Papers - MAKINO Takuma

光免疫療法:頭頸部アルミノックス治療の現況 光免疫療法後における病理組織学的検討

牧野 琢丸, 佐藤 康晴, 安藤 瑞生

日本癌治療学会学術集会抄録集   62回   OWS1 - 5   2024.10

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Language：English   Publisher：(一社)日本癌治療学会  

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頭頸部アルミノックス治療により喉頭温存が可能となった再発下咽頭癌症例

手島 大雅, 牧野 琢丸, 深澤 茉祐, 直井 勇人, 藤本 将平, 安藤 瑞生

口腔・咽頭科   37 ( 3 )   254 - 254   2024.8

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Language：Japanese   Publisher：日本口腔・咽頭科学会  

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診断に苦慮した舌内神経鞘腫の1例

深澤 茉祐, 牧野 琢丸, 手島 大雅, 直井 勇人, 藤本 将平, 安藤 瑞生

口腔・咽頭科   37 ( 3 )   239 - 239   2024.8

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Language：Japanese   Publisher：日本口腔・咽頭科学会  

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Adverse Reactions of Photoimmunotherapy Invited Reviewed

Takuma Makino

The Journal of Japan Society for Laser Surgery and Medicine   45 ( 2 )   89 - 95   2024.7

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Authorship：Lead author   Publishing type：Research paper (scientific journal)  

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A case of an electric toothbrush tip penetrating from the oral cavity to the submandibular gland. Reviewed International journal

Naoki Akisada, Takuma Makino, Yuto Naoi, Yoshinori Taguchi, Yuto Moriwaki, Mizuo Ando

Clinical case reports   12 ( 6 )   e8987   2024.6

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This report describes a case of an electric toothbrush head being retained between the floor of the mouth and the submandibular gland following a fall. Computed tomography imaging is recommended in cases of oral cavity damage to assess tissue damage and ascertain the position of the foreign body concerning blood vessels.

DOI： 10.1002/ccr3.8987

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3Dバイオプリンターを用いたCAFとがん細胞の位置関係についての検討

直井 勇人, 長崎 譲慈, 秋定 直樹, 藤本 将平, 牧野 琢丸, 冨樫 庸介, 安藤 瑞生

頭頸部癌   50 ( 2 )   159 - 159   2024.5

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Language：Japanese   Publisher：(一社)日本頭頸部癌学会  

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舌根部癌に対する頭頸部アルミノックス治療の検討

牧野 琢丸, 松井 裕輔, 藤本 将平, 秋定 直樹, 直井 勇人, 平木 隆夫, 安藤 瑞生

頭頸部癌   50 ( 2 )   188 - 188   2024.5

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Language：Japanese   Publisher：(一社)日本頭頸部癌学会  

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上顎再建 遊離腓骨移植による上顎再建

松本 洋, 太田 智之, 加藤 基, 武田 斉子, 牧野 琢丸, 安藤 瑞生

頭頸部癌   50 ( 2 )   105 - 105   2024.5

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Language：Japanese   Publisher：(一社)日本頭頸部癌学会  

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上顎再建 遊離腓骨移植による上顎再建

松本 洋, 太田 智之, 加藤 基, 武田 斉子, 牧野 琢丸, 安藤 瑞生

頭頸部癌   50 ( 2 )   105 - 105   2024.5

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Language：Japanese   Publisher：(一社)日本頭頸部癌学会  

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Near-infrared photoimmunotherapy for salivary duct carcinoma Reviewed

Takuma Makino, Yasuharu Sato, Kensuke Uraguchi, Yuto Naoi, Yujiro Fukuda, Mizuo Ando

Auris Nasus Larynx   51 ( 2 )   323 - 327   2024.4

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.anl.2023.09.006

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Combined simultaneous endoscopic endonasal and transcranial surgery using high-definition three-dimensional exoscope for malignant tumors of the anterior skull base. Reviewed International journal

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   2024.3

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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

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Various arrangements of pharyngeal flap in soft palate reconstruction after cancer treatment Reviewed

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

Head & Neck   46 ( 7 )   1573 - 1581   2024.3

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Abstract

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

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Extent of thyroidectomy and paratracheal lymph node dissection in total pharyngolaryngectomy for pyriform sinus cancer, and recurrence, survival, and postoperative hypoparathyroidism: A multicenter retrospective study Reviewed

Yosuke Ariizumi, Nobuhiro Hanai, Takahiro Asakage, Akira Seto, Toshifumi Tomioka, Junji Miyabe, Hisashi Kessoku, Takashi Mukaigawa, Go Omura, Masanori Teshima, Daisuke Nishikawa, Yuki Saito, Yukinori Asada, Takuo Fujisawa, Takuma Makino, Hiroshi Nishino, Daisuke Sano, Mitsuhiko Nakahira, Kunihiko Tokashiki, Hirokazu Uemura, Tsutomu Ueda, Akihiro Sakai, Muneyuki Masuda, Takahiro Tsujikawa, Yusuke Hiei, Naoki Nishio, Hidetoshi Matsui, Naomi Kiyota, Akihiro Homma

Head & Neck   46 ( 2 )   269 - 281   2023.11

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Abstract

Background

Total pharyngolaryngectomy (TPL) is standard treatment for hypopharyngeal cancer. However, extensive thyroidectomy and paratracheal nodal dissection (PTND) can cause hypoparathyroidism. We sought to determine the optimum extent of resection.

Methods

We analyzed the clinicopathological information of 161 pyriform sinus cancer patients undergoing TPL from 25 Japanese institutions. Rates of recurrence and risk factors for hypoparathyroidism, as well as incidence of pathological contralateral level VI nodal metastasis and stomal recurrence, were investigated.

Results

The extent of thyroidectomy and nodal dissection were not independent risk factors for recurrence. Incidences of contralateral level VI nodal involvement and stomal recurrence were 1.8% and 1.2%, respectively. Patients undergoing hemithyroidectomy/ipsilateral PTND did not develop stomal recurrence and had the lowest incidence of hypoparathyroidism. Prognosis in patients without tracheostomy prior to hemithyroidectomy/ipsilateral PTND was comparable to that with more extensive resections.

Conclusions

Hemithyroidectomy/ipsilateral PTND may be sufficient for pyriform sinus cancer cases without tracheostomy.

DOI： 10.1002/hed.27572

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Nasopharyngeal low-grade papillary schneiderian carcinoma with cervical metastasis. Reviewed International journal

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

Auris, nasus, larynx   50 ( 5 )   821 - 826   2023.10

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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

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Application of the Valsalva maneuver to prevent adhesion and deformity after hypopharyngeal endoscopic submucosal dissection. Reviewed International journal

Hironao Sato, Kenta Hamada, Makoto Abe, Takuma Makino, Yoshiro Kawahara

Gastrointestinal endoscopy   98 ( 2 )   254 - 256   2023.8

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DOI： 10.1016/j.gie.2023.02.029

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Degree of pharyngeal deformation caused by pharyngeal endoscopic submucosal dissection is associated with the incidence of aspiration pneumonia. Reviewed International journal

Makoto Abe, Yoshiro Kawahara, Yuka Obayashi, Yuki Baba, Kenta Hamada, Hiroyuki Sakae, Yoshiyasu Kono, Hiromitu Kanzaki, Masaya Iwamuro, Seiji Kawano, Takuma Makino, Yohei Noda, Hidenori Marunaka, Hiroyuki Okada

Endoscopy international open   11 ( 4 )   E351-E357   2023.4

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Background and study aims  Endoscopic submucosal dissection (ESD) is one of the most minimally invasive treatments for superficial squamous cell cancer of the pharynx. However, aspiration pneumonia (AsP) associated with postoperative deformity of the pharynx may occur. The purpose of this study was to investigate the frequency of AsP and the degree of pharyngeal deformity after pharyngeal ESD. Patients and methods  This was a retrospective observational study of patients who underwent pharyngeal ESD at Okayama University Hospital between 2006 and 2017. The degree of pharyngeal deformation was assessed using the pharyngeal deformation grade (PDG). The primary endpoint was the frequency of AsP as a long-term adverse event. Results  Among the 52 patients enrolled, nine developed aspiration pneumonia, with a 3-year cumulative incidence of 9.0 % (95 % confidence interval [CI], 3.3 %-22.0 %). There were 16, 18, 16, and two patients that had PDG 0, 1, 2, and 3, respectively. Patients with a history of radiotherapy, as a treatment of head and neck cancer (44.4 % vs. 11.6 %; P  = 0.02) and the high PDG group (PDG 2 and 3) (77.8 % vs. 25.6 %; P  = 0.005) had a significantly higher incidence of AsP. The 3-year cumulative incidence rate of AsP after ESD in the high PDG group was significantly higher than that in the low PDG group (PDG 0 and 1) (23.9 % [95 %CI, 9.2.-49.5%] vs. 0 %; P  = 0.03). Conclusions  The incidence of aspiration pneumonia in the long-term course after pharyngeal ESD was revealed. The incidence of aspiration pneumonia may be associated with pharyngeal deformity, but further studies are needed.

DOI： 10.1055/a-2033-9707

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5年の経過で増大した上咽頭形質細胞肉芽腫の1例 Reviewed

駿河 有莉, 牧野 琢丸, 假谷 伸, 安藤 瑞生

口腔・咽頭科   36 ( 1 )   48 - 53   2023.3

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Language：Japanese   Publisher：日本口腔・咽頭科学会  

形質細胞肉芽腫(plasma cell granuloma)は形質細胞の増殖を伴う非腫瘍性,反応性の病変である.今回,我々は上咽頭形質細胞肉芽腫の1症例を経験したので報告する.症例は68歳女性であり主訴は鼻閉であった.PET検査で上咽頭に集積が認められ,精査加療を目的に当科を紹介され受診となった.生検で診断は確定できなかったが悪性腫瘍は否定されたため,数年間経過観察をされた後に終診となった.その後5年の経過で上咽頭腫瘤の増大による鼻閉が出現した.鼻閉症状の改善および診断を目的として手術の方針となり,形質細胞肉芽腫の診断となった.確定診断がついていない場合は悪性所見がなくても定期的なフォローアップが必要と考えられる.(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J02661&link_issn=&doc_id=20230412340008&doc_link_id=10.14821%2Fstomatopharyngology.36.48&url=https%3A%2F%2Fdoi.org%2F10.14821%2Fstomatopharyngology.36.48&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

A Case of Radiation-Induced Osteosarcoma with RB1 Gene Alteration Treated by Skull Base Surgery and Craniofacial Reconstruction. Reviewed

Yuki Matsuda, Yoshihiro Otani, Takao Yasuhara, Mizuo Ando, Takaya Higaki, Takuma Makino, Hiroshi Matsumoto, Tadashi Oyama, Hisakazu Nishimori, Isao Date

Acta medica Okayama   77 ( 1 )   85 - 90   2023.2

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A 35-year-old female presented with headache, photophobia and developed sudden loss of vision after having undergone right-side ophthalmectomy and radiochemotherapy for retinoblastoma in infancy. A neoplastic lesion was found in the left middle cranial fossa and was surgically removed. The diagnosis was radiation-induced osteosarcoma with RB1 gene alteration. Although she received chemotherapy for the residual tumor, it progressed 17 months later. Maximal surgical resection with craniofacial reconstruction was required. We utilized two three-dimensional models for surgical planning. She was discharged without neurological deficits other than loss of light perception subsequent to left ophthalmectomy. In cases where retinoblastoma is treated with radiotherapy, long-term follow-up is necessary to monitor for radiation-induced tumor development.

DOI： 10.18926/AMO/64367

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【咽頭癌-最新の治療戦略】転移・再発咽頭癌に対するがん光免疫療法（頭頸部アルミノックス治療）

牧野琢丸

医学と薬学   79 ( 12 )   1599 - 1603   2022.12

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Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma Reviewed International journal

Maki Akamatsu, Takuma Makino, Shinya Morita, Yohei Noda, Shin Kariya, Tomoo Onoda, Mizuo Ando, Yoshihiro Kimata, Kazunori Nishizaki, Mitsuhiro Okano, Aiko Oka, Kengo Kanai, Yoshihiro Watanabe, Yorihisa Imanishi

Frontiers in Oncology   12   1010252 - 1010252   2022.10

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Frontiers Media SA  

Introduction

Although patients with oral squamous cell carcinoma who develop contralateral neck metastasis (CLNM) have worse survival outcomes than those without CLNM, accurate prediction of occult CLNM in clinically negative contralateral neck (contralateral cN0) remains difficult. This study aimed to identify clinicopathological factors that could reliably predict CLNM in patients with locally advanced (clinical T3 and T4a) tongue squamous cell carcinoma (TSCC).

Patients and methods

The medical data of 32 patients with cT3–4a TSCC who underwent curative surgery between 2010 and 2017 were retrospectively analyzed. The correlation of clinicopathological variables with CLNM was examined using logistic regression analysis. The diagnostic performance of significant variables was evaluated using the area under the receiver operating characteristic curves (AUC). Overall survival (OS) and disease-free survival (DFS) were assessed using a Cox proportional hazards model.

