記述言語：日本語   出版者・発行元：一般社団法人 日本耳鼻咽喉科頭頸部外科学会  

<p>　急性喉頭蓋炎は急激な気道閉塞を引き起こし致命的になり得る疾患であり, 迅速な診断と治療を要する. 気道確保の方法は, 過去の報告では大半の症例で気管切開がされていたが, 近年では内視鏡下挿管が増加しており喉頭浮腫が比較的高度な症例に対しても気道確保ができる場合がある. 今回, われわれは当院を受診した急性喉頭蓋炎73例について検討した. Katori らの重症度分類 (Katori 分類) ではⅠ度が36例, Ⅱ度が23例, Ⅲ度が14例であり, 田中らの重症度分類 (田中分類) では, １点が33例, ２点が９例, ３点が17例, ４点が８例, ５点が６例であった. 気道確保を要した症例は73例中13例 (17.7%) で, 喉頭所見は Katori 分類でⅢＢが12例で, ⅡＢが１例であり田中分類では５点が５例で, ４点が８例であった. 気道確保の方法は, ６例は気管切開, ７例は内視鏡下挿管が施行された. 内視鏡下挿管は気管切開以外の選択肢として有用であると考えたが, 喉頭浮腫が高度で挿管困難が予測される症例に内視鏡下挿管を行うには, 日頃から麻酔科・集中治療医との緊密な連携が必要と考えた. Katori 分類ⅢＢの13例中12例と, 田中分類４点以上の14例中13例で気道確保された. 窒息直前まで経皮的酸素濃度低下や自覚症状悪化を認めない症例も多く, Katori 分類ⅢＢや田中分類４点以上の症例では早急に気道確保をするのが安全と思われた.</p>

DOI： 10.3950/jibiinkotokeibu.127.2_100

CiNii Research

記述言語：英語   出版者・発行元：Laryngoscope Investigative Otolaryngology  

Objective: The pathophysiology and symptoms underlying Meniere's disease (MD) manifest as endolymphatic hydrops (EH), potentially impacting acoustic power absorbance in vestibular EH. The longitudinal effects of middle ear pressure therapy (MEPT) and conservative therapies for EH by magnetic resonance imaging (MRI) and on acoustic power absorbance on wideband acoustic immittance (WAI) were evaluated, and their changes were compared with clinical symptoms. Methods: Eleven patients with definite MD or delayed endolymphatic hydrops (DEH), resistant to conservative therapies and who continued MEPT for 1 year, were included. Vertigo scores, hearing levels, acoustic power absorbance on WAI, and degrees of EH on 3-T MRI were evaluated and compared before and after the treatments. Results: One year after the start of MEPT, all cases showed symptomatic improvement in vertigo score; however, the degrees of EH showed no improvements except in one case. In the affected ears with EH, their absorbances on WAI improved, particularly at 1580–1905 or 2400–2953 Hz (p <.05). Conclusion: Alleviation of vestibular symptoms with the therapy of MD was not necessarily associated with improved EH. Vestibular symptoms could be related to the change in the impedance of inner ear pressure, which was proven by the normalization of acoustic power absorbance. Assessments of acoustic power absorbance may provide useful information for physiological conditions and causative factors of vertigo in ears with EH. Level of evidence: 4.

DOI： 10.1002/lio2.1210

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PubMed

記述言語：英語   出版者・発行元：Acta Oto-Laryngologica  

Background: Posterior expansion of the utricular endolymphatic space (ES) is a finding occasionally observed, and often occurs in bilateral ears. The clinical significance of posterior expansion of the utricular ES is not clear. Objectives: To investigate the clinical significance of posterior expansion of the utricular ES detected on magnetic resonance imaging (MRI). Materials and Methods: Among 957 patients who underwent contrast-enhanced MRI to investigate the presence of endolymphatic hydrops (EH), clinical findings in cases with posterior expansion of the utricular ES were evaluated and the significance of their existence is considered. Results: Posterior expansion of the utricular ES was detected in 30 ears from 20 cases (7 males, 13 females; mean age 48.7 years). The ears with posterior expansion had a significantly lower incidence of vestibular EH than those without, and this tendency was more prominent in cases in bilateral ears. Some cases with posterior expansion had vestibular symptoms and were diagnosed with Ménière’s disease, although EH was not detected in their vestibules. Conclusion and Significance: Posterior expansion of the utricular ES was associated with Ménière’s disease without vestibular EH. Posterior expansion of the utricular ES might not be associated with the formation of EH but may occur independently.

