2024/03/15 更新

写真a

コバヤシ マスミ
小林 万純
KOBAYASHI Masumi
所属
医学部附属病院 耳鼻いんこう科 助教
大学院担当
大学院医学系研究科
職名
助教

学位 2

  1. 博士(医学) ( 2022年3月   名古屋大学 ) 

  2. 学士(医学) ( 2013年3月   名古屋大学 ) 

 

論文 43

  1. 当科における急性喉頭蓋炎73例と気道確保との関係

    小島 慶悟, 杉浦 真, 吉田 忠雄, 桑原 優, 後藤 祐輝, 小林 万純, 曾根 三千彦

    日本耳鼻咽喉科頭頸部外科学会会報   127 巻 ( 2 ) 頁: 100 - 109   2024年2月

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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

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  2. Improvement of vertigo symptoms and acoustic power absorbance in cases with endolymphatic hydrops.

    Kobayashi M, Yoshida T, Fukunaga Y, Hara D, Sugimoto S, Naganawa S, Sone M

    Laryngoscope investigative otolaryngology   9 巻 ( 1 ) 頁: e1210   2024年2月

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    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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  3. Disruption of the Blood-Perilymph Barrier Preceding Endolymphatic Hydrops Formation in Meniere's Disease.

    Kobayashi M, Yoshida T, Sugimoto S, Naganawa S, Sone M

    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology   44 巻 ( 10 ) 頁: e766 - e767   2023年12月

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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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  4. 高齢人工内耳装用者の認知機能と装用効果

    吉田 忠雄, 小林 万純, 杉本 賢文, 福永 有可里, 原 大介, 曾根 三千彦

    AUDIOLOGY JAPAN   66 巻 ( 5 ) 頁: 318 - 318   2023年9月

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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.66.318

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  5. 当院における聞き取り困難症例の現状と課題

    福永 有可里, 吉田 忠雄, 小林 万純, 杉本 賢文, 原 大介, 曾根 三千彦

    AUDIOLOGY JAPAN   66 巻 ( 5 ) 頁: 404 - 404   2023年9月

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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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  6. 両側急性重度感音難聴症例

    小林 万純, 吉田 忠雄, 杉本 賢文, 福永 有可里, 原 大介, 曾根 三千彦

    AUDIOLOGY JAPAN   66 巻 ( 5 ) 頁: 446   2023年9月

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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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  7. Slim Straight 電極と Slim Modiolar 電極の電荷量の比較

    原 大介, 吉田 忠雄, 福永 有可里, 杉本 賢文, 小林 万純, 曾根 三千彦

    AUDIOLOGY JAPAN   66 巻 ( 5 ) 頁: 325 - 325   2023年9月

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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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  8. Evaluation of the Listening Environment of Bilateral Cochlear Implant Users through Data Logging: A Comparison of Bilateral Simultaneous and Sequential Implantation.

    Yoshida T, Hara D, Kobayashi M, Sugimoto S, Fukunaga Y, Sone M

    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology   44 巻 ( 8 ) 頁: e560 - e565   2023年9月

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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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  9. Evaluation of the Listening Environment of Bilateral Cochlear Implant Users through Data Logging: A Comparison of Bilateral Simultaneous and Sequential Implantation

    Yoshida Tadao, Hara Daisuke, Kobayashi Masumi, Sugimoto Satofumi, Fukunaga Yukari, Sone Michihiko

    Otology & Neurotology   44 巻 ( 8 ) 頁: e560 - e565   2023年9月

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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.

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  10. Comparative Analysis of Cartilage Conduction Hearing Aid Users and Non-Users: An Investigative Study.

