研究者詳細 - 牧原　靖一郎

論文 - 牧原　靖一郎

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Endoscopic surgical strategy for highly vascular pediatric sinonasal and pterygopalatine fossa tumors. 査読国際誌

Aiko Shimizu, Seiichiro Makihara, Minori Noda, Aya Murai, Mizuo Ando

Auris, nasus, larynx 52 ( 3 ) 243 - 247 2025年4月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

Pediatric sinonasal tumors are rare, and minimally invasive approaches are preferred because of unknown long-term effects on development. We report three cases of highly vascular pediatric sinonasal and pterygopalatine fossa tumors that were successfully removed using an endonasal endoscopic approach with transcatheter arterial embolization (TAE). The patients (9-11 years old) had contrast-enhanced tumors in the left ethmoid sinus near the sphenopalatine foramen in case 1, in the right nasal cavity near the sphenopalatine foramen in case 2, and in the right pterygopalatine fossa in case 3, with diameters of 32, 50, and 61 mm, respectively. Computed tomography and magnetic resonance imaging demonstrated tumors with strong contrast enhancement and flow voids in all cases. TAE was performed in all cases on the day of surgery, followed by endoscopic sinus surgery with nasal septal modification. Pathology revealed pyogenic granuloma, nasal polyps, and juvenile angiofibroma. After TAE, tumor reduction improved visualization in case 1. Nasal septum manipulation enabled medial traction and tumor base identification in cases 2 and 3. The combination of preoperative TAE and septal modification proved effective for achieving complete endoscopic tumor removal. No complications occurred, and follow-up at 1-1.5 years showed no tumor recurrence or developmental abnormalities.

DOI： 10.1016/j.anl.2025.04.006

Identification of factors related to functional prognoses in craniopharyngiomas. 査読国際誌

Tsuyoshi Umeda, Yoshihiro Otani, Kentaro Fujii, Joji Ishida, Shuichiro Hirano, Yasuki Suruga, Naoya Kemmotsu, Ryoji Imoto, Yasuhito Kegoya, Ryo Mizuta, Yohei Inoue, Madoka Hokama, Seiichiro Makihara, Kosei Hasegawa, Kenichi Inagaki, Fumio Otsuka, Takao Yasuhara, Shota Tanaka

Journal of neuro-oncology 2025年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Craniopharyngiomas are histologically benign tumors, but their proximity to vital neurovascular structures can significantly deteriorate functional prognoses and severely restrict patients' social interaction and activity. We retrospectively identified risk factors related to the functional prognoses in patients with craniopharyngioma treated at our center. METHODS: A retrospective analysis was conducted on 40 patients who underwent surgery for craniopharyngioma and follow-up at our institution between 2003 and 2022. Functional prognoses were evaluated in terms of obesity (body mass index [BMI] ≥ 25 for adults, BMI-Z ≥ 1.65 for children), visual function, endocrine function, and social participation. We investigated whether patient characteristics, tumor size, tumor location, hypothalamic involvement, surgical hypothalamic damage, extent of resection, and recurrence rate correlated with these functional prognostic factors. RESULTS: The median age at diagnosis was 28.0 years, with a median follow-up of 80.5 months. Postoperative obesity was present in 22 patients, and those with postoperative obesity had a significantly higher preoperative BMI or BMI-Z (preoperative BMI for adults: p = 0.074; preoperative BMI-Z for children: p = 0.020) and were significantly correlated with preoperative hypothalamic involvement grade 2 (p = 0.012) and surgical hypothalamic damage grade II (p = 0.0001). Deterioration in social participation was significantly associated with a larger tumor size (p = 0.023) and tumor recurrence (p = 0.0047). CONCLUSIONS: Patients with higher preoperative BMI or BMI-Z and hypothalamic involvement have a greater risk of postoperative obesity, and larger tumor size and recurrence can significantly deteriorate the rate of patients' social participation.

