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

DOI： 10.3233/VES-190662

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PubMed

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

Background and Purpose: In the horizontal canal benign paroxysmal positional vertigo (BPPV), cupulolithiasis shows apogeotropic direction changing nystagmus lasting more than 1 min, while canalolithiasis leads to geotropic direction changing nystagmus lasting < 1 min. The difference between cupulolithiasis and canalolithiasis is widely accepted to be the attachment of the displaced otoconia to the cupula of a semicircular canal. Several studies have shown a relationship between BPPV and vitamin D deficiency, but no studies have compared serum levels of vitamin D between canalolithiasis and cupulolithiasis patients. The purpose of this study was to clarify the difference in vitamin D serum level between canalolithiasis and cupulolithiasis of the horizontal canal. Methods: This retrospective study included 20 and 15 patients with canalolithiasis and cupulolithiasis of the horizontal canal, respectively. Serum levels of 25-hydroxyvitamin D [25(OH)D] during the acute phase of BPPV were measured. Results: The mean 25(OH)D serum level in patients with canalolithiasis and cupulolithiasis was 13.2 ± 1.4 and 20.4 ± 1.6 ng/mL, respectively, and the difference was statistically significant (p = 0.0014), also after adjusting for age and sex (p = 0.0351). Eighteen out of 20 (90%) and 5 of 15 (33%) patients were diagnosed with vitamin D deficiency in the canalolithiasis and cupulolithiasis groups, respectively, and this difference was also statistically significant (p = 0.0005). Conclusion: We found that serum vitamin D level in patients with canalolithiasis was significantly lower than that in patients with cupulolithiasis of the horizontal canal.

DOI： 10.3389/fneur.2019.00176

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

DOI： 10.1016/j.anl.2009.04.013

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

The amount of attention to age-related hearing loss (ARHL) has been growing, not only from the perspective of being one of the most common health conditions affecting older adults, but also from the perspective of its relation to cognition. Results from a number of epidemiological and laboratory studies have demonstrated a significant link between ARHL and cognitive decline. The Lancet International Commission on Dementia, Prevention, Intervention, and Care has estimated that mid-life hearing loss, if eliminated, might decrease the risk of dementia by nine percent, since hearing loss is a modifiable age-associated condition linked to dementia. Despite numerous research efforts, elucidation of the underlying causal relationships between auditory and cognitive decline has not yet reached a consensus. In this review article, we focused on the hypotheses of etiological mechanisms between ARHL and cognitive decline: (1) cognitive load hypothesis; (2) common cause hypothesis; (3) cascade hypothesis; and (4) overdiagnosis or harbinger hypothesis. Factual evidence obtained in previous studies was assessed to understand the link between ARHL and cognitive decline or dementia. Additionally, an overview of the conceivable effects of hearing intervention, e.g., hearing aids and cochlear implants, on cognition were presented, and the role of hearing aid use was considered for the relevant hypotheses. We should continue to strive for social enlightenment towards the importance of 'hearing well', and cultivate a necessity for hearing screening among patients at risk of cognitive decline.

DOI： 10.1016/j.anl.2018.08.010

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

DOI： 10.1080/00016480802226163

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

DOI： 10.1016/j.jaci.2018.12.579

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

DOI： 10.1016/j.otohns.2006.08.024

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

DOI： 10.1080/00016489.2018.1521526

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PubMed

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

DOI： 10.1097/MAO.0b013e3181587d95

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

DOI： 10.2463/mrms.bc.2017-0158

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CiNii Research

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

DOI： 10.1080/00016480600868406

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

OBJECTIVE: Patients with benign paroxysmal positional vertigo (BPPV) can have vitamin D deficiency, which is a cause of abnormal bone turnover. Several studies have established a relationship between osteoporosis and BPPV. The World Health Organization Fracture Risk Assessment Tool, widely known as FRAX® (http://www.shef.ac.uk/FRAX), is a computer-based algorithm for assessing fracture risk. No direct comparison has been made between the FRAX scores of patients with BPPV and controls. The purpose of this study was to determine whether women with BPPV are at high risk of fracture as assessed using FRAX. METHODS: The study involved 40 postmenopausal women diagnosed with BPPV between July 2015 and April 2016, and 40 postmenopausal women as controls. The 10-year major osteoporotic and hip fracture risks were calculated using FRAX and were compared between BPPV patients and controls using Welch's t test and a general linear model. RESULTS: The 10-year major osteoporotic fracture risk was 20.4%±12.1% for BPPV patients (aged 72.4±8.6years) and 14.3%±6.5% for controls (aged 71.2±6.3years). The 10-year hip fracture risk was 9.0%±9.8% for BPPV patients and 5.0%±3.9% for controls. The BPPV group had significantly higher 10-year major risks of osteoporotic fracture (p=0.0069) and hip fracture (p=0.0202) compared with controls. Similarly, after adjustment for age, the BPPV group had significantly higher 10-year risks of major osteoporotic fracture (p=0.0007) and hip fracture (p=0.0092) compared with controls. CONCLUSION: Fracture risk calculated using FRAX was significantly higher in the BPPV group than in controls. Women with BPPV may need early intervention to prevent future fractures.

DOI： 10.1016/j.anl.2018.05.002

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Language：English  

DOI： 10.1097/WCO.0000000000001440

PubMed

Language：English  

DOI： 10.1016/j.anl.2025.12.006

PubMed

Language：Japanese   Publisher：Japanese Society of Practical Otolaryngology  

<p>Tuberculosis infections encountered in otorhinolaryngological practice include tuberculous lymphadenitis, pharyngeal tuberculosis, and tuberculous otitis media. The majority of cases are cases of secondary tuberculosis, and primary cases are rarely reported. In particular, primary nasopharyngeal tuberculosis is an extremely rare disease, with only a few reported cases from Japan. We report the case of a 51-year-old female patient with a lesion in the right nasopharynx. The patient had suffered from a sore throat of unknown cause for a year and was referred to our hospital for further investigation. Fiberoptic nasal endoscopic examination revealed an elevated lesion with a white membrane in the right nasopharynx. Biopsy revealed nasopharyngeal tuberculosis. Imaging studies showed no lung lesions, and we made a diagnosis of primary nasopharyngeal tuberculosis. After multidrug antituberculosis therapy as used for pulmonary tuberculosis, the raised lesion with the white membrane disappeared. In addition, sputum culture was negative, and the patient was considered cured. Nasopharyngeal tuberculosis manifests with nonspecific symptoms such as cervical lymphadenopathy, otorrhea, and sore throat. There are also no characteristic local findings. Early diagnosis is important because delay in diagnosis can lead to spread of secondary infection. Therefore, nasopharyngeal tuberculosis should be included in the differential diagnosis of nasopharyngeal lesions.</p>

DOI： 10.5631/jibirin.119.31

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CiNii Research

Language：English   Publisher：Japanese Society for Magnetic Resonance in Medicine  

Purpose: The ocular and brain glymphatic systems may share common physiological pathways. We hypothesized that the anteroposterior movement of gadolinium-based contrast agent (GBCA) that has leaked into the vitreous could serve as a biomarker for brain glymphatic function. This study aimed to retrospectively investigate the association between the intravitreal GBCA distribution on MRI and recently proposed imaging markers of impaired brain waste clearance.<br>
Methods: We analyzed 156 eyes from 78 adult participants who underwent 3T MRI 4 hr after standard-dose GBCA administration. On 3D-real IR images, we calculated a “contrast shift index” (the signal difference between anterior and posterior vitreous volumes of interest: VOIa-VOIp) to quantify the anteroposterior GBCA distribution. The primary outcome was a composite endpoint of positivity for either putative meningeal lymphatics at the posterior sigmoid sinus (PML-PSS) or enhanced basal ganglia perivascular spaces (PVS-BG). Multivariable logistic regression with cluster-robust inference was used to assess predictors, including the contrast shift index, mean vitreous contrast distribution, age, sex, and axial length of the eye.<br>
Results: A positive contrast shift index, indicating preferential anterior GBCA distribution, was significantly and independently associated with the composite outcome of impaired brain clearance (<i>P</i> = 0.006). Age (<i>P</i> <0.001) and male sex (<i>P</i> = 0.009) were also independent predictors. A predictive model incorporating these factors demonstrated high discrimination, with an area under the receiver operating characteristic curve (AUC) of 0.872. Axial length of the eye and mean vitreous contrast distribution were not significant independent predictors.<br>
Conclusion: The anteroposterior distribution of GBCA in the vitreous is a novel, non-invasive imaging biomarker associated with impaired brain clearance function. This “contrast shift index” may reflect systemic glymphatic dysregulation common to both the eye and brain, offering a new avenue for assessing neurodegenerative risk.

DOI： 10.2463/mrms.mp.2025-0127

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.68.480

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.68.453

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.68.364

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.68.402

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.68.387

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CiNii Research

Language：English   Publisher：Acta Oto Laryngologica  

Background: The trabecular mesh of the inner ear plays a critical role in maintaining the structure of the vestibular organs, particularly within the pars superior. Cases have been reported in which the saccule cannot be visualized in the pars inferior lacking this structure. Objectives: To investigate the clinical features and endolymphatic hydrops (EH) and perilymphatic enhancement (PE) on MRI in ears with an invisible saccule (IS) and to clarify the mechanism of IS. Materials and methods: Retrospective study of 89 IS ears and 71 contralateral visible saccule (VS) ears from 406 patients with hearing impairment and vertigo between 2021 and 2024. Middle ear disease, schwannoma, perilymphatic fistula, and ears after intratympanic injection were excluded. Results: Compared with VS ears, IS ears had worse hearing, especially in the low-frequency range, and higher PE. Cases diagnosed with Meniere’s disease accounted for 13% of IS, all of which showed EH limited to the cochlea, and PE showed higher in IS ears with vertigo than in those without. Conclusions and significance: The development of IS is associated with loss of anatomical support and subsequent collapse and fistula of the membranous labyrinth, which may cause the breakdown of the blood–labyrinth barrier and changes in lymphatic flow.

DOI： 10.1080/00016489.2025.2546390

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Language：English   Publisher：Auris Nasus Larynx  

The currently available evaluation methods for determining appropriate treatment strategies in patients with asymptomatic inner ear dysfunction are insufficient. Recently, we demonstrated the efficacy of 100-Hz sound stimulation for treating vestibular dysfunction in Meniere's disease. This case report presents the utility of 100-Hz sound stimulation as a new method for evaluating cases with asymptomatic vestibular dysfunction and their potential for recovery with early medical intervention. We evaluated the change in cervical vestibular-evoked myogenic potential (cVEMP) amplitude before and after sound stimulation (75 dB at a frequency of 100 Hz for 5 to 10 min) in two female patients with endolymphatic hydrops (EH), comparing the change based on the presence of EH. One patient presented with hearing difficulty and the other with otalgia, and neither had hearing loss and vestibular symptoms. As a result, cVEMP amplitudes in ears without EH showed no changes after the stimulation. Conversely, cVEMP amplitudes showed significant increases in ears with vestibular EH compared with the values before stimulation. Application of a 100-Hz sound stimulus might be a new method for evaluating asymptomatic vestibular dysfunction associated with EH, and for providing information about the potential for recovery from the dysfunction, facilitating early medical intervention.

DOI： 10.1016/j.anl.2025.07.006

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Language：English   Publisher：Audiology and Neurotology  

Introduction: Tinnitus and smell dysfunction have been reported to be associated. The long-term course of tinnitus and sensory dysfunctions, including olfactory and gustatory dysfunctions, following COVID-19 infection requires further study. Materials and Methods: A cohort study of tinnitus and sensory dysfunctions before and during the COVID-19 pandemic was conducted through health checkups in a rural area in Japan. Five hundred ten participants attended health checkups in August 2019, 434 in 2023, and 437 in 2024. Two hundred twenty-five participants attended the 2019 and 2023 health checkups, and one hundred seventy-one participants attended all three. The subjects included people 40 years of age or older. The questionnaire included information on tinnitus, hearing, vertigo, headache, smell, taste, and lifestyle habits. In 2023, the questionnaire included questions about COVID-19. Results: Tinnitus, hearing impairment, and smell dysfunction were associated. Fear and anxiety about COVID-19 infection were significantly associated with tinnitus after adjusting for age and sex. Irregular sleep time and fewer sports and exercise habits were significantly associated with tinnitus, not smell or taste dysfunction. In an investigation of identical persons, deterioration of tinnitus was conspicuous in 2023 compared to 2019 in persons with strong fear and anxiety about COVID-19. Conclusions: Tinnitus is related to lifestyle habits compared to other sensory disorders. Fear and anxiety about COVID-19, rather than COVID-19 infection itself, significantly influenced tinnitus during the COVID-19 pandemic in rural areas.