    Sugimoto S, Yoshida T, Fukunaga Y, Motegi A, Saito K, Kobayashi M, Sone M

    Audiology research   13 巻 ( 4 ) 頁: 563 - 572   2023年7月

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    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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  11. Significance of an augmented response on cervical vestibular evoked myogenic potential testing in Meniere's disease

    Kobayashi Masumi, Katayama Naomi, Yoshida Tadao, Sugimoto Satofumi, Naganawa Shinji, Sone Michihiko

    NAGOYA JOURNAL OF MEDICAL SCIENCE   85 巻 ( 2 ) 頁: 375 - 379   2023年5月

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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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  12. Labyrinthine calcification in ears with otitis media and antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV): A report of two cases

    Yoshida Tadao, Kobayashi Masumi, Sugimoto Satofumi, Naganawa Shinji, Sone Michihiko

    AURIS NASUS LARYNX   50 巻 ( 2 ) 頁: 299 - 304   2023年4月

  13. Presence of endolymphatic hydrops on listening difficulties in patients with normal hearing level

    Yoshida Tadao, Kobayashi Masumi, Sugimoto Satofumi, Fukunaga Yukari, Hara Daisuke, Naganawa Shinji, Sone Michihiko

    Acta Oto-Laryngologica   143 巻 ( 2 ) 頁: 163 - 169   2023年2月

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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.

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  14. Presence of endolymphatic hydrops on listening difficulties in patients with normal hearing level

    Yoshida Tadao, Kobayashi Masumi, Sugimoto Satofumi, Fukunaga Yukari, Hara Daisuke, Naganawa Shinji, Sone Michihiko

    ACTA OTO-LARYNGOLOGICA   143 巻 ( 2 ) 頁: 163 - 169   2023年2月

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    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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  15. Impact of endolymphatic hydrops on DPOAE in subjects with normal to mild hearing loss.

    Inagaki K, Yoshida T, Kobayashi M, Sugimoto S, Fukunaga Y, Hara D, Naganawa S, Sone M

    Laryngoscope investigative otolaryngology   8 巻 ( 1 ) 頁: 262 - 268   2023年2月

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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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  16. Pathophysiological analysis of idiopathic sudden sensorineural hearing loss by magnetic resonance imaging: A mini scoping review.

    Sone M, Kobayashi M, Yoshida T, Naganawa S

    Frontiers in neurology   14 巻   頁: 1193104   2023年

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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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  17. A Case of Bilateral Cochlear Implantation for Congenital Visual-Auditory Dual Disability Associated with Wolfram Syndrome and Osteogenesis Imperfecta

    Takatsu Y., Kobayashi M., Sugimoto S., Yoshida T., Sone M., Morimoto K.

    Practica Oto-Rhino-Laryngologica   116 巻 ( 5 ) 頁: 415 - 420   2023年

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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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  18. Primary laryngeal cryptococcosis mimicking laryngeal malignancy: a case report

    Nishio Naoki, Tonai Kazuya, Yokoi Sayaka, Kobayashi Masumi, Sone Michihiko

    NAGOYA JOURNAL OF MEDICAL SCIENCE   84 巻 ( 4 ) 頁: 900 - 905   2022年11月

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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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  19. 聴覚情報処理障害例における MRI 内リンパ水腫評価

    吉田 忠雄, 小林 万純, 杉本 賢文, 福永 有可里, 原 大介, 曾根 三千彦

    AUDIOLOGY JAPAN   65 巻 ( 5 ) 頁: 417 - 417   2022年9月

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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

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  20. 人工内耳手術前後の耳鳴評価

    小林 万純, 吉田 忠雄, 杉本 賢文, 原 大介, 福永 有可里, 曾根 三千彦

    AUDIOLOGY JAPAN   65 巻 ( 5 ) 頁: 428 - 428   2022年9月

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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.65.428

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  21. 成人両側人工内耳装用者における装用時間のデータログによる比較

    原 大介, 吉田 忠雄, 福永 有可里, 杉本 賢文, 小林 万純, 曾根 三千彦

    AUDIOLOGY JAPAN   65 巻 ( 5 ) 頁: 431 - 431   2022年9月

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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.65.431

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  22. Pathological significance and classification of endolymphatic hydrops in otological disorders. 査読有り

    Sone M, Yoshida T, Sugimoto S, Kobayashi M, Teranishi M, Naganawa S

    Nagoya journal of medical science   84 巻 ( 3 ) 頁: 497 - 505   2022年8月

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    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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  23. メニエール病