DOI： 10.1007/s11060-024-04925-7

Association Between Dinner-to-Bed Time and Gastroesophageal Reflux-Related Diseases in Children. 査読国際誌

Kensuke Uraguchi, Naomi Matsumoto, Toshiharu Mitsuhashi, Soshi Takao, Seiichiro Makihara, Mizuo Ando, Takashi Yorifuji

Cureus 17 ( 1 ) e77709 2025年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Gastroesophageal reflux disease (GERD) is characterized by esophageal mucosal injury due to the reflux of gastroduodenal contents. Typical symptoms include heartburn and acid regurgitation. In addition, gastroesophageal reflux (GER) can influence conditions such as otitis media, rhinitis, and asthma. This study aimed to examine the association between dinner-to-bed time and GER-related diseases, such as otitis media, allergic rhinitis, and asthma. METHODS: This was a longitudinal cohort study using secondary data. Data were collected from a large-scale birth cohort study conducted in Japan including babies born in 2001 and 2010. Dinner-to-bed time was categorized as "longer dinner-to-bed time" (>120 minutes), "shorter dinner-to-bed time" (≤120 minutes or less), and "irregular dinner-to-bed time." Modified Poisson regression with robust variance was used to estimate risk ratios (RRs). RESULTS: A total of 60,392 children were included in this study. Children with shorter dinner-to-bed time had a higher risk of asthma (adjusted RR (aRR) = 1.10; 95% confidence interval (CI), 1.03-1.18) than those with longer dinner-to-bed time. However, no significant association was observed between shorter dinner-to-bed time and otitis media or allergic rhinitis. Furthermore, supplementary analyses revealed that the risk of asthma was significantly higher in children born in 2001 (aRR = 1.13; 95% CI, 1.04-1.22). CONCLUSION: This study showed that dinner-to-bed time within 120 minutes after dinner increases the risk of developing asthma. This underscores the importance of considering lifestyle modifications, as certain pediatric asthma cases may be influenced by behaviors that promote GER.

DOI： 10.7759/cureus.77709

【指定難病 Up to Date】好酸球性副鼻腔炎

牧原靖一郎

岡山医学会雑誌 136 ( 3 ) 127 - 131 2024年12月

【内視鏡下鼻副鼻腔手術-基本とコツで上手くなる】内視鏡下鼻副鼻腔手術の実際篩骨洞手術

清水藍子, 牧原靖一郎

耳鼻咽喉科・頭頸部外科 96 ( 13 ) 1121 - 1127 2024年12月

【第一線のエキスパートが教える耳科・鼻科における術前プランニングと手術テクニック】TACMI(transseptal access with crossing multiple incisions)法

清水藍子, 牧原靖一郎

ENTONI ( 302 ) 123 - 129 2024年10月

記述言語：日本語出版者・発行元：(株)全日本病院出版会

Transseptal access with crossing multiple incisions(TACMI)法は2017年に初めてOmuraらによって報告された手術手技である.両側の鼻中隔粘膜に切開を入れることにより,対側鼻孔からのアプローチと対側鼻腔の利用が可能となる.この手技により,より正確に腫瘍基部を確認でき,より少ない出血量で手術を行うことができる.2021年には健側の鼻中隔粘膜に切開をおかないMINI TACMIも報告された.TACMI法では両側の鼻中隔粘膜に切開を入れるため,鼻中隔穿孔のリスクがある.一方,MINI TACMIでは健側の鼻中隔粘膜が温存されるため,そのリスクは低減できる.TACMI法を成功させるには手順のみならず,通常の手術手技での意識も重要であると考えている.(著者抄録)

Endoscopic Transpterygoid Repair of Sphenoid Sinus Meningocele: A Comprehensive Case Report and Literature Review. 査読国際誌

Aiko Shimizu, Seiichiro Makihara, Ryoji Imoto, Koji Hirashita, Mizuo Ando

Auris, nasus, larynx 51 ( 5 ) 875 - 879 2024年8月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

We report a challenging and uncommon case involving a 53-year-old Japanese man with cerebrospinal fluid (CSF) leakage caused by a meningocele in the lateral recess of the sphenoid sinus. Our innovative treatment approach involved a combination of transpterygoid and endoscopic modified medial maxillectomy techniques, with special emphasis on the preservation of the sphenopalatine artery. This strategic preservation was pivotal to the successful use of the ipsilateral nasoseptal flap for reconstruction, which played a crucial role in the prevention of postoperative CSF leakage. Otolaryngologists and neurosurgeons collaborated to perform the bath-plugging technique; effective collaboration was instrumental to the success of the procedure. This report highlights significant advancement from conventional frontal craniotomy to a more sophisticated endoscopic technique, shows the importance of meticulous surgical planning and execution, emphasizes careful preservation of critical anatomical structures during complex neurosurgical and otolaryngological procedures, and underscores the evolving landscape of surgical approaches for managing complex medical conditions.