DOI： 10.1159/000547317

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Language：English   Publisher：Frontiers in Neurology  

Background: The impact of cochlear implantation on cognitive function in older adults and the relationship between preoperative cognitive ability and postoperative speech perception remain poorly understood. In this study, we aimed to evaluate the effect of cochlear implant use on cognitive function in older adults and to explore the association between preoperative cognitive ability and postoperative speech discrimination. Methods: We conducted a retrospective cohort study at a university hospital between June 2017 and March 2025. Thirty cochlear implant recipients aged ≥61 years were included, with 21 receiving unilateral implants and nine receiving bilateral implants. All participants underwent cognitive assessments both preoperatively and postoperatively. We analyzed the cognitive function test results before and after cochlear implantation. The primary outcomes measured were: (1) the correlation between preoperative cognitive test scores and postoperative speech discrimination scores; and (2) longitudinal changes in postoperative cognitive function. Results: A significant positive correlation was observed between preoperative Kohs Block Design Test scores and postoperative speech discrimination scores (p < 0.01). Preoperative Raven’s Colored Progressive Matrices scores also correlated positively with postoperative speech discrimination scores (p < 0.05). Postoperatively, Kohs scores demonstrated significant positive correlations with both the Mini-Mental State Examination (p < 0.01) and Reading Cognitive Test Kyoto test (p < 0.0001) scores. Following a 3.7-year mean follow-up, Kohs scores remained stable, with some patients showing improvements. Conclusion: Cognitive assessments performed during the preoperative CI evaluation may yield valuable insights into postoperative outcomes in older adults. Additionally, long-term postoperative cognitive function is generally preserved, with the potential for improvement following cochlear implantation.

DOI： 10.3389/fneur.2025.1630946

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Language：English   Publisher：Nutrition and Health  

Aim: Few health checkup studies have reported lifestyle habits and examination results before and during the COVID-19 pandemic. We compared lifestyle habits and examination results surveyed before and during the COVID-19 pandemic. Methods: Five hundred and ten and 396 participants attended the health checkup in 2019 and 2022, respectively. The median age of females was 65 in 2019 and 2022, and that of males was 68 in 2019 and 69 in 2022. We investigated dietary and exercise habits, alcohol consumption, sleeping situation, and examination results, including body mass index (BMI), smell function, and blood examination results before and during the COVID-19 pandemic in a rural area in Japan. Results: An ordinal logistic regression analysis revealed that the intake frequency of vegetables and marine products was significantly less in 2022 than in 2019 after adjusting age and sex; green leafy vegetables (p = .016), fish (p = .002), and other marine products, including squid, shrimp, crabs, and octopus (p = .008). Alcohol consumption amount increased significantly in 2022 than in 2019 in men who drank beer (p = .007) and chuhai (p = .040). Albumin, hematocrit, cholesterols, and uric acid decreased, but serum calcium increased significantly in 2022 than in 2019 after adjusting age and sex. BMI and hemoglobin A1c were not significantly different between 2019 and 2022. A decrease in subjective smell feeling and smell test results was associated with decreased intake frequency of vegetables. Conclusion: Both dietary habits and blood examination results changed significantly during the COVID-19 pandemic in a rural area in Japan.

DOI： 10.1177/02601060241256201

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Language：English   Publisher：Movement Disorders Clinical Practice  

DOI： 10.1002/mdc3.70043

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PubMed

Language：Japanese   Publisher：The Japan Broncho-esophagological Society  

DOI： 10.2468/jbes.76.108

CiNii Research

Language：English   Publisher：Neuroscience Research  

Sensorineural hearing loss causes cell death in central auditory neurons, but molecular mechanisms of triggering this process are not fully understood. We report here that loss of afferent activity promotes cell death by facilitating proBDNF-p75NTR signals in cochlear nucleus of chicks around hatch. RNA-seq analyses revealed up-regulation of genes related to proBDNF-p75NTR-JNK signals as well as apoptosis at the nucleus within 24 h after unilateral cochlea deprivation. Western blotting confirmed a high level of proBDNF protein at the nucleus. Moreover, FLAG-tagged p75NTR accumulated at the plasma membrane of the neurons within 6 h after the deprivation, well before the upregulation of apoptotic genes. Cell viability assay using propidium iodide in organ culture showed that proBDNF increased the fraction of dying neurons in a dose-dependent manner. In addition, pharmacological blockades of synaptic and spike activities in the culture reproduced the surface accumulation of p75NTR in vivo and increased the fraction of dying neurons, while genetic inhibition of p75NTR signals occluded the cell death during the activity blockades. These results indicate that afferent activity is crucial for suppressing surface accumulation of p75NTR and hence proBDNF-p75NTR signals and that the loss of this suppression would contribute to triggering cell death after deafferentation in the developing brainstem auditory circuit.

DOI： 10.1016/j.neures.2025.01.004

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Language：English   Publisher：Laryngoscope Investigative Otolaryngology  

Purpose: This study aims to elucidate the incidence of cancer-related post-traumatic stress (PTS) and the fluctuations in anxiety and depression levels before and one year after laryngectomy. Methods: A prospective longitudinal study was conducted on 97 consecutive patients scheduled to undergo laryngectomy (total laryngectomy or pharyngolaryngectomy) at a single university hospital between 2007 and 2022. To assess cancer-related PTS, anxiety, and depression, participants completed two brief self-reported questionnaires: the Impact of Event Scale-Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS). Results: Prior to laryngectomy, 32 patients planning for the procedure were considered as cancer-related PTS based on IES-R. The prevalence of anxiety and depression before surgery was 56% and 76% in the 32 patients with PTS, respectively, compared to 8% and 20% in the 65 patients without PTS. Patients with PTS exhibited significantly worse HADS-anxiety and HADS-depression scores compared to those without PTS at baseline (p < 0.001 for both). Although no significant difference was found in the HADS-anxiety score between the two groups (p = 0.15), patients with PTS exhibited a significantly worse HADS-depression score than those without PTS one year after surgery (p = 0.03). Conclusion: Early identification of possible depressive disorders and active psychiatric interventions are crucial for patients undergoing laryngectomy during the follow-up period. Preoperative assessment of cancer-related PTS may offer an opportunity to implement appropriate psychological interventions. Level of Evidence: 4.

DOI： 10.1002/lio2.70109

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Language：English   Publisher：International Journal of Pediatric Otorhinolaryngology  

We would like to add a correction regarding the affiliation of the first author, Tomoko Esaki. Since she belongs to two institutions at the same time as a researcher, she should be listed as above.

DOI： 10.1016/j.ijporl.2024.112206

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

BACKGROUND: Prognostic factors from neck dissection for regional recurrent or residual head and neck cancer remain undetermined. AIMS/OBJECTIVES: We studied whether continuous variables from pathologic lymph nodes of salvage neck dissection could estimate survival outcomes in patients with head and neck squamous cell carcinomas (HNSCC). MATERIALS AND METHODS: Pathologic continuous variables from neck dissection without primary tumor resection in 184 patients with HNSCC were retrospectively evaluated. Cutoff values from both lymph node density (LND) and log odds of positive lymph nodes (LODDS) as the variables were applied to death estimation. Uni-/multivariate survival analyses adjusting for pathologic N classification and extranodal extension were evaluated by log-rank test or Cox's proportional hazard model, respectively. RESULTS: LND ≥ 0.14 and LODDS ≥ -1.72 were significantly related to univariate shorter survival outcomes. Multivariate analysis indicated a significant association between LND ≥ 0.14 and shorter overall (hazard ratio [HR] = 2.16, 95% confidence interval [CI] = 1.30-3.58), local recurrence-free (HR = 2.34, 95% CI = 1.06-5.16), regional recurrence-free (HR = 2.32, 95% CI = 1.27-4.25), and distant metastasis-free survival (HR = 2.17, 95% CI = 1.31-3.61). CONCLUSIONS AND SIGNIFICANCE: Based on the obtained results, increased LND was a poor prognostic factor following salvage neck dissection.

DOI： 10.1080/00016489.2024.2432505

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: The endolymph of the inner ear, vital for balance and hearing, has long been considered impermeable to intravenously administered gadolinium-based contrast agents (GBCAs) due to the tight blood-endolymph barrier. However, anecdotal observations suggested potential GBCA entry in delayed heavily T2-weighted 3D-real inversion recovery (IR) MRI scans. This study systematically investigated GBCA distribution in the endolymph using this 3D-real IR sequence.</p><p>Methods: Forty-one patients suspected of endolymphatic hydrops (EHs) underwent pre-contrast, 4-h, and 24-h post-contrast 3D-real IR imaging. Signal intensity in cerebrospinal fluid (CSF), perilymph, and endolymph was measured and analyzed for temporal dynamics of GBCA uptake, correlations between compartments, and the influence of age and presence of EH.</p><p>Results: Endolymph showed a delayed peak GBCA uptake at 24h, contrasting with peaks in perilymph and CSF at 4h. Weak to moderate positive correlations between endolymph and CSF contrast effect were observed at both 4 (r = 0.483) and 24h (r = 0.585), suggesting possible inter-compartmental interactions. Neither the presence of EH nor age significantly influenced endolymph enhancement. However, both perilymph and CSF contrast effects significantly correlated with age at both time points.</p><p>Conclusion: This study provides the first <i>in vivo</i> systematic confirmation of GBCA entering the endolymph following intravenous administration. Notably, endolymph uptake peaked at 24h, significantly later than perilymph and CSF. The lack of a link between endolymph contrast and both perilymph and age suggests distinct uptake mechanisms. These findings shed light on inner ear fluid dynamics and their potential implications in Ménière’s disease and other inner ear disorders.</p>

DOI： 10.2463/mrms.mp.2024-0011

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CiNii Research

Language：English   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: To investigate whether significant differences exist in labyrinthine lymph fluid signal intensities on non-contrast-enhanced 3D real inversion recovery (3D-real IR) images between patients with and without significant endolymphatic hydrops (EH), potentially enabling the non-contrast detection of EH.</p><p>Methods: Thirty-nine patients suspected of having EH underwent 3D-real IR MRI before and 4 hours after intravenous administration of a single dose of gadobutrol. Signal intensities of the cerebrospinal fluid (CSF), perilymph, and endolymph were manually measured on pre-contrast images using ROIs. Patients were categorized into 2 groups based on post-contrast imaging: those with significant EH and those without. Normalized signal intensities (nSIs) of the endolymph were calculated and compared between the groups using the Mann–Whitney U test.</p><p>Results: The nSIs of the vestibular endolymph on non-contrast 3D-real IR images were significantly lower in the group with significant EH compared to the group without EH (<i>P</i>  < 0.05), suggesting T1 prolongation in the vestibular endolymph of patients with significant EH. However, considerable overlap was observed in the nSIs between the 2 groups, and significant EH did not always result in T1 prolongation. No significant differences were found in the nSIs of the perilymph or CSF between the groups.</p><p>Conclusion: The study suggests that T1 prolongation occurs in the vestibular endolymph in cases of significant EH. This finding indicates the potential for developing non-contrast MRI methods to detect EH and underscores the importance of understanding the mechanisms behind T1 changes in the endolymph. Further research with larger patient cohorts and inclusion of healthy control subjects is necessary to validate these results and to elucidate the pathophysiology of EH in Ménière’s disease.</p>

DOI： 10.2463/mrms.mp.2024-0191

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Language：English   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>A recently proposed non-contrast MRI technique for evaluating endolymphatic hydrops employs inversion recovery without T2-preparation and the subtraction of 2 inversion time images. However, our high-resolution non-contrast positive endolymph images (PEI) reveal inconsistencies in delineating the endolymphatic space, challenging this method’s reliability. Comprehensive analysis is required to address the interplay among signal intensity, T1 relaxation times, and inversion efficiency within endolymphatic and perilymphatic spaces to establish its diagnostic accuracy.</p>

DOI： 10.2463/mrms.bc.2025-0005

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CiNii Research

Language：English  

DOI： 10.22575/interventionalradiology.2024-0025

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PubMed

Language：Japanese   Publisher：The Society of Practical Otolaryngology  

<p>Langerhans cell sarcoma (LCS) is an extremely rare disease, with only a few reported cases so far of the condition involving the palatine tonsil. We report a case of a 69-year-old man with a lesion in the right palatine tonsil, who was referred to our hospital with a history of a mass detected in the right palatine tonsil two weeks earlier and multiple lymphadenopathies in the right cervical region. Biopsy revealed an increased number of Langerhans cells with prominent nuclear dysmorphism and polymorphism. Immunohistochemistry revealed positive staining for S-100 protein and CD1a. Based on these findings, we made the diagnosis of LCS. PET-CT showed strong FDG accumulation in multiple enlarged lymph nodes, as well as FDG accumulation in the lungs, liver, bones, and skin. The patient received chemotherapy and autologous peripheral blood stem cell transplantation and remains alive. LCS is a very rare disease, and there is no established treatment. Treatment options include surgery, chemotherapy, and bone marrow transplantation, selected depending on the degree of disease progression.</p>

DOI： 10.5631/jibirin.118.49

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Language：Japanese   Publisher：The Society of Practical Otolaryngology  