    小林 万純, 曾根 三千彦

    救急医学 = The Japanese journal of acute medicine   46 巻 ( 5 ) 頁: 583 - 588   2022年5月

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    記述言語:日本語   出版者・発行元:東京 : へるす出版  

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  24. Labyrinthitis With Endolymphatic Hydrops Revealed by Imaging Analysis in a Case With Severe Postoperative Complications Following Stapes Surgery 査読有り

    Kobayashi Masumi, Yoshida Tadao, Uchida Yasue, Sugimoto Satofumi, Naganawa Shinji, Sone Michihiko

    OTOLOGY & NEUROTOLOGY   43 巻 ( 1 ) 頁: E134 - E136   2022年1月

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

    DOI: 10.1097/MAO.0000000000003328

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  25. Slim Modiolar電極を用いた人工内耳手術症例の検討

    小林 万純, 吉田 忠雄, 杉本 賢文, 曾根 三千彦

    Otology Japan   32 巻 ( 1 ) 頁: 136 - 142   2022年

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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

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  26. (17)O-labeled water distribution in the human inner ear: Insights into lymphatic dynamics and vestibular function.

    Yoshida T, Naganawa S, Kobayashi M, Sugimoto S, Katayama N, Nakashima T, Kato Y, Ichikawa K, Yamaguchi H, Nishida K, Sone M

    Frontiers in neurology   13 巻   頁: 1016577   2022年

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    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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  27. めまい症状から高度難聴に至った多発性硬化症再発例

    小林 万純, 杉本 賢文, 吉田 忠雄, 寺西 正明, 曾根 三千彦

    AUDIOLOGY JAPAN   64 巻 ( 5 ) 頁: 391 - 391   2021年9月

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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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  28. Evaluation of the blood-perilymph barrier in ears with endolymphatic hydrops

    Yoshida Tadao, Kobayashi Masumi, Sugimoto Satofumi, Teranishi Masaaki, Naganawa Shinji, Sone Michihiko

    ACTA OTO-LARYNGOLOGICA   141 巻 ( 8 ) 頁: 736 - 741   2021年8月

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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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  29. Dilatation of the Endolymphatic Space in the Ampulla of the Posterior Semicircular Canal: A New Clinical Finding Detected on Magnetic Resonance Imaging

    Morioka Masaru, Sugimoto Satofumi, Yoshida Tadao, Teranishi Masaaki, Kobayashi Masumi, Nishio Naoki, Katayama Naomi, Naganawa Shinji, Sone Michihiko

    Otology & Neurotology   42 巻 ( 6 ) 頁: e643 - e647   2021年7月

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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

  30. Cochlear implantation in patient with Charcot-Marie-Tooth disease

    Kobayashi Masumi, Yoshida Tadao, Sugimoto Satofumi, Teranishi Masaaki, Hara Daisuke, Kimata Yukari, Sone Michihiko

    AURIS NASUS LARYNX   48 巻 ( 2 ) 頁: 327 - 330   2021年4月

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    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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  31. Lesion-specific prognosis by magnetic resonance imaging in sudden sensorineural hearing loss 査読有り

    Yang Cheng-Jui, Yoshida Tadao, Sugimoto Satofumi, Teranishi Masaaki, Kobayashi Masumi, Nishio Naoki, Naganawa Shinji, Sone Michihiko

    ACTA OTO-LARYNGOLOGICA   141 巻 ( 1 ) 頁: 5 - 9   2021年1月

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    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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  32. Significance of high signal intensity in the endolymphatic duct on magnetic resonance imaging in ears with otological disorders 査読有り

    Morimoto Kyoko, Yoshida Tadao, Kobayashi Masumi, Sugimoto Satofumi, Nishio Naoki, Teranishi Masaaki, Naganawa Shinji, Sone Michihiko

    ACTA OTO-LARYNGOLOGICA   140 巻 ( 10 ) 頁: 818 - 822   2020年10月

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    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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  33. 内リンパ水腫症例における Wideband Tympanometry の応用と評価