Results

CLNM was eventually confirmed in 11 patients (34.4%). Multivariate logistic regression showed that midline involvement [odds ratio (OR) = 23.10, P = 0.017] and perineural invasion (PNI, OR = 14.96, P = 0.014) were independent predictors of CLNM. Notably, the prediction model comprising a combination of midline involvement and PNI exhibited superior diagnostic performance with an even higher OR of 80.00 (P < 0.001), accuracy of 90.3%, and AUC of 0.876. The multivariate Cox hazards model revealed independent significance of CLNM as an unfavorable prognostic factor for both OS [hazard ratio (HR) = 5.154, P = 0.031] and DFS (HR = 3.359, P = 0.038), as well as that of PNI for OS (HR = 5.623, P = 0.033).

Conclusion

Our findings suggest that coexisting midline involvement and PNI of the primary tumor is highly predictive of CLNM development, which independently affects both OS and DFS in patients with locally advanced TSCC. Such reliable prediction enables efficient control of CLNM by optimizing management of the contralateral cN0 neck, which will likely contribute to improved prognosis of those patients without unnecessarily compromising their quality of life.

DOI： 10.3389/fonc.2022.1010252

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Candidemia in patients with head and neck cancer: mortality and a novel risk factor Reviewed International journal

Kensuke Uraguchi, Takuma Makino, Shin Kariya, Youhei Noda, Hidenori Marunaka, Akira Doi, Kenichi Kozakura, Soshi Takao, Mizuo Ando

Supportive Care in Cancer   30 ( 7 )   5921 - 5930   2022.7

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

PURPOSE: Candidemia is a bloodstream infection (BSI) by Candida spp. and is associated with high mortality. However, there have been few reports about BSI in head and neck cancer (HNC). We aimed to evaluate the impact of candidemia in patients with HNC and compared it with bacteremia. STUDY DESIGN: A multicenter retrospective study. METHODS: We retrospectively analyzed 83 BSI episodes in HNC (2011 to 2020) and divided them into the candidemia and bacteremia groups. We then compared the survival rate and risk factors for candidemia between the groups. RESULTS: The overall cumulative incidence (risk) of candidemia in BSI was 12 out of 83 episodes (14.5%). The 1-year mortality for the bacteremia and candidemia groups was 33.3% and 58.3%, respectively (log-rank p = 0.041). Broad-spectrum antibiotics (odds ratio [OR]: 29.5; 95% confidence interval [CI], 2.49-350), mucositis (OR 11.0; 95% CI, 1.52-80.1), and malignant wounds (OR 79.5; 95% CI 1.33-4737) were significant risk factors for candidemia in HNC. CONCLUSIONS: Candidemia causes high mortality in patients with HNC. To our knowledge, malignant wounds have not been previously reported as a risk factor for candidemia. For early diagnosis and treatment of candidemia, risk factors should be considered, and antifungal therapy started earlier.

DOI： 10.1007/s00520-022-07010-9

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Other Link： https://link.springer.com/article/10.1007/s00520-022-07010-9/fulltext.html

【今日からの診療に役立つ ビジュアルでダイレクトに解説する体表・軟部疾患の検査&臨床画像】画像検査各論 頭蓋・顔面・頭頸部 見逃せない疾患を中心とした頸部腫瘤の鑑別診断

秋定 直樹, 牧野 琢丸, 安藤 瑞生

形成外科   65 ( 増刊 )   S92 - S100   2022.6

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Language：Japanese   Publisher：克誠堂出版(株)  

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ANL Secondary Publication 上顎洞癌に対する動注化学放射線治療の病理学的評価

牧野 琢丸, 橘 智靖, 假谷 伸, 松井 裕輔, 松崎 秀信, 藤本 将平, 折田 頼尚, 藤井 邦明, 平木 隆夫, 佐藤 康晴, 金澤 右, 西崎 和則

日本耳鼻咽喉科頭頸部外科学会会報   125 ( 5 )   913 - 915   2022.5

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J07551&link_issn=&doc_id=20220530470016&doc_link_id=10.3950%2Fjibiinkotokeibu.125.5_913&url=https%3A%2F%2Fdoi.org%2F10.3950%2Fjibiinkotokeibu.125.5_913&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

【頸部リンパ節を見直す】頸部リンパ節腫脹 鑑別の手順 頸部リンパ節腫脹の視診と触診について

牧野琢丸

JOHNS   38 ( 3 )   268 - 270   2022.3

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Resection and immediate reconstruction of two pediatric intraosseous capillary mandibular malformations Reviewed

Hiroshi Matsumoto, Tomoyuki Ota, Sho Komagoe, Yohei Noda, Takuma Makino, Seiko Takeda, Nobuyoshi Mizukawa, Kohei Taniguchi, Tomoka Ikeda, Hiroyuki Yanai, Yoshihiro Kimata

European Journal of Plastic Surgery   45 ( 5 )   831 - 839   2022.1

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s00238-021-01905-2

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Other Link： https://link.springer.com/article/10.1007/s00238-021-01905-2/fulltext.html

【新たに薬事承認・保険収載された薬剤・医療資材・治療法ガイド】頭頸部 セツキシマブサロタロカンナトリウムを用いた頭頸部イルミノックス治療

牧野琢丸

耳鼻咽喉科・頭頸部外科   94 ( 1 )   59 - 64   2022.1

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小児、思春期・若年がん患者に対する妊孕性温存療法 現状と改善の取り組み Reviewed

秋定 直樹, 牧野 琢丸, 門田 伸也, 菅谷 明子, 片岡 祐子, 中塚 幹也, 安藤 瑞生

耳鼻咽喉科臨床   114 ( 12 )   957 - 962   2022

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外耳道癌治療中に発症した胆道感染症例 Reviewed

秋定 直樹, 牧野 琢丸, 森本 光作, 佐藤 明日香, 駿河 有莉, 梶原 壮平, 浦口 健介, 大道 亮太郎, 安藤 瑞生

頭頸部外科   31 ( 3 )   301 - 305   2022

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Language：Japanese   Publisher：(NPO)日本頭頸部外科学会  

胆道感染症は,胆石や胆泥により胆汁が鬱滞することで十二指腸乳頭より上行性に細菌感染が生じ発症する。長期間の絶食や経口摂取量不足が続くと胆汁がよどみ,胆石や胆泥発生の好条件となる。また,オピオイド鎮痛薬によるオッジ括約筋機能不全に陥る場合もあり,化学放射線療法中の腹部症状には注意を要する。今回われわれは外耳道癌に対するセツキシマブ併用放射線療法中に発症した胆道感染症を経験した。胆道感染症は診断と治療が遅れれば,開腹手術を要することがある。化学放射線療法を行う機会のある耳鼻咽喉科医は留意すべき治療中合併症のひとつであろう。(著者抄録)

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Cytopathological Findings of Secretory Carcinoma of the Salivary Gland and the Diagnostic Utility of Giemsa Staining Reviewed

Yuria Egusa, Midori Filiz Nishimura, Satoko Baba, Kengo Takeuchi, Takuma Makino, Tomoyasu Tachibana, Asami Nishikori, Azusa Fujita, Hiroyuki Yanai, Yasuharu Sato

Diagnostics   11 ( 12 )   2284 - 2284   2021.12

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Secretory carcinoma is a salivary gland neoplasm first described as a mammary analogue secretory carcinoma by Skalova et al. in 2010 and redesignated as a secretory carcinoma in the 2017 World Health Organization Classification of Head and Neck Tumors. Secretory carcinoma diagnosis is reliant on specific cytological and histological findings and the detection of an ETV6-NTRK3 fusion gene. Here, we examined the clinical and cytopathological features of four cases of secretory carcinoma occurring in three males and a female, aged between 39 and 74 years. All four tumors involved the parotid gland, and were found to have the ETV6-NTRK3 fusion gene. Fine-needle aspiration-based cytology smears of all tumors displayed papillary and/or dendritic pattern clusters, some of which were associated with blood vessels. The neoplastic cells displayed enlarged nuclei with fine chromatin and small, distinct, single nucleoli. Furthermore, several neoplastic cells with a characteristic vacuolated cytoplasm were identified in each specimen. Giemsa staining revealed cytoplasmic vacuolation, intracytoplasmic metachromatic secretions and/or various sized metachromatic granules, and a background of metachromatic mucin in all four specimens. Given this, we conclude that these cytological findings, especially those of the Giemsa staining, might be helpful in the diagnosis of secretory carcinoma.

DOI： 10.3390/diagnostics11122284

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Morphological Changes and Durability of Skin and Mucosal Flaps in Intraoral and Pharyngeal Reconstructions: Long-term Follow-up and Literature Review for Potential Second Carcinomas. Reviewed

Hiroshi Matsumoto, Yoshihiro Kimata, Tomoyuki Ota, Narushi Sugiyama, Satoshi Onoda, Takuma Makino, Seiko Takeda, Nobuyoshi Mizukawa

Acta medica Okayama   75 ( 6 )   725 - 734   2021.12

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The long-term changes in tissues implanted in the oral cavity and pharynx after head and neck reconstruction have not been fully evaluated. This study aimed to clarify the morphological changes, long-term durability, and potential for secondary carcinogenesis in such tissues. In our single-center study, the rough morphological changes in 54 cases of intraoral and pharyngeal skin and mucosal flaps were evaluated more than 10 years after flap transfer. In addition, the literature on the development of second carcinomas from skin flaps was reviewed. The mean follow-up period for transferred flaps was 148 months. The reconstruction areas and the probability of morphological changes were significantly correlated (p=0.006), especially in cases with tongue, lower gingiva, and buccal mucosal reconstruction. Free jejunal flap surfaces were well maintained, whereas tubed skin flaps showed severe morphological changes in cases with pharyngeal reconstruction. None of the flaps in our series developed second primary carcinomas. Skin flaps generally had good durability for > 10 years in intraoral environments, while mucosal flaps had better durability for pharyngeal reconstruction. Second squamous carcinomas arising from skin flaps are extremely rare; however, surgeons should take this possibility into consideration and conduct meticulous and long-term follow-up.

DOI： 10.18926/AMO/62813

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PD-L1 expression in tongue squamous cell carcinoma. Reviewed

Naoki Akisada, Kohei Nishimoto, Soshi Takao, Yuka Gion, Hidenori Marunaka, Tomoyasu Tachibana, Takuma Makino, Kentaro Miki, Yusuke Akagi, Munechika Tsumura, Tomohiro Toji, Tadashi Yoshino, Kazunori Nishizaki, Yorihisa Orita, Yasuharu Sato

Medical molecular morphology   54 ( 1 )   52 - 59   2021.3

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PURPOSE: Immune checkpoint proteins programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) are important therapeutic targets for head and neck cancer. This large-scale case study aimed to analyze tongue squamous cell carcinomas (SCCs) and evaluate the correlation between PD-L1 expression and clinical prognosis. So far, this study is the largest case study on PD-L1 expression in tongue SCCs. METHODS: This is a case-control study that analyzed 121 tongue SCCs. Paraffin-embedded sections and clinical data were obtained retrospectively and immunohistochemistry with PD-L1 was performed. RESULTS: 11.6% contained ≥ 50% of PD-L1-positive cells, 57.1% of these cases had a poor prognosis with nodal metastasis. Among cases of T1/2 primary lesions with nodal metastasis, cases of high PD-L1 expression had a significantly shorter disease-free survival than cases of no PD-L1 expression (p = 0.018). The hazard ratio for high PD-L1 expression was 3.21 (95 per cent CI, 1.26-8.72) compared with no PD-L1 expression after adjusting for other factors. CONCLUSIONS: These data indicate that PD-L1 upregulation in tongue SCCs is associated with a more advanced stage and shorter disease-free survival. PD-1/PD-L1 inhibitors might hence constitute potential adjuvant therapy for tongue SCCs with PD-L1 upregulation.

DOI： 10.1007/s00795-020-00261-7

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Correction to: PD-L1 expression in tongue squamous cell carcinoma. Reviewed

Naoki Akisada, Kohei Nishimoto, Soshi Takao, Yuka Gion, Hidenori Marunaka, Tomoyasu Tachibana, Takuma Makino, Kentaro Miki, Yusuke Akagi, Munechika Tsumura, Tomohiro Toji, Tadashi Yoshino, Kazunori Nishizaki, Yorihisa Orita, Yasuharu Sato

Medical molecular morphology   54 ( 1 )   68 - 68   2021.3

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DOI： 10.1007/s00795-020-00270-6

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A Case Report of Spindle Cell Carcinoma with Osteoid and Cartilage Formation in the Tongue Reviewed

Sawako Ono, Takuma Makino, Hiroyuki Yanai, Hotaka Kawai, Kiyofumi Takabatake, Keisuke Nakano, Kenji Nishida, Kohei Taniguchi, Tomohiro Toji, Hitoshi Nagatsuka, Tadashi Yoshino

Reports   4 ( 1 )   5 - 5   2021.2

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Spindle cell carcinoma (SCSCC) with osteoid and/or cartilage formation in the head and neck is rare; only one case was reported in the tongue. Herein, we report an SCSCC with osteoid and cartilage formation of the tongue developed in an 85-year-old man, and then review the report.