<p>We report a case of tuberculous otitis media. This disease is very rare and hence not easily diagnosed by most otolaryngologists in Japan. An 86-year-old man with hearing loss and ear discharge was referred to Kariya Toyota General Hospital. Initially, he was diagnosed as having acute otitis media at a local clinic, and treated with antibiotics and myringotomy, but his symptoms failed to improve. At his first visit to our hospital, we diagnosed him as having otitis media with effusion and inserted a tympanostomy tube. However, 32 days later, his ear discharge persisted. We then suspected intractable otitis media and conducted tests to rule out tuberculous otitis media and anti-neutrophil cytoplasmic antibody (ANCA)-associated disease; the results led to the diagnosis of tuberculous otitis media. The interval from a patient’s first visit to a medical institution to diagnosis of the disease is called “Doctor’s delay.” On the other hand, the interval between the onset of symptoms and the patient’s first visit to a medical institution is called “Patient’s delay.” In this case, the Doctor’s delay was 11 weeks, while the Patient’s delay was only a few days. It is often difficult to diagnose tuberculous otitis media in the absence of typical physical findings. A delay in diagnosis may lead to the development of pulmonary tuberculosis, since patients with tuberculous otitis media also often suffer from pulmonary tuberculosis. Hence, in patients presenting with intractable otitis media, examinations such as smear and culture examinations and polymerase chain reaction assay of ear discharge fluid and biopsy of granulation tissue should be conducted to rule out tuberculosis otitis media.</p>

DOI： 10.5631/jibirin.118.99

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CiNii Research

Language：Japanese   Publisher：一般社団法人　日本耳科学会  

DOI： 10.11289/otoljpn.35.1

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CiNii Research

Language：Japanese   Publisher：The Society of Practical Otolaryngology  

<p>Nodular fasciitis, a commonly encountered condition in children and young adults, usually arises in the fascia, with reactive proliferation of myofibroblast-like cells in the surrounding subcutaneous tissue. It typically arises in the fascia and enlarges rapidly within weeks or months, usually less than 20 mm in size. Histopathology shows myofibroblast-like spindle-shaped cell proliferation. The condition often resolves spontaneously during follow-up, and recurrence post-resection is rare. In this report, we present two cases of nodular fasciitis. Case 1 was a 35-year-old male patient who had presented to his previous doctor a month earlier with swelling in the right cervical region, and was referred by the doctor to our hospital. We performed a thorough examination at our department; cervical ultrasonography revealed a well-defined, low-echoic mass measuring about 15 mm in diameter in the subcutaneous tissue. Imaging and aspiration cytology did not provide a definitive diagnosis. As the tumor did not show any spontaneous decrease in the size, the patient requested removal of the tumor, and we performed a right cervical tumor resection. Histopathological examination revealed findings suggestive of nodular fasciitis. Case 2 was a 49-year-old male patient who had presented to his previous doctor a month earlier with swelling of the right nasal dorsum, and was referred by the doctor to our hospital. Contrast-enhanced computed tomography revealed a mass with contrast effect measuring about 10 mm in diameter in the right cheek region. Imaging and aspiration cytology did not provide a definitive diagnosis. Because the tumor showed no spontaneous decrease in size, the patient requested removal of the tumor. We performed excision of the tumor under local anesthesia, and the histopathological diagnosis was nodular fasciitis. A definitive diagnosis of nodular fasciitis is difficult to obtain from physical and imaging examinations alone, and differentiation from malignant disease can be difficult. In order to avoid unnecessary extended resection, it is important to attempt to make an accurate diagnosis by imaging and cytology.</p>

DOI： 10.5631/jibirin.118.353

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Publisher：Nature Communications  

In the central nervous system, astrocytes enable appropriate synapse function through glutamate clearance from the synaptic cleft; however, it remains unclear how astrocytic glutamate transporters function at peri-synaptic contact. Here, we report that Down syndrome cell adhesion molecule (DSCAM) in Purkinje cells controls synapse formation and function in the developing cerebellum. Dscam-mutant mice show defects in CF synapse translocation as is observed in loss of function mutations in the astrocytic glutamate transporter GLAST expressed in Bergmann glia. These mice show impaired glutamate clearance and the delocalization of GLAST away from the cleft of parallel fibre (PF) synapse. GLAST complexes with the extracellular domain of DSCAM. Riluzole, as an activator of GLAST-mediated uptake, rescues the proximal impairment in CF synapse formation in Purkinje cell-selective Dscam-deficient mice. DSCAM is required for motor learning, but not gross motor coordination. In conclusion, the intercellular association of synaptic and astrocyte proteins is important for synapse formation and function in neural transmission.

DOI： 10.1038/s41467-023-44579-z

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Language：English   Publisher：Laryngoscope Investigative Otolaryngology  

Objective: In this study, we aimed to summarize magnetic resonance imaging (MRI) findings of perilymphatic enhancement (PE) and endolymphatic hydrops (EH) of the inner ear, which are associated with vestibular and cochlear symptoms. Methods: We analyzed data on ears with definite Meniere's disease (MD), sensorineural hearing loss (SNHL), vertigo, and listening difficulties (LiD) from 508 ears of 254 patients who underwent contrast-enhanced 3-Tesla MRI between April 2021 and March 2023. We evaluated the degree of endolymphatic hydrops (EH), signal intensity ratios (SIRs) between the basal turns of the cochlea and cerebellum, and hearing levels for all ears. Ears with definite MD were also assessed for changes in vestibular and cochlear symptoms within 6 months. Results: Ears with definite MD exhibited significantly higher percentages of EH in both the vestibule and cochlea compared with ears with other diseases. Furthermore, ears with MD or sensorineural hearing loss (SNHL) had significantly higher SIRs of PE compared with ears with other diseases or asymptomatic ears. Among patients with definite MD, those experiencing hearing fluctuations or vertigo attacks within the last 6 months had significantly higher SIRs of PE compared with those who did not experience any symptoms. Conclusion: Significant EH in the vestibule and cochlea was a major finding for the imaging diagnosis of definite MD. A high SIR of PE was a good indicator for assessing MD activity, reflecting vestibular and cochlear symptoms and fluctuations. Level of Evidence: 4.

DOI： 10.1002/lio2.1312

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Language：English   Publisher：Otology and Neurotology  

Objective: Bilateral high signal intensity (SI) in the endolymphatic duct (ED) on magnetic resonance imaging (MRI) has been reported as a common characteristic in ears with large vestibular aqueduct syndrome (LVAS). However, the significance of bilateral high SI in the ED remains unknown. The present study aimed to compare the correlation between SI in the ED and the clinical manifestations in various otological disorders and consider the significance of the MRI findings. Study Design: Retrospective study. Setting: University hospital. Patients: The study included 2,450 ears from 1,225 patients with various otological disorders. Intervention: All ears underwent 3Tenhanced MRI and were evaluated for the degree of endolymphatic hydrops (EH) and the SI ratios (SIRs; i.e., the calculation between SIs in the ED and those in the cerebellum). Main Outcome Measure: The imaging findings were compared with their clinical symptoms. Results: Ears with bilateral high SIRs in the ED tended to have considerably less occurrence of EH in both the cochlea and vestibule than those with bilateral low SIRs. Ears with SIR ≥8 showed significantly elevated hearing thresholds at lower frequencies on pure-tone audiometry, although they exhibited a markedly lower incidence of cochlear EH than those with SIR <8. Moreover, ears with vertigo exhibited notably higher SIRs than those without vertigo. Conclusion: Bilateral high SI in the ED on MRI may reflect pathophysiology underlying sensorineural hearing loss and vestibular symptoms, which are not associated with EH formation.

DOI： 10.1097/MAO.0000000000004309

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Language：English   Publisher：International Journal of Pediatric Otorhinolaryngology  

Background: To elucidate the factors influencing auditory brainstem response (ABR) threshold improvement in infants. Methods: This retrospective study included 626 infants who underwent ABR at the our Health and Medical Center between 2016 and 2020. Preliminary assessment indicated that 352 infants had an ABR threshold ≥40 dBnHL in both ears. A second ABR examination was conducted 5 months after delivery. The participants were divided into the improved (improvement ≥20 dBnHL) and unchanged (improvement <20 dBnHL) groups. The associations between risk factors were evaluated. Furthermore, we measured and compared the latencies of waves I, III, and V between participants with normal hearing and those in the improved and unchanged groups. Results: The improved and unchanged groups consisted of 185 and 167 participants, respectively. ABR deterioration occurred in one infant with unilateral congenital cytomegalovirus-associated hearing loss. Binary logistic regression analysis revealed that the presence of otitis media with effusion and Down syndrome were factors contributing to ABR threshold improvement. In the ABR waveform analysis, patients in the improved group who had otitis media with effusion exhibited prolonged latencies of waves I, III, and V. Conversely, patients in the unchanged group who had Down syndrome showed shortened I–V interval. Conclusions: Half of the infants tested the second time showed improvement in ABR threshold. Children with congenital syndromes (such as Down syndrome) or otitis media with effusion should undergo a second ABR examination or other auditory assessments to ensure an accurate diagnosis of hearing loss.

DOI： 10.1016/j.ijporl.2024.112094

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Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.67.410

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.67.447

Open Access

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.67.357

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.67.377

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.67.329

Open Access

CiNii Research

Publisher：Developmental Cell  

Normal cells coordinate proliferation and differentiation by precise tuning of gene expression based on the dynamic shifts of the epigenome throughout the developmental timeline. Although non-mutational epigenetic reprogramming is an emerging hallmark of cancer, the epigenomic shifts that occur during the transition from normal to malignant cells remain elusive. Here, we capture the epigenomic changes that occur during tumorigenesis in a prototypic embryonal brain tumor, medulloblastoma. By comparing the epigenomes of the different stages of transforming cells in mice, we identify nuclear factor I family of transcription factors, known to be cell fate determinants in development, as oncogenic regulators in the epigenomes of precancerous and cancerous cells. Furthermore, genetic and pharmacological inhibition of NFIB validated a crucial role of this transcription factor by disrupting the cancer epigenome in medulloblastoma. Thus, this study exemplifies how epigenomic changes contribute to tumorigenesis via non-mutational mechanisms involving developmental transcription factors.

DOI： 10.1016/j.devcel.2024.05.013

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

PURPOSE: The diploic veins have been suggested to be involved in the excretion of cerebrospinal fluid and intracranial waste products; however, to date, there have been no reports evaluating the space surrounding the diploic veins. Therefore, we aimed to visualize the distribution of gadolinium-based contrast agent (GBCA) in the space surrounding the diploic veins and to evaluate the spatial characteristics. MATERIALS AND METHODS: Ninety-eight participants (aged 14-84 years) were scanned 4 h after intravenous GBCA injection at Nagoya University Hospital between April 2021 and December 2022. The volume of the space surrounding the diploic veins where the GBCA was distributed was measured using contrast-enhanced T1-weighted images with the application of three-axis motion-sensitized driven equilibrium. The parasagittal dura (PSD) volume adjacent to the superior sagittal sinus was also measured using the same images. Both volumes were corrected for intracranial volume. The correlation between age and the corrected volume was examined using Spearman's rank correlation coefficient; the relationship between the corrected volume and sex was assessed using the Mann-Whitney U test. RESULTS: A significant weak negative correlation was observed between the volume of the space surrounding the diploic veins and age (r = -0.330, p < 0.001). Furthermore, there was a significant weak positive correlation between the PSD volume and age (r = 0.385, p < 0.001). Both volumes were significantly greater in men than in women. There was no correlation between the volume of the space surrounding the diploic veins and the volume of the PSD. CONCLUSION: The volume of the space surrounding the diploic veins was measurable and, in contrast to the volume of the PSD, was greater in younger participants. This space may be related to intracranial excretory mechanisms and immune responses during youth, requiring further research.

DOI： 10.1007/s11604-024-01572-w

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

BACKGROUND: Fluorescence-guided surgery (FGS) can help surgeons to discriminate tumor tissue from adjacent normal tissues using fluorescent tracers. METHODS: We developed a surgical training model, manufactured using sustainable vegetable organic material with indocyanine green (ICG)-containing "tumor." Surgeons evaluated the model with both the closed-field and endoscopic fluorescence imaging devices and assessed its efficacy to identify residual tumor after enucleation using electrocautery. RESULTS: Strong correlations of fluorescence were obtained at all working distance (3, 5, 7, and 10 cm), showing the robustness of fluorescence signal for the closed-field and endoscopic fluorescence imaging devices. The higher fluorescence signals were obtained in the wound bed in the closed-field fluorescence imaging device and the residual tumor could be clearly identified by fluorescence endoscopy. CONCLUSIONS: Our FGS training model may provide experience for surgeons unfamiliar with optical surgery and subsequent tissue interactions. The model seemed particularly helpful in teaching surgeons the principles of FGS.