    小林 万純, 吉田 忠雄, 杉本 賢文, 寺西 正明, 曾根 三千彦

    AUDIOLOGY JAPAN   63 巻 ( 5 ) 頁: 367   2020年9月

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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.63.367

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  34. Effects of endolymphatic hydrops on acoustic energy absorbance 査読有り

    Kobayashi Masumi, Yoshida Tadao, Sugimoto Satofumi, Shimono Mariko, Teranishi Masaaki, Naganawa Shinji, Sone Michihiko

    ACTA OTO-LARYNGOLOGICA   140 巻 ( 8 ) 頁: 626 - 631   2020年7月

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    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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  35. Significance of Endolymphatic Hydrops Herniation Into the Semicircular Canals Detected on MRI

    Sugimoto Satofumi, Yoshida Tadao, Teranishi Masaaki, Kobayashi Masumi, Shimono Mariko, Naganawa Shinji, Sone Michihiko

    OTOLOGY & NEUROTOLOGY   39 巻 ( 10 ) 頁: 1229 - 1234   2018年12月

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    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

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  36. 前庭内リンパ水腫が音響エネルギーのアブソーバンスへ及ぼす影響

    小林 万純, 杉本 賢文, 吉田 忠雄, 寺西 正明, 曾根 三千彦

    AUDIOLOGY JAPAN   61 巻 ( 5 ) 頁: 494 - 494   2018年9月

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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.61.494

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  37. 眼咽頭筋ジストロフィーに伴う声帯萎縮に対して甲状軟骨形成術Ⅰ+Ⅲ型を施行した1例

    下野 真理子, 中村 一博, 藤本 保志, 小林 万純, 木下 稚子, 横井 紗矢香, 西尾 直樹, 丸尾 貴志, 平松 真理子, 澤木 優治, 原 大介, 門野 泉, 渡辺 宏久, 曾根 三千彦

    耳鼻と臨床   64 巻 ( 5 ) 頁: 189 - 196   2018年9月

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    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

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  38. 軟骨伝導補聴器に対する東海地方の助成状況と経過

    杉本 賢文, 福永 有可里, 水野 知美, 原 大介, 小林 万純, 吉田 忠雄, 寺西 正明, 曾根 三千彦

    AUDIOLOGY JAPAN   64 巻 ( 5 ) 頁: 489 - 489   2021年9月

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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.64.489

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  39. OTOF 遺伝子の新規変異が原因と考えられたAuditory neuropathy spectrum disorder の一例

    杉本 賢文, 木全 由佳理, 福永 有可里, 水野 知美, 原 大介, 小林 万純, 吉田 忠雄, 寺西 正明, 曾根 三千彦

    AUDIOLOGY JAPAN   63 巻 ( 5 ) 頁: 484   2020年9月

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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.63.484

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  40. 成人両側人工内耳の装用効果と方向性マスキング解除の検討

    原 大介, 吉田 忠雄, 杉本 賢文, 小林 万純, 木全 由佳理, 福永 有可里, 水野 知美, 寺西 正明, 曾根 三千彦

    AUDIOLOGY JAPAN   63 巻 ( 5 ) 頁: 342   2020年9月

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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.63.342

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  41. リニア乗車時における人工内耳装用者の聴こえの変化に関するアンケート聴取

    木全 由佳理, 原 大介, 吉田 忠雄, 杉本 賢文, 小林 万純, 福永 有可里, 水野 知美, 寺西 正明, 曾根 三千彦

    AUDIOLOGY JAPAN   63 巻 ( 5 ) 頁: 430   2020年9月

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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.63.430

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  42. 名古屋大学における軟骨伝導補聴器の装用状況

    杉本 賢文, 小林 万純, 吉田 忠雄, 寺西 正明, 曾根 三千彦

    AUDIOLOGY JAPAN   62 巻 ( 5 ) 頁: 406   2019年10月

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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.62.406

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  43. 名古屋大学附属病院における軟骨伝導補聴器外来の現状