DOI： 10.1080/00016489.2024.2329783

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PubMed

記述言語：日本語   出版者・発行元：Practica Oto-Rhino-Laryngologica  

Syphilis is a systemic bacterial infection caused by Treponema pallidum that is exclusively transmitted through direct contact with contagious mucocutaneous lesions, with the exception of vertical transmission. The laryngeal mucosa serves as a vital portal of entry and manifests various signs and symptoms as the disease progresses through chronic stages. A 26-year-old female was referred to our hospital with progressively enlarging neck swelling and sore throat that had persisted for a month. Palpable and painful neck masses were observable at levels II, III, and IV, and contrast-enhanced CT imaging confirmed pronounced bilateral cervical lymphadenopathy. Laryngoscopy revealed bulky lingual tonsils and an epiglottis covered in pus, as well as edematous changes in the arytenoids. We diagnosed laryngeal syphilis due to positive results from syphilis blood tests and her occupation as a commercial sex worker for several years. Laboratory tests for other possible venereal infections were all negative, and no genital lesions were found during the gynecological examination. We initiated treatment with intravenous ampicillin/sulbactam and adjuvant steroids. However, on the third day of admission, her respiratory status deteriorated due to airway obstruction. An emergency tracheostomy was required to alleviate the obstruction caused by supraglottic edema. She continued to receive ceftriaxone plus clindamycin and gradually recovered, ultimately being decannulated on the 20th day of admission. Impaired neck lymph drainage, elicited by the swelling of pharyngeal lesions along with bilateral cervical lymphadenopathy, may have been the underlying etiology for the acute supraglottic edema in this case. Clinicians should be aware of the atypical presentation of early syphilis characterized by prominent swelling of neck lymph nodes and the absence of typical mucosal lesions.

DOI： 10.5631/jibirin.117.523

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記述言語：日本語   出版者・発行元：Practica Oto-Rhino-Laryngologica  

A 70-year-old female patient complaining of persistent pain in the left temporal region was referred to our university hospital by her physician. Audiometry and examination of the tympanic membrane yielded no unremarkable findings. Further diagnostic evaluation by computed tomography of the temporal bone revealed an infiltrative opacity and irregularity in the temporal bone, and on magnetic resonance imaging, both T1- and T2-weighted images revealed low signal intensity signals in the same area. Based on the presence of an infiltrative opacity in the left middle ear, elevated conductive thresholds in the temporal bone, and left facial nerve paresis, we scheduled a biopsy of the temporal bone lesion. A preoperative workup uncovered evidence of a primary lung neoplasm located in the middle lobe of the left lung. Histopathological examination confirmed the primary lung cancer, and consistent histological features in the temporal bone lesions. While the temporal bone is a relatively uncommon site of metastasis from malignant tumors, the most common primary sites are the lung, breast, and prostate. It is therefore recommended to conduct a systematic investigation of temporal bone lesions, including a search for primary tumors, given the possibility of malignant tumor metastasis in patients presenting with temporal bone lesions.

DOI： 10.5631/jibirin.117.469

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記述言語：英語   出版者・発行元：Otology and Neurotology  

DOI： 10.1097/MAO.0000000000003981

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PubMed

記述言語：英語  

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.66.318

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記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.66.404

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記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.66.446

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記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.66.325

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記述言語：英語   出版者・発行元：Otology and Neurotology  

Objective To evaluate the listening conditions of bilateral cochlear implant (CI) users in their daily living environment. Study Design Retrospective study. Setting University hospital. Patients Thirty-one adult CI users 16 years or older; 18 underwent sequential surgery, and 13 underwent simultaneous surgery. Inclusion criteria included the availability of CI data logging features and a minimum duration of binaural use of 6 months. Intervention Retrospective analysis of data obtained from the automatic scene classifier data logging system. Main Outcome Measure Comparison of data logging and maximum speech discrimination scores of the two surgery groups (sequential vs. simultaneous) to investigate the potential influence of these factors on the listening conditions of CI users. Results The maximum speech discrimination score of the second CI in the sequential group was significantly worse than that of any other CI in the sequential and simultaneous CI groups. Additionally, the longer the interval between surgeries, the more significant the difference in "time on air"between the first and the second CIs. The second CI in sequential CI surgery had a shorter "time on air"than the first or the bilateral simultaneous CIs; the second CI was also used more frequently in noisy and speech with background noise environments. Conclusions A second CI may be more frequently used in challenging listening environments because of its binaural auditory effect, despite its lower speech discrimination performance. The timing of sequential implantation and the potential impact of binaural hearing should be considered when developing rehabilitation strategies for individuals with bilateral CIs.