DOI： 10.1002/hed.27835

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

BACKGROUND: This study aimed to assess anxiety, depression and quality of life (QoL) in patients with head and neck cancer undergoing laryngectomy using comprehensive self-reported questionnaires for a period of up to 5 years. METHODS: This prospective observational study enrolled 150 consecutive patients with locally advanced head and neck cancer who underwent laryngectomy at Nagoya University Hospital between 2007 and 2020. Anxiety, depression and QoL were assessed at baseline (preoperative) and at 3, 6, 12, 24, 36, 48 and 60 months after surgery using two brief self-reported questionnaires, such as the eight-item Short Form Health Survey (SF-8) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: The surgical procedures were total laryngectomy, pharyngo-laryngectomy and pharyngo-laryngo-oesophagectomy in 97 (65%), 41 (27%) and 12 (8%) patients, respectively. All eight items of the SF-8 were significantly worse than those of the normal population at baseline and at 3 months after surgery. However, general health, vitality, mental health and bodily pain improved to normal levels within 1 year after surgery and were maintained for 5 years. In this study, 35% of patients were categorised as potential cases of depression, and 35% were potential cases of anxiety. During the follow-up period, the proportion of patients with anxiety gradually decreased after surgery. Further analysis revealed that the SF-8 and HADS scores and trends in 89 patients without tumour recurrence were similar to those in the total enrolled 150 patients. CONCLUSION: Anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. WHAT THIS PAPER ADDS: What is already known on the subject Laryngectomy is associated with prolonged functional and psychological effects and has a major impact on patient quality of life (QoL). Several prospective studies evaluating the QoL in laryngectomised patients have been reported, in which significant deterioration in social functioning was found even 1 year after surgery. What this paper adds to existing knowledge One year is not a sufficient period for laryngectomised patients to return to normal life and spend their time in a social community. A recent review showed that most studies on QoL in laryngectomised patients were conducted under 1 year after the procedure, and there were not enough studies of sufficient quality. This is the first long-term prospective observational study of Japanese patients with head and neck cancer who underwent laryngectomy up to 5 years after surgery. What are the potential or actual clinical implications of this work? Our long-term observational study showed that the scores for anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. Clinicians should recognize the importance of psychosocial risk factors in their QoL and multidisciplinary management, including social and psychological support, is essential for long-term laryngectomised survivors.

DOI： 10.1111/1460-6984.13036

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Language：Japanese   Publisher：Japanese Society of Otorhinolaryngology-Head and Neck Surgery  

<p>　　Noise is a significant risk factor for hearing loss, and it is known that noise-induced hearing loss causes hearing loss especially around 4,000 Hz. In this study, we examined the changes in the noise environment and hearing at 4,000 Hz over a 10-year period based on the survey data from the National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA).</p><p>　　The 7^th wave of NILS-LSA (carried out in 2010-2012) revealed a fewer number of subjects reporting current occupational noise exposure, and the 2^nd wave of NILS-LSA (carried out in 2000-2002) revealed a significantly higher number of subjects with no noise exposure at home. Blue-collar workers constituted the highest number of respondents reporting occupational noise exposure. The 7^th wave revealed better air-conduction hearing thresholds at 4,000 Hz in all age groups, except in subjects in their 60s. Pearson's correlation coefficient adjusted for age and sex revealed that the years of employment in a noisy workplace was significantly correlated with the thresholds at 4,000 Hz in both ears.</p><p>　　Our results suggest that the noise environment is changing with time, and that hearing around 4,000 Hz is also changing accordingly.</p>

DOI： 10.3950/jibiinkotokeibu.127.8_936

CiNii Research

Publisher：ACS Materials Letters  

With the escalating demand for clean and sustainable energy sources, hydrogen emerges as a paramount contender, necessitating efficient and innovative production methods of water splitting. This review ventures into the burgeoning field of yolk@shell nanostructures and their pivotal role in advancing water splitting technologies. The synthesis, unique properties, and multifaceted applications of yolk@shell nanostructures across electrocatalytic (EC), photocatalytic (PC), and photoelectrocatalytic (PEC) water splitting processes are evaluated. We start with a brief introduction to various synthetic strategies, including template-assisted formation, the Kirkendall effect, galvanic replacement, and Ostwald ripening, each contributing to the tailored construction of yolk@shell nanostructures with enhanced catalytic efficiencies. Highlights are put on the significant advancements in utilizing these nanostructures to optimize EC activities, PC hydrogen production rates, and PEC water splitting efficiency. Furthermore, we address the challenges of integrating hydrogen generation with valuable compound production, near-infrared photoactivity, and seawater splitting, underscoring the necessity for innovation and the potential for yolk@shell nanostructures in diversifying energy conversion systems. Through a comprehensive analysis, this review not only showcases the current developments but also outlines prospects, emphasizing the critical importance of yolk@shell nanostructures in the sustainable energy landscape.

DOI： 10.1021/acsmaterialslett.4c00790

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Publisher：Medical Hypotheses  

Various types of nystagmus during vertigo attacks in Meniere's disease (MD) include direction-changing and non-direction-changing nystagmus. The direction-changing and non-direction-changing nystagmus may be associated with how the inner ear balance organs are influenced spatially and temporally. We hypothesized that the density difference inside the endolymph elicits the stereocilia inclination of the inner ear balance organs even if the density difference area does not directly touch the stereocilia. The direction of the nystagmus could change if the density difference area spreads around the inner ear balance organs. Numerous records of the nystagmus direction with new devices from the beginning of the nystagmus during the vertigo attacks will contribute to understanding how vertigo attacks appear in MD. The influence of the density difference may be associated with the degree of endolymphatic hydrops. Under significant endolymphatic hydrops, the volume effect due to the density difference becomes more prominent. The trabecular meshwork located in the perilymph in the superior part of the inner ear may maintain the perilymphatic space and prevent the enlargement of the endolymphatic space.

DOI： 10.1016/j.mehy.2024.111401

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

BACKGROUND: Anti-programmed cell death-1 (ligand-1) antibody [PD-(L)1-Ab] can cause destructive thyroiditis and/or hypothyroidism. In addition, tyrosine kinase inhibitors (TKIs) frequently induce hypothyroidism. The aim of this prospective study is to examine the incidence and clinical characteristics of thyroid dysfunction induced by combination therapy of a PD-(L)1-Ab and TKI [PD-(L)1-Ab/TKI]. METHODS: A total of 757 patients treated with PD-(L)1-Ab or PD-(L)1-Ab/TKI were evaluated for anti-thyroid antibodies (ATAs) at baseline and for thyroid function for 48 weeks after treatment initiation and then observed until the last visit. RESULTS: The cumulative incidences of destructive thyroiditis [4/23 (17.4%) vs. 45/734 (6.1%) patients, p < 0.001], isolated hypothyroidism [10/23 (43.5%) vs. 29/734 (4.0%) patients, p < 0.001], and all thyroid dysfunction [14/23 (60.9%) vs. 74/734 (10.1%) patients, p < 0.001] were significantly higher in the PD-(L)1-Ab/TKI group than PD-(L)1-Ab group, respectively. All patients positive for ATAs at baseline developed thyroid dysfunction after PD-(L)1-Ab/TKI treatment, a significantly higher incidence than that in those negative for ATAs at baseline [4/4 (100%) vs. 10/19 (52.6%) patients, p = 0.026]. CONCLUSIONS: The addition of TKIs increased the risk of thyroid dysfunction induced by PD-(L)1-Ab, with the risk being higher in patients positive for baseline ATAs.

DOI： 10.1007/s00262-024-03733-2

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Language：English   Publisher：Acta Oto Laryngologica  

Background: Although various medical remedies have been attempted to alleviate the symptoms of Meniere’s disease (MD), the risk–benefit ratios of these various treatments remain debatable. Objective: We investigated the efficacy of sound stimulation of 100 Hz for treating vestibular dysfunction in patients with Meniere’s disease (MD). Materials and methods: Patients with definitive MD with intractable vestibular symptoms and endolymphatic hydrops (EH) in the inner ear were evaluated. The experimental group received sound stimulation of 75 dB at a frequency of 100 Hz for 5 min, and the control group received sound stimulation of 75 dB at a frequency of 250 Hz for 5 min. Cervical vestibular-evoked myogenic potentials (cVEMPs) were measured before and after each sound stimulation, and the results of the clinical tests were compared between the two patient groups. Results: Significant increases in cVEMP amplitudes were observed after sound stimulation of 100 Hz in ears with vestibular endolymphatic hydrops, although no such improvement was observed in the control group. Conclusion: Sound stimulation of 75 dB at a frequency of 100 Hz leads to improvement in cVEMP amplitude in patients with definitive MD. Adequate sound stimulation might be a new method for treating vestibular dysfunction associated with MD.

DOI： 10.1080/00016489.2024.2363462

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Language：Japanese   Publisher：Japanese Society of Otorhinolaryngology-Head and Neck Surgery  

<p>　　Acute epiglottis can cause sudden upper airway obstruction and death, so that prompt and accurate diagnosis and timely treatment are essential. In previous years, tracheostomy was used to secure the airway in most cases, however, in recent years, endotracheal intubation using an endoscope (endoscopic intubation) has been increasingly adopted. Endoscopic intubation may be effective for securing the airway even in cases with relatively severe laryngeal edema.</p><p>　　We retrospectively reviewed the data of 73 patients diagnosed as having acute epiglottis at our hospital. The subjects were 48 men and 25 women aged 21 to 90 years. The patients were classified according to the endoscopic severity score of Katori et al., as grade 1 (slight swelling of the epiglottis, n=36), grade 2 (moderate swelling of the epiglottis, n=23), or grade 3 (severe swelling of the epiglottis, n=14). The endoscopic severity score of Tanaka et al. was rated as 1 (n=33), 2 (n=9), 3 (n=17), 4 (n=8), or 5 (n=6). Airway intervention was necessary in 13 of the 73 cases, including tracheostomy in 6 cases and endoscopic intubation in 7 cases. Not only tracheostomy, but also endoscopic intubation was confirmed to be useful for securing the airway, even in cases with relatively severe laryngeal edema in which intubation was predicted to be difficult. We believe that treatment of acute epiglottitis by endoscopic intubation requires close co-operation among otolaryngologists, anesthesiologists, and intensive care physicians. In all the 12 cases with grade 3B acute epiglottitis according to Katori's classification, worsening of the laryngeal edema and progression of airway stenosis were observed immediately before the airway intervention, but no significant decrease of the percutaneous arterial oxygen saturation (Sp0₂) or cyanosis was observed in any of the cases. In 7 of 12 cases, even aggravation of the subjective symptoms was not observed. In view of the high frequency of cases in which neither decrease of the percutaneous arterial oxygen saturation nor aggravation of subjective symptoms is observed until just before suffocation, it is considered safe to secure the airway as soon as possible in cases with grade 3B acute epiglottitis. The indications for airway intervention to secure were (1) orthopnea, (2) stridor, (3) dyspnea within 24 hours after the onset of symptoms, (4) severe swelling of the epiglottis and arytenoids (grade 3B according to Katori's classification, and/or a score of 4 or higher according to Tanaka's classification), and (5) grade 2 or greater swelling of the epiglottis according to Katori's classification associated with marked abscess formation. Any one of (1) to (5) is considered as an indication for airway intervention to secure the airway as early as possible.</p>

DOI： 10.3950/jibiinkotokeibu.127.2_100

CiNii Research

Language：English   Publisher：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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Language：English   Publisher：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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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: To investigate the characteristics of the putative meningeal lymphatics located at the posterior wall of the sigmoid sinus (PML-PSS) in human subjects imaged before and after intravenous administration (IV) of a gadolinium-based contrast agent (GBCA). The appearance of the PML-PSS and the enhancement of the perivascular space of the basal ganglia (PVS-BG) were analyzed for an association with gender, age, and clearance of the GBCA from the cerebrospinal fluid (CSF).</p><p>Methods: Forty-two patients with suspected endolymphatic hydrops were included. Heavily T2-weighted 3D-fluid attenuated inversion recovery (hT2w-3D-FLAIR) and 3D-real inversion recovery (IR) images were obtained at pre-administration, immediately post-administration, and at 4 and 24 hours after IV-GBCA. The appearance of the PML-PSS and the presence of enhancement in the PVS-BG were analyzed for a relationship with age, gender, contrast enhancement of the CSF at 4 hours after IV-GBCA, and the washout ratio of the GBCA in the CSF from 4 to 24 hours after IV-GBCA.</p><p>Results: The PML-PSS and PVS-BG were seen in 23 of 42 and 21 of 42 cases, respectively, at 4 hours after IV-GBCA. In all PML-PSS positive cases, hT2w-3D-FLAIR signal enhancement was highest at 4 hours after IV-GBCA. A multivariate analysis between gender, age, CSF signal elevation at 4 hours, and washout ratio indicated that only the washout ratio was independently associated with the enhancement of the PML-PSS or PVS-BG. The odds ratios (95% CIs; <i>P</i> value) were 4.09 × 10^–5 (2.39 × 10^–8 – 0.07; 0.0078) for the PML-PSS and 1.7 × 10^–4 (1.66 × 10^–7 – 0.174; 0.014) for the PVS-BG.</p><p>Conclusion: The PML-PSS had the highest signal enhancement at 4 hours after IV-GBCA. When the PML-PSS was seen, there was also often enhancement of the PVS-BG at 4 hours after IV-GBCA. Both observed enhancements were associated with delayed GBCA excretion from the CSF.</p>

DOI： 10.2463/mrms.mp.2022-0110

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Language：Japanese   Publisher：The Society of Practical Otolaryngology  

