen in cases of tonsillitis or peritonsillitis. He was treated with intravenous antibiotics for four days, however, his symptoms did not improve, and contrast-enhanced CT and MRI were performed. These images revealed the existence of a right parapharyngeal abscess and fresh thrombus in the right internal jugular vein extending into the lateral sinus. These findings suggested Lemierre’s syndrome, but there was no abnormality on chest CT. Therefore, he was diagnosed as being suspected as having Lemierre’s syndrome. After intraoral incisional drainage of the parapharyngeal abscess, his symptoms disappeared rapidly. Bacterial culture of the pus in the abscess showed growth of Fusobacterium necrophorum. Anticoagulant therapy with heparin and warfarin was also started and continued after discharge. On the 43rd day from onset of symptoms, remarkable reduction of thrombus was observed on the follow-up MRI. In this case, enhanced MRI was more useful than enhanced CT for detecting the presence of thrombus and confirming the extension of the thrombus. In examining patients with a peritonsillar abscess and severe neck pain, it is important to take Lemierre’s syndrome into consideration because the disease may sometimes be life threatening if overlooked.

Peritonsillar Abscess

Fusobacterium necrophorum

Acute Tonsillitis

Neck pain

Sore throat

Cavernous sinus thrombosis

Lemierre's syndrome

Internal jugular vein

10.5631/jibirin.107.147

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Advantage of a higher position of the tracheostoma with glottic closure for preventing complications related to tracheostomy tube: a retrospective cohort study

BMC Surgery (2022)

Yuji Kanazawa Yasuhisa Kurata Miki Nagai Kenji Inoue Fumihito Nozaki

Abstract Background Surgery to prevent aspiration has complications related to tracheostomy tube, such as the trachea-brachiocephalic artery fistula. Glottic closure procedure makes tracheostoma at a position higher than the first ring of the trachea and theoretically has a potential to prevent such complications owing to a longer distance between the tip of tracheostomy tube and the tracheal membrane adjacent to the brachiocephalic artery. Our aim is to evaluate the safety of glottic closure in neurologically impaired patients by comparing outcomes with laryngotracheal separation. Methods This study is a single-center retrospective study from 2004 to 2019, using data of 15 and 12 patients who underwent glottic closure (GC) and laryngotracheal separation (LTS). The primary outcome was the incidence of postoperative complications induced by tracheostomy tube placement and adjustment of the tracheostomy tube position to prevent these complications, such as by converting to a length-adjustable tube and/or placing gauze between the skin and tube flange. Additionally, we analyzed the anatomical relationship between the tracheostomy tube tip and brachiocephalic artery and measured the distance between them using postoperative CT images. Results No patients in either group had trachea-brachiocephalic artery fistula. Erosion or granuloma formation occurred in 1 patient (7%) and 4 patients (33%) in the GC and LTS groups, respectively. Adjustment of the tracheostomy tube was needed in 2 patients (13%) and 6 patients (50%) in the GC and LTS groups. CT revealed a higher proportion of patients with the tracheostomy tube tip superior to the brachiocephalic artery in GC than LTS group. The mean tracheostoma-brachiocephalic artery distance was 40.8 and 32.4 mm in the GC and LTS groups. Conclusions Glottic closure reduces the risk of postoperative complications related to a tracheostomy tube. This may be due to the higher position of the tracheostoma at the level of the cricoid cartilage, increasing the distance between the tracheostoma and brachiocephalic artery.