DOI： 10.1016/j.anl.2024.08.003

Shifting paradigms in endoscopic sinus surgery: a comprehensive analysis from Japan's national database. 査読国際誌

Seiichiro Makihara, Kensuke Uraguchi, Shohei Fujimoto, Aiko Shimizu, Shin Kariya, Mitsuhiro Okano, Takashi Yorifuji, Mizuo Ando

Acta oto-laryngologica 144 ( 9 ) 1 - 6 2024年8月

担当区分：筆頭著者記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: In 2013, Japan established a standardized classification system for categorizing endoscopic sinus surgery (ESS) into types I-V, yet no evaluation has been conducted thereof. OBJECTIVE: We assessed the ESS trends and status in Japan, focusing on outpatient and inpatient surgeries. MATERIAL AND METHODS: This descriptive retrospective cohort study used Japan's National Database of Health Insurance Claims and Specific Health Checkups between 2014 and 2021. The distribution of ESS types I-V and outpatient and inpatient surgeries was analysed, along with age groups and regional differences, focusing on ESS type III. RESULTS: Overall, 427,813 ESS procedures were performed, with types III and IV being most common. Outpatient ESS type III increased substantially compared to inpatient surgeries. Younger individuals favoured outpatient ESS type III over inpatient surgeries, with substantial regional variations across prefectures. CONCLUSIONS AND SIGNIFICANCE: The adoption of a standardized ESS classification in Japan has facilitated a detailed understanding of surgical trends. The shift toward outpatient surgeries, especially for type III ESS, aligns with global trends toward minimally invasive procedures and reflects changing patient preferences and healthcare delivery practices. Consequently, continuous monitoring and research are crucial for adapting surgical practices to the evolving healthcare needs and patient expectations.

DOI： 10.1080/00016489.2024.2389179

Pneumocephalus with Inverted Papilloma in the Frontoethmoidal Sinus: Case Report and Literature Review. 査読

Seiichiro Makihara, Yoshihiro Otani, Kensuke Uraguchi, Sawako Ono, Aiko Shimizu, Ryosuke Ikemachi, Yosuke Okazaki, Tomoyuki Ota, Hiroshi Matsumoto, Shotaro Miyamoto, Munechika Tsumura, Seiya Hayashi, Michiari Umakoshi, Koji Hirashita, Mizuo Ando

Acta medica Okayama 78 ( 4 ) 337 - 343 2024年8月

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

Here, we describe the unique case of a pneumocephalus originating from an inverted papilloma (IP) in the frontoethmoidal sinus. A 71-year-old man with diabetes presented with headaches and altered consciousness. Imaging revealed the pneumocephalus together with bone destruction in the left frontal sinus. He underwent simultaneous endoscopic endonasal and transcranial surgery using an ORBEYE exoscope. Pathological diagnosis of the tumor confirmed IP. Post-surgery, the pneumocephalus was significantly resolved and the squamous cell carcinoma antigen level, which had been elevated, decreased. This case underscores the importance of a multidisciplinary approach and innovative surgical methods in treating complex sinonasal pathologies.

DOI： 10.18926/AMO/67550

Neurectomy for allergic rhinitis in Japan: Increasing trends and surgeon preferences. 査読国際誌

Seiichiro Makihara, Kei Hosoya, Kensuke Uraguchi, Yohei Maeda, Taro Komachi, Takashi Yorifuji, Mizuo Ando, Shoji Matsune, Kimihiro Okubo

Auris, nasus, larynx 51 ( 5 ) 834 - 839 2024年7月

担当区分：筆頭著者記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: There is no consensus on the optimal surgical technique for allergic rhinitis (AR). Furthermore, the appropriateness of surgical intervention in children and older individuals remains debatable. This study aimed to analyze trends and patterns in the surgical management of AR in Japan, focusing on parasympathetic neurectomy. METHODS: Using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), we conducted a comprehensive review of procedures performed between April 2014 and March 2022. In addition, a cross-sectional survey targeting otolaryngologists across Japan was conducted to gather insights into surgical preferences and practices. RESULTS: The NDB data showed an increasing trend in neurectomies, with the most frequent age group being 25-29 years; the procedure was also performed in pediatric and older patients. The survey among otolaryngologists indicated that 58.2 % of surgeons preferred peripheral branch neurectomy of the posterior nasal nerve. The findings of this study also indicated a cautious approach toward conducting these procedures in children, with 51.2 % of surgeons considering patients less than 18 years of age unsuitable for the procedure. CONCLUSION: This study highlighted a shift toward simple and minimally invasive surgical methods, such as peripheral branch neurectomy, in Japan. However, further research is needed to understand the long-term outcomes and refine the surgical techniques. The findings of this study also emphasized the need for age-specific considerations when treating pediatric and older patients with AR.