DOI： 10.3390/reports4010005

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Supraglottic subepithelial benign mass lesions: Focus on clinical features of sialolipoma-like lesion. Reviewed International journal

Tomoyasu Tachibana, Shin Kariya, Yoji Wani, Yasutoshi Komatsubara, Yuto Naoi, Kazunori Kuroda, Soichiro Fushimi, Machiko Hotta, Katsuya Haruna, Tami Nagatani, Takuma Makino, Yuko Kataoka, Kazunori Nishizaki

Auris, nasus, larynx   48 ( 1 )   154 - 160   2021.2

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OBJECTIVES: Sialolipoma has been classified as a benign soft tissue lesion in the 2017 World Health Organization classification of head and neck tumors. To our knowledge, only one case of laryngeal sialolipoma has been reported in the English literature. We conducted a retrospective study to identify clinical characteristics of supraglottic sialolipoma-like lesion and differentiate it from other supraglottic subepithelial masses. METHODS: Medical records of 16 patients with supraglottic subepithelial benign mass lesions who underwent histological evaluation between 2003 and 2019 were retrospectively analyzed. Sialolipoma-like lesion was defined as a local finding of a well-circumscribed gross mass with pathological presence of salivary gland-like parenchymal lobules with evenly interspersed adipose tissue. RESULTS: Eight patients showed histological positivity for sialolipoma-like lesion, 3 for amyloidosis, 2 for hemangioma, and 1 each for cyst, lymphoid hyperplasia, and chondrometaplasia. Sialolipoma-like lesion tended to be predominant among men; those affected had a mean age of 52.8 (range, 39-74) years. By contrast, among patients with amyloidosis, the ratio of men to women was 1:2 (100% vs. 33%; p = 0.055). Fiberscopic examination of all patients with sialolipoma-like lesions identified well-circumscribed, yellowish masses, closely resembling local amyloidosis findings. Sialolipoma-like lesion was associated with a significantly higher body-mass index (BMI; 27.4 ± 2.8 kg/m2) than amyloidosis (21.6 ± 1.4 kg/m2; p = 0.014). The transoral approach was used for lesion resection in all patients with sialolipoma-like lesion. No patient experienced postoperative recurrence. CONCLUSION: Laryngeal sialolipoma-like lesion might be more prevalent than was previously reported, and histological examination is important to differentiate it from amyloidosis. Supraglottic sialolipoma-like lesion must be differentially diagnosed in patients with high BMI presenting with well-circumscribed, yellowish supraglottic masses.

DOI： 10.1016/j.anl.2020.07.017

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Fertility Preservation Therapy Provided for Childhood, Adolescent, and Young Adult Cancer Patients —Current Status and Efforts to Improvement—,小児，思春期・若年がん患者に対する妊孕性温存療法―現状と改善の取り組み― Reviewed

Akisada, N., Makino, T., Sugaya, A., Kataoka, Y., Ando, M., Monden, N., Nakatsuka, M.

Practica Oto-Rhino-Laryngologica   114 ( 12 )   2021

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DOI： 10.5631/jibirin.114.957

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Application of Lip Biopsy for the Histological Diagnosis of Immunoglobulin G4-Related Disease. Reviewed International journal

Tomoyasu Tachibana, Yorihisa Orita, Yoji Wani, Yasutoshi Komatsubara, Kazunori Kuroda, Yuto Naoi, Yuka Gion, Takuma Makino, Kazunori Nishizaki, Yasuharu Sato

Ear, nose, & throat journal   101 ( 8 )   145561320971932 - 145561320971932   2020.11

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We describe the case of a 51-year-old woman with immunoglobulin G4-related disease (IgG4-RD) diagnosed using lip biopsy. She reported having bilateral submandibular nodules for a month. Magnetic resonance imaging showed diffuse swelling in the bilateral submandibular glands (SMGs), suggesting inflammatory changes. Laboratory data revealed an elevated level of serum IgG4. Fine needle aspiration cytology of the SMG showed a considerable number of lymphocytes with degeneration but did not demonstrate specific findings for a definitive diagnosis of IgG4-RD. Lip biopsy was performed, and a biopsy specimen from the labial salivary gland showed abundant lymphoplasmacytic infiltration with a large number of IgG4-positive cells. The patient was diagnosed with IgG4-RD based on histological and laboratory findings. Findings of further examinations revealed that the patient had autoimmune pancreatitis, confirming our diagnosis. Four months after prednisolone administration, improvement of the submandibular and pancreatic lesions was observed. One year after the initial presentation, the serum IgG4 level was normalized. In cases of IgG4-RD with salivary gland involvement, lip biopsy might be one of the options for the histological diagnosis of IgG4-RD.

DOI： 10.1177/0145561320971932

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Pathological evaluation of radiotherapy and concomitant intraarterial cisplatin for maxillary sinus cancer. Reviewed International journal

Takuma Makino, Tomoyasu Tachibana, Shin Kariya, Yusuke Matsui, Hidenobu Matsuzaki, Shohei Fujimoto, Yorihisa Orita, Kuniaki Katsui, Takao Hiraki, Yasuharu Sato, Susumu Kanazawa, Kazunori Nishizaki

Auris, nasus, larynx   47 ( 5 )   881 - 886   2020.10

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OBJECTIVE: Since 2010, we have mainly performed surgical treatment following radiotherapy and concomitant intraarterial cisplatin (RADPLAT) for locally advanced maxillary sinus cancer (MSC). The present study investigated treatment results and pathological evaluations following RADPLAT for MSC. METHODS: Pathological response to RADPLAT was evaluated using surgical specimens. Pathological response was graded in accordance with the classification method that Shimosato reported in 1964, as grade V (no tumor cells remain in any of section), grade IV, III, II, I, and 0. Five-year overall and disease-specific survival rates were estimated using Kaplan-Meier methods. Univariate analyses of correlations between recurrence of MSC and other clinicopathological parameters were evaluated using the chi-square or Fisher's exact tests. RESULT: 19 patients were enrolled in this study, 5 patients showed T3 disease and 14 had T4 disease. One patient demonstrated local recurrence and 3 patients experienced distant metastasis. The 5-year overall survival rate was 67.1% (T3, 50.0%; T4, 69.6%), and the 5-year disease-specific survival rate was 81.9% (T3, 100%; T4, 76.0%). Histological response was categorized as grade V in 9 cases. No significant risk factors for residual cancer were identified. CONCLUSION: Our study suggested that RADPLAT not only has a low risk of side effects, but also could represent an effective procedure for locally advanced MSC by pathological evaluation. Increasing the therapeutic intensity of RADPLAT might provide an effective modality to avoid highly invasive surgery.

DOI： 10.1016/j.anl.2020.04.004

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Clinical characteristics of subglottic cancer: emphasis on therapeutic management strategies for stage II subglottic cancer. Reviewed International journal

Yasutoshi Komatsubara, Tomoyasu Tachibana, Yorihisa Orita, Takuma Makino, Kazunori Kuroda, Yuto Naoi, Yuko Kataoka, Yasuharu Sato, Shin Kariya, Kazunori Nishizaki

Acta oto-laryngologica   140 ( 9 )   773 - 778   2020.9

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Background: Subglottic cancer (SGC) is extremely rare, as most laryngeal cancers are localized to the glottic region. Accordingly, the clinical characteristics of SGC have not been well characterized.Objectives: In the current study, SGCs were clinically evaluated, and the outcomes of radiotherapy (RT) in patients with stage II SGC were assessed.Materials and Methods: Medical data derived from 11 patients with SGC, who were treated at our hospital between 1995 and 2019, were retrospectively reviewed.Results: In our department SGC accounted for 3.9% of the 280 laryngeal cancer patients treated during the study period. At the time of SGC diagnosis, 9 (81.8%) had stage II cancer, 1 had stage III cancer, and 1 had stage IV cancer. Stage II SGC patients treated with concurrent chemoradiotherapy (CCRT) showed a significantly higher local control rate (p = .026) and laryngeal dysfunction free rate (p = .026) than those treated with RT alone. Salvage surgery, performed in 4 patients whose disease was not locally controlled with CCRT/RT, was successful in 3 patients.Conclusion: As a treatment strategy for stage II SGC, CCRT is an acceptable initial treatment for laryngeal function and preservation while salvage surgery is effective for recurrence after CCRT/RT treatment.

DOI： 10.1080/00016489.2020.1767303

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AYA世代女子に発症した上顎エナメル上皮線維肉腫の1例 Reviewed

野田 洋平, 橘 智靖, 丸中 秀格, 黒田 一範, 牧野 琢丸, 假谷 伸

耳鼻咽喉科・頭頸部外科   92 ( 10 )   851 - 856   2020.9

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Language：Japanese   Publisher：(株)医学書院  

症例は17歳女性で、左上歯肉部に軽度の疼痛を自覚しており、生検でエナメル上皮線維肉腫が疑われたため、さらなる精査および加療を目的に当院受診した。左側上顎第二大臼歯の周囲歯肉にび漫性の淡赤色調の膨隆を認めた。CTでは上顎洞後壁に骨破壊を伴う軟部陰影を認めた。MRIでは、病変は左上顎骨から上顎洞にかけて液体成分と充実成分が混在する、造影効果を伴う長径約6cmの腫瘤影として描出された。以上より上顎エナメル上皮線維肉腫と診断し、外科的切除に加え、術後5週目より術後化学療法としてイホスファミドおよびドキソルビシンを4コース施行した。化学療法施行後のMRIおよびPET/CTにて左頬骨の骨髄内に異常陰影を認め、再発の可能性が疑われたため、初回手術より6ヵ月後に切除範囲を追加し上顎全摘を施行した。現在、化学療法後約2年経過するが明らかな再発徴候はなく、形態および機能面で良好な経過が得られている。

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耳下腺分泌癌の1経験例 Reviewed

藤本 将平, 牧野 琢丸, 津村 宗近, 丸中 秀格, 野田 洋平, 假谷 伸, 西崎 和則

口腔・咽頭科   33 ( 2 )   105 - 109   2020.6

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Authorship：Corresponding author   Language：Japanese   Publisher：日本口腔・咽頭科学会  

分泌癌は、2017年に改定された新WHO分類において新たに加えられた唾液腺悪性腫瘍であるが、耳鼻咽喉科医からの報告例が未だ少なく、臨床的特徴が明らかでない。症例は61歳男性で、左耳下腺癌cT3N0M0の診断にて手術を行い、病理組織学的検査の結果、分泌癌と診断した。術後2年が経過した時点で肺転移を認めたが、患者の希望で経過観察とした。その後、転移病変は緩徐に増大しているが長期に担癌生存している。分泌癌は低悪性度癌の経過をたどると考えられているが、なかには急激な転帰をたどるものや遠隔転移死の報告もあるため、引き続き厳重な経過観察が必要である。(著者抄録)

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MACC1 expression is an indicator of recurrence in early-stage glottic cancer. Reviewed International journal

Takuma Makino, Yorihisa Orita, Yuka Gion, Tomoyasu Tachibana, Soshi Takao, Hidenori Marunaka, Kentaro Miki, Naoki Akisada, Yusuke Akagi, Tadashi Yoshino, Kazunori Nishizaki, Yasuharu Sato

Japanese journal of clinical oncology   50 ( 4 )   392 - 398   2020.4

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Metastasis-associated in colon cancer 1 (MACC1) has been reported to be an independent indicator of poor prognoses in some kinds of cancer due to disease metastasis or recurrence. We investigated the correlation between MACC1 expression and the prognosis of glottic cancer. METHODS: Paraffin-embedded, early-stage (I or II) glottic cancer specimens (n = 52) were immunohistochemically analyzed to explore MACC1 expression. The clinical records associated with each case were also examined. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method, and between-group RFS differences were assessed using the log-rank test. The multivariate analyses were evaluated using the Cox's proportional-hazard model. RESULTS: Patients were treated with only radiotherapy (RT) (n = 37, including 18 with T1 disease and 19 with T2 disease), or with chemoradiotherapy (CRT) (n = 15, including 1 with T1 disease and 14 with T2 disease). Eleven patients demonstrated local recurrence and two patients experienced cervical lymph node recurrence. Tumor specimens were MACC1-positive in 9 of the 13 (69.2%) patients with local or neck recurrence, and 7 of the 11 (63.6%) patients with local recurrence. The RFS rate of patients who were treated with only RT was significantly lower than that of patients who were treated with CRT (P = 0.0243). The RFS rate was significantly lower in cases with MACC1 expression than in those without MACC1 expression (P = 0.0003). Multivariate analysis revealed that MACC1 expression was an independent risk factor of local recurrence (P = 0.0016). CONCLUSION: MACC1 is an independent indicator of recurrence related to RFS in early-stage glottic cancer.