Brachiocephalic artery

Tracheal tube

10.1186/s12893-022-01505-2

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Predictive value of middle ear aeration before second-stage operation in staged tympanoplasty with soft-wall reconstruction

Acta Oto-Laryngologica (2013)

Yuji Kanazawa Yasushi Naito Risa Tona Keizo Fujiwara Shogo Shinihara

Conclusion: The extent of middle ear aeration before second-stage canal wall-down (CWD) tympanoplasty was correlated with postoperative middle ear stability. Objective: To evaluate middle ear aeration before second-stage CWD tympanoplasty as a predictor of postoperative re-aeration potential and external auditory canal (EAC) stability in staged CWD tympanoplasty with soft-wall reconstruction (SWR). Methods: Middle ear aeration was evaluated before and at 1 year after the second-stage operation in patients who underwent staged CWD tympanoplasty with SWR for middle ear cholesteatoma. Based on the computed tomography (CT) findings, middle ear aeration was graded as A when the mastoid and tympanic cavities were aerated, B when only the tympanic cavity was aerated, and C in cases with no aeration in the tympanic cavity. We also examined postoperative EAC stability. Results: Forty-one ears were included. In all, 17 of 19 ears (89.5%) with grade A aeration preoperatively maintained grade A aeration postoperatively, while 5 of 18 ears (27.8%) with grade B aeration had grade A aeration, and no ear with grade C aeration had recovered grade A aeration. All ears with grade A aeration preoperatively maintained smooth EACs. EAC retraction requiring additional treatment occurred in five ears with grade B aeration and all ears with grade C aeration.

10.3109/00016489.2013.852690

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A Case of Relapsing Polychondritis with Respiratory Symptom Manifestation Alone

Nippon Jibiinkoka Gakkai Kaiho (2011)

Yuji Kanazawa Masahiro Kikuchi Yasushi Naito Shogo Shinohara Keizo Fujiwara

気道症状のみを呈した再発性多発性軟骨炎 (relapsing polychondritis: RP)の1例を経験した. 症例は呼吸苦を主訴に来院した65歳男性である. 喉頭ファイバースコープで声門下狭窄およびCT検査でびまん性気管狭窄を認めたが膜様部が正常であり, RPが疑われた. 気管切開術を施行し, 同時に気管軟骨から生検を行ったが, 病理組織学的には軟骨の骨化像のみで確定診断が得られなかった. そこで視触診上は異常のない耳介軟骨を生検したところ, 軟骨組織の過去の破壊を示唆する所見がみられ, RPと診断した. ステロイドの投与を行ったところ, 気道狭窄は速やかに改善した. 臨床症状が少なくRPの診断が困難な例では, 耳介軟骨生検を試みるべきである.

10.3950/jibiinkoka.114.30

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A Case of MEN 2B Initially Suspected in Jaw-Deformity Surgery

Practica Oto-Rhino-Laryngologica (2011)

Risa Kurihara Shogo Shinohara Masahiro Kikuchi Keizo Fujiwara Hiroshi Yamazaki

Multiple endocrine neoplasia type 2B (MEN 2B), an autosomal dominant syndrome, involves endocrine tumors caused by RET protooncogene germ-line mutations in chromosome 10. The case we report, initially suspected in jaw deformity surgery, was a 19-year-old man whose malocclusion was found in a school health checkup. In surgery, his somewhat abnormal buccal mucosa and mandible were biopsied and pathological findings indicated multiple mandibular and buccal mucosal neuromas suggesting de novo MEN 2B. Whole-body examination confirmed diagnosis, showing medullary thyroid carcinoma, megacolon, prominent corneal nerves, and mucosal tongue and lips neuromas. Gene examination showed germ-line mutations of the RET protooncogene affecting codon 918 in exon 16. Medullary thyroid carcinoma was treated by total thyroidectomy with central compartment and bilateral neck dissection. Pathological analysis revealed multiple bilateral lobe cancer foci and one central-compartment lymph-node metastasis were detected pathologically. Normal calcitonin and CEA serum levels proved the biochemical cure for medullary thyroid carcinoma 7 months postoperatively. MEN 2B-associated medullary thyroid carcinoma is more aggressive than that without known gene mutations, necessitating early diagnosis and close follow-up. Findings of multiple oral-cavity neuromas thus mandate examination for MEN 2B.

