Nishiyama ENT Clinic

Kawasaki, Japan

Nishiyama ENT Clinic

Kawasaki, Japan

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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 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.


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.


Ota T.,Seirei Yokohama Hospital | Matsui K.,Seirei Yokohama Hospital | Kure K.,Seirei Yokohama Hospital | Esu Y.,Seirei Yokohama Hospital | And 3 more authors.
Practica Oto-Rhino-Laryngologica | Year: 2013

In recent years, there are many reports about percutaneous dilatational tracheostomy (PDT). This procedure has been reported as being simple to perform and has less complications. However, we experienced a case in which a tracheostoma stenosis and granulation hyperplasia occurred due to PDT, and dysphagia occurred because of the defective laryngeal elevation. A 79 years old woman presented with disturbance of consciousness due to a subarachnoid hemorrhage and PDT was performed at an intensive care unit. Following the procedure she was quadriplegic with dysphagia and had to continue rehabilitation. Because of the dysphagia and difficulty in the management of the tracheotomy tube, she was referred to us. We selected laryngeal closure as preventive surgery against aspiration, and obtained a good result. PDT complications have also been reported in several studies. As the procedure is performed blindly, the tube may not be placed medially in the trachea or it may happen to break tracheal cartilages. When particularly long-term breathing management is necessary, we think that surgical tracheotomy associated with very few occurrences of tracheostoma stenosis and granulation hyperplasia is desirable. In addition, the operation that we performed was useful because it was hard to make a diastasis and it was easy to make a permanent tracheal stoma. In those patients with a tracheostoma and dysphagia, we would like to recommend a laryngeal closure operation.


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.


PubMed | Nishiyama ENT Clinic, Kitasato University, Kyoto University and Yamato Municipal Hospital
Type: Journal Article | Journal: The Annals of otology, rhinology, and laryngology | Year: 2016

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).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 g (1 g bFGF + fascia group) or 0.1 g (0.1 g 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.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.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.


Kimura Y.,Tokyo Metropolitan Geriatric Hospital | Kato T.,Tokyo Metropolitan Geriatric Hospital | Nagaoka M.,Tokyo Metropolitan Geriatric Hospital | Ono K.,Tokyo Metropolitan Geriatric Hospital | And 2 more authors.
Journal of Otolaryngology of Japan | Year: 2014

The advent of a super aging society is causing a rapid increase in the number of patients with dysphagia, and, in response, the use of percutaneous endoscopic gastrostomy (PEG) has become markedly widespread over the past decade. As the result of its rapid spread, PEG is controversial both ethically and economically, and, in the revision of medical treatment fees for 2014, the preoperative deglutition usability test of all cases is fixed for the full amount request requirements of gastrostomy. Thus, the demands on dysphagia practice are rising. Therefore, we conducted a survey of the dysphagia practice of otolaryngologists, doctors, and speech therapists in charge of dysphagia practice in hospitals, home medical care clinics, and dental offices in Itabashi-ku, Tokyo, and we considered the role of otolaryngologists in dysphagia practice. According to the survey, the roles that are expected of otolaryngologists in dysphagia practice are the evaluation of swallowing function using videoendoscopic examination of swallowing in over 50% of home medical care clinics and dental offices. On the other hand, surgical treatment is expected of otolaryngologists in over half in the hospital group. A total of 64% of the home care clinic group and 47% of the dental group did not coordinate with otolaryngologists in dysphagia practice because there are no otolaryngologists to consult. The home care clinic group indicated a demand of the swallowing function test in short-term admission or home practice. In the survey of departments of otolaryngology in hospitals or otolaryngology clinics, 40% of these institutions evaluate deglutition, while the other institutions did not perform evaluations because of the lack of human resources or deficient facilities. The otolaryngologist specializes in the laryngopharynx where aspiration occurs, and not only diagnoses local organic disease, but also directs the patient to a doctor in an appropriate department on the basis of understanding the patient's background diseases. We conclude that organized participation and leadership in this region are urgent tasks of otolaryngologist.


Nishiyama K.,Nishiyama ENT Clinic | Nagai H.,Nishiyama ENT Clinic | Usui D.,Nishiyama ENT Clinic | Kurihara R.,Nishiyama ENT Clinic | And 2 more authors.
Nihon Jibiinkoka Gakkai kaiho | 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.


PubMed | Nishiyama ENT Clinic
Type: Journal Article | Journal: Nihon Jibiinkoka Gakkai kaiho | 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.


PubMed | Nishiyama ENT Clinic
Type: Journal Article | Journal: Nihon Jibiinkoka Gakkai kaiho | 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.

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