<p>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.</p>

DOI： 10.5631/jibirin.117.469

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CiNii Research

Language：Japanese   Publisher：The Society of Practical Otolaryngology  

<p>Lipomas are benign, slow-growing tumors of the head and neck that usually cause few symptoms. When lipomas gradually increase in size, it is sometimes difficult to distinguish them from liposarcomas, which are malignant tumors.</p><p>We report the case of a 72-year-old female patient with a giant lipoma arising from the anterior neck. Computed tomography (CT) showed a 13.9 × 4.6 × 10.3 cm giant mass in the anterior neck. Fine-needle aspiration performed under ultrasound guidance, showed no evidence of malignancy, suggesting that the tumor was a benign lipoma. Preoperative CT images were transferred to the Synapse Vincent volume analyzer to measure the tumor volume and CT values: the tumor volume was 496 mL and the mean radiodensity of the tumor was －58 HU (standard deviation, 27 HU); these values lent support to the diagnosis of a benign lipoma. The tumor was surgically removed without any intraoperative complications and the tumor weight was 481 g. After extubation in the operating room, the patient was admitted to the intensive care unit for safe airway management. The postoperative course was uneventful, and the final pathological diagnosis was lipoma. There was no evidence of recurrence at the 3-month follow-up. Herein, we present a case of a giant lipoma of the anterior neck in which measurement of the tumor radiodensity in Hounsfield units (HU) on CT was useful for the diagnosis.</p>

DOI： 10.5631/jibirin.117.541

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CiNii Research

Language：Japanese   Publisher：The Society of Practical Otolaryngology  

<p>Syphilis is a systemic bacterial infection caused by <i>Treponema pallidum</i> 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.</p><p>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.</p><p>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.</p>

DOI： 10.5631/jibirin.117.523

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CiNii Research

Language：Japanese   Publisher：THE JAPAN LARYNGOLOGICAL ASSOCIATION  

<p>Laryngectomy still plays an important role in the treatment of head and neck cancer. However, laryngectomized patients experience several difficulties in their lives because of the loss of their original voice. This study aimed to record the original voice before laryngectomy via a recording application or studio recording in patients who planned to undergo laryngectomy (Save the Voice project). In 2021, a multicenter prospective observational study was initiated for patients who planned to undergo laryngectomy in Japan. Before surgery, patients recorded their original voices using a voice recording application or in a recording studio. After laryngectomy, electrolarynx voices were obtained and stored in our database system. The study included 34 patients who were managed in three academic university hospitals (30 males, 4 females; median age at the time of surgery, 69 [range, 46–80] years). The tumor sites were the hypopharynx in 21 patients, esophagus in 6, larynx in 5, oropharynx in 1, and trachea in 1 patient. Among the 34 patients, the original voices were preoperatively recorded via a voice-recording application in 28 patients and via a recording studio in 6 patients. Preoperative recording of the patient’s original voice is essential to regenerate the voice after laryngectomy.</p>

DOI： 10.5426/larynx.35.142

CiNii Research

Language：English   Publisher：Otology and Neurotology  

DOI： 10.1097/MAO.0000000000003981

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Language：Japanese   Publisher：日本喉頭科学会  

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J02852&link_issn=&doc_id=20231226240021&doc_link_id=10.5426%2Flarynx.35.142&url=https%3A%2F%2Fdoi.org%2F10.5426%2Flarynx.35.142&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：English  

Sporadic inclusion body myositis (s-IBM) is an acquired degenerative inflammatory myopathy that leads to slowly progressive muscle weakness and atrophy of the limbs, face, and pharynx. Owing to the slow progression of the disease, the indications for surgical intervention remain unclear. Herein, we retrospectively reviewed the records of four patients with s-IBM who had undergone cricopharyngeal myotomy for severe dysphagia at our institution between 2016 and 2021. Among these, one patient underwent transcervical cricopharyngeal myotomy and laryngeal suspension, as videofluoroscopic examination of swallowing revealed poor laryngeal elevation. The remaining three patients underwent endoscopic cricopharyngeal myotomy using a curved rigid laryngoscope. Preoperatively, the mean Hyodo score was 8 points (range: 6-10) using a flexible endoscope. The mean surgical duration was 104 min, and no severe complications were observed. Postoperatively, all patients achieved improvement in swallowing function and food intake. Moreover, swallowing function was maintained in all four patients even 6-12 months postoperatively. Cricopharyngeal myotomy may be a safe surgical procedure with the potential to improve swallowing function, and a Hyodo score of 6 may be considered a surgical indication for cricopharyngeal myotomy in patients with s-IBM.

DOI： 10.18999/nagjms.85.4.866

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Language：Japanese   Publisher：(一社)日本めまい平衡医学会  

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.66.318

Open Access

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.66.325

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.66.404

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.66.446

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.66.458

Open Access

CiNii Research

Language：English   Publisher：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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Language：Japanese   Publisher：(一社)日本言語聴覚士協会  

Language：Japanese   Publisher：(一社)日本言語聴覚士協会  

Language：English   Publisher：Nature Communications  

DOI： 10.1038/s41467-023-40507-3

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Language：English   Publisher：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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Language：Japanese   Publisher：Japan Audiological Society  

<p>　 The Committee on Hearing Loss of Japan Audiological Society conducted a review to determine what kind of auditory tests are used to evaluate the efficacy of rehabilitation and the status of rehabilitation for hearing disorders in Japan and overseas, to grasp the current situation. The subjects were patients with cochlear implants, hearing aids, or tinnitus. We report the results herein.</p>

DOI： 10.4295/audiology.66.169

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CiNii Research

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

DOI： 10.1016/j.ijom.2022.11.010

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Language：English   Publisher：Investigational New Drugs  

Immune-related sclerosing cholangitis (irSC) is relatively rare and its clinical characteristics are not well known. In this study, we aimed to summarize the clinical features of irSC. Clinical data were collected retrospectively from 1,393 patients with advanced malignancy treated with immune-checkpoint inhibitors (ICIs) between August 2014 and October 2021. We analyzed patients with immune-related adverse events of liver injury (liver-irAEs) and compared irSC and non-irSC groups. Sixty-seven patients (4.8%) had a liver-irAE (≥ grade 3) during the follow-up period (median, 262 days). Among these, irSC was observed in eight patients (11.9%). All patients in the irSC group were treated with anti-PD-1/PD-L1 antibodies. Compared with the non-irSC group, the irSC group showed mainly non-hepatocellular liver injury (87.5 % vs 50.8 %, P = 0.065), and had elevated serum inflammatory markers (e.g., CRP and NLR) and biliary enzymes (e.g., GGTP and ALP) at the onset of liver-irAEs. Furthermore, most patients with irSC had abdominal pain. In the non-irSC group, the liver injury of 23 patients improved only with the discontinuation of ICIs, and 22 patients improved with medication including prednisolone (PSL). Conversely, almost all patients (n=7) in the irSC group were treated with PSL, but only two patients experienced an improvement in liver injury. We found that irSC is characterized by a non-hepatocellular type of liver injury with abdominal pain and a high inflammatory response and is refractory to treatment. Further examination by imaging is recommended to detect intractable irSC in cases with these characteristics.

DOI： 10.1007/s10637-023-01366-3

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Language：Japanese   Publisher：(一社)日本聴覚医学会  

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

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

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

INTRODUCTION: Sensory dysfunctions and cognitive impairments are related to each other. Although a relationship between tinnitus and subjective olfactory dysfunction has been reported, there have been no reports investigating the relationship between tinnitus and olfactory test results. METHODS: To investigate the relationship between tinnitus and olfactory test results, we conducted sensory tests, including hearing and visual examinations. The subjects included 510 community-dwelling individuals (295 women and 215 men) who attended a health checkup in Yakumo, Japan. The age of the subjects ranged from 40 to 91 years (mean ± standard deviation, 63.8 ± 9.9 years). The participants completed a self-reported questionnaire on subjective tinnitus, olfactory function, and hearing function, as well as their lifestyle. The health checkup included smell, hearing, vision, and blood examinations. RESULTS: After adjusting for age and sex, the presence of tinnitus was significantly associated with subjective olfactory dysfunction, poor olfactory test results, hearing deterioration, vertigo, and headache. Additionally, high serum calcium levels and a low albumin/globulin ratio were significantly associated with low physical activity and nutrition. Women scored higher than men in olfactory and hearing examinations, but there was no gender difference in vision examinations. CONCLUSION: Subjective smell dysfunction and poor smell test results were significantly associated with tinnitus complaints. Hearing and vision were associated even after adjusting for age and sex. These findings suggest that evaluating the mutual relationships among sensory organs is important when evaluating the influence of sensory dysfunctions on cognitive function.

DOI： 10.3389/fpubh.2023.1124404

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Language：English  

DOI： 10.1016/j.anl.2022.01.004

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PubMed

DOI： 10.1016/j.anl.2022.01.0040385-8146

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

Language：Japanese   Publisher：(NPO)日本気管食道科学会  

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

This study evaluated the safety of laryngeal closure and post-surgical changes in swallowing function of patients with amyotrophic lateral sclerosis (ALS) and proposed an appropriate surgical strategy for patients with ALS. Clinical and surgical data of 26 consecutive patients with ALS who underwent laryngeal closure at Nagoya University Hospital in Japan between 2003 and 2020 were retrospectively analyzed. Changes in swallowing functions were evaluated before and approximately 1 month post-surgery using Neuromuscular Disease Swallowing Status Scale (NdSSS), and Functional Oral Intake Scale (FOIS). The median operation time was 126 min (range, 51-163 min), and the median intraoperative blood loss was 20 mL (range, 0-88 mL). Among the 26 ALS patients who underwent laryngeal closure, grade 1 (mild) complications occurred in three patients (12%); however, no severe complications were observed. After surgery, 25 patients (96%) maintained the swallowing function and only one patient (4%) had deteriorating NdSSS and FOIS scores. No patients were referred to our hospital due to severe aspiration pneumonia after the surgery. Two patients did not require a feeding tube after the surgery and returned to oral intake. Laryngeal closure may be a safe surgical procedure for preventing chronic aspiration and may also maintain swallowing function of patients with ALS. Further multicenter prospective studies using the gold standard videofluoroscopic swallowing examination are required to support our findings.

DOI： 10.1007/s00455-022-10454-0

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

Objective  Surgical indications for advanced-stage squamous cell carcinoma (SCC) of the external auditory canal (EAC) are highly dependent on the skull base surgery team. The aim of this study was to evaluate the surgical outcomes in patients with SCC of the EAC and to clarify the surgical indication of far advanced cases using the T4 subclassification. Methods  Patients with SCC of the EAC who underwent curative treatment from 2002 to 2021 at our hospital were retrospectively reviewed. Clinical and surgical results, including operative data, overall survival (OS), and disease-specific survival (DSS), were analyzed. To clarify the surgical indication for advanced-stage tumors, we proposed the T4 subclassification. Results  In the 46 patients included in the study, 8 patients had T1 tumors, 10 had T2 tumor, 5 had T3 tumors, and 23 had T4 tumors. The 5-year DSS with T1, T2, T3, and T4 tumors were 100, 85.7, 100, and 61.7%, respectively. No prognostic impacts for margin status were found between the 5-year OS and DSS ( p  = 0.23 and 0.13, respectively). Patients with far-advanced-stage (T4b) tumors were significantly associated with shorter DSS than those with early-stage (T1/T2) and advanced-stage (T3/T4a) tumors ( p  = 0.007 and 0.03, respectively). Conclusion  The present study focused on patients with SCC of the EAC at a university hospital over a period of 20 years, especially with skull base involvement, and a T4 subclassification was proposed. Complete tumor resection in an en bloc fashion could help achieve a good survival rate even in patients with locally advanced tumors.

DOI： 10.1055/a-1733-2585

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Language：English  

Endoscopic cricopharyngeal myotomy (ECPM) is a safe and minimally invasive technique that is used to treat patients whose esophageal inlet fails to open because of specific diseases, such as Wallenberg's syndrome and neuromuscular diseases. The present study described the performance of a new, safe and simple ECPM using a curved rigid laryngoscope, which is used for endoscopic laryngopharyngeal surgery for patients with dysphagia due to pharyngeal residue after swallowing. The patient was an 80-year-old woman with laryngeal palsy caused by lower cranial nerve palsy after cranial base schwannoma surgery. ECPM was performed with a curved rigid laryngoscope. The postoperative course was good; postoperative rehabilitation eliminated the residue after swallowing a thickened solution and mealtimes were shorter than before surgery. This procedure allows the hypopharynx to be widely expanded and it is possible to develop a wider surgical field than when using a direct laryngoscope. In addition, this procedure appears to be relatively easy to perform if the surgeon is familiar with the curved rigid laryngoscope technique.