DOI： 10.1093/jjco/hyz206

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Clinical significance of cytoplasmic IgE-positive mast cells in eosinophilic chronic rhinosinusitis Reviewed International journal

Gion Y, Okano M, Koyama Y, Oura T, Nishikori A, Orita Y, Tachibana T, Marunaka H, Makino T, Nishizaki K, Sato Y

Int J Mol Sci   7 ( 21 )   2020

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Cross-linking of antigen-specific IgE bound to the high-affinity IgE receptor (FcεRI) on the surface of mast cells with multivalent antigens results in the release of mediators and development of type 2 inflammation. FcεRI expression and IgE synthesis are, therefore, critical for type 2 inflammatory disease development. In an attempt to clarify the relationship between eosinophilic chronic rhinosinusitis (ECRS) and mast cell infiltration, we analyzed mast cell infiltration at lesion sites and determined its clinical significance. Mast cells are positive for c-kit, and IgE in uncinated tissues (UT) and nasal polyps (NP) were examined by immunohistochemistry. The number of positive cells and clinicopathological factors were analyzed. Patients with ECRS exhibited high levels of total IgE serum levels and elevated peripheral blood eosinophil ratios. As a result, the number of mast cells with membranes positive for c-kit and IgE increased significantly in lesions forming NP. Therefore, we classified IgE-positive mast cells into two groups: membrane IgE-positive cells and cytoplasmic IgE-positive cells. The amount of membrane IgE-positive mast cells was significantly increased in moderate ECRS. A positive correlation was found between the membrane IgE-positive cells and the radiological severity score, the ratio of eosinophils, and the total serum IgE level. The number of cytoplasmic IgE-positive mast cells was significantly increased in moderate and severe ECRS. A positive correlation was observed between the cytoplasmic IgE-positive cells and the radiological severity score, the ratio of eosinophils in the blood, and the total IgE level. These results suggest that the process of mast cell internalization of antigens via the IgE receptor is involved in ECRS pathogenesis.

DOI： 10.3390/ijms21051843

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An adolescent case of maxillary ameloblastic fibrosarcoma Reviewed

Yohei Noda, Tomoyasu Tachibana, Hidenori Marunaka, Kazunori Kuroda, Takuma Makino, Shift Kariya

Otolaryngology - Head and Neck Surgery (Japan)   92 ( 10 )   851 - 856   2020

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We report about 17-year-old girl with maxillary ameloblastic fibrosarcoma. She underwent surgery and received postoperative chemotherapy comprising ifos-famide and doxorubicin. Considering fertility preservation. mature oocytes were cryopreserved before initiating chemotherapy. Two years after chemotherapy, there were no signs of recurrence. In adolescent and young adult patients, treatment and fertility preservation should be considered in the management of head and neck cancer.

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The efficacy of OK-432 sclerotherapy on thyroglossal duct cyst and the influence on a subsequent surgical procedure. Reviewed International journal

Tomoyasu Tachibana, Shin Kariya, Yorihisa Orita, Takuma Makino, Takenori Haruna, Yuko Matsuyama, Yasutoshi Komatsubara, Yuto Naoi, Michihiro Nakada, Yoji Wani, Soichiro Fushimi, Machiko Hotta, Katsuya Haruna, Tami Nagatani, Yasuharu Sato, Kazunori Nishizaki

Acta oto-laryngologica   139 ( 9 )   788 - 792   2019.9

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Background: Although there are studies regarding the efficacy of OK-432 sclerotherapy on thyroglossal duct cyst (TDC), its effects on surgical procedure following this therapy have not been properly described. Objectives: The present study aimed to delineate the prognostic factors of OK-432 sclerotherapy in patients with TDC and investigate its influence on subsequent surgical procedure and the histological characteristics in patients with poor response to OK-432 sclerotherapy. Material and methods: We conducted a retrospective analysis of the medical records of 20 TDC patients treated with OK-432 sclerotherapy. Results: Of the 20 patients, OK-432 sclerotherapy was effective in 5 patients (25.0%). OK-432 showed a lower effective rate in multilocular cysts (9.1%) than in unilocular cysts (44.4%), although not significantly. Five cases were treated with surgery following OK-432 sclerotherapy. There was no significant difference in the operating time and the amount of bleeding between patients with and without OK-432 sclerotherapy. From the results of the histological examination of the cyst wall, two cases had stratified squamous epithelium and two cases showed the absence of lymphocyte infiltration. Conclusion and significance: OK-432 sclerotherapy is an acceptable initial treatment for TDC, especially in unilocular cysts, because of lack of influence on surgical procedure.

DOI： 10.1080/00016489.2019.1633019

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KRAS mutations in tongue squamous cell carcinoma. Reviewed International journal

Yusuke Akagi, Tomoyasu Tachibana, Yorihisa Orita, Yuka Gion, Hidenori Marunaka, Takuma Makino, Kentaro Miki, Naoki Akisada, Tadashi Yoshino, Kazunori Nishizaki, Yasuharu Sato

Acta oto-laryngologica   139 ( 7 )   647 - 651   2019.7

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Background: p16INK4a (p16) expression in tongue cancer (TC) is reportedly not associated with human papilloma virus (HPV). Mutations of KRAS in cancer cells are most frequently observed within codon 12. However, few reports have investigated the association between KRAS mutations and p16 status in TC. Objectives: This study aimed to evaluate the influence of KRAS mutations on TC. Methods: Clinical records and surgically resected specimens of 85 TC patients were analyzed. Tumor samples were analyzed for mutations of KRAS located within codons 12 and 13. p16 staining was performed and considered positive in cases with moderate to strong nuclear and cytoplasmic staining. Results: Positive p16 staining was observed in 10 cases (11.8%). A KRAS mutation was detected in one case (1.2%). The case with KRAS mutation showed negative p16 staining. Despite being at an early stage, the patient died of lung metastasis at 43 months from initial treatment. Conclusions and Significance: KRAS mutations are not associated with p16 expression in TC and may predict poor prognosis in TC patients. Further analysis of mutations in regions other than codons 12 and 13 of KRAS will be necessary to determine the relationship between KRAS mutations and prognosis of this disease.

DOI： 10.1080/00016489.2019.1610574

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Spontaneous closure of traumatic tympanic membrane perforation following long-term observation. Reviewed International journal

Tomoyasu Tachibana, Shin Kariya, Yorihisa Orita, Takuma Makino, Takenori Haruna, Yuko Matsuyama, Yasutoshi Komatsubara, Yuto Naoi, Michihiro Nakada, Yohei Noda, Yasuharu Sato, Kazunori Nishizaki

Acta oto-laryngologica   139 ( 6 )   487 - 491   2019.6

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BACKGROUND: Traumatic tympanic membrane perforation (TTMP) is usually managed conservatively because most close spontaneously within a few months. Nevertheless, spontaneous closure of TTMP during long-term observation has not been well described in the literature. OBJECTIVES: The present study investigated factors associated with spontaneous closure of TTMP, and the characteristics of cases exhibiting spontaneous closure following long-term observation. MATERIALS AND METHODS: The medical records of 40 patients with TTMP who visited the authors' hospital were retrospectively reviewed. RESULTS: Spontaneous closure was observed in 27 (67.5%) patients. The healing period was <2 weeks in 6 cases, <4 weeks in 9, <3 months in 5, <6 months in 3, and ≥6 months in 4. All four cases in which spontaneous closure took ≥6 months exhibited a sign of spontaneous closure at 6 months following injury. Perforation in contact with the malleus was associated with a lower frequency of spontaneous closure. CONCLUSIONS AND SIGNIFICANCE: In TTMP, surgery should be considered in patients who exhibit perforation in contact with the malleus. However, it has also been suggested that long-term observation may be a viable treatment option when a sign of spontaneous closure is observed within 6 months following injury.

DOI： 10.1080/00016489.2019.1592225

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Clinicopathological Features and Outcomes of Endoscopic Submucosal Dissection for Superficial Cancer of the Pharynx. Reviewed

Makoto Abe, Masaya Iwamuro, Yoshiro Kawahara, Hiromitsu Kanzaki, Seiji Kawano, Takehiro Tanaka, Munechika Tsumura, Takuma Makino, Yohei Noda, Hidenori Marunaka, Kazunori Nishizaki, Hiroyuki Okada

Acta medica Okayama   73 ( 2 )   109 - 115   2019.4

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The efficacy and safety of endoscopic submucosal dissection (ESD) for superficial cancer of the pharynx are still unclear. To identify clinicopathological features of superficial pharyngeal cancer, and the efficacy and safety of ESD, we retrospectively assessed 70 pharyngeal cancers in 59 patients who underwent ESD. Of these patients, 61.0% and 50.8% had a history of esophageal cancer and head and neck cancer, respectively. The median tumor size was 15 mm, and 75.7% of the lesions were located at the piriform sinus. The en bloc resection rate was 94.9%. Treatment-related adverse events occurred in 8 cases, but there was no treatment-related death. The lateral margin was positive for neoplasm in 3 lesions (4.3%) and inconclusive in 27 lesions (38.6%), but no local recurrence was observed. Cervical lymph node metastasis was observed in 6 patients, and was successfully treated by cervical lymph node dissection. The three-year overall survival rate was 91.5% (95%CI: 76.6-97.3%) and the cause-specific survival rate was 97.6% (95%CI: 84.9-99.7%). In conclusion, ESD for superficial pharyngeal cancer was safe and effective. "Resect and watch" is probably a feasible and rational strategy for treatment of patients with superficial pharyngeal cancer.

DOI： 10.18926/AMO/56646

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Young adult patients with squamous cell carcinoma of the tongue strongly express p16 without human papillomavirus infection. Reviewed International journal

Tachibana T, Orita Y, Gion Y, Miki K, Ikegami K, Marunaka H, Makino T, Akagi Y, Akisada N, Tsumura M, Ito T, Yoshino T, Nishizaki K, Sato Y

Acta oto-laryngologica   139 ( 1 )   80 - 84   2019.1

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BACKGROUND: Long-term smoking and drinking are known to contribute to the onset of tongue cancer (TC). However, the increasing incidence of TC in younger adults has been suggested to be associated with other factors. OBJECTIVES: The present study investigated the relationship between TC and human papillomavirus (HPV) infection. MATERIAL AND METHODS: Clinical records and surgically resected specimens from 86 patients (<40-years-old, n = 12; ≥40-years-old, n = 74) with TC were analyzed. Strong nuclear and cytoplasmic p16 staining was considered positive. HPV DNA (high-risk subtypes: 16, 18, 31, 33, 35, 52b, and 58; low-risk subtypes: 6 and 11) was detected using consensus primer-mediated polymerase chain reaction. RESULTS: Strong p16 expression was observed in 10 (11.6%) patients. HPV DNA was detected in 9 (10.5%) patients (high-risk subtypes, n = 2; low-risk subtypes, n = 7). Strong p16 expression was observed more frequently among younger adults than among older adults (33.3% vs. 8.1%; p = .045). p16 staining did not correlate with the detection of HPV DNA (correlation coefficient, 0.113; p = .300). CONCLUSIONS AND SIGNIFICANCE: In TC, p16 expression was not associated with HPV infection, suggesting that it may be caused by a different mechanism.

DOI： 10.1080/00016489.2018.1541506

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Factors that prolong the duration of recovery in acute rhinosinusitis with orbital complications. Reviewed

Tachibana T, Kariya S, Orita Y, Nakada M, Makino T, Haruna T, Matsuyama Y, Komatsubara Y, Naoi Y, Sato Y, Nishizaki K

Acta Otolaryngol   10   1 - 5   2019

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Factors that prolong the duration of recovery in acute rhinosinusitis with orbital complications. Reviewed International journal

Tomoyasu Tachibana, Shin Kariya, Yorihisa Orita, Michihiro Nakada, Takuma Makino, Takenori Haruna, Yuko Matsuyama, Yasutoshi Komatsubara, Yuto Naoi, Yasuharu Sato, Kazunori Nishizaki

Acta oto-laryngologica   139 ( 1 )   52 - 56   2019

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BACKGROUND: Regarding prognostic factors of acute rhinosinusitis (ARS) with orbital complications, there are few studies including adult cases. OBJECTIVES: The present study aims to delineate prognostic factors of ARS with orbital complications. MATERIAL AND METHODS: We conducted a retrospective analysis of medical records of 21 patients (6 pediatric and 15 adult patients) with ARS with orbital complications. The duration of recovery was defined as the time from initial diagnosis to complete resolution of local findings and all symptoms. Orbital complications due to postoperative cysts or mycosis were excluded. RESULTS: Twenty-one patients comprised 11 males and 10 females. Chandler's classification showed group I in 4, group II in 8, and group III in 9. None of six pediatric patients required any surgical intervention, whereas five adult patients (23.8%) underwent surgical intervention. The average period of recovery was 8.1 days. In univariate analysis, the duration of recovery was significantly longer among adult cases (p < .01) and cases with Chandler's groups II-III (p = .019). In multivariate analysis, adult patients had a significantly longer duration of recovery than pediatric patients (p = .027). CONCLUSION AND SIGNIFICANCE: The present study suggested that ARS with orbital complications may have prolonged clinical course in adults.