DOI： 10.1097/MAO.0000000000003955

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記述言語：英語  

Objective: To evaluate the listening conditions of bilateral cochlear implant (CI) users in their daily living environment. Study Design: Retrospective study. Setting: University hospital. Patients: Thirty-one adult CI users 16 years or older; 18 underwent sequential surgery, and 13 underwent simultaneous surgery. Inclusion criteria included the availability of CI data logging features and a minimum duration of binaural use of 6 months. Intervention: Retrospective analysis of data obtained from the automatic scene classifier data logging system. Main Outcome Measure: Comparison of data logging and maximum speech discrimination scores of the two surgery groups (sequential vs. simultaneous) to investigate the potential influence of these factors on the listening conditions of CI users. Results: The maximum speech discrimination score of the second CI in the sequential group was significantly worse than that of any other CI in the sequential and simultaneous CI groups. Additionally, the longer the interval between surgeries, the more significant the difference in “time on air” between the first and the second CIs. The second CI in sequential CI surgery had a shorter “time on air” than the first or the bilateral simultaneous CIs; the second CI was also used more frequently in noisy and speech with background noise environments. Conclusions: A second CI may be more frequently used in challenging listening environments because of its binaural auditory effect, despite its lower speech discrimination performance. The timing of sequential implantation and the potential impact of binaural hearing should be considered when developing rehabilitation strategies for individuals with bilateral CIs.

CiNii Research

記述言語：英語   出版者・発行元：Audiology Research  

Clinical findings on cartilage conduction hearing aids (CCHAs) have gradually become clear; however, few reports include a large number of cases. This study included 91 ears from 69 patients who underwent CCHA fitting in our hospital. Their ears were divided into six groups (i.e., bilateral aural atresia or severe canal stenosis, unilateral aural atresia or severe canal stenosis, chronic otitis media or chronic otitis externa with otorrhea, sensorineural hearing loss, mixed hearing loss, and conductive hearing loss) according to their clinical diagnosis and type of hearing loss. Most clinical diagnoses were aural atresia or meatal stenosis (bilateral, 21.8%; unilateral, 39.6%). The purchase rate of CCHAs was higher in the closed-ear group (bilateral, 77.3%; unilateral, 62.5%). In the bilateral closed-ear group, air conduction thresholds at 1000, 2000, and 4000 Hz and aided thresholds with CCHAs at 4000 Hz were significantly lower in the purchase group than the non-purchase group. No significant difference was observed between the purchase and non-purchase groups in the unilateral closed-ear group. In the bilateral closed-ear group, air conduction thresholds and aided thresholds were associated with the purchase rate of CCHAs. In the unilateral closed-ear group, factors other than hearing might have affected the purchase rate of CCHAs.

DOI： 10.3390/audiolres13040049

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記述言語：英語   出版者・発行元：Nagoya Journal of Medical Science  

The potential mechanism of augmented response on cervical vestibular evoked myogenic potential (cVEMP) testing and its decrease following treatment in a patient with Meniere’s disease (MD) are discussed. Changes of static posturography and cVEMP testing before and after a glycerol drip in a 69-year-old man with unilateral MD, in which significant endolymphatic hydrops (EH) was confirmed on magnetic resonance imaging (MRI) on the diseased side, were evaluated. Values of total locus lengths, areas of postural sway, and their Romberg ratios were decreased after the glycerol drip. On cVEMP testing, the diseased ear demonstrated a 375% larger amplitude than the contralateral ear before treatment, but both ears showed almost the same responses after treatment. An augmented response on cVEMP testing and a decrease following treatment for MD reflect the diversity of clinical findings in MD. Responses on cVEMP testing may relate not only to the degree of EH, but also be due to abnormal acoustic energy absorbance transmitted into the saccule

DOI： 10.18999/nagjms.85.2.375

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DOI： 10.1016/j.anl.2022.01.0040385-8146