DOI： 10.3892/mco.2023.2606

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Language：English  

Erdheim-Chester disease is characterized by the infiltration of foamy histiocytes in tissues. Lesional tissue biopsy is recommended to confirm diagnosis and establish the BRAF mutational status. A 52-year-old man presented to our hospital with hydronephrosis. Computed tomography showed enhancement of soft shadows around the left renal pelvis transition area and the aorta. He was treated with prednisolone 0.2 mg/kg for 1 year; however, no improvement was observed. 18Fluorodeoxyglucose-positron emission tomography/computed tomography revealed increased fluorodeoxyglucose uptake in various body parts, including the maxillary sinuses, indicative of Erdheim-Chester disease. He refused further examination, and the maxillary sinus lesions were treated with antibiotics and intranasal steroids, but no improvement was observed. Two years later, he underwent biopsy with endoscopic sinus surgery of the maxillary sinus, which showed the highest increase in fluorodeoxyglucose uptake on repeat 18fluorodeoxyglucose-positron emission tomography/computed tomography. Endoscopic findings showed only nonspecific inflammatory findings, but pathological findings revealed the proliferation of cells with abundant foamy cytoplasms. Sufficient tumor volume was available to perform PCR for BRAF V600E mutation analysis, which was positive and resulted in a diagnosis of Erdheim-Chester disease with the BRAF V600E mutation. This is the first case of a patient with Erdheim-Chester disease with the BRAF V600E mutation identified in a sinus lesion. Endoscopic sinus surgery biopsy of the paranasal sinuses was considered to contribute to the histological and genetic diagnosis of Erdheim-Chester disease, particularly following the notable increase in fluorodeoxyglucose uptake.

DOI： 10.18999/nagjms.85.1.150

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: Peripheral retinal leakage (PRL) of contrast medium from the ora serrata (i.e., the peripheral part of the retina) was recently reported in normal eyes using ultra-widefield fluorescein angiography. We occasionally see PRL of gadolinium-based contrast agents (GBCAs) in the vitreous from the temporal and inferior sides of the ora serrata on MR images of subjects without ophthalmic disease. In this study, we retrospectively evaluated these MR images to determine if PRL was associated with aging. We also evaluated whether the initial leakage appeared in the temporal and inferior sides, and whether there was uniform distribution within the vitreous after 24 hours.</p><p>Methods: In 127 subjects (9 volunteers, 85 patients with sudden deafness, and 33 patients with a suspicion of endolymphatic hydrops), pre- and post-contrast-enhanced heavily T2-weighted 3D-fluid attenuated inversion recovery (FLAIR) images were obtained. The presence or absence of PRL was subjectively evaluated. For patients with a suspicion of endolymphatic hydrops, 3D-real inversion recovery (IR) images were also obtained at pre-, 10 mins, 4 hours, and 24 hours after intravenous administration (IV) of GBCA. Four circular ROIs were placed in the vitreous humor and the signal intensity was measured.</p><p>Results: In the cases with PRL (n = 88) and without PRL (n = 47), the median age was 59 and 47 years, respectively (<i>P</i> = 0.001). At 4 hours after IV-GBCA, the mean signal increase in the inferior temporal ROI was greater than all the other ROIs. At 24 hours after IV-GBCA, no significant difference in signal intensity was observed for the four ROIs.</p><p>Conclusion: PRL of GBCA is age-dependent and occurs mainly from the inferior temporal side of the ora serrata. The contrast effect was uniformly distributed at 24 hours after IV-GBCA. Future observations in a variety of diseases will determine the clinical significance of these findings.</p>

DOI： 10.2463/mrms.mp.2021-0100

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>It has been reported that perivenous cystic structures near the parasagittal dura are associated with the leakage of gadolinium-based contrast agents at 4 hours after intravenous administration. The origin of such cystic structures remains unknown. While reading many cases of MR cisternography, we noticed that some of the cystic structures appeared to connect to the perivenous subpial space. This new imaging finding might facilitate future research of the waste clearance system for the central nervous system.</p>

DOI： 10.2463/mrms.bc.2021-0141

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: To determine whether T2-contrast enhancement techniques can be used to diagnose endolymphatic hydrops, we compared fluid signal artifacts with and without T2-contrast enhancement techniques in 3D fluid-attenuated inversion recovery (3D-FLAIR).</p><p>Methods: We prepared a custom-made phantom consisting of eight tubes half-filled with saline. Images were obtained using four 3D-FLAIR: without T2-contrast enhancement (Normal), with non-selective T2-inversion recovery (T2-IR), and two with non-selective T2 preparation IR (T2-prep). Scans were performed with and without rice covering the phantom to simulate minimal and severe B0-inhomogeneity conditions. The average signal intensity (SI) values of eight saline tubes were compared between the four sequences and between each other. Comparisons were performed for all measurement slices and the central 10 slices. The images using T2-contrast enhancement technique were obtained from a volunteer and a patient suspected of Meniere’s disease.</p><p>Results: The Normal sequence SI for all slices was significantly lower than that for the other sequences, with smaller standard deviation (SD) and no outliers. Several outliers were detected in the other sequences. The SDs and outliers were larger without rice than with rice. When the central 10 slices with rice, the T2-IR had a significantly higher SI with more outliers compared with the Normal sequence. The T2-prep had no outliers and SIs that were comparable to those of the Normal sequence. However, without rice, the T2-IR and T2-prep sequences had significantly higher SIs with outliers and larger SDs compared to the Normal sequence. In the corresponding images, the Normal sequence achieved excellent fluid suppression, whereas the T2-IR and T2-prep sequences showed high-signal artifacts. Imperfect fluid suppressions were observed in the volunteer image and the endolymphatic hydrops on the post-gadolinium image differed in size and shape in the non-injected T2-IR in the patient image.</p><p>Conclusion: T2-contrast enhancement techniques should be used with caution in 3D-FLAIR for diagnosing endolymphatic hydrops.</p>

DOI： 10.2463/mrms.mp.2022-0017

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CiNii Research

Language：Japanese   Publisher：The Society of Practical Otolaryngology  

<p>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 <i>WFS1</i> and <i>COL1A1</i>. 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.</p>

DOI： 10.5631/jibirin.116.415

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

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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Language：English  

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-year-old 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

Open Access

Web of Science

Scopus

PubMed

Language：Japanese   Publisher：一般社団法人 日本耳鼻咽喉科頭頸部外科学会  

<p>　MRI による内リンパ水腫評価の導入は, 臨床におけるメニエール病診断のみならず, その病態解明や治療法の選択にも大きな影響を及ぼしてきた. めまい平衡医学会のメニエール病の診断基準では, 確実例に加えて検査所見として聴覚症状のある耳に造影 MRI で内リンパ水腫を認める症例は確定診断例と定義された. メニエール病症例を中心に MRI 内リンパ水腫評価を通じて多くの情報が得られることは大きな恩恵となっている. 一方, MRI 設備のある施設であれば画像評価が可能という訳ではなく, また全ての症例に MRI 評価が必要ということはない. 画像評価に偏重する余り, 不適切な応用から誤った結論に陥るリスクも潜んでいる. 今後の MRI 内リンパ水腫評価の適応は, 臨床面と研究面の観点から考慮していく必要がある. MRI 評価の高い有用性を応用し, メニエール病やほかの内リンパ水腫関連疾患の真の病態に迫る画像所見の把握を, 今後も推進していきたい.</p>

DOI： 10.3950/jibiinkotokeibu.125.10_1455

CiNii Research

Publisher：東京医学社  

DOI： 10.24479/ohns.0000000337

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.65.428

Open Access

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.65.431

Open Access

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.65.321

Open Access

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.65.417

Open Access

CiNii Research

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

BACKGROUND/AIM: The utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) for clinical T classification of synchronous esophageal cancer (SEC) in pharyngeal cancer has not been fully elucidated. We investigated the association between 18F-FDG-PET/CT and clinical T classification for SEC. PATIENTS AND METHODS: We retrospectively enrolled 90 patients with pharyngeal cancer having both Lugol chromoendoscopy and 18F-FDG-PET/CT at pretreatment. The association between 18F-FDG-PET/CT and pathological examination was compared by the Fisher's exact test. RESULTS: Pathologically, 12 patients with SEC were diagnosed. The number of locations for SEC with cT1a, cT1b, and cT3 was 20, 1, and 1, respectively. Sensitivity for cT1a-cT3, cT1b-cT3, and cT3 was 9.1%, 100%, and 100%, respectively. Locations of SEC with cT1b-cT3 were significantly detected. The locations of SEC with cT1b-cT3 were more frequently detected than those without cT1b-cT3 by 18F-FDG-PET/CT (p<0.01). CONCLUSION: Detection of SEC with clinical T1b-T3 in comparison to clinical T1a on pretreatment 18F-FDG-PET/CT for patients with pharyngeal cancer, was achieved with high sensitivity.

DOI： 10.21873/anticanres.15963

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PubMed

Language：English   Publisher：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

Open Access

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PubMed

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

Objective: To determine the efficacy of a surgical training model for fluorescence-guided cancer surgery and validate its utility to detect any residual tumors after tumor resection using electrocautery. Methods: We developed surgical training models containing indocyanine green (ICG) for near-infrared (NIR) fluorescence imaging using a root vegetable organic material (konjac). After the fluorescence assessment for the models, the surgical simulation for fluorescence-guided cancer surgery using electrocautery was performed. ICG-containing tumors were divided into two surgical groups: "Enucleation" (removal of the entire visible tumor) and "Complete resection" (removal of the tumor with an appropriate 5-mm surgical margin). Results: All 12 ICG-containing tumors were clearly visible from the normal view but not from the flipped view. The tumor resection time was significantly longer in the "Complete resection" group than in the "Enucleation" group (p < .001). The ICG-containing tumors showed a high tumor-to background ratio from the normal (average = 45.8) and flipped (average = 19.2) views, indicating that the models including ICG-containing tumors were useful for a surgical simulation in fluorescence-guided surgery. The average mean fluorescence intensity of the wound bed was significantly higher in the "Enucleation" group than in the "Complete resection" group (p < .01). No decrease in fluorescence signal was found in the wound bed even at 2 days postresection. Conclusion: Our surgical training model containing a fluorescent agent is safe, inexpensive, not harmful for humans, and easy to dispose after use. Our model would be beneficial for surgeons to learn NIR fluorescence imaging and to accelerate fluorescence-guided cancer surgery into clinical application.

DOI： 10.1002/lio2.858

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PubMed

Language：English   Publisher：Sleep and Biological Rhythms  

Sleep problems and obstructive sleep apnea (OSA) increase with age and disturb life in old age. Positional therapy is one option to treat OSA, but the differences in clinical pathophysiology between elderly and other age groups have not been fully investigated. We explored the pathophysiological features of sleep apnea, factors that are independently associated with positional OSA and the prevalence in elderly patients. We studied demographic and polysomnographic data of 85 elderly individuals with OSA (age ≥ 65 years) and 124 non-elderly patients with OSA (age, 20–64 years). The Amsterdam Positional OSA Classification (APOC) was used to evaluate positional OSA. Body mass index (BMI) and Epworth sleepiness scale were both significantly lower in the elderly group than in the non-elderly group, although apnea/hypopnea index (AHI) did not differ between groups. OSA severity affected total sleep time, sleep efficiency, and waking after sleep onset more in the elderly than in the non-elderly. AHI in the lateral position was significantly lower in elderly than in non-elderly, although AHI in the supine position was almost the same between two groups. The distribution of APOC 1 and 2 (lateral sleep effective) was significantly higher in the elderly than in the non-elderly. Relative factors such as BMI, rate of hypopnea, and lowest SpO<inf>2</inf> associated with positional OSA in non-elderly groups did not differ significantly among APOC subgroups in elderly patients. Our findings are suggesting that characteristics of the positional OSA is different between elderly and younger-age OSA patients.

DOI： 10.1007/s41105-022-00385-6

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PubMed

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

Language：English   Publisher：Radiologia Medica  

DOI： 10.1007/s11547-022-01486-5

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PubMed

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

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

BACKGROUND: Previous studies showed that although the risk of thyroid dysfunction [thyroid immune-related adverse events (irAEs)] induced by anti-programmed cell death-1 antibodies (PD-1-Ab) was as low as 2% to 7% in patients negative for anti-thyroid antibodies (ATAs) at baseline, it was much higher (30%-50%) in patients positive for ATAs. However, whether a similar increase occurs with combination therapy using PD-1-Ab plus anti-cytotoxic T-lymphocyte antigen-4 antibody (CTLA-4-Ab) is unknown. METHODS: A total of 451 patients with malignancies treated with PD-1-Ab, CTLA-4-Ab, or a combination of PD-1-Ab and CTLA-4-Ab (PD-1/CTLA-4-Abs) were evaluated for ATAs at baseline and for thyroid function every 6 weeks for 24 weeks after treatment initiation and then observed until the last clinical visit. RESULTS: Of the 451 patients, 51 developed thyroid irAEs after immunotherapy [41 of 416 (9.9%) treated with PD-1-Ab, 0 of 8 (0%) treated with CTLA-4-Ab, and 10 of 27 (37.0%) treated with PD-1/CTLA-4-Abs]. The cumulative incidence of thyroid irAEs was significantly higher in patients who were positive vs negative for ATAs at baseline after both PD-1-Ab [28/87 (32.2%) vs 13/329 (4.0%), P < 0.001] and PD-1/CTLA-4-Abs [6/10 (60.0%) vs 4/17 (23.5%), P < 0.05] treatments. The risk of thyroid irAEs induced by PD-1/CTLA-4Abs, which was significantly higher than that induced by PD-1-Ab, in patients negative for ATAs at baseline was not statistically different from that induced by PD-1-Ab in patients positive for ATAs at baseline. CONCLUSIONS: This study showed that the incidence of thyroid irAEs was high and not negligible after PD-1/CTLA-4-Abs treatment even in patients negative for ATAs at baseline.