DOI： 10.1080/00016489.2018.1539516

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Computed Tomography Findings for Diagnosing Follicular Thyroid Neoplasms. Reviewed

Makino T, Orita Y, Tachibana T, Marunaka H, Miki K, Akisada N, Akagi Y, Usui Y, Sato Y, Yoshino T, Nishizaki K

Acta medica Okayama   72 ( 6 )   577 - 581   2018.12

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Since no diagnostic method has been established to distinguish follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA), surgery has been the only way to reach a diagnosis of follicular neoplasm. Here we investigated the computed tomography (CT) features of follicular neoplasms, toward the goal of being able to identify specific CT features allowing the preoperative differentiation of FTC from FTA. We retrospectively analyzed the cases of 205 patients who underwent preoperative CT of the neck and were histopathologically diagnosed with FTC (n=31) or FTA (n=174) after surgery between January 2002 and June 2016 at several hospitals in Japan. In each of these 205 cases, non-enhanced and contrast-enhanced CT images were obtained, and we analyzed the CT features. On univariate analysis, inhomogeneous features of tumor lesions on contrast-enhanced CT were more frequently observed in FTC than in FTA (p=0.0032). A multivariate analysis identified inhomogeneous features of tumor lesions on contrast-enhanced CT images as an independent variable indicative of FTC (p=0.0023). CT thus offers diagnostic assistance in distinguishing FTC from FTA.

DOI： 10.18926/AMO/56375

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Canal wall-down procedure with soft posterior meatal wall reconstruction in acquired cholesteatoma: focus on postoperative middle ear status* Reviewed International journal

Tomoyasu Tachibana, Shin Kariya, Yorihisa Orita, Michihiro Nakada, Takuma Makino, Yasutoshi Komatsubara, Yuko Matsuyama, Yuto Naoi, Kazunori Nishizaki

Acta Oto-Laryngologica   138 ( 8 )   695 - 700   2018.8

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Objectives: We reviewed surgical results of canal wall-down tympanoplasty (CWDT) with soft posterior meatal wall reconstruction (SWR) for acquired cholesteatoma (AC), and identified factors associated with surgical outcomes. Methods: Results from 119 ears with AC (pars flaccida, n = 99
pars tensa, n = 20) that underwent CWDT with SWR were retrospectively reviewed. We defined postoperative balloon-like retraction (PBR) with web formation, which needed reoperation to clean accumulated cerumen, as postoperative deep retraction pocket (PDRP). Results: Residual cholesteatoma was found in 11 ears (9.2%). Seven residual cholesteatomas were treated with outpatient operation. Seven ears (5.9%) showed PDRP. A transcanal approach was applied to all PDRPs. Postoperative mastoid reaeration was observed in 57 ears (47.9%). No factors significantly associated with residual cholesteatoma or PDRP were identified. The frequency of postoperative mastoid reaeration was significantly higher among cases with young age (&lt
50 years), stage I cholesteatoma, or type I ossiculoplasty. Conclusion: CWDT with SWR showed low rates of residual cholesteatoma or postoperative deep retraction pocket (PDRP). Most residual cholesteatomas and PDRPs could be dealt with using a minimally invasive procedure. Young age, stage I cholesteatoma, and type I ossiculoplasty were associated with postoperative mastoid reaeration. This procedure seems fully feasible for surgical treatment of AC.

DOI： 10.1080/00016489.2018.1439593

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Prognostic factors and importance of recognition of adult croup Reviewed International journal

Tomoyasu Tachibana, Yorihisa Orita, Takuma Makino, Yasutoshi Komatsubara, Yuko Matsuyama, Yuto Naoi, Michihiro Nakada, Yasuharu Sato, Kazunori Nishizaki

Acta Oto-Laryngologica   138 ( 6 )   579 - 583   2018.6

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Objectives: Croup, or laryngotracheobronchitis, is a common disease in childhood. On the other hand, to our knowledge, there are only 14 cases in six English literatures describing adult croup (AC). The clinical features of AC have not been well known. Methods: We conducted a retrospective analysis of medical records of 18 patients with AC during the period from 2008 to 2016. Results: None of the 18 patients required an urgent airway intervention. Univariate analysis indicated that the duration of symptoms was significantly longer in patients with cough (p &lt
.01) and younger patients (age &lt
60, p =.037). The duration of subglottic edema was significantly longer in female (p =.035), patients with high levels of CRP (≥1 mg/dL, p =.049), and patients with cough symptom (p =.035). Conclusions: Female, young age (&lt
60 years), the symptom of cough, and high levels of CRP should be recognized as signs of prolonged AC. It is important to confirm the diagnosis of AC by laryngoscopic examination, which also help to avoid airway intervention.

DOI： 10.1080/00016489.2017.1422140

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Neck metastasis in patients with T1-2 supraglottic cancer Reviewed International journal

Tomoyasu Tachibana, Yorihisa Orita, Hidenori Marunaka, Sei-ichiro Makihara, Misato Hirai, Yuka Gion, Kana Ikegami, Kentaro Miki, Takuma Makino, Yasuyuki Noyama, Yasutoshi Komatsubara, Miyuki Kimura, Tadashi Yoshino, Kazunori Nishizaki, Yasuharu Sato

Auris Nasus Larynx   45 ( 3 )   540 - 545   2018.6

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Objectives: Unlike glottic cancer, supraglottic cancer often presents with neck metastases. This different might be attributable to the location of the primary lesion. This study aimed to clarify the relationships between the sublocation of T1-2 supraglottic cancer, human papillomavirus (HPV) infection, neck metastasis, and prognosis of supraglottic cancer. Methods: This retrospective clinical study investigated 55 Japanese patients with T1-2 supraglottic cancer treated between 1994 and 2015. Results: Of 55 patients with T1-2 supraglottic cancer, neck metastasis was present at initial diagnosis in 14 patients (25.5%). Presence of neck metastasis was the only factor associated with worse prognosis of T1-2 supraglottic cancer (p = 0.004). In multivariate analysis, age &lt
70 years (p = 0.033) and sublocation of the primary lesion in the superior epilaryngeal portion (p = 0.017) were significantly associated with presence of neck metastasis in multivariate analysis. Twelve (27.9%) of 43 patients showed positive results for human papillomavirus infection. However, human papillomavirus infection was not associated with prognosis, presence of neck metastasis, or primary lesion sublocation in T1-2 supraglottic cancer. Conclusion: Relatively young patients with supraglottic cancer at the superior epilaryngeal portion are more likely to show neck metastasis. Human papillomavirus infection was not associated with frequency of neck metastasis.

DOI： 10.1016/j.anl.2017.06.002

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Squamous cell carcinoma of the bilateral external auditory canals Reviewed

Shin Kariya, Yohei Noda, Munechika Tsumura, Takuma Makino, Hidenori Marunaka, Kazunori Nishizaki

Otolaryngology - Head and Neck Surgery (Japan)   90 ( 7 )   577 - 582   2018.6

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Squamous cell carcinoma of the external auditory canal is an unusual head and neck malignancy with a reported incidence of between 1 to 6 cases per million population per year. We presented a case of Squamous cell carcinoma of the bilateral external auditory canals in a 69-year-old female. Right side tumor mas treated with surgery. Left side tumor was treated with radiotherapy. Five years after treatment, the recurrence of the tumor was found in the left side, and the surgery was performed. No recurrence or metastasis was observed at 10 years follow-up.

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耳後部有茎皮弁にて外耳道再建した両側性外耳道扁平上皮癌の1例 Reviewed

假谷 伸, 野田 洋平, 津村 宗近, 牧野 琢丸, 丸中 秀格, 西崎 和則

耳鼻咽喉科・頭頸部外科   90 ( 7 )   577 - 582   2018.6

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症例は69歳女性で、7年前に右耳漏を主訴に受診し、右外耳道扁平上皮癌と診断された。術前放射線治療施行後に、外側側頭骨切除術および遊離腹直筋皮弁による再建術を施行した。その後、術後放射線治療を施行した。右外耳道癌の経過観察目的で受診した際に左外耳道下壁の皮膚不整を指摘された。左外耳道扁平上皮癌の診断で電子線照射、腔内照射を施行し、腫瘍は消失した。標準純音聴力検査では、右耳の混合性難聴を認めた。定期再診時に左外耳道に不整を認めた。左外耳道より生検を行い、病理組織診断は扁平上皮癌であった。左外耳道には過去の治療により高線量の放射線照射が行われており、さらなる放射線治療は不可能と判断し、左外耳道腫瘍切除手術を行った。摘出標本の病理組織学的検査にて高分化型扁平上皮癌と診断した。術後、皮弁は生着し、術後3週間で外耳道内は乾燥した。現在、最終手術から約10年を経過して両側とも外耳道癌の再発や転移は認めない。

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椎周囲間隙に発生した頸部筋間脂肪腫例 Reviewed

牧野 琢丸, 橘 智靖, 小松原 靖聡

耳鼻咽喉科臨床   111 ( 6 )   395 - 399   2018.6

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症例は48歳男性で、約2年前から右頸部腫瘤を自覚した。右頸部に可動性不良な弾性軟の腫瘤を認めた。頸部超音波検査では胸鎖乳突筋の背側、内頸静脈の後方に、境界明瞭で内部が均一な等〜やや高エコーの腫瘤を認めた。MRIでは胸鎖乳突筋と肩甲挙筋の間、およびその背側に連続するダンベル型の嚢胞様の腫瘤として描出され、内部は均一でT1強調画像、T2強調画像でともに高信号を呈し、脂肪抑制画像にて信号が抑制された。全身麻酔下に仰臥位で腫瘍摘出術を行った。摘出した腫瘤の大きさは70×55×21mmで、色調は黄色であった。病理組織所見では、成熟した脂肪組織の増生から成り、筋線維束は認めなかったことから、単純脂肪腫と診断した。術後明らかな神経症状は認めず、現在外来にて経過観察中である。

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Laryngeal squamous cell papilloma is highly associated with human papillomavirus Reviewed International journal

Yorihisa Orita, Yuka Gion, Tomoyasu Tachibana, Kana Ikegami, Hidenori Marunaka, Seiichiro Makihara, Yasuhiko Yamashita, Kentaro Miki, Takuma Makino, Naoki Akisada, Yusuke Akagi, Miyuki Kimura, Tadashi Yoshino, Kazunori Nishizaki, Yasuharu Sato

Japanese Journal of Clinical Oncology   48 ( 4 )   350 - 355   2018.4

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Objective: To delineate the association between characteristics of adult-onset laryngeal squamous cell papilloma and human papillomavirus (HPV) infection. Methods: Clinical records and paraffin-embedded specimens of 77 papilloma patients who had been treated between 1998 and 2014 were collected. Of the 77 cases, 34 were identified in the larynx, 28 in the oral cavity and 15 in the oropharynx. Specimens were investigated by polymerase chain reaction (PCR) to detect HPV 6, 11, 16, 18, 31, 33, 35, 52b and 58, and immunohistochemical (IHC) staining for anti-p16INK4a antibody. Results: In 21 cases (61.8%) with laryngeal squamous cell papilloma, various types of HPV were detected: 14 cases (41.2%) were positive of high-risk HPV, 18 (52.9%) were positive of low-risk HPV and 11 (32.4%) were positive of both high-risk HPV and low-risk HPV. Younger patients (&lt
60 years) showed a higher rate of HPV infection than older patients. Among the 34 cases with laryngeal papilloma, no malignant transformation was observed during the study period. With IHC staining, positive expression of p16 was observed in 20 cases (58.8%). HPV infection and p16-expression were associated with the pathological finding of koilocytosis. Only four cases (14.3%) showed HPV-positivity in the oral cavity, and none of the 15 oropharyngeal cases were positive for HPV, and none of the oral cavity and oropharyngeal cases showed koilocytosis. Results of HPV-PCR and p16-IHC staining were significantly correlated each other. Conclusions: HPV infection is frequently associated with laryngeal squamous cell papilloma, and koilocytosis is a characteristic pathological finding. To the best of our knowledge, this is the first report which have described infections with multiple HPV types in laryngeal papilloma.

DOI： 10.1093/jjco/hyy009

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A case of intermuscular lipoma in the perivertebral space Reviewed

Takuma Makino, Tomoyasu Tachibana, Yasutoshi Komatsubara

Practica Oto-Rhino-Laryngologica   111 ( 6 )   395 - 399   2018

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We describe our experience of a case of intermuscular lipoma located in the perivertebral space. The patient was a 48-year-old male who presented with the chief complaint of a right neck swelling, first noticed about two years earlier. Cervical ultrasonography and MRI revealed a tumorous lesion expanding into the perivertebral space. Intraoperatively, there were no adhesions between the lipoma and the surrounding tissue. Manual ablation of the lipoma was effective in the deep region, where the lipoma could not be visualized directly. We successfully accomplished complete resection of the lipoma without any serious complications. In the management of intermuscular lipomas expanding into the perivertebral space, surgical treatment should be considered, because resection can be accomplished with little risk of postoperative complications.