DOI： 10.1016/j.anl.2024.07.005

Role of nasal polyp-derived innate lymphoid cells in staphylococcal enterotoxin-induced cellular responses. 査読国際誌

Kengo Kanai, Aiko Oka, Shin Kariya, Tazuko Fujiwara, Takaya Higaki, Seiichiro Makihara, Takenori Haruna, Maki Akamatsu, Kazunori Nishizaki, Mizuo Ando, Mitsuhiro Okano

Allergology international : official journal of the Japanese Society of Allergology 73 ( 3 ) 477 - 480 2024年7月

Pediatric otitis media in Japan: A nationwide longitudinal study of the pre- and post-pneumococcal conjugate vaccine eras born in 2001 and 2010. 査読国際誌

Kensuke Uraguchi, Naomi Matsumoto, Toshiharu Mitsuhashi, Soshi Takao, Seiichiro Makihara, Mizuo Ando, Takashi Yorifuji

Vaccine 42 ( 19 ) 4081 - 4087 2024年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Otitis media (OM) is a prevalent respiratory disease in children and poses significant public health challenges due to its impact on child health and economic burdens. However, there have no nationwide epidemiological studies conducted in Japan. This study investigates the epidemiological trends of OM in Japan, taking into account the impact of the 7-valent pneumococcal conjugate vaccine (PCV7) introduction. METHOD: This study was retrospective cohort study using secondary data on the nationwide longitudinal birth cohort. This survey followed two cohorts born in 2001 (pre-PCV era) and 2010 (post-PCV era) until the age of 9. Every year, parents were surveyed about their children's health status, including occurrences of OM. The annual period prevalence and cumulative incidence of OM were assessed in this study, and the two cohorts were compared using a modified Poisson regression model adjusted environmental factors with the 2001 cohort as reference. RESULT: The study included 47,015 children from the 2001 cohort and 38,554 from the 2010 cohort. Peak annual period prevalence of OM varied by era. Cumulative incidence was 13.8 % for the 2001 cohort and 18.5 % for the 2010 cohort by 1.5 years of age and 28.9 % and 33.3 %, respectively, by 3.5 years of age. In particular, from the fourth survey onward, covering ages 2.5-3.5 years, a shift was observed from an increased risk to a decreased risk of OM. CONCLUSION: This nationwide longitudinal study emphasizes variations in OM epidemiology across Japan over time, with changes potentially influenced by the introduction of PCV7. In this study, due to the absence of individual PCV7 vaccination data, the effect of PCV7 was estimated based on the vaccination rate at the population level. The results suggest a notable decrease in the incidence of OM in later years, aligning with the increased uptake of PCV7.

DOI： 10.1016/j.vaccine.2024.05.020

Combined simultaneous endoscopic endonasal and transcranial surgery using high-definition three-dimensional exoscope for malignant tumors of the anterior skull base. 査読国際誌

Seiichiro Makihara, Yoshihiro Otani, Kensuke Uraguchi, Aiko Shimizu, Aya Murai, Takaya Higaki, Naoki Akisada, Shohei Fujimoto, Takuma Makino, Joji Ishida, Kentaro Fujii, Takao Yasuhara, Tomoyuki Ota, Hiroshi Matsumoto, Mizuo Ando

Head & neck 46 ( 5 ) 1074 - 1082 2024年3月

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Advanced surgical interventions are required to treat malignancies in the anterior skull base (ASB). This study investigates the utility of endoscopic endonasal and transcranial surgery (EETS) using a high-definition three-dimensional exoscope as an alternative to traditional microscopy. METHODS: Six patients with carcinomas of varying histopathologies underwent surgery employing the EETS maneuver, which synchronized three distinct surgical modalities: harvesting of the anterolateral thigh flap, initiation of the transnasal technique, and initiation of the transcranial procedure. RESULTS: The innovative strategy enabled successful tumor resection and skull base reconstruction without postoperative local neoplastic recurrence, cerebrospinal fluid leakage, or neurological deficits. CONCLUSION: The integration of the exoscope and EETS is a novel therapeutic approach for ASB malignancies. This strategy demonstrates the potential of the exoscope in augmenting surgical visualization, enhancing ergonomics, and achieving seamless alignment of multiple surgical interventions. This technique represents a progressive shift in the management of these complex oncological challenges.