DOI： 10.1210/clinem/dgab829

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PubMed

Language：Japanese  

DOI： 10.1080/23772484.2022.2033122

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Language：Japanese  

Web of Science

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

Brain reserve is a topic of great interest to researchers in aging medicine field. Some individuals retain well-preserved cognitive function until they fulfill their lives despite significant brain pathology. One concept that explains this paradox is the reserve hypothesis, including brain reserve that assumes a virtual ability to mitigate the effects of neuropathological changes and reduce the effects on clinical symptoms flexibly and efficiently by making complete use of the cognitive and compensatory processes. One of the surrogate measures of reserve capacity is brain volume. Evidence that dementia and hearing loss are interrelated has been steadily accumulating, and age-related hearing loss is one of the most promising modifiable risk factors of dementia. Research focused on the imaging analysis of the aged brain relative to auditory function has been gradually increasing. Several morphological studies have been conducted to understand the relationship between hearing loss and brain volume. In this mini review, we provide a brief overview of the concept of brain reserve, followed by a small review of studies addressing brain morphology and hearing loss/hearing compensation, including the findings obtained from our previous study that hearing loss after middle age could affect hippocampal and primary auditory cortex atrophy.

DOI： 10.3389/fnagi.2021.791604

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Scopus

PubMed

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

DOI： 10.1097/MAO.0000000000003328

Open Access

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Scopus

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: To evaluate the relationship between the size of the venous structures related to the inner ear and the degree of endolymphatic hydrops (EH).</p><p>Methods: Thirty-four patients with a suspicion of EH underwent whole brain MR imaging including the inner ear. Images were obtained pre- and post-administration, and at 4 and 24 hours after the intravenous administration of a gadolinium-based contrast agent (IV-GBCA). The cross-sectional areas (CSA) of the internal jugular vein (IJV), superior petrosal sinus (SPS), and inferior petrosal sinus (IPS) were measured on the magnetization prepared rapid acquisition of gradient echo (MPRAGE) images obtained immediately after the IV-GBCA. The grade of EH was determined on the hybrid of reversed image of positive endolymph signal and native image of positive perilymph signal (HYDROPS) images obtained at 4 hours after IV-GBCA as no, mild, and significant EH according to the previously proposed grading system for the cochlea and vestibule, respectively. The ipsilateral CSA was compared between groups with each level of EH grade. <i>P</i> < 0.05 was considered statistically significant.</p><p>Results: There were no statistically significant differences between EH grades for the CSA of the IJV or that of the IPS in either the cochlea or the vestibule. The CSA of the SPS in the groups with significant EH was significantly smaller than that in the group with no EH, for both the cochlea (<i>P</i> < 0.01) and the vestibule (<i>P</i> < 0.05). In an ROC analysis to predict significant EH, the cut-off CSA value in the SPS was 3.905 mm² for the cochlea (AUC: 0.8762, 95% confidence interval [CI]: 0.7952‒0.9572) and 3.805 mm² for the vestibule (AUC: 0.7727, 95% CI: 0.6539‒0.8916).</p><p>Conclusion: In the ears with significant EH in the cochlea or vestibule, the CSA of the ipsilateral SPS was smaller than in the ears without EH.</p>

DOI： 10.2463/mrms.mp.2021-0010

Open Access

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PubMed

CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>In this study, we present images acquired by a fast-imaging method for the evaluation of endolymphatic hydrops after intravenous administration of a single dose of gadolinium-based contrast agent. We utilized the hybrid of reversed image of MR cisternography and a positive perilymph signal by heavily T2- weighted 3D-fluid attenuated inversion recovery-multiplied by T2 (HYDROPS2-Mi2) method combined with deep learning reconstruction denoising. The scan time for the fast protocol was approximately 5 mins, which is far shorter than previously reported scan times. The fast acquisition provides similar image quality and less motion artifacts compared to the longer method.</p>

DOI： 10.2463/mrms.ici.2021-0022

Open Access

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PubMed

CiNii Research

Publisher：Practica Oto Rhino Laryngologica  

Fluorouracil (5-FU) is one of key therapeutic drugs for many solid tumors, including head and neck cancer. Pneumatosis intestinalis and portal venous gas, while being rare adverse effects of 5-FU administration, could prove fatal. Hyperammonemia is also one of the serious adverse effects of 5-FU. Herein, we report the case of a patient with hypopharyngeal cancer who developed both portal venous gas and hyperammonemia during 5-FU chemotherapy. A 79-year-old man with a few months’ history of difficulty in swallowing was referred to our hospital. Upper gastrointestinal endoscopy and tissue biopsy revealed squamous cell carcinoma and the patient was diagnosed as having locally advanced hypopharyngeal cancer, cT4aN0M0. He was initiated on neoadjuvant chemotherapy with carboplatin (CBDCA) and 5-FU on day 1. On the day 3, he presented with consciousness disturbance and Kussmaul breathing. Upper gastrointestinal endoscopy revealed pneumatosis intestinalis under the gastric mucosa and abdominal computed tomography revealed portal venous gas. At the same time, blood test revealed hyperammonemia. As we considered these events to be serious adverse effects of 5-FU, we discontinued the 5-FU infusion and started the patient on treatment with antibiotics and a proton-pump inhibitor. The general condition of the patient gradually improved under careful observation, and the patient eventually showed complete recovery. In clinical settings, it is important to have a high index of suspicion for serious adverse effects of 5-FU, such as pneumatosis intestinalis, portal venous gas, and hyperammonemia.

DOI： 10.5631/jibirin.115.333

Open Access

Scopus

Language：Japanese   Publisher：Japan Otological Society  

<p>The Slim Modiolar electrode (CI532/632), a pre-curved electrode for cochlear implants released by Cochlear^®, can effectively stimulate the nerves in its proximity and reduce the risk of cochlear injury and the likelihood of electrode translocation from the scala tympani to scala vestibuli in comparison with the Slim Straight electrode (CI522/622). In this study, 31 ears underwent implantation of the CI532/632 electrode. The neural response telemetry (NRT) thresholds and impedances for CI532/632 electrodes around the cochlear cupula were lower than those for CI522. No difference was observed in the operative time and the short-term postoperative hearing and clinical performance of the two electrodes. Due to the complexity of the sheath and electrode configuration, insertion of the electrode can be challenging, and tip folding can occur. A broad extension of posterior tympanotomy is required while inserting the CI532/632 electrode. The round-window niche overhang (the ridge of bone around the round window fossa) has to be drilled out following exposure of the round window fossa. If electrode insertion via the round window is difficult, an extended round-window approach should be employed inserted. The NRT threshold and impedance of the Slim Modiolar electrodes were better in the short term. However, Slim Modiolar electrodes showed no significant difference from Slim Straight electrodes in terms of cochlear implant performance after six months. Thus, Slim Modiolar electrodes are options for cases with a normal cochlear study, and long-term evaluations of cochlear implant performance with these electrodes are essential.</p>

DOI： 10.11289/otoljpn.32.136

CiNii Research

Language：Japanese   Publisher：The Society of Practical Otolaryngology  

<p>Dermoid cysts are rare lesions of the head and neck that usually present with few symptoms. Complete resection is the mainstay of treatment for dermoid cysts, however, airway management after surgery is essential, especially in children. We report the case of sublingual dermoid cyst arising from the floor of the mouth in a 6-year-old female child. CT/MRI images demonstrated a 50×40×30 mm cystic mass in the sublingual space. Fine-needle aspiration was performed under ultrasound guidance, and the findings were suggestive of a dermoid cyst in the floor of mouth. The cyst was surgically removed via a transoral approach. After the surgery, the patient was returned to the intensive care unit under tracheal intubation for safe airway management. After some days, she was extubated and the postoperative course was good. There was no evidence of recurrence during the 6-month follow up period. When encountering sublingual dermoid cysts arising from the floor of the mouth in a pediatric case, it is important to consider not only the appropriate surgical procedure, but also about postoperative airway management, even during the preoperative period.</p>

DOI： 10.5631/jibirin.115.277

Open Access

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CiNii Research

Language：Japanese   Publisher：The Society of Practical Otolaryngology  

<p>In this report, we describe the case a 68-year-old man who developed buccal herpes zoster during the course of steroid treatment for sudden deafness, followed by the development of peripheral-like facial nerve palsy. The patient developed right hearing loss on day 1, and his right audiogram showed a hearing threshold of 88.8 dB on day 8. Since head magnetic resonance imaging (MRI) showed no abnormalities, he was hospitalized for steroid therapy. On day 11, he developed herpes zoster of the left buccal region, for which he was started on treatment with valacyclovir. Right facial nerve palsy became apparent on day 17. Since the facial paralysis appeared on the side contralateral to the rash, it was inconsistent with Ramsay Hunt syndrome. Therefore, head MRI was performed, which lead to the diagnosis of pontine infarction. Cerebrospinal fluid examination on day 19 showed a slight increase in the number of cells as well as an increase in the protein and sugar levels, the clinical findings being suggestive of varicella zoster virus (VZV) meningitis. The VZV-index on day 27, calculated from the total IgG and anti-VZV-IgG levels in the blood and cerebrospinal fluid, was 2.04 (>2.0), indicative of cerebral infarction caused by VZV vasculopathy. Cerebrospinal fluid examination revealed no abnormalities on day 32, and the patient was discharged from the hospital.</p><p>In this patient, the facial paralysis appeared on the side opposite to the rash. Since the typical rash of Ramsay Hunt syndrome appears on the pinna or the pharynx, other diseases, such as cerebral infarction or mononeuritis multiplex, should have been suspected even if the rash had appeared on the same side. Paralysis of the forehead is usually mild in cases of central facial paralysis, but in this case, the forehead was also paralyzed because of involvement of the entire right facial nerve nucleus. The risk of development of cerebrovascular disease secondary to VZV meningitis, so-called VZV vasculopathy, is 1.3 times higher during the first 3 months after the onset of facial herpes zoster. Nuclear facial nerve paralysis should be considered in the differential diagnosis, even if movements of the forehead are only affected unilaterally.</p>

DOI： 10.5631/jibirin.115.587

Open Access

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CiNii Research

Language：Japanese   Publisher：The Society of Practical Otolaryngology  

<p>Neurofibromatosis type I (NF1) refers to neurofibromatosis associated with the presence of café-au-lait spots, and carries a relatively good prognosis. Pseudo-aneurysm formation in the head and neck region is relatively rare in patients with NF1, but could prove fatal by causing acute airway obstruction. We report a case of NF1 who presented with airway stenosis due to formation of a pseudo-aneurysm in the buccal region.</p><p>A 33-year-old man with NF1 presented with acute onset of swelling in the right buccal region. Computed tomography (CT) revealed a contrast-enhancing mass lesion measuring 4.0×4.0×7.5 cm in size in the right masseter muscle. Angiography showed an aneurysm of the maxillary artery, with extravasation of the contrast medium. The patient was admitted to the hospital and endovascular coil embolization of the aneurysm was performed by neurosurgeons. However, the facial swelling began to worsen gradually after about seven hours and bruising was found in the neck region. CT revealed re-bleeding in the right buccal region and tracheal deviation due to acute hemorrhage. Therefore, the patient was admitted to the ICU, intubated and initiated on mechanical ventilation. A repeat angiography showed a pseudo-aneurysm in the transverse facial artery, which was different from the pseudo-aneurysm treated earlier. This aneurysm had multiple feeding arteries, and was treated by coil embolization as well as embolized with N-butyl-2-cyanoacrylate (NBCA). Three days after the embolization, the patient was extubated and the postoperative course was satisfactory. No recurrence of the pseudo-aneurysms has been observed until date, more than half a year after the treatment. In patients with NF1 presenting with rupture of a pseudo-aneurysm in the head and neck region, prompt airway management is essential.</p>

DOI： 10.5631/jibirin.115.151

Open Access

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CiNii Research

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

<title>Abstract</title><sec>
<title>Purpose</title>
To identify magnetic resonance cisternography (MRC) imaging findings related to Gadolinium-based contrast agent (GBCA) leakage into the subarachnoid space.


</sec><sec>
<title>Materials and methods</title>
The number of voxels of GBCA leakage (V-leak) on 3D-real inversion recovery images was measured in 56 patients scanned 4 h post-intravenous GBCA injection. Bridging veins (BVs) were identified on MRC. The numbers of BVs with surrounding cystic structures (BV-cyst), with arachnoid granulations protruding into the superior sagittal sinus (BV-AG-SSS) and the skull (BV-AG-skull), and including any of these factors (BV-incl) were recorded. Correlations between these variables and V-leak were examined based on the Spearman’s rank correlation coefficient. Receiver-operating characteristic (ROC) curves were generated to investigate the predictive performance of GBCA leakage.