Medullary carcinoma

Neck dissection

Medullary Thyroid Cancer

10.5631/jibirin.104.365

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A Suspected Case of Lemierre’s Syndrome with Neck Abscess

Practica oto-rhino-laryngologica Suppl (2014)

Ippei Kishimoto Masahiro Kikuchi Shogo Shinohara Keizo Fujiwara Yuji Kanazawa

Peritonsillar Abscess

Fusobacterium necrophorum

Acute Tonsillitis

Sore throat

Neck pain

Lemierre's syndrome

Cavernous sinus thrombosis

Internal jugular vein

10.5631/jibirinsuppl.140.114

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Heating Properties of Developed Needle Type Applicator Made of Shape Memory Alloy

Conference proceedings (2007)

Yuji Kanazawa K. Kato T. Yabuhara R. Miyata Takeo Uzuka

This paper discusses radio frequency (RF) interstitial hyperthermia for a brain tumor with a needle type applicator made of a shape memory alloy (SMA). In this method, it is necessary to make appropriate thermal distribution to the region of the brain tumor. However, it is not easy to predict the thermal distribution during the heating. We estimated the temperature distribution inside an agar phantom by the finite element method (FEM), and heated the agar phantom with the developed needle type applicator. Here, first, the developed RF interstitial hyperthermia system with the SMA needle was presented. Second, the results obtained by the computer simulation and the experimental heating results of the agar phantom by using the developed SMA needle type applicator were presented. Comparing computer simulation results and experimental results, we discussed the heating properties of the developed system. Finally, from these results, it is confirmed that the developed needle type applicator made of SMA is useful for wide heating of invasive hyperthermia.

Hyperthermia Treatment

10.1109/iembs.2007.4352584

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Citations (3)

Clinical epidemiology of tracheal invasion from thyroid cancer in Japanese population: Functional outcomes and effect of aging

Cancer Epidemiology (2017)

Yuji Kanazawa Masato Takeuchi Ichiro Tateya Koichi Omori Koji Kawakami

10.1016/j.canep.2017.08.011

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Preoperative Diagnosis and Surgical Strategy in Congenital Auditory Ossicular Malformation of 26 Ears

Nippon Jibiinkoka Gakkai Kaiho (2012)

Yuji Kanazawa Yasushi Naito Shogo Shinohara Keizo Fujiwara Masahiro Kikuchi

当科で2004年から2010年に手術を行った中耳奇形例21例26耳について, 術前検査, 奇形の病態分類, 手術所見, 術式, 術後聴力につき検討した. 側頭骨CT検査で病態を予測できた症例は, キヌタ・アブミ関節離断が12耳中9耳 (75%), ツチ骨キヌタ骨の周囲骨壁との固着が12耳中7耳 (58%), アブミ骨底板の固着が0耳であった (複数病態の重複例あり). 複数の奇形を合併した6例8耳では, 全例で複合する病態を正確には予測できていなかった. 耳介奇形, 外耳道奇形, 鼓膜所見異常を10例12耳に認めた. そのうち9例10耳がツチ骨キヌタ骨の周囲骨壁との固着を伴っており, これらの所見はツチ骨キヌタ骨の固着を予測する上で重要な参考所見と考えられた. 術後1年以上経過した15例20耳 (外耳道形成術を同時に行った症例を除く) の術後経過をみると, 手術による聴力改善率は20耳中18耳 (90%) であり, 不成功例2耳はそれぞれ先天性真珠腫合併例, キヌタ骨体固着, キヌタ—アブミ関節離断, アブミ骨底板固着の合併例であった. このように, 複数の異常の合併例では, より複雑な手術が必要となり, これが不十分な聴力改善につながったと考えられる. 中耳奇形の手術治療に際しては, 側頭骨CTのみならず, 外耳の状態などを含めた術前検査所見を総合して病態のより詳細な把握に努めると同時に, 事前に予測できない病態の可能性について患者へ十分な説明を行っておく必要がある.

10.3950/jibiinkoka.115.158

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