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記述言語：英語  

Background: Listening difficulties (LiD) present difficulties in listening and paying attention to spoken information despite normal pure tone audiometry. Endolymphatic hydrops (EH) is a common inner ear condition associated with Ménière’s disease but may also be present in the asymptomatic ear. Objectives: Using magnetic resonance imaging, we investigated EH in patients with LiD and assessed whether the severity of EH was related to the results of auditory processing tests (APTs). Materials and Methods: 111 patients with no abnormalities on pure tone audiometry, but displaying difficulties in listening, underwent evaluation through APTs and questionnaires. Upon obtaining informed consent, the inner ears of 20 consenting patients were evaluated utilizing a 3-Tesla magnetic resonance imaging. Results: A higher percentage of patients diagnosed with LiD by APTs had significant EH in the cochlea and vestibule than in previously reported control cases. The percentage of correct answers in the speech-in-noise test was significantly lower in patients with than in those without significant EH. Conclusion and significance: In this study, significant EH of the cochlea was associated with poor listening to noise. The presence of EH affects the functioning of the auditory processing system, even in ears that test normally on standard audiometric tests.

CiNii Research

記述言語：英語   出版者・発行元：Acta Oto-Laryngologica  

Background: Listening difficulties (LiD) present difficulties in listening and paying attention to spoken information despite normal pure tone audiometry. Endolymphatic hydrops (EH) is a common inner ear condition associated with Ménière’s disease but may also be present in the asymptomatic ear. Objectives: Using magnetic resonance imaging, we investigated EH in patients with LiD and assessed whether the severity of EH was related to the results of auditory processing tests (APTs). Materials and Methods: 111 patients with no abnormalities on pure tone audiometry, but displaying difficulties in listening, underwent evaluation through APTs and questionnaires. Upon obtaining informed consent, the inner ears of 20 consenting patients were evaluated utilizing a 3-Tesla magnetic resonance imaging. Results: A higher percentage of patients diagnosed with LiD by APTs had significant EH in the cochlea and vestibule than in previously reported control cases. The percentage of correct answers in the speech-in-noise test was significantly lower in patients with than in those without significant EH. Conclusion and significance: In this study, significant EH of the cochlea was associated with poor listening to noise. The presence of EH affects the functioning of the auditory processing system, even in ears that test normally on standard audiometric tests.

DOI： 10.1080/00016489.2023.2182450

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記述言語：英語   出版者・発行元：Laryngoscope Investigative Otolaryngology  

Objective: The increased endolymph volume affects a shift in the organ of Corti and basilar membrane in ears with endolymphatic hydrops (EH), which might affect distortion-product otoacoustic emissions (DPOAE) by altering the operating point of the outer hair cells. We investigated how changes in DPOAE are related to the distribution site of EH. Study Design: Prospective study. Methods: Among 403 patients with hearing or vestibular symptoms who underwent contrast-enhanced magnetic resonance imaging (MRI) for the diagnosis of EH and subsequent DPOAE testing, subjects whose hearing levels on pure tone audiometry were ≤35 dB at all frequencies were included in this study. In patients with EH on MRI, the presence and amplitude of DPOAE were evaluated between groups with hearing levels of ≤25 dB at all frequencies versus hearing levels of >25 dB at one or more frequencies. Results: There were no differences in the distribution of EH between groups. The amplitude of DPOAE had no clear correlation with the presence of EH. However, in both groups, there was a significantly higher probability of the presence of a DPOAE response from 1001 to 6006 Hz in cases with EH in the cochlea. Conclusion: Among patients whose hearing levels were ≤35 dB at all frequencies, better responses on DPOAE testing were found in subjects with EH in the cochlea. Alteration of DPOAEs in the early stages of hearing impairment could indicate morphological changes in the inner ear with altered basilar membrane compliance due to EH. Level of Evidence: 4.