DOI： 10.1002/hed.27724

Various arrangements of pharyngeal flap in soft palate reconstruction after cancer treatment. 査読国際誌

Hiroshi Matsumoto, Tomoyuki Ota, Motoi Kato, Takuma Makino, Seiichiro Makihara, Mizuo Ando, Yoshihiro Kimata

Head & neck 46 ( 7 ) 1573 - 1581 2024年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The pharyngeal flap (PF) is useful for reconstruction of soft palate defects, but effective arrangements of PF for various types of soft palate defects are controversial. Here, we classify three types of soft palate defects and discuss the arrangements of PF and their functional prognosis. METHODS: Reconstruction was performed based on the classification of the defects. Clinical details were collected, and postoperative function was analyzed. RESULTS: Eight patients were included in the study. The defect sizes ranged from 25 (width) × 40 (depth) to 40 × 60 mm. Six patients underwent pharyngeal flap reconstruction with free-flap reconstruction, and two underwent pharyngeal flap reconstruction. The pharyngeal flap was harvested at the maximum width of the posterior pharyngeal wall, ranging from 25 to 40 mm in length. Eating and speaking functions were maintained in all patients. CONCLUSIONS: Good postoperative function can be maintained by narrowing the velopharyngeal space with a pharyngeal flap.

DOI： 10.1002/hed.27712

高齢者に多い耳鼻咽喉科疾患鼻領域副鼻腔嚢胞

清水藍子, 牧原靖一郎

鼻アレルギーフロンティア 24 ( 1 ) 20 - 24 2024年2月

Chronic rhinosinusitis possibly associated with decreased lung function in chronic cough patients. 査読国際誌

Pengfei Zhao, Shin Kariya, Takaya Higaki, Seiichiro Makihara, Toru Rikimaru, Mitsuhiro Okano, Mizuo Ando

Brazilian journal of otorhinolaryngology 90 ( 4 ) 101424 - 101424 2024年

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: The purpose of this study is to investigate the lung function in Chronic Rhinosinusitis (CRS) patients with Chronic Cough (CC). METHODS: A total of 1413 CC patients were retrospectively screened and 109 CRS patients with CC were enrolled. Lung function, Lund-Mackay Computed Tomography (CT) score, smoking status, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples, and Sino-Nasal Outcome Test were examined. Normal control subjects are also recruited. RESULTS: The Forced Expiratory Volume in 1 second (FEV1.0), Percent Predicted FEV1.0, and FEV1.0/Forced Vital Capacity (FVC) ratio in the patients were significantly low as compared with the control subjects. The FEV1.0/FVC ratio was negatively correlated with the Lund-Mackay CT scores of the patients with a high CT score. CONCLUSIONS: The CRS patients with CC should be investigated with lung function. In addition, the multidisciplinary evaluation including a pulmonologist is needed to manage the CRS patients with CC. LEVEL OF EVIDENCE: Level 4.

DOI： 10.1016/j.bjorl.2024.101424

Association Between Clinical Remission of Infantile-Onset Allergic Rhinitis During the School-Age Period and the Type of Housing: A Longitudinal Population-Based Japanese Study. 査読国際誌

Kensuke Uraguchi, Naomi Matsumoto, Toshiharu Mitsuhashi, Soshi Takao, Seiichiro Makihara, Mizuo Ando, Takashi Yorifuji

Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners 38 ( 4 ) 629 - 636 2023年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

This study investigated the association between housing type and clinical remission of infantile-onset allergic rhinitis (AR) in 53,575 children born in 2001 in Japan. Infantile-onset AR was defined as the presence of AR symptoms reported between ages 1.5 and 4.5 years, and remission was assessed between ages 10 and 12. The type of housing was categorized into detached houses and multi-unit residential buildings with 1-2, 3-5, or ≥6 floors. Among the 4,352 infantile-onset AR, 42.9% experienced remission. Notably, living in multi-unit residential buildings, particularly those with 1-2 and ≥6 floors, was positively associated with AR remission.