</sec><sec>
<title>Results</title>
V-leak and the number of BV-incl were strongly correlated (<italic>r</italic> = 0.609, <italic>p</italic> &lt; 0.0001). The numbers of BV-cyst and BV-AG-skull had weaker correlations with V-leak (<italic>r</italic> = 0.364, <italic>p</italic> = 0.006; <italic>r</italic> = 0.311, <italic>p</italic> = 0.020, respectively). The number of BV-AG-SSS was not correlated with V-leak. The ROC curve for contrast leakage exceeding 1000 voxels and the number of BV-incl had moderate accuracy, with an area under the curve of 0.871.


</sec><sec>
<title>Conclusion</title>
The number of BV-incl may be a predictor of GBCA leakage and a biomarker for waste drainage function without using GBCA.



</sec>

DOI： 10.1007/s11604-021-01137-1

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PubMed

Other Link： https://link.springer.com/article/10.1007/s11604-021-01137-1/fulltext.html

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

BACKGROUND: The clinical course of liver injury induced by immune checkpoint inhibitors (ICIs) varies among individuals, and there were few reports on the therapeutic effects of corticosteroids based on the patterns of liver injury. METHODS: We evaluated the characteristics and clinical course of immune-related liver injury in 1214 patients treated with ICIs for advanced malignancies except for hepatocellular carcinoma between August 2014 and May 2021. RESULTS: During the follow-up period (median, 252 days), 58 patients (4.8%) had an immune-related liver injury (≥ Grade 3). The liver-injury patterns were hepatocellular (n = 26, 44.8%), mixed (n = 11, 19.0%), or cholestatic (n = 21, 36.2%), and the median time to onset of liver injury was 39, 81, and 53 days, respectively; the hepatocellular pattern occurred earlier than the other types (p = 0.047). Corticosteroids were administered to 30 (51.7%) patients; while liver injury was improved in almost all patients with the hepatocellular pattern (n = 13/14, 92.9%), that failed to show improvement in over half of the patients with the non-hepatocellular patterns, and three patients with mixed patterns needed secondary immunosuppression with mycophenolate mofetil. Liver biopsies performed in 13 patients mainly showed lobular injury, endothelialitis, and spotty necrosis with infiltration of T cells positive for CD3 and CD8, but not CD4 or CD20. CONCLUSION: The incidence pattern and therapeutic response to corticosteroids in immune-related liver injury differ according to the injury type. Although corticosteroids were effective for the hepatocellular pattern, an additional strategy for refractory non-hepatocellular patterns is needed.

DOI： 10.1007/s12072-021-10238-y

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

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

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.64.391

Open Access

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.64.436

Open Access

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.64.489

Open Access

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.64.351

Open Access

CiNii Research

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

DOI： 10.1111/ped.14563

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PubMed

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

OBJECTIVE: The influence of living alone on multiple food and nutrition behaviors across a range of ages and genders has not been sufficiently investigated. Moreover, to our knowledge, no studies have described both dietary status and medical examination findings in persons living alone. Among individuals who attended a health checkup in a rural town in Japan, we investigated dietary habits and medical examination findings in persons living alone and those living with one or more other persons. METHODS: The participants in this investigation were 501 community-dwelling individuals aged 40 to 91 y (mean, 63.8 ± 9.9 y). Thirty-four (16.4%) of the 207 men and 45 (15.3%) of the 294 women lived alone. Dietary intake frequency of 28 types of foods and drinks, including various vegetables, fruits, meat, seafood, and dairy products, was investigated based on responses to a self-completed questionnaire. During the physical examination, body weight, body mass index, body fat percentage, and blood pressure (systolic and diastolic) were measured. Blood examination included red blood cell count, white blood cell count, platelet count, hemoglobin, hematocrit, total protein, albumin/globulin ratio, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, creatinine, blood urea nitrogen, uric acid, and serum calcium. RESULTS: Multivariate analysis revealed that living alone independently was associated with a reduced intake frequency of various vegetables and seafood, especially in men. Diastolic blood pressure and triglyceride levels were significantly higher in men living alone than in men living with other persons. The albumin/globulin ratio in women living alone was significantly lower than in women living with other persons. CONCLUSIONS: It was found that living alone was associated not only with a reduced quality of dietary intake but also with an unfavorable trend in some of the medical examination findings.

DOI： 10.1016/j.nut.2021.111268

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

BACKGROUND: Otological diseases including Meniere's disease (MD) involve endolymphatic hydrops (EH), which can be visualized by magnetic resonance imaging (MRI) with gadolinium contrast agents, but the temporal changes of contrast in the inner ear have not been evaluated. OBJECTIVES: We investigated the permeability of the blood-perilymph barrier (BPB) in ears with EH to evaluate the severity of the inner ear disturbances. MATERIALS AND METHODS: The study included 32 ears from 16 patients with EH or related diseases who underwent MRI. The permeability of the BPB was assessed by the signal-intensity ratio (SIR) at four-time points: before and at 10 min, 4 h, and 24 h after administration of gadolinium for assessing EH. RESULTS: Cochlear EH was found in 25 of the 32 ears, and vestibular EH in 11. The rate of EH was significantly higher in symptomatic ears; however, the existence of EH was not related to SIR values. Nevertheless, SIR values in the basal turn were significantly higher 4 and 24 h after injection of gadolinium in patients aged ≥50 years. CONCLUSION AND SIGNIFICANCE: Higher SIR values observed in older patients with EH indicate severe disturbances of the BPB in the cochlea, which may account for intractable inner ear disturbances in older patients.

DOI： 10.1080/00016489.2021.1957500

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

Language：English   Publisher：EMBO Journal  

During development, neural progenitors are in proliferative and immature states; however, the molecular machinery that cooperatively controls both states remains elusive. Here, we report that cyclin D1 (CCND1) directly regulates both proliferative and immature states of cerebellar granule cell progenitors (GCPs). CCND1 not only accelerates cell cycle but also upregulates ATOH1 protein, an essential transcription factor that maintains GCPs in an immature state. In cooperation with CDK4, CCND1 directly phosphorylates S309 of ATOH1, which inhibits additional phosphorylation at S328 and consequently prevents S328 phosphorylation-dependent ATOH1 degradation. Additionally, PROX1 downregulates Ccnd1 expression by histone deacetylation of Ccnd1 promoter in GCPs, leading to cell cycle exit and differentiation. Moreover, WNT signaling upregulates PROX1 expression in GCPs. These findings suggest that WNT-PROX1-CCND1-ATOH1 signaling cascade cooperatively controls proliferative and immature states of GCPs. We revealed that the expression and phosphorylation levels of these molecules dynamically change during cerebellar development, which are suggested to determine appropriate differentiation rates from GCPs to GCs at distinct developmental stages. This study contributes to understanding the regulatory mechanism of GCPs as well as neural progenitors.

DOI： 10.15252/embj.2020105712

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

Oncolytic viruses (OVs) remodel the tumor microenvironment by switching a 'cold' tumor into a 'hot' tumor with high CD8+ T cell infiltration. CD8+ T cell activity plays an essential role in the antitumor efficacy of OVs. However, the activity of T cells is impaired by the PD-1/PD-L1 interaction. To date, it remains unclear why OVs alone have a significant antitumor activity even when PD-L1 expression persists on tumor or immune cells. In this study, we found that C-REV treatment significantly suppressed tumor growth, even though it induced a significant increase in PD-L1 expression in tumors in vivo as well as persistence of high PD-L1 expression on antigen-presenting cells (macrophage and dendritic cells [DCs]). Surprisingly, we observed that C-REV treatment increased the abundance of activated CD8+ PD-1- tumor-infiltrating lymphocytes (TILs) in the tumor on both the injected and contralateral sides, although infiltration of CD8+ PD-1high TILs into the tumor was observed in the control group. Moreover, the difference in PD-1 expression was observed only in tumors after treatment with C-REV, whereas most CD8+ T cells in the spleen, tumor-draining lymph nodes, and blood were PD-1-negative, and this did not change after C-REV treatment. In addition, changes in expression of TIM-3 and TIGIT were not observed on CD8+ TILs after C-REV treatment. Taken together, our findings may reveal mechanisms that allow oncolytic viruses to trigger an antitumor immune response, irrespective of a PD-L1-enriched tumor microenvironment, by recruitment of CD8+ PD-1- TILs.

DOI： 10.1002/ijc.33550

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

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.

DOI： 10.1097/MAO.0000000000003073

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

OBJECTIVE: To review the authors' surgical experience with radical temporal bone resection (TBR) with an emphasis on the classification of skull base osteotomy and transcranial tympanotomy (TCT) that is required for middle ear transection. METHODS: We reviewed the records of 25 patients who underwent radical TBR at our facilities between 2011 and 2020. RESULTS: The osteotomy line of radical TBR was divided into 3 segments: anterior (A), medial (M), and posterior (P). Each segment was further classified as follows: A1, through the glenoid fossa (1 patient); A2, in front of the glenoid fossa (23 patients); A3, through the greater wing of the sphenoid bone (1 patient); M1, through the middle ear (16 patients); M2, through the inner ear (9 patients); P1, through the mastoid (9 patients); and P2, through the posterior cranial fossa (16 patients). The M segment was significantly associated with operation time and intraoperative blood loss. In all patients with M1 osteotomy, TCT was performed; TCT was classified into superior and far posterior approaches. A superior approach was performed in all 16 patients, whereas the far posterior approach was performed in only 7 patients with both M1 and P2 osteotomy. CONCLUSIONS: Our newly proposed osteotomy classification of radical TBR is suitable for minute but clinically important adjustment of the osteotomy line. TCT is an indispensable technique for M1 osteotomy; our newly proposed classification expands our understanding of TCT and how to incorporate this technique into radical TBR.

DOI： 10.1016/j.wneu.2021.04.002

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Language：English   Publisher：Life Science Alliance  

The early-stage pathologies of frontotemporal lobal degeneration (FTLD) remain largely unknown. In VCPT262A-KI mice carrying VCP gene mutation linked to FTLD, insufficient DNA damage repair in neural stem/progenitor cells (NSCs) activated DNA-PK and CDK1 that disabled MCM3 essential for the G1/S cell cycle transition. Abnormal neural exit produced neurons carrying over unrepaired DNA damage and induced early-stage transcriptional repression-induced atypical cell death (TRIAD) necrosis accompanied by the specificmarkers pSer46-MARCKS and YAP. In utero gene therapy expressing normal VCP or nonphosphorylated mutant MCM3 rescued DNA damage, neuronal necrosis, cognitive function, and TDP43 aggregation in adult neurons of VCP^T262A-KI mice, whereas similar therapy in adulthood was less effective. The similar early-stage neuronal necrosis was detected in PGRN^R504X-KI, CHMP2B^Q165X-KI, and TDP^N267S-KI mice, and blocked by embryonic treatment with AAV non-phospho-MCM3. Moreover, YAPdependent necrosis occurred in neurons of human FTLD patients, and consistently pSer46-MARCKS was increased in cerebrospinal fluid (CSF) and serum of these patients. Collectively, developmental stress followed by early-stage neuronal necrosis is a potential target for therapeutics and one of the earliest general biomarkers for FTLD.

DOI： 10.26508/lsa.202101022

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

OBJECTIVE: Understanding the relationships among aging, cognitive function, and olfaction may be useful for diagnosing olfactory decline in older adults. Olfactory function declines in the early stage of neurodegenerative diseases, including Alzheimer's and Parkinson's diseases. Aging and cognitive impairment are associated with olfactory decline. Moreover, the assessment of hyposmia and anosmia is paramount to the diagnosis of neurodegenerative diseases. We aimed to assess the relationships among aging, cognitive function, and olfaction in patients with olfactory impairment. METHODS: This observational study included 141 patients with olfactory deterioration who presented with dementia, mild cognitive impairment (MCI), age-related hyposmia, or postviral olfactory dysfunction (PVOD). The patients underwent T&T olfactometry, a self-administered odor questionnaire (SAOQ), a visual analog scale (VAS), and a Mini-Mental State Examination. RESULTS: T&T odor recognition thresholds decreased with aging (p < 0.01) and cognitive impairment (p < 0.08). The average T&T recognition thresholds were 5.1,4.6,4.2, and 3.7 in dementia, MCI, age-related hyposmia, and PVOD, respectively. Moreover, the average differences between the detection and recognition thresholds were 3.7, 2.8, 2.3, and 2.0 in dementia, MCI, age-related hyposmia, and PVOD, respectively. Hyposmia with dementia presented the highest recognition thresholds (p < 0.05) and the largest differences between the T&T detection and recognition thresholds, compared with age-related hyposmia and PVOD (p < 0.05). Hyposmia with dementia had the highest SAOQ and VAS scores compared with the other groups (p < 0.05). CONCLUSION: The possibility of dementia should be investigated in patients with hyposmia, including those with high T&T recognition thresholds, a large difference between the T&T detection and recognition thresholds, and high SAOQ and VAS scores.

DOI： 10