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医学部 医学科 感覚運動医学講座耳鼻咽喉・頭頸部外科学分野 |
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助教 |
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論文 【 表示 ／ 非表示 】
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Okuda T., Kawabata T., Koga H., Kajihara K.
Indian Journal of Otolaryngology and Head and Neck Surgery 77 ( 3 ) 1573 - 1579 2025年3月
掲載種別：研究論文（学術雑誌） 出版者・発行元：Indian Journal of Otolaryngology and Head and Neck Surgery
Closed suction drains are commonly used after head and neck surgery, but airway obstruction due to postoperative hemorrhaging can be fatal. Some studies have suggested that cervical circumference should be assessed after thyroid surgery to detect such problems early. Rapid responses may be difficult at facilities with limited staffing. We opted for Penrose drains in cases in which the risk of postoperative hemorrhaging was expected to be high, and we examined the effectiveness of this approach in this study. Between October 2022 and December 2023, 25 of 68 (37%) head and neck operations involved the placement of a Penrose drain. Their medical records were reviewed retrospectively. There were 20 cases involving neck dissection, which was performed via a wide range of surgical techniques. Intraoperative findings (e.g., significant oozing of blood) was the most common reason for choosing the open technique (10 cases). The duration of drain placement was < 7 days (mean: 4.68 days). There were no surgical site infections; two cases of postoperative hemorrhaging; and no fatal problems, such as airway obstruction, but delayed wound healing due to wound-edge dehiscence was observed in some cases. There were no cases of airway narrowing due to postoperative hemorrhaging. Penrose drains are considered a good indication for cases with a history of radiotherapy causing postoperative haemorrhage, cases on oral anticoagulants, lesions in the deep parotid to parapharyngeal space that are difficult to recognise for haematoma formation, and cases where negative pressure should be avoided for exposure of anastomotic vessels and nerves, and should continue to be investigated.
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Kajihara K., Ganaha A., Matsuda K., Nakamura T., Tono T.
Journal of International Advanced Otology 18 ( 2 ) 183 - 187 2022年3月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of International Advanced Otology
Bony abnormalities, including sphenoid dysplasia and calvarial defects, are well recognized in patients with neurofibromatosis type 1. However, having multiple calvarial defects is rare. We present a case of a 35-year-old Japanese male patient who was referred to our hospital because of hearing loss. He was diagnosed with neurofibromatosis type 1 during early childhood. Otoscopic examination revealed a protrusion from the anterior wall of the external auditory canal that obstructed the external auditory canal. Computed tomography findings revealed multiple defects and an uneven skull surface. Large bony defects of the anterior wall of the external auditory canal were also identified bilaterally. Conductive hearing loss was caused by temporomandibular joint herniation that was obstructing the external auditory canal in both ears. An active middle ear implant was implanted in the right ear. A floating mass transducer was placed into the round window niche using a round window coupler. The active middle ear implant improved postoperative audiometric thresholds to approximately 35 dB across all frequencies. No complications occurred for up to 30 months after the operation. An active middle ear implant is a feasible and valuable option for patients with neurofibromatosis type 1 and conductive hearing loss due to multiple skull defects that result in temporomandibular joint herniation.
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Tsuruda T., Yoshikawa N., Kai M., Yamaguchi M., Toida R., Kodama T., Kajihara K., Kawabata T., Nakamura T., Sakata K., Hatakeyama K., Gi T., Asada Y., Tono T., Kitamura K., Ikeda R.
Internal Medicine 60 ( 3 ) 423 - 429 2021年2月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Internal Medicine
We herein report the cytokine expression at different stages for three patients who developed cardiac complications after immune checkpoint inhibitor (ICI) therapy. Case 1 with biopsy-proven myocarditis showed increased levels of interleukin (IL)-8, monocyte chemotactic and activating factor, and granulocyte macrophage colony-stimulating factor (GM-CSF) when he developed Takotsubo cardiomyopathy. Case 2 with subclinical myocarditis showed predominant activation of IL-8 during the progressive clinical course. Case 3 with cytokine-releasing syndrome showed substantial activations of IL-6, IL-8, GM-CSF, and interferon-γ. Our data suggest the development of unique cytokine activation in individual patients with cardiac complications after ICI therapy.
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奥田 匠, 井手 慎介, 梶原 啓, 川畑 隆之, 東野 哲也
耳鼻と臨床 67 ( 1 ) 13 - 18 2021年1月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：耳鼻と臨床会
当科で 2013 年 4 月から 2019 年 12 月の 6 年 9 カ月間に喉頭全摘出術を行い、残存咽頭粘膜を一次縫合して閉創した 36 例について、咽頭皮膚瘻の発生率と危険因子について検討した。発生率は 25％（9/36 例）であった。糖尿病合併例では 50％（3/6 例）と高いが、評価においては診断名や血糖値ではなく、組織の血行障害の程度による病態でのリスクの把握に努めるべきであった。救済手術例での発生率は 31.6％（6/19 例）で、救済手術例全例への血流豊富な皮弁による予防的被覆の適用は過剰と考え、引続き早期処置で対応する方針とした。
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顔面浮腫を初発症状とした好酸球性多発血管炎性肉芽腫症例． 査読あり
梶原 啓，鍋倉 隆，東野哲也
耳鼻咽喉科臨床 2019年12月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
講演・口頭発表等 【 表示 ／ 非表示 】
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当院で経験した甲状腺濾胞癌と乳頭癌を合併した2症例．
久冨木冠，奥田 匠，川畑隆之，井手慎介，梶原 啓，東野哲也
第30回日本頭頸部外科学会総会ならびに学術講演会
開催年月日： 2020年1月30日 - 2020年1月31日
記述言語：日本語 会議種別：口頭発表（一般）
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喉頭全摘出術後に咽頭皮膚瘻を来した症例の検討．
奥田 匠，川畑隆之，井手慎介，久冨木冠，梶原 啓，後藤隆史，東野哲也
第30回日本頭頸部外科学会総会ならびに学術講演会
開催年月日： 2020年1月30日 - 2020年1月31日
記述言語：日本語 会議種別：口頭発表（一般）
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VSB implantation in a NF1 patient with multiple bony defects in the temporal bones and the skull.
Akira Ganaha, Keiji Matsuda, Kei Kajihara, Takeshi Goto, Takeshi Nakamura, Noriaki Miyanaga, Tetsuya Tono
12th Asia Pacific Symposium on Cochlear Implants and Related Sciences
開催年月日： 2019年11月27日 - 2019年11月30日
記述言語：英語 会議種別：口頭発表（一般）
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アブミ骨手術における顔面神経の解剖学的要因の影響．
中島崇博，梶原 啓，中村 雄，後藤隆史，我那覇章，松田圭二，東野哲也
第29回日本耳科学会総会・学術講演会
開催年月日： 2019年10月10日 - 2019年10月12日
記述言語：日本語 会議種別：口頭発表（一般）
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外耳道閉鎖術施行例の臨床的検討．
後藤隆史，東野哲也，中村 雄，梶原 啓，松田圭二
第81回耳鼻咽喉科臨床学会総会・学術講演会
開催年月日： 2019年6月27日 - 2019年6月28日
記述言語：日本語 会議種別：口頭発表（一般）