DOI： 10.1002/lio2.998

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記述言語：英語   出版者・発行元：Frontiers in Neurology  

Objective: To summarize the pathophysiological analysis of idiopathic sudden sensorineural hearing loss (ISSNHL) by magnetic resonance imaging (MRI), focusing on the findings of high signal or endolymphatic hydrops (EH) in the inner ear. Methods: We summarize the published studies of our research group regarding the pathophysiological analysis of ISSNHL on MRI and review related clinical articles that have reported significantly high signal or the existence of EH in ears with ISSNHL. Results: Pre-contrast high signal on MRI may indicate minor hemorrhage or increased permeability of surrounding vessels to the perilymph, whereas post-contrast high signal indicates breakdown of the blood–labyrinth barrier, in which irreversible changes would lead to poor prognosis. In some cases of ISSNHL, primary EH could be pre-existing and may be a risk factor for the onset of ISSNHL. Conclusion: Analysis of ISSNHL by cutting-edge MRI evaluation could provide useful information for elucidating its pathophysiology and for predicting prognosis in this disease.

DOI： 10.3389/fneur.2023.1193104

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記述言語：日本語   出版者・発行元：Practica Oto-Rhino-Laryngologica  

We report a case of bilateral cochlear implant surgery performed for profound sensorineural hearing loss in a 2-year-old girl with Wolfram syndrome and osteogenesis imperfecta type I. Wolfram syndrome is a rare autosomal-recessive genetic disorder characterized by juvenile diabetes mellitus and visual impairment. The hearing loss in Wolfram syndrome is typically a slowly progressive sensorineural hearing loss, primarily in the high-frequency range. Genetic testing of our patient showed mutations in WFS1 and COL1A1. Bilateral cochlear implant surgery was performed, because adequate wearing thresholds could not be achieved with hearing aids. This report is the first case of a patient with Wolfram syndrome with profound congenital hearing loss who benefited from cochlear implant surgery. The patient had a visual-auditory dual disability and lacked external stimuli. The cochlear implant provided valuable auditory compensation to ensure auditory stimulation. In the future, it is necessary to continue comprehensive rehabilitation for the patient with collaboration among the parents, speech-language pathologists, and rehabilitation facilities.

DOI： 10.5631/JIBIRIN.116.415

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記述言語：英語   出版者・発行元：Nagoya Journal of Medical Science  

Primary laryngeal cryptococcosis is an extremely rare infection and presents with non-specific symptoms such as hoarseness or sore throat, resulting in delayed diagnosis. Here, we report the patient of a 56-yearold female patient with primary laryngeal cryptococcosis, who was being treated with oral and inhaled steroids for rheumatoid arthritis and bronchial asthma. The patient suffered from prolonged hoarseness and sore throat, and endoscopic biopsy was performed several times under local anesthesia, demonstrating only inflammatory cell infiltration. Considering the possibility of laryngeal malignancy, a third biopsy was performed by endoscopic laryngomicrosurgery under general anesthesia. Intraoperative frozen section revealed non-neoplastic laryngeal mucosa with erosion and severe inflammatory cell infiltration. However, we could not confirm the definite diagnosis of the lesion in the intraoperative consultation. Postoperative histopathological examination revealed a small number of yeast-type fungi and a definitive diagnosis was established by special stains including Alcian blue stain. Finally, the patient was diagnosed as primary laryngeal cryptococcosis. Daily oral administration of fluconazole (400 mg/day) was performed for 6 months according to the treatment protocol for pulmonary cryptococcosis. The symptoms gradually improved, and endoscopy revealed no recurrence 6 months post-treatment. Clinicians should consider the possibility of laryngeal cryptococcosis when severe inflammation is found in the larynx and discuss the disease history and pathological results with pathologists more closely.

DOI： 10.18999/nagjms.84.4.900

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記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.65.417

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.65.428

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.65.431

CiNii Research

記述言語：英語   出版者・発行元：Nagoya Journal of Medical Science  

We summarize the presence of endolymphatic hydrops (EH) in otological disorders evaluated with magnetic resonance imaging (MRI) of temporal bones, and propose a classification of EH based on its pathological significance. A search of the literature published in English-language journals was performed using electronic databases, especially focusing on EH-related otological disorders. Clinical articles that contained the terms EH and contrast-MRI published from 2007 to the present, with relevant human temporal bone studies, were included. The following three main points are discussed based on the results in the relevant articles: i) otological disorders that present EH, ii) current grading for evaluation of EH on MRI, and iii) a proposed classification of EH based on its pathological significance. MRI evaluation revealed that EH exists extensively not only in ears with typical Meniere’s disease (MD), but also in those with various other otological disorders. The etiological classification of EH helps to summarize ideas for determining the pathophysiology of otological disorders, while a therapeutic classification provides clues to their management. MRI evaluations of EH have led to breakthroughs in investigations of EH in otological disorders. Precise grading for evaluation and clarification of EH on MRI based on its pathological significance could provide keys to elucidating the pathophysiology of EH-related otological disorders