DOI： 10.1016/j.pedhc.2023.11.011

Risk Factors for Anterior Skull Base Injury in Endoscopic Sinus Surgery 査読国際誌

Seiichiro Makihara, Kensuke Uraguchi, Tomoyuki Naito, Aiko Shimizu, Aya Murai, Takaya Higaki, Yohei Noda, Shin Kariya, Mitsuhiro Okano, Mizuo Ando

Cureus 15 ( 11 ) e49273 2023年11月

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

Objectives This retrospective study aimed to investigate the relationships between the Keros classification, the Gera classification, the vertical height of the posterior ethmoid roof (ER), and anterior ethmoidal artery (AEA) types in Japanese patients. Methods We investigated the computed tomography (CT) slices of paranasal sinuses (120 sides) of 60 patients; measured the cribriform plate (CP) depth, lateral lamella CP angle (LLCPA), and vertical height of the lateral ER from the hard palate (LERHP) at the coronal plane of the posterior ethmoidal artery (PEA); and reviewed the AEA types, whether floating or non-floating. Results CP depth was positively correlated with LLCPA (r=0.63; p<0.01) and the height of LERHP (r=0.19; p<0.05). The height of the LERHP in females was significantly lower than that in males. With increased CP depth, floating AEAs became prevalent (p<0.001). Conclusion In females, low height of the posterior ethmoid sinus roof, where cerebrospinal fluid (CSF) leaks occurred while penetrating the basal lamella, often existed; the heights positively correlated with the Keros classification in Japanese patients. The Keros and Gera classifications, AEA type, and posterior ER height do not individually constitute a complete risk assessment but may correlate, preventing major complications, such as CSF leak and orbital hemorrhage.

DOI： 10.7759/cureus.49273

Nasopharyngeal low-grade papillary schneiderian carcinoma with cervical metastasis. 査読国際誌

Kensuke Uraguchi, Kenji Nishida, Takuma Makino, Seiichiro Makihara, Masahiro Tabata, Shin Kariya, Mizuo Ando

Auris, nasus, larynx 50 ( 5 ) 821 - 826 2023年10月

記述言語：英語

Low-grade papillary Schneiderian carcinoma (LGPSC) is a rare and newly described type of cancer arising from the Schneiderian epithelium. Owing to cellular atypia, it is difficult to differentiate this type from other papillomas and malignancies. Although this condition remains unclear, it is associated with mortality and recurrence. Therefore, treating physicians should be aware of the possibility of LGPSC for prompt diagnosis and treatment. In this article, we present an additional case of nasopharyngeal LGPSC with cervical lymph node metastasis and reviewed the 14 cases reported thus far in the literature. A 76-year-old female was referred to our department for detailed examination of nasopharyngeal and cervical lymph node tumors detected by positron emission tomography-computed tomography. Based on the biopsy of the nasopharyngeal tumor, we suspected LGPSC. Considering the clinical course and pathological findings, the patient was diagnosed with cervical lymph node metastasis through neck dissection. We performed radiotherapy for the primary lesion of the nasopharynx, which led to the disappearance of the tumor. After 13 months following the radiotherapy, the patient died from a recurrence of retroperitoneal liposarcoma without the recurrence of LGPSC.

DOI： 10.1016/j.anl.2022.12.010

内視鏡下鼻副鼻腔手術後のナゾポアによる鼻内パッキングの有用性査読

岡愛子, 小池隆史, 北村寛志, 上斗米愛実, 金井健吾, 渡部佳弘, 今西順久, 野口佳裕, 赤松摩紀, 牧原靖一郎, 岡野光博

耳鼻咽喉科・頭頸部外科 95 ( 10 ) 849 - 853 2023年9月

記述言語：日本語出版者・発行元：(株)医学書院

当院では慢性副鼻腔炎に対する内視鏡下鼻副鼻腔手術(ESS)後の出血予防を目的とした鼻内パッキングにナゾポア(日本ストライカー社)を用いている。今回、2020年12月～2021年12月にナゾポアを使用した46例の成績を報告した。ESSのクリニカルパス逸脱を伴う出血を認めたのは1例のみであり、再手術を要する大出血や重症感染症は認めなかった。ナゾポアに抗菌薬やステロイドを浸潤させることで創傷治癒促進も期待できることから、ナゾポアはESS後の鼻内パッキングに有用と考えられた。

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