DOI： 10.5631/jibirin.111.395

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A case of a fish bone in the neck removed using CT- guided hookwire placement Reviewed

Yasutoshi Komatsubara, Tomoyasu Tachibana, Takuma Makino, Yuto Naoi, Aiko Shimizu, Mayu Uga, Akihito Mitsumori

Otolaryngology - Head and Neck Surgery (Japan)   89 ( 10 )   849 - 853   2017.9

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A 67-year-old woman complained of right sided neck pain and a swelling at right sided neck. CT showed a severe inflammatory change and a linear calcification in the right neck region. We could not identify the foreign body in the initial surgery. After placing a hook-wire near the linear calcification under CT guide, we could safely remove a fish bone. We considered that preoperative CT-guided hookwire placement would be very useful for the removal of foreign bodies in the neck.

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CTガイド下マーキングが有用であった頸部魚骨異物例 Reviewed

小松原 靖聡, 橘 智靖, 牧野 琢丸, 直井 勇人, 清水 藍子, 宇賀 麻由, 三森 天人

耳鼻咽喉科・頭頸部外科   89 ( 10 )   849 - 853   2017.9

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症例は67歳女性で、4ヵ月前に魚を食べた直後より咽頭に激痛を自覚した。2ヵ月経過した頃に右頸部痛を自覚し、その後右頸部の腫脹が出現した。精査・加療を目的に当科を紹介され受診した。頸部に迷人した魚骨異物の感染による右頸部蜂窩織炎および内頸静脈血栓症と診断し、パニペネム、ベタミプロン、クリンダマイシンの投与および抗凝固療法を開始した。治療開始6日目に頸部外切開による異物の摘出を試みたが異物の同定ができず、CTガイド下マーキングを行ったうえで前後方向の検索を行った。総頸動脈背側の線維化した組織内に長さ約1cm、棘状の魚骨を同定し摘出した。異物の摘出後、新たな合併症の出現はなく、頸部の発赤および胸鎖乳突筋の硬結は徐々に改善した。

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Sphenoid sinusitis with trismus in a child Reviewed

Yyto Naoi, Tomoyasu Tachibana, Takuma Makino, Yasutoshi Komatsubara, Akihito Mitsumori

Otolaryngology - Head and Neck Surgery (Japan)   89 ( 6 )   465 - 470   2017.5

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A 12-year-old boy complained of headache and trismus. CT showed right sphenoid sinusitis with an expanding inflammation from parapharyngeal space to infratemporal fossa. We suspected an abscess formation at the infratemporal fossa. Endoscopic sinus surgery was performed immediately. Subsequently. carbapenem and clindamycin were administered. The patient recovered uneventfully. We considered that drainage and appropriate administration of antibacterial agents would be very useful for severe sphenoid sinusitis.

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開口障害を伴った小児蝶形骨洞炎例 Reviewed

直井 勇人, 橘 智靖, 牧野 琢丸, 小松原 靖聡, 三森 天人

耳鼻咽喉科・頭頸部外科   89 ( 6 )   465 - 469   2017.5

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12歳男児。鼻閉を主訴に近医を受診し、急性副鼻腔炎の診断でクラリスロマイシンを処方され、内服終了2日後より頭痛が出現した。セフジトレンピボキシル(CDTR-PI)、クラブラン酸カリウム・アモキシシリン水和物(CVA/AMPC)を処方されたが頭痛は増悪し、40度台の発熱、開口障害が出現した。初診時は開口1.5横指で、右蝶形骨洞自然口付近の膿性鼻汁を認めた。造影CT所見で右側頭下窩から副咽頭間隙にかかる炎症の進展を認め、側頭下窩の膿瘍形成が疑われた。血液検査では炎症反応が認められた。以上より、側頭下窩に波及した右蝶形骨洞炎と診断し、ドレナージ目的に内視鏡下鼻内副鼻腔手術を行った。洞内から多量の白色膿汁が流出し、膿汁からはHaemophilus influenza BLNARが検出された。CDTR-PI、CVA/AMPCは無効であったため、術当日よりカルバペネム系抗菌薬、CLDMを併用投与し、開口障害は消失した。術後7ヵ月時点で蝶形骨洞炎の再燃は認めない。

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気管憩室を併存した甲状腺乳頭癌例 Reviewed

橘 智靖, 折田 頼尚, 牧野 琢丸, 小松原 靖聡, 西崎 和則

日本内分泌・甲状腺外科学会雑誌   34 ( 1 )   65 - 69   2017.3

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Language：Japanese   Publisher：日本内分泌外科学会・日本甲状腺外科学会  

今回われわれは、気管憩室を併存した甲状腺乳頭癌の1例を経験したので若干の文献的考察を加えて報告する。症例は63歳、男性。甲状腺乳頭癌の術前CTで、偶然右気管傍領域に気腫像を認識し気管憩室の存在を予想することによって、安全に手術を施行しえた。気管憩室を損傷した場合には縦隔気腫・縦隔炎・肺瘻を生じうるため、甲状腺手術に限らず頭頸部手術において気管憩室を始めとした気管形態の異常の可能性を念頭に置くことが重要と考えられた。(著者抄録)

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Tumor-Associated Macrophages in the Development of 4-Nitroquinoline-1-Oxide-Induced Tongue Squamous Cell Carcinoma in a Mouse Model Reviewed International journal

Kentaro Miki, Yorihisa Orita, Yuka Gion, Soshi Takao, Kyotaro Ohno, Mai Takeuchi, Toshihiro Ito, Akira Minoura, Tomoyasu Tachibana, Hidenori Marunaka, Takuma Makino, Akihiro Matsukawa, Kazunori Nishizaki, Tadashi Yoshino, Yasuharu Sato

ONCOLOGY   93 ( 3 )   204 - 212   2017

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Objective: We aimed to determine the distribution of tumor-associated macrophages (TAMs) in the development of tongue squamous cell carcinoma (SCC) and to elucidate the role of TAMs in the progression of tongue SCC. Methods: The expression of the macrophage markers nitric oxide synthase, Retnla, and mannose receptor 1 in the development of tongue SCC was longitudinally observed using real-time quantitative polymerase chain reaction. Additionally, an immunohistochemical study using an anti-mannose receptor (MR) antibody was performed. Results: The numbers of both of M1 and M2 macrophages in the tongues of mice treated with 4-nitroquinoline-1-oxide (4NQO) were significantly lower compared with those of normal tongues. The cyclo-oxygenase-2 (COX-2) inhibitor did not prevent cancer progression and did not affect the total number of macrophages in the tongues of 4NQO-treated mice. In the immunohistochemical studies, MR staining was observed in lymphangio-endothelium in the subepithelial area of the tongues. The staining intensity of the MR was significantly stronger in the 4NQO-treated mice compared with that in control mice and 4NQO-treated mice treated with the COX-2 inhibitor. Conclusion: TAMs may not contribute to the development of 4NQO-induced tongue SCC. MR expression is associated with the progression of 4NQO-induced tongue SCC. (C) 2017 S. Karger AG, Basel

DOI： 10.1159/000477301

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A case of herpetic tonsillitis showing tumor-like lesion Reviewed

Aiko Shimizu, Tomoyasu Tachibana, Takuma Makino, Yuko Matsuyama, Yasutoshi Komatsubara, Yoji Wani, Tami Nagatani

Otolaryngology - Head and Neck Surgery (Japan)   88 ( 13 )   1053 - 1056   2016.12

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Igaku-Shoin Ltd  

A 39-year-old female complained of sore throat. We suspected the possibility of neoplastic, viral, or infectious diseases such as tuberculosis for the right tonsil showing rough-surfaced tumorous lesion. A biopsy specimen of the lesion revealed herpes simplex virus infection. Histological examination seemed to be useful for early diagnosis of HSV and differentiatial diagnosis.

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腫瘍様所見を呈した単純ヘルペスウイルスによる扁桃炎例 Reviewed

清水 藍子, 橘 智靖, 牧野 琢丸, 松山 祐子, 小松原 靖聡, 和仁 洋治, 永谷 たみ

耳鼻咽喉科・頭頸部外科   88 ( 13 )   1053 - 1056   2016.12

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Language：Japanese   Publisher：(株)医学書院  

39歳女。咽頭痛、発熱を主訴とした。初診時、右側口蓋扁桃は正中を超えて八つ頭状に隆起しており、表面全体に白苔が付着していた。咽頭培養にてKlebsiella pneumoniaeが検出され、ツベルクリン反応は中等度陽性を示した。悪性疾患との鑑別を目的に一部を生検したところ、細菌の集塊・壊死物が付着し、肉芽組織を形成していた。上皮には核のすりガラス状変化を認めた。腫脹していた頸部リンパ節の細胞診でも悪性所見は認めず、細菌感染による扁桃炎としてセフジトレンピボキシル投与を開始した。治療開始5日目には咽頭痛は消失して解熱も得られ、口蓋扁桃の隆起も縮小傾向を認め、白苔もほぼ消失した。病理組織所見にて核のすりガラス状変化を認めたことから、SV-1、2に対するpolyclonal抗体を用いて免疫染色を行った結果、HSVによる扁桃炎と診断した。治療開始から7週間経過観察を行ったが、症状の再燃、右側口蓋扁桃の再隆起は認めなかった。

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Regulatory T cells function at the early stage of tumor progression in a mouse model of tongue squamous cell carcinoma Reviewed International journal

Kentaro Miki, Yorihisa Orita, Yuka Gion, Soshi Takao, Kyotaro Ohno, Mai Takeuchi, Toshihiro Ito, Hiroyuki Hanakawa, Tomoyasu Tachibana, Hidenori Marunaka, Takuma Makino, Akira Minoura, Akihiro Matsukawa, Kazunori Nishizaki, Tadashi Yoshino, Yasuharu Sato

CANCER IMMUNOLOGY IMMUNOTHERAPY   65 ( 11 )   1401 - 1410   2016.11

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

The objective of this study was to observe the distribution of regulatory T cells (Tregs) in the development of tongue squamous cell carcinoma (SCC) and to determine the role of Tregs in the progression of tongue SCC. A mouse model of 4-nitroquinoline-1-oxide (4NQO)-induced-tongue SCC was established. The expression of Forkhead box P3 (Foxp3), interleukin 10, transforming growth factor-beta, chemokine CC motif ligands 17, 20, and CC chemokine receptor 4 was determined using real-time quantitative polymerase chain reaction. Foxp3 expression was also analyzed using immunohistochemistry. The results were compared with those of control mice and of 4NQO-treated mice treated with a cyclooxygenase-2 (COX-2) inhibitor. Well to moderately differentiated tongue SCC was induced in all of the experimental mice. The amount of Tregs of the experimental mice was over 10 times as much as control mice at the early stage of tumor progression. COX-2 inhibitor did not prevent the progression of tongue SCC and did not reduce the total amount of Tregs. Tregs function at the early stage of the development of tongue SCC, and it may be effective to suppress Tregs at the early stage of tumor progression for the treatment and/or prevention of tongue SCC.

DOI： 10.1007/s00262-016-1902-x

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Kikuchi-Fujimoto disease: evaluation of prognostic factors and analysis of pathologic findings Reviewed International journal

Hidenori Marunaka, Yorihisa Orita, Tomoyasu Tachibana, Kentaro Miki, Takuma Makino, Yuka Gion, Kazunori Nishizaki, Tadashi Yoshino, Yasuharu Sato

ACTA OTO-LARYNGOLOGICA   136 ( 9 )   944 - 947   2016.9

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：TAYLOR & FRANCIS LTD  

Conclusion: In Kikuchi-Fujimoto disease (KFD), a low ratio of blastic cells (&lt;70%) in lymph node specimens and absence of atypical lymphocytes in peripheral blood are predictive of a protracted clinical course. Objectives: Since KFD is a self-limiting disorder that does not require any specific management, prognostic factors have received little attention. The present study identified clinical and pathological factors that may affect the period from onset to cure of KFD. Methods: This retrospective study investigated 43 KFD patients who underwent lymph node biopsy diagnosed by immunohistochemical staining at Okayama University Hospital and Okayama Medical Center from January 2001 to December 2013. Results: Mean total period from onset to cure was 6 months (median =9.4 months; range =1-37 months). Low ratios of blastic cell proliferation area (&lt;70%) in lymph node specimens (p=0.011) and absence of atypical lymphocytes in peripheral blood (p=0.026) were associated with a relatively long duration of KFD.