DOI： 10.18999/nagjms.84.3.497

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記述言語：日本語   出版者・発行元：東京 : へるす出版  

CiNii Research

記述言語：英語   出版者・発行元：Otology and Neurotology  

DOI： 10.1097/MAO.0000000000003328

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記述言語：日本語   出版者・発行元：一般社団法人　日本耳科学会  

<p>蝸牛軸近接型のSlim Modiolar電極（CI532/632）は，蝸牛外側壁に設置するSlim Straight電極（CI522/622）と比較して術後成績の改善が得られ，蝸牛の損傷リスクや鼓室階から転座する可能性も低いとされる．一方，手術手技においてシース挿入の難易度が高いこと，tip fold-overを起こしうることが問題とされる．当科で最近1年間に施行されたCI532/632挿入例31耳とCI522挿入例を比較した．CI532/632挿入例では正円窓を拡大して電極を挿入した症例が多く，術中Neural response telemetry（NRT） 閾値や術後半年後のインピーダンスは蝸牛頂周辺電極でより低かった．手術時間や術後の短期的な聴取成績に差は見られなかった．CI532/632を挿入する際は正円窓経由で電極を無理に挿入することで先端の屈曲をきたす危険があるため，後鼓室を広く開放し正円窓周辺の骨突出部を削除し正円窓窩を露出した後，さらに卵円窓側の骨を十分に削除し，必要に応じて正円窓を拡大することとしている．今回CI532/632挿入例はCI522挿入例と比較して半年後の装用効果に有意差は認めなかったが，短期的にはNRT閾値やインピーダンスは良好であった．渉猟しうる限りSlim Modiolar電極の装用効果は良好であるという報告も踏まえ，今後長期的な検討は必要だが，正常蝸牛例ではSlim Modiolar電極はSlim Straight電極の代替となりうると考えられた．</p>

DOI： 10.11289/otoljpn.32.136

CiNii Research

記述言語：英語   出版者・発行元：Frontiers in Neurology  

We evaluated the inner ear distribution of 17O-labeled saline administered to the human tympanic cavity. Magnetic resonance imaging was performed after intratympanic administration in five healthy volunteers and one patient with cochlear endolymphatic hydrops. In all volunteers, 17O-labeled water permeated the cochlear basal turn and vestibule at 30 min and disappeared gradually within 2–4 h. All participants experienced positional vertigo lasting a few hours to a few days. Visualization of 17O-labeled water distribution in the endolymphatic space of the posterior ampulla showed indistinct separation of endolymph and perilymph in the cochlea and most of the vestibule in all participants. Intralabyrinthine distribution of 17O-labeled water differed from that in previous reports of intratympanically administered gadolinium-based contrast agent. 17O-labeled water in the endolymphatic space may cause heavier endolymph and positional vertigo. These results of this study may add new insights for investigating the distribution and the effects of molecules in the inner ear after the intratympanic administration in living humans.

DOI： 10.3389/fneur.2022.1016577

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記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.64.391

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記述言語：英語   出版者・発行元：Taylor & Francis  

DOI： 10.1080/00016489.2021.1957500

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記述言語：英語  

Objectives: To investigate the clinical features of ears with dilatation of the endolymphatic space in the ampulla of the posterior semicircular canal on magnetic resonance imaging. Study Design: Retrospective study. Setting: A university hospital. Methods: This study included 1,842 ears from 934 patients who underwent 3-T magnetic resonance imaging with gadolinium to investigate the presence of endolymphatic hydrops. Age, sex distribution, hearing thresholds on pure-tone audiometry, and vestibular symptoms were compared between cases of unilateral and bilateral dilatation of the endolymphatic space in the ampulla of the posterior semicircular canal. Results: Forty-eight ears (17 men and 14 women; mean age 49.9 yrs) showed dilatation of the endolymphatic space in the ampulla of the posterior semicircular canal. Age and the rate of chronic sensorineural hearing loss were significantly higher in the unilateral group (14 ears) than in the bilateral group (34 ears). The average hearing thresholds and rates of vestibular symptoms reported did not differ between unilateral and bilateral cases, but some patients showed positional nystagmus. Conclusions: Dilatation of the endolymphatic space in the ampulla was observed selectively in the posterior semicircular canal, though its pathogenesis was not clear. Such dilatation is not usually accompanied by vestibular endolymphatic hydrops, and it may be a cause of vertigo and dizziness.

