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Nishiyama K.,Nishiyama ENT Clinic | Nagai H.,Yamato Municipal Hospital | Usui D.,Kanagawa Dental College | Kurihara R.,Kanagawa Dental College | And 2 more authors.
Journal of Otolaryngology of Japan | Year: 2010

In a one-year-plus follow-up study in 17 of 26 cases involving apparent liquid aspiration during videoendoscopic screening, subjects were instructed in swallowing using video images and in choosing food, utensils, and posture. The amount of sputum decreased in 10 case (59%), and sputum sticking in the throat disappeared in 4 (18%). Body weight also increased in 4 (24%). Choking coughs noted in 11 during initial videoendoscopy disappeared in 2 (18%). We thus, concluded that detecting dysphagia symptoms early and providing follow-up could help prevent aspiration pneumonia.


Nagai H.,Yamato Municipal Hospital | Nishiyama K.,Nishiyama ENT Clinic | Seino Y.,Kitasato University | Tabata Y.,Kyoto University | Okamoto M.,Kitasato University
Annals of Otology, Rhinology and Laryngology | Year: 2016

Objectives: Paralyzed tissue due to long-term denervation is resistant to many treatments because it induces irreversible histological changes and disorders of deglutition or phonation. We sought to determine the effect of autologous transplantation of fascia into the vocal fold (ATFV) with controlled release of basic fibroblast growth factor (bFGF) on long-term unilateral vocal fold paralysis (UVFP). Methods: Unilateral recurrent laryngeal nerve (RLN) section was performed on 20 rats. Five rats were implanted with autologous fascia only (fascia group), and 10 rats were implanted with autologous fascia and a gelatin hydrogel sheet with 1 μg (1 μg bFGF + fascia group) or 0.1 μg (0.1 μg bFGF + fascia group) of bFGF 4 months after RLN section. We evaluated the normalized glottal gap and laryngeal volume and histological changes 3 months after implantation. Results: The normalized glottal gap was significantly reduced in the 3 fascia implantation groups. Normalized laryngeal volume, fat volume, and lateral thyroarytenoid muscle volume were significantly increased in the 2 fascia implantation with bFGF groups. Conclusions: The ATFV with controlled release of bFGF repaired the glottal gap and laryngeal volume after RLN section and may reduce the occurrence of aspiration and hoarseness. We speculate that this treatment improves laryngeal function in long-term RLN denervation. © SAGE Publications.


Nagai H.,Yamato Municipal Hospital | Nishiyama K.,Nishiyama ENT Clinic | Seino Y.,Kitasato University | Kimura Y.,Kyoto University | And 2 more authors.
American Journal of Otolaryngology - Head and Neck Medicine and Surgery | Year: 2013

Purpose The purpose of this prospective study was to determine the effect of autologous transplantation of fascia into the vocal fold (ATFV) with controlled release of basic fibroblast growth factor (bFGF) on unilateral vocal fold paralysis (UVFP) in a rat model. Materials and methods Unilateral recurrent laryngeal nerve (RLN) section was performed on 15 rats. Ten rats received an autologous fascia implant and gelatin hydrogel with or without bFGF (1 μg) to their larynxes (fascia only, "fascia group"; bFGF + fascia, "fascia + bFGF group"), while the rest underwent RLN transection ("RLN section group"). Four months later, evaluation of the laryngeal glottal gap and histological analysis were performed. Results The glottal gap was significantly reduced in the fascia + bFGF group, and fat volume increased significantly relative to the RLN section. The volume of the remaining fascia in the bFGF + fascia group was significantly greater than that of the fascia group. Conclusions ATFV with controlled release of bFGF may compensate for diminished laryngeal volume in UVFP by reducing resorption of the implanted fascia and increasing fat volume. Our findings suggest that this modality may represent an attractive option for treating UVFP. © 2013 Elsevier Inc.


Okami K.,Tokai University | Ebisumoto K.,Tokai University | Sakai A.,Tokai University | Sugimoto R.,Tokai University | And 8 more authors.
Head and Neck | Year: 2013

Background The objective of this study was to evaluate the efficacy and safety of minimally invasive transoral en bloc resection of superficial pharyngeal and laryngeal cancers. Methods Forty-one superficial lesions (from 35 patients) were resected transorally under a surgical microscope using a monopolar cautery. Quality of life (QOL) was assessed using a questionnaire European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Cancer Module (EORTC QLQ-H&N35) 1 year after the surgery. Results Twenty-eight hypopharyngeal, 5 oropharyngeal, and 8 laryngeal cancers were operated on using this method. The surgical field was widely exposed with a wide-caliber scope or extending laryngoscope. A bimanual procedure under a surgical microscope enabled us to achieve en bloc resection. The local control rate was 98%. No postoperative dyspnea or dysphagia was observed. Postoperative QOL scores were favorable. Conclusions Our transoral en bloc resection technique can be easily adopted, and it effectively maintained QOL after treatment. Copyright © 2012 Wiley Periodicals, Inc.


Nishiyama K.,Nishiyama ENT Clinic | Nagai H.,Yamato Municipal Hospital | Usui D.,Kanagawa Dental College | Kurihara R.,Kanagawa Dental College | And 2 more authors.
Journal of Otolaryngology of Japan | Year: 2010

In screening tests for dysphagia conducted using videoendoscopy in 81 subjects over 75 years old apparent liquid aspiration was found in 26 (32%). In 2 of these 26 saliva aspiration was observed. Logistic analysis of aspiration versus clinical symptoms, including endoscopic findings, showed a significant correlation between aspiration and longer time required for meals, bending forward during swallowing, choking during meals, hypoesthesia of the larynx, delayed swallowing reflex and difficulty in spitting. Results were considered clinically significant although they did not appear to fully agree with those of previous studies. The usefulness of videoendoscopy was confirmed.

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