    杉本 賢文, 小林 万純, 吉田 忠雄, 寺西 正明, 曾根 三千彦

    AUDIOLOGY JAPAN   61 巻 ( 5 ) 頁: 344 - 344   2018年9月

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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.61.344

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▼全件表示

MISC 4

  1. Significance of an augmented response on cervical vestibular evoked myogenic potential testing in Meniere's disease.

    Kobayashi M, Katayama N, Yoshida T, Sugimoto S, Naganawa S, Sone M  

    Nagoya journal of medical science85 巻 ( 2 ) 頁: 375 - 379   2023年5月

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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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  2. Labyrinthine calcification in ears with otitis media and antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV): A report of two cases.

    Yoshida T, Kobayashi M, Sugimoto S, Naganawa S, Sone M  

    Auris, nasus, larynx50 巻 ( 2 ) 頁: 299 - 304   2023年4月

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    記述言語:英語   出版者・発行元:Auris Nasus Larynx  

    Otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV) has been proposed as a new type of otitis media. The hearing loss caused by OMAAV can be expected to improve with early detection and intervention, but if it continues to worsen and leads to deafness, it is challenging to recover the patient's hearing. When bilateral deafness occurs, cochlear implant (CI) surgery is the only way to improve hearing. Here, Case 1 showed unilateral cochlear calcification, and Case 2 showed bilateral cochlear calcification. In Case 1, CI surgery was performed on the ear lacking calcification, and in Case 2 it was performed on the ear with milder calcification. In Case 2, granulation was present from the tympanic space to the mastoid, the round window was closed, and the basal turn of the cochlea was narrowed. Such calcification of the cochlea caused by OMAAV has not been reported so far. It is essential to detect these changes by computed tomography scans at an early stage and to perform CI surgery at an appropriate time, because hearing improvements are not expected in patients who become deaf because of OMAAV.

    DOI: 10.1016/j.anl.2022.01.004

    Scopus

    PubMed

  3. Primary laryngeal cryptococcosis mimicking laryngeal malignancy: a case report.

    Tonai K, Nishio N, Yokoi S, Kobayashi M, Sone M  

    Nagoya journal of medical science84 巻 ( 4 ) 頁: 900 - 905   2022年11月

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  4. Labyrinthine calcification in ears with otitis media and antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV): A report of two cases

    Yoshida T, Kobayashi M, Sugimoto S, Naganawa S, Sone M  

    Auris, nasus, larynx   2022年1月

     詳細を見る

    記述言語:英語   出版者・発行元:Auris Nasus Larynx  

    Otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV) has been proposed as a new type of otitis media. The hearing loss caused by OMAAV can be expected to improve with early detection and intervention, but if it continues to worsen and leads to deafness, it is challenging to recover the patient's hearing. When bilateral deafness occurs, cochlear implant (CI) surgery is the only way to improve hearing. Here, Case 1 showed unilateral cochlear calcification, and Case 2 showed bilateral cochlear calcification. In Case 1, CI surgery was performed on the ear lacking calcification, and in Case 2 it was performed on the ear with milder calcification. In Case 2, granulation was present from the tympanic space to the mastoid, the round window was closed, and the basal turn of the cochlea was narrowed. Such calcification of the cochlea caused by OMAAV has not been reported so far. It is essential to detect these changes by computed tomography scans at an early stage and to perform CI surgery at an appropriate time, because hearing improvements are not expected in patients who become deaf because of OMAAV.

    DOI: 10.1016/j.anl.2022.01.004

    Scopus

    PubMed

科研費 1

  1. 内リンパ水腫の質的診断に関する新規評価法と治療のアルゴリズムの開発

    研究課題/研究課題番号:22K16897  2022年4月 - 2024年3月

    科学研究費助成事業  若手研究

    小林 万純

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    担当区分:研究代表者 

    配分額:4550000円 ( 直接経費:3500000円 、 間接経費:1050000円 )