CiNii Research

記述言語：英語   出版者・発行元：Elsevier  

Two patients with auditory neuropathy spectrum disorder (ANSD) considered to be associated with Charcot-Marie-Tooth (CMT) are reported. In case 1, a 23-year-old man presented with progressive bilateral sensorineural hearing loss (SNHL) from 10 years of age and was diagnosed with ANSD. He was later diagnosed with CMT by neurological testing. In case 2, a 16-year-old girl, the younger sister of the patient in case 1, presented with progressive SNHL with similar auditory findings since 6 years of age as those of her brother. Both cases underwent bilateral cochlear implantation. In case 1, the maximum discrimination score improved to 45% 24 months after the first side of cochlear implantation from 5% before the surgery. In case 2, the score was 5% 10 months after cochlear implant (CI) surgery from 0% before the surgery. CI treatment for CMT patients has been considered difficult because of both failure in synchronization of nerve conduction due to demyelination and axonal failure of the auditory nerve. Though slower progress compared to the average subset of patients receiving CI was seen, significant improvement was gradually observed in the present patients after bilateral cochlear implantations. CI is thus a viable option for rehabilitation of SNHL in CMT patients.

DOI： 10.1016/j.anl.2020.03.003

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Scopus

PubMed

CiNii Research

記述言語：日本語   出版者・発行元：Acta Oto-Laryngologica  

Background: High signals in the inner ear of idiopathic sudden sensorineural hearing loss (ISSNHL) on magnetic resonance imaging (MRI) have been reported, but no quantitative evaluation has yet been done. Objectives: To evaluate hearing outcomes and cochlear signal intensities on 3-T heavily T2-weighted three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (hT2W-3D-FLAIR) in patients with ISSNHL. Materials and methods: Twenty-nine patients with ISSNHL were included. Patients underwent hT2W-3D-FLAIR with intravenous gadolinium injection and pure tone audiometry (PTA) at initial visits and 3 months later. Signal intensity ratios (SIRs) were measured in the basal or apical-middle turns of the affected cochlea. A statistical analysis of relationships between SIRs and the average hearing levels (HLs) at low (125, 250, and 500 Hz) and high (2, 4, and 8 kHz) tone frequencies was performed. Results: Hearing improvements at high-tone frequencies in ears with HLs ≥60 dB were significantly worse in those with high SIRs at the basal turns on pre-contrast images. Similarly, hearing improvements at low-tone frequencies in ears with HLs ≥60 dB were significantly worse in those with high SIRs at the apical-middle turns on post-contrast images. Conclusions and significance: High SIRs on hT2W-3D-FLAIR indicate cochlear disturbances with severe ISSNHL and could provide lesion-specific prognostic information.

DOI： 10.1080/00016489.2020.1827159

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Scopus

PubMed

記述言語：日本語   出版者・発行元：Acta Oto-Laryngologica  

Background: High signal intensity in the endolymphatic duct (ED) is occasionally observed on magnetic resonance imaging (MRI) in ears that have otological disorders. Objective: The signal intensity (SI) in the ED on post-contrast MRI was investigated in subjects with various otological disorders, and the meaning of high SI in the ED was evaluated. Material and methods: 392 patients with otological disorders and 21 controls without otological symptoms underwent 3 T MRI. The SIs of the ED and the cerebellum were measured, the SI ratio (SIR) was calculated, and ears with SIR ≥4 were identified. Results: A high SIR was identified in the ED of 3.7% of ears affected by definite Meniere’s disease (dMD), 100% of ears affected by large vestibular aqueduct syndrome (LVAS), and 7.1% of ears with no otological symptoms. On the whole, a significant relationship was found between the existence of vestibular or cochlear EH and the SIR in the ED. Conclusion: The MRI finding of high SI in the ED may indicate the mechanism of inner ear disturbances in ears with otological disorders, especially in those with LVAS, and it may suggest an underlying disorder in some ears in which otological symptoms are not apparent.