DOI： 10.3109/00016489.2016.1164895

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術前診断が困難であったCarcinoma showing thymus-like differentiation(CASTLE)の1例 Reviewed

橘 智靖, 折田 頼尚, 牧野 琢丸, 清水 藍子, 和仁 洋治

日本内分泌・甲状腺外科学会雑誌   33 ( 3 )   184 - 188   2016.9

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Language：Japanese   Publisher：日本内分泌外科学会・日本甲状腺外科学会  

38歳女性。嗄声・声帯麻痺で発見され、高危険度の乳頭癌・未分化癌が疑われたが術前診断できず、手術後Carcinoma showing thymus-like differentiation(CASTLE)と判明した。術後、放射線外照射(60Gy)を施行し、治療終了後18ヵ月時点で明らかな再発・転移を認めていない。甲状腺疾患の診療において、悪性を示唆する理学所見が存在するにも関わらず、細胞診で乳頭癌もしくは濾胞性腫瘍を示唆する所見が得られない場合には、CASTLEの存在を念頭に置くことが重要である。またCASTLEの診断においては、術前に細胞診のみに頼らず、発生部位・形状・理学所見を含めた総合的な判断が必要と考えた。(著者抄録)

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[A Clinical Study on 64 Cases of Laryngeal Granuloma]. Reviewed

Tomoyasu Tachibana, Yorihisa Orita, Takuma Makino, Yuya Ogawara, Yuko Matsuyama, Aiko Shimizu, Michihiro Nakada, Hidenori Marunaka, Kazunori Nishizaki

Nihon Jibiinkoka Gakkai kaiho   119 ( 6 )   860 - 866   2016.6

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Vocal process granulomas are mainly associated with vocal abuse, gastroesophageal reflux disease (GERD), or
endotracheal intubation. In the present study, we evaluate the prognostic factors and the usefulness of a grading system
in 64 patients with vocal process granulomas. We classified the granuloma which limited the vocal process of the arytenoid
cartilage as grade I, and which originated from the vocal process but extended beyond the vocal process of the
arytenoid cartilage as grade II, according to the grading system proposed by Wang CP, et al. First, we treated this disease
with conservative treatments including a proton pump inhibitor, steroid inhalation, or voice therapy. Surgical treatment
was reserved for failures of conservative treatments or when the diagnosis was in doubt. The overall post-surgical
recurrence rate was 65.7%, and it was significantly higher in male than female patients, and in younger than older
patients. The overall remission rate was 79.7%. A multivariate analysis revealed that Grade II was a significantly poor
prognostic factor and the patients with BMI ≥23 or Age <60 had a tendency to have a poor remission rate. The grading
system is useful for anticipating the prognosis in cases of vocal process granuloma.

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A Case of Epithelial-myoepithelial Carcinoma of the Nasopharynx Treated by Radiation Therapy Reviewed

Tachibana Tomoyasu, Makino Takuma, Ogawara Yuya, Matsuyama Yuko, Shimizu Aiko, Orita Yorihisa, Nishizaki Kazunori

Practica oto-rhino-laryngologica. Suppl.   147   78 - 79   2016

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Language：English   Publisher：The Society of Practical Otolaryngology  

<p>Epithelial-myoepithelial carcinoma (EMC) is a rare tumor, most commonly arising from the parotid gland. We present the case of an 80-year-old woman who presented with the chief complaint of nasal bleeding and was diagnosed as having EMC of the nasopharynx. Fiberopic endoscopy revealed a mass with erosion on the left side in the posterior wall of the nasopharynx. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a tumorous shadow limited to the nasopharynx, not extending into the surrounding tissue. Histological and immunohistochemical examination of biopsy specimens confirmed the diagnosis. Full-dose radiation therapy was administered. The tumor disappeared completely, and no evidence of recurrence or metastasis has since become apparent. We considered that radiation therapy is one of the valid treatment options for patients with inoperable EMC.</p>

DOI： 10.5631/jibirinsuppl.147.78

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下肢麻痺を認めた脊椎転移性多形腺腫の1例 Reviewed

浦口 健介, 野田 洋平, 藤本 将平, 牧野 琢丸, 小野田 友男, 假谷 伸, 西崎 和則

口腔・咽頭科   28 ( 2 )   177 - 182   2015.6

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Language：Japanese   Publisher：日本口腔・咽頭科学会  

多形腺腫は唾液腺腫瘍の中で最も発生頻度の高い良性腫瘍である。また、多形腺腫は遠隔転移を来たす症例が報告されており、WHO分類では転移性多形腺腫として分類されている。今回、耳下腺良性多形腺腫の術後に脊椎転移による下肢麻痺を来たした転移性多形腺腫の1例を経験したので報告する。症例は77歳女性。過去2回、耳下腺多形腺腫の切除手術を受けていた。2013年末より背部痛と両側の下肢麻痺を認め、精査の結果、第3胸椎に腫瘍性病変を認めたため脊髄除圧術・腫瘍の組織検査を施行した。病理検査の結果は多形腺腫であり転移性多形腺腫と診断した。神経症状に対して放射線治療を行い、下肢麻痺は若干改善した。(著者抄録)

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Diffuse large B-cell lymphoma of the lacrimal sac arising from a patient with IgG4-related disease. Reviewed International journal

Hidenori Marunaka, Yorihisa Orita, Tomoyasu Tachibana, Kentaro Miki, Takuma Makino, Tadashi Yoshino, Kazunori Nishizaki, Yasuharu Sato

Modern rheumatology   28 ( 3 )   559 - 563   2015

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Taylor and Francis Ltd  

A rare case of diffuse large B-cell lymphoma (DLBCL) possibly induced by IgG4-related disease is described. A 78-year-old woman was presented with a mass of the right lacrimal sac that extended to the inferior nasal meatus through the nasolacrimal duct. Pathological diagnosis was DLBCL with diffuse distribution of IgG4 + cells in the background of this lesion. The chronic inflammatory state of IgG4-related disease could have caused the development of DLBCL.

DOI： 10.3109/14397595.2015.1131353

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Chronic rhinosinusitis patients have decreased lung function Reviewed International journal

Shin Kariya, Mitsuhiro Okano, Takaya Higaki, Yasuyuki Noyama, Takenori Haruna, Hisashi Ishihara, Takuma Makino, Tomoo Onoda, Kazunori Nishizaki

INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY   4 ( 10 )   828 - 833   2014.10

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Background: The relationship between upper and lower airway diseases has been reported. However, the pulmonary function of patients with chronic rhinosinusitis (CRS) has not been fully examined.
Methods: Pulmonary function was measured in 273 patients with CRS and 100 age-matched normal control subjects. No patients with chronic obstructive pulmonary disease (COPD) were included in this study. The patients with CRS were divided into 8 subgroups based on the presence of asthma, sensitization to common inhaled antigens, and nasal polyposis. The relationships between pulmonary function and clinical parameters, including radiographic severity of CRS according to the Lund-Mackay computed tomography (CT) staging system, eosinophil count in the peripheral blood, and serum total immunoglobulin E (IgE) levels, were assessed.
Results: In pulmonary function testing, the CRS patients had affected pulmonary function. The CRS patients without asthma showed latent obstructive pulmonary function changes when compared to normal controls. No significant correlations were observed between pulmonary function and any clinical parameters (Lund-Mackay CT staging score, eosinophil count in the peripheral blood, and serum total IgE levels).
Conclusion: CRS patients had significant obstructive lung function changes regardless of the presence of asthma. The patients with CRS who had not been clinically diagnosed as having lower respiratory tract diseasesmight have had subclinical lower airway diseases. Therefore, clinicians should be aware of pulmonary function and lower lung diseases in patients with CRS. (C) 2014 ARS-AAOA, LLC.

DOI： 10.1002/alr.21370

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当科における上咽頭癌症例の検討 Reviewed

牧野 琢丸, 小野田 友男, 小山 貴久, 春名 威範, 江口 元治, 假谷 伸, 西崎 和則

口腔・咽頭科   26 ( 2 )   203 - 206   2013.6

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Authorship：Lead author   Language：Japanese   Publisher：日本口腔・咽頭科学会  

我々は2005年より上咽頭癌に対する初期治療として、化学放射線同時併用療法(CCRT)にて治療を行っている。治療後2ヵ月で評価し、局所残存例に対してはサイバーナイフ治療を追加している。遠隔転移例に対しては、手術やラジオ波焼灼療法等の局所治療も積極的に行っている。当科にて初期治療にCCRTを行った19例を検討したところ、初期治療の奏効率は94.7%、3年生存率は92.9%であった。引き続き現在の治療方針で症例を蓄積し、検討を重ねていく予定である。(著者抄録)

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重粒子線治療が有効であった顎下腺唾液腺導管癌(salivary duct carcinoma)の1例

小野田 友男, 牧野 琢丸, 小山 貴久, 石原 久司, 平井 悠, 春名 威範, 假谷 伸, 西崎 和則

口腔・咽頭科   26 ( 2 )   207 - 210   2013.6

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唾液腺導管癌(Salivary Duct Carcinoma、以下SDC)は唾液腺癌のなかでも数%とまれではあるが、早期に局所再発やリンパ節転移、遠隔転移をきたす悪性度の高い腫瘍である。放射線治療、化学療法は効果が乏しく、外科的切除が治療の中心となり、切除不能例は予後不良となる。今回、我々は三叉神経浸潤をきたし切除不能と診断した顎下腺SDCに対し、重粒子線(炭素線)を照射し、その後頸部郭清を行った。顎下腺のSDCは大部分が壊死に陥るほどの高い効果が認められた。治療後、2年6ヵ月経過した現在、明らかな再発を認めていない。(著者抄録)

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鼻副鼻腔結核の1例

小野田 友男, 岡野 光博, 假谷 伸, 江口 元治, 野田 洋平, 牧野 琢丸, 宮武 智美, 橋本 香里, 西崎 和則, 丸中 秀格

頭頸部外科   22 ( 3 )   273 - 276   2013.2

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症例は31歳女性。右上顎洞から篩骨洞にかけて易出血性のもろい肉芽が充満していた。鼻腔と上顎洞から生検を行い、塗抹検査でガフキー1号、結核菌群PCRは陽性であり、鼻副鼻腔結核と診断した。INH・RFP・EB内服およびSMネブライザーを2ヵ月間行ったが画像上の改善傾向に乏しく、鼻副鼻腔根本術をおこなった。結核菌のように非メチル化DNAをもつ細菌では、死菌となってもホストのToll-like-receptor(TLR)9に結合し強力にサイトカインを誘導するため、炎症や肉芽が遷延することが考えられる。保存的治療を行っても病変の退縮が乏しい場合、根本術は有効な治療手段と思われる。(著者抄録)

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スギ・ヒノキ花粉症における初期療法の検討 エバスチン(エバステルOD錠)投与による観察研究

小川 晃弘, 松本 亮典, 春名 威範, 西川 奈見, 黒田 一彬, 宮武 智実, 宮原 聡子, 牧野 琢丸, 黒坂 文武

医学と薬学   66 ( 6 )   993 - 1002   2011.12

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スギ・ヒノキ花粉の近年まれな大量飛散が予測された2011年シーズンにおいて、エバスチンを用いた初期療法での治療効果と患者QOLの推移を、花粉飛散開始日以降に治療を開始した導入療法と比較検討した。花粉飛散数が比較的少ない時期における症状の程度、QOLスコアは初期療法群が導入療法群に比して有意に低値で、エバスチンによる初期療法が有効であることが示唆された。花粉の大量飛散時期においては初期療法群と導入療法群との間に有意差は認めず、花粉飛散景によってはエバスチンによる初期療法に限界があることが示唆された。安全性評価対象99例中、6例に副作用を認め、眠気3例、気分不良1例、胃部不快感1例、口内炎1例で、エバスチンとの因果関係が否定できない症例は眠気の3例であった。5例で投与を中止したが、いずれの副作用も軽微であった。

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Fanconi貧血に合併した舌癌の1例

阿部 郁, 小野田 友男, 牧野 琢丸, 河野 達也, 江口 元治, 假谷 伸, 西崎 和則

口腔・咽頭科   24 ( 2 )   183 - 186   2011.6

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Fanconi貧血は染色体が不安定な疾患であり、小児期に再生不良性貧血を、成長に伴い扁平上皮癌などの、固型癌を合併する頻度が高い。今回、我々はFanconi貧血に合併した舌癌の1例を経験したので報告する。症例は37歳女性。3歳頃より再生不良性貧血を指摘されていた。舌癌の疑いで当科紹介となった。右側舌縁癌T2N0M0 stage IIと診断し、舌部分切除術を施行した。しかし、手術6ヵ月後、右上内深頸リンパ節に転移が認められた。Fanconi貧血症例においては、創部易感染性の危惧があっても、その再発・転移リスクの高さから、初回治療としてpull throughを含めた拡大手術、少なくとも頸部郭清術を考慮すべきであったと考える。(著者抄録)

