The relationship between varicella-zoster virus and idiopathic associated laryngeal paralysis was examined in five patients, using complement fixation or enzyme immunoassay testing. In all cases, significant changes in serum levels of varicella-zoster virus antibody were observed. Videofluoroscopy was useful in assessing the severity of the dysphagia and in making an accurate diagnosis; both laryngeal elevation and weakness of pharyngeal wall contraction were also observed. In two cases in which antiviral therapy was delayed, the outcome was poor, with increased levels of varicella-zoster virus immunoglobulin M found on enzyme immunoassay. The outcome of the condition may thus depend both on the speed of antiviral therapy commencement following onset of symptoms, and on the levels of varicella-zoster virus immunoglobulin M antibody (measured by enzyme immunoassay). Our study suggests that varicella-zoster virus should be considered in the differential diagnosis of patients with idiopathic associated laryngeal paralysis, and rapid antiviral therapy should be initiated when necessary.
This study reviewed 24 cases of parapharyngeal space tumour treated at Kurume University Hospital between 1990 and 2007. Histological diagnoses were generally obtained from the excised tumour (22/24). Seventy-seven per cent of the parapharyngeal space tumours were benign and 23 per cent were malignant. Thirty-eight per cent (eight of 22) of these tumours were pleomorphic adenomas and 23 per cent (five of 22) were schwannomas. A transparotidectomy and transcervical approach were used in 88 per cent (15/17) of benign tumours. A mandibular swing approach was used for one malignant tumour. Post-operative complications were identified in 16 of 22 patients. The most common complication, facial nerve paralysis, was identified in eight patients, and seven of these patients demonstrated first bite syndrome. In consideration of the high incidence of post-operative complications, the surgical approach should therefore be carefully selected when treating patients with parapharyngeal space tumours.
Sixty-one long-term hemodialysis patients were inoculated with influenza vaccine. Antibody responses measured by hemagglutination inhibition test were comparable to that of controls. Side reactions of vaccination were similar to controls in frequency and severity. No adverse effects were observed in the clinical course of inoculated hemodialysis patients. Influenza vaccination can be recommended for annual immunization of hemodialysis patients as a group at high risk from influenza infection .
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