DOI： 10.1080/00016489.2020.1781927

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Scopus

PubMed

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.367

CiNii Research

記述言語：日本語   出版者・発行元：Acta Oto-Laryngologica  

Background: The presence of endolymphatic hydrops (EH) may cause hearing loss and affect the transmission of acoustic energy to the inner ear. Objectives: Acoustic energy absorbance on wideband acoustic immittance (WAI) was evaluated, focusing especially on EH in the vestibule. Material and methods: A total of 32 ears from 16 patients who underwent 3-T magnetic resonance imaging (MRI) to evaluate the presence of EH were examined, retrospectively. The degree of EH in the vestibule was classified into three grades (no, mild, and significant), and pure tone audiometry (PTA) and WAI were measured before and after a glycerol drip. Results: Ears with significant EH showed significantly higher hearing levels and air-bone gaps (ABG), and higher absorbance values on WAI at low frequencies (560–600 Hz) than ears with mild or no EH. Changes in absorbance values were observed in some ears without threshold change on PTA. Conclusions and Significance: This study showed significantly higher absorbance values of acoustic energy with significant vestibular EH at low frequencies. Considering ABGs observed in ears with significant EH, the presence of EH in the vestibule might cause an obstacle to the transmission of acoustic energy to the inner ear.

DOI： 10.1080/00016489.2020.1754460

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Scopus

PubMed

記述言語：日本語   出版者・発行元：Otology and Neurotology  

Objective: The objective of this study was to investigate the relationship between endolymphatic hydrops (EH) and hearing level or vestibular symptoms by focusing on EH herniation into the semicircular canal (SCC). Study Design: Retrospective study. Setting: University hospital. Methods: The study included 1,548 ears of 775 patients who underwent magnetic resonance imaging (MRI) examination in our university hospital to investigate possible EH. MRI was performed 4 hours after intravenous injection of a standard dose of gadodiamide hydrate and/or 24 hours after intratympanic injection of gadopentetate dimeglumine diluted eightfold. The hearing threshold and vestibular symptoms were compared between ears with unilateral and bilateral EH herniation into the SCC and between ears having vestibular EH adjacent to the stapes footplate with or without EH herniation. Results: Forty-four ears (19 men and 25 women, mean age 53.6 yr) showed EH herniation into the SCC. The average hearing thresholds at 500 to 4000 Hz and presence of vestibular EH adjacent to the stapes footplate were significantly higher in ears with unilateral herniation than in those with bilateral herniation. The average hearing thresholds at 500 and 1000 Hz were significantly higher in the group of ears having adjacency with herniation than in those without herniation. Vestibular symptoms did not differ significantly between groups. Conclusion: Unilateral herniation occurs with EH progression. Bilateral herniation may occur regardless of EH progression and might be influenced by other factors that alter the membranous labyrinth. Key Words: Endolymphatic hydrops—Herniation—Magnetic resonance imaging—Menière’s disease.

DOI： 10.1097/MAO.0000000000002022

Web of Science

Scopus

PubMed

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.61.494

CiNii Research

記述言語：日本語   出版者・発行元：耳鼻と臨床会  

<p>眼咽頭筋ジストロフィー（oculopharyngeal muscular dystrophy：OPMD）に伴う高度の声帯萎縮による嗄声に対し、甲状軟骨形成術Ⅰ型（TP Ⅰ）とⅢ型（TP Ⅲ）を併用し（TP Ⅰ＋Ⅲ）、音声の改善を得た。症例は 68 歳、男性。X − 10 年 OPMD と診断され、X − 7 年嚥下障害に対して右輪状咽頭筋切除術を行い、いったん嚥下機能は改善した。その後も嗄声が進行し、複数回の右声帯内脂肪注入術や右声帯内アテロコラーゲン注入術を行うも音声改善は乏しかった。嚥下機能も次第に悪化し、嚥下機能改善手術の必要性も再度検討されたが本人希望はあくまで音声改善であり、X 年10月局所麻酔下に TP Ⅰ+Ⅲを施行した。術後両側声帯の内方移動が得られ、声門閉鎖不全は残存したが、他覚的な音声検査所見の改善を一部認めた。TP Ⅲの甲状軟骨縦切除が行われた右側の声帯の内方移動が左側に比べて良好であった。高度声帯萎縮に対する音声外科的治療として TP Ⅰ＋Ⅲが有用と考えられた。</p>

DOI： 10.11334/jibi.64.5_189

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.64.489

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.484

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.342

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.430

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.62.406

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.61.344

CiNii Research