    めまいや難聴の症状を繰り返すメニエール病や、蝸牛型や前庭型など非定型メニエール病、低音障害型感音難聴、遅発性内リンパ水腫や前庭水管拡大症など内リンパ水腫関連疾患の患者さんに対して、内服や非侵襲中耳加圧装置による治療の前後に、病態である内リンパ水腫の形態を評価する内耳造影MRIを撮影し、機能的評価のために前庭機能検査やWideband Tympanometryを用いて症状の推移とともに内リンパ水腫の質的評価を行う。
    本研究は難聴やめまい発作を繰り返すメニエール病・遅発性内リンパ水腫を主に対象とした内リンパ水腫関連疾患に対して、内リンパ水腫の形態的・質的な評価を行い、症状との関連について検討し、簡便に施行可能な新しい検査法の確立を目的としている。
    内耳造影MRIにより内リンパ水腫が可視化され、特に前庭における内リンパ水腫がめまいを伴う内リンパ水腫関連疾患に与える影響が重要視されている。また近年MRIにおける外リンパの造影効果と内リンパ水腫の程度を組み合わせた評価が病状の活動性に影響するという報告もされはじめた。しかしMRIは内リンパ水腫の画像的診断に有用であるものの、簡便に経時的な変化を捉えることは難しい。従来の内リンパ水腫推定検査であるVEMPなどは簡便に行えるものの、陽性率は40-60%程度である。
    近年難治性内リンパ水腫疾患に対して中耳加圧療法が保険適応になったように、外耳からの圧力により治療効果を得るほどの変動が起こる。Wideband Tympanometryは外耳道圧変化させることで、音響インピーダンスを測定するのみならず音響エネルギーの耳内への吸収率を測定できるため、前庭の内リンパ水腫が影響する吸収率を簡便に評価できることが示されている。
    今年度は主にメニエール病、遅発性内リンパ水腫の患者、ほか変動性難聴やめまい感を呈する患者に対して、内耳造影MRIによる内リンパ水腫の程度・造影効果の形態的評価を行うとともに、内リンパ水腫の治療に伴う症状の変動と、聴力検査、VEMP、Wideband Tympanometryにより測定された内耳への音響エネルギーの吸収率の経時的変化の評価を行った。
    難治性メニエール病、遅発性内リンパ水腫の患者、ほか変動性難聴やめまい感を呈する内リンパ水腫関連疾患の患者20名に対して、内耳造影MRIによる内リンパ水腫の程度・造影効果の形態的評価を行うとともに、1か月間のめまい回数、聴力検査、VEMP、Wideband Tympanometryにより測定された内耳への音響エネルギーの吸収率の1年間の経時的変化の評価を行い、解析中である。
    またメニエール病、感音難聴、めまい症、聴覚異常感の症状を呈する患者における活動性・非活動性について、1か月間のめまい回数、聴力検査、MRIとWideband Tympanometryを用いて評価した。MRIにおける内リンパ水腫の程度と外リンパの造影効果、Wideband Tympanometryにより測定された内耳への音響エネルギーの吸収率と、半年間の聴力変動・めまい発作の有無との関連性を解析中である。
    内リンパ水腫関連疾患、主に難治性メニエール病、遅発性内リンパ水腫の患者に対しての内耳造影MRIによる内リンパ水腫の程度・造影効果と、めまい回数、聴力検査、VEMP、Wideband Tympanometryにより測定された内耳への音響エネルギーの吸収率の1年間の経時的変化の評価について解析を行い、治療に伴う変化と形態的・質的評価をおこない、数値化して論文・国際的発表を行う。
    MRIにて内リンパ水腫を呈する患者には二次的な非活動性の内リンパ水腫も含まれていると考えられており、内リンパ水腫の活動性・非活動性の評価を行う。めまい症状も聴力も変動するメニエール病、めまい症状のない感音難聴、難聴のないめまい症、難聴もめまいもない聴覚異常感の症状を呈する患者に対し、内リンパ水腫の程度と外リンパの造影効果、MRIとWideband Tympanometryにより測定された内耳への音響エネルギーの吸収率と、半年間のめまい回数、聴力変動の有無との関連を解析し、論文・国際的発表を行う。