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舌癌に対する頸部郭清の適応に関する検討

河野 達也, 小野田 友男, 江口 元治, 牧野 琢丸, 阿部 郁, 假谷 伸, 西崎 和則

口腔・咽頭科   24 ( 2 )   179 - 182   2011.6

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2003年から2009年にかけての過去7年間に当科で舌癌と診断され、当科で手術治療を施行した71症例を対象として検討を行った。リンパ節転移はT1症例では5/31例、T2症例では19/24例、T3症例では7/11例、T4症例では4/5例に認められた。T2N0症例では後発リンパ節転移の頻度が高かったが、救済手術で良好な結果が得られた。T3N(+)症例、T4症例では健側リンパ節転移の頻度が高く、健側の予防郭清を考慮する必要があると考えられた。(著者抄録)

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当院における頸部膿瘍症例の検討

宮武 智実, 小川 晃弘, 松本 亮典, 西川 奈見, 牧野 琢丸

日本耳鼻咽喉科感染症研究会会誌   29 ( 1 )   71 - 73   2011.5

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過去7年間に入院治療を行った頸部膿瘍14症例(平均年齢63.5歳、男11例、女3例)について検討した。基礎疾患として、HbA1c7.0以下の軽度の糖尿病を4例、高脂血症を2例、高血圧症を3例認めた。膿瘍形成の原因は、抜歯・齲歯、魚骨異物、扁桃炎・扁桃周囲炎等で、6例は不明であった。病原細菌は6例で検出し、うち5例は嫌気性菌で、1例はグラム陽性球菌であった。全例に抗菌薬点滴による治療を行い、11例にはペニシリン系またはセフェム系抗菌薬とクリンダマイシンを併用したが、うち1例はカルバペネム系に変更した。その他3例にも嫌気性菌に感受性のある抗菌薬を選択した。外科治療の有無により3群に分けたところ、気管切開と切開排膿術を8例(A群)、気管切開のみは2例(B群)で、保存的治療は4例(C群)であった。膿瘍形成部の平均はA群3.9ヶ所、B群2.3ヶ所、C群1.4ヶ所であった。全症例中での膿瘍形成部位は傍咽頭間隙11例、前頸間隙10例などであった。全例後遺症を残さず退院したが、A群の3例は再ドレナージを必要とし、別の1例は縦隔炎を併発して開胸ドレナージを要した。平均在院日数はA群19.3日、B群15.0日、C群8.0日であった。

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遷延する咳嗽・咽喉頭異常感に対するトシル酸スプラタスト(IPD)の治療効果の検討

松本 亮典, 小川 晃弘, 牧野 琢丸, 宮武 智実

耳鼻咽喉科免疫アレルギー   28 ( 4 )   291 - 295   2010.12

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遷延する咳嗽・咽喉頭異常感を主訴として受診し、アレルギー機序の関与を疑ってトシル酸スプラタストを投与した32例(男11例・女21例・平均52.7歳)の治療成績をした。病悩期間は咳嗽が平均5.7週、咽喉頭異常感は7.0週であった。飲酒有りは6例、喫煙有りは2例、アトピー性疾患既往有りは7例、合併症有りは14例で、アレルギー性鼻炎合併は約40%に認めた。披裂部の蒼白浮腫状腫脹は2例のみに認めた。自覚症状の変化および診察所見に基づく改善度評価(投与4週後)では、著効10例、有効13例、改善3例、無効1例、悪化0例で、改善率96.3%であった。効果発現時期は咳嗽が平均2.1週、咽喉頭異常感も2.1週で、投与開始後約2週目より明らかな効果を認めた症例が多かった。病悩期間(3週未満・以上)により治療効果に有意差はなかった。

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当院における入院を要した鼻出血症例の検討

宮武 智実, 小川 晃弘, 松本 亮典, 西川 奈見, 牧野 琢丸

姫路聖マリア病院誌   21   9 - 12   2010.12

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今回我々は、2004年4月から2009年12月までの5年9ヵ月の間で入院加療を要した特発性鼻出血の68症例について臨床的に検討した。全症例について、年齢、性別、患側、基礎疾患の有無、出血部位、ベロックタンポンや手術的治療の要否のほか、受診時に出血点が確認できたかどうか等の検討をおこなった。対象は男性42例、女性26例、年齢は22歳から95歳までの平均67歳であった。出血部位は、キーゼルバッハ部が18例と最多であり、受診時に出血点が不明であった症例が35例存在した。また出血点不明で入院した35例中13例(約37%)に何らかの形で再出血がみられた。基礎疾患では68例中40例に高血圧がみられ、17例の症例で抗凝固剤・抗血小板を内服していた。止血方法としては、電気焼灼は26例、ガーゼによる圧迫は26例でおこなった。これらの症例を通して得られたエビデンスをもとに鼻出血症例への対応を検討した。また、ベロックタンポンや外頸動脈系の動脈塞栓術を行うも再出血をきたし、最終的に内視鏡手術が必要となった特異的な1症例を報告する。(著者抄録)

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遷延する咳嗽・咽喉頭異常感に対するトシル酸スプラタスト(IPD)の治療効果の検討

松本 亮典, 小川 晃弘, 牧野 琢丸, 宮武 智実

耳鼻咽喉科免疫アレルギー   28 ( 2 )   139 - 141   2010.9

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当科におけるハント症候群の検討

牧野 琢丸, 小川 晃弘, 松本 亮典, 宮武 智実

日本耳鼻咽喉科感染症研究会会誌   28 ( 1 )   63 - 66   2010.5

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Authorship：Lead author   Language：Japanese   Publisher：日本耳鼻咽喉科感染症研究会  

2000〜2009年に当科で加療したRamsay Hunt症候群19例について臨床的検討を行った。男性8例、女性11例、年齢は12〜82歳(平均58.6歳)、患側は右側8例、左側11例であった。初発症状は、耳痛10例、顔面神経麻痺7例、前庭症状2例であった。初診時に水痘・帯状疱疹ウイルス(VZV)IgG抗体を測定しえた13例のうち32倍以上の高値を示したのは8例(62%)であった。初診時にVZV IgM抗体が陽性を示した症例はなかった。ペア血清を測定しえた4例のうち、VZV IgGペア血清において2倍以上の変動を認めたものが3例(75%)存在した。治療に用いた薬剤は、ステロイド剤が17例(89%)、ATP製剤が19例(100%)、ビタミンB12製剤が19例(100%)、PGEが4例(21%)、抗ウイルス剤が13例(68%)であった。顔面神経減荷術は2例(11%)に施行された。日本顔面神経研究会の判定に基づいて算出した治癒率は68%(13/19例)であった。治癒群と非治癒群とで諸データの比較解析を行った結果、治癒群には次のような特徴が認められた。1)年齢が若い。2)治療開始までの期間が短い。3)初診時の顔面神経麻痺スコアが高い。

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【口臭へのアプローチ】鼻・副鼻腔疾患と口臭

小川 晃弘, 牧野 琢丸, 松本 亮典

ENTONI   ( 108 )   28 - 34   2009.11

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病的口臭の原因となる病態は様々であるが、口腔以外が原因のそれは約10%となり鼻・副鼻腔疾患は主たるひとつである。副鼻腔炎では副鼻腔から流下する嫌気性菌や粘液物質が口臭の原因となる。アレルギー性鼻炎でも鼻閉が持続すれば、口臭を発生する。鼻・副鼻腔腫瘍で潰瘍、壊死があると強い腐敗臭をきたすことになる。また異物とくに有機物が長期に局所に停滞すれば、腐敗臭のある口臭が生じることになる。それぞれ原因に合致した有用な対応を模索する必要がある。一方では嗅覚障害者では、口臭や体臭に対する気遣いが増えることが指摘されている。これらの問題に対して耳鼻科医としては、とくに鼻・副鼻腔領域に原因のあるものについては、早期に的確な診断と治療と解決法を打ち立てることが重要である。(著者抄録)

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塩酸オロパタジン塩によるスギ花粉症初期治療群と飛散後治療群の比較検討

牧野 琢丸, 小川 晃弘, 松本 亮典, 宮武 智実

耳鼻咽喉科免疫アレルギー   27 ( 2 )   149 - 150   2009.9

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BiPAPが奏効した重症SASの一例

宮武 智実, 小川 晃弘, 松本 亮典, 牧野 琢丸, 公文 啓二, 正木 昭次, 福本 初, 岸本 朋之, 柴田 康博, 柳 文修

姫路聖マリア病院誌   20   10 - 12   2009.8

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現在、睡眠時無呼吸症候群(sleep apnea syndrome:SAS)治療においては持続気道陽圧呼吸(continuous positive airway pressure:CPAP)が一般的な治療法として処方されることが多い。今回我々は高度肥満かつ重症SASの女性で、CPAPで十分な換気が得られず、二相性気道陽圧呼吸(Bilevel positive airway pressure:BiPAP)が奏効した症例を経験した。症例は38歳の女性で、BMI50.6kg/m2、と高度の肥満を認めた。終夜睡眠ポリグラフ(PSG)を施行したところ、AHI234.4、最長無呼吸時間26.1秒、SpO2最低値70%と重度の無呼吸低呼吸を認め、まずはCPAPによるタイトレーションを施行した。CPAP圧を使用機械の上限である20cmH2Oまで上げてもAHI79.3とコントロール不良であった。次にBiPAPを用いてタイトレーション施行したところ、AHI6.3、最長無呼吸時間13.5秒、SpO2最低値81%まで改善し、良好な睡眠を得ることができた。(著者抄録)

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[A clinical study of admitted the review of cases of food-dependent exercise-induced anaphylaxis].

Ryosuke Matsumoto, Teruhiro Ogawa, Takuma Makino, Mitsuhiro Okano

Arerugi = [Allergy]   58 ( 5 )   548 - 53   2009.5

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BACKGROUND: Food-dependent exercise-induced anaphylaxis (FDEIA) is characterized by anaphylactic symptoms after eating certain foods, followed by exercise. As we examine more patients who have pollinosis, we have more opportunities to see allergic disease such as FDEIA, OAS, and so on. METHODS: We performed a retrospective analysis of six cases, diagnosed FDEIA for this three years. RESULTS: Of six cases, the ages are 8 to 47 years old, and the trigger allergens were wheat, shrimp, and grapefruit. The trigger exercises were running, volleyball, as well as taking a bath. In four cases, the patients had history of allergic disease such as atopic dermatitis, allergic rhinitis, and so on. In two cases of wheat-dependent exercise-induced anaphylaxis, the IgE levels for omega5-gliadin (a major wheat allergen) in a RAST were positive. CONCLUSION: Of six cases diagnosed FDEIA, the trigger allergens were wheat, shrimp, and grapefruit. In cases of wheat-dependent exercise-induced anaphylaxis, the IgE levels for omega5-gliadin in a RAST were positive. After the food allergen has been identified, we advised strict restrictions on ingestion of trigger allergens in the case of shrimp and grapefruit, and on any exercise after eating foods containing wheat flour in the case of wheat.

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当科における歯性上顎洞炎症例の検討

松本 亮典, 小川 晃弘, 牧野 琢丸, 宮武 智実

日本耳鼻咽喉科感染症研究会会誌   27 ( 1 )   49 - 52   2009.5

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当科で経験した歯性上顎洞炎20症例(平均51歳)について、起炎菌、分類、手術症例、歯科との連携診療等に関し、retrospectiveに検討した。初診時、20例中16例は歯科的に既に治療済みとされたケースであり、特定された原因歯の70%は上顎第2大臼歯で、起因菌はグラム陽性球菌4例、真菌2例、グラム陰性桿菌と嫌気性菌が各1例であった。歯性上顎洞分類はII型13例、IV型5例で、I型、III型は各1例であり、保存的治療抵抗例10例においては内視鏡下鼻内手術で良好な結果が得られ、上顎洞瘻孔形成例では瘻孔閉鎖術の併用が有効であった。歯性上顎洞炎が疑われる場合にはCT画像による副鼻腔の評価および歯根部・上顎洞底の把握が大切であり、歯科医との連携診療・情報交換が不可欠であると思われた。

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当院での成人睡眠時無呼吸症候群における手術治療の評価 Reviewed

小川 晃弘, 牧野 琢丸, 松本 亮典, 宮武 智実, 公文 啓二, 正木 昭次, 福本 初, 岸本 朋之, 柴田 泰弘, 柳 文修

兵庫県医師会医学雑誌   51 ( 2 )   113 - 118   2009.4

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2004年から2006年まで、成人睡眠時無呼吸症候群に対して40症例で鼻腔形態手術、14例で鼻・副鼻腔内視鏡手術、16例で扁桃摘出術ないし咽頭形成術、2例で舌根扁桃切除を計画し施行した。これらを術前後のAHIと鼻腔通気度を中心に検討を加えた。手術を施行した患者は20歳から79歳までで平均は44.9歳であった。さらに2005年から2008年において当院でSAS治療目的にて耳鼻科手術を施行した14例について、術後CPAPが不要と判断された。多くは手術治療により、鼻腔通気度と咽頭レベルでの気道狭窄が著明に改善されたことによると考える。手術成功例はAHIが50%以下になるか、20以下に低下した症例と定義すると、データの欠落のない今回の10症例中9例が成功に分類された。よって耳鼻科手術はCPAP以外での成人重症SASの有力な治療選択肢といえる。(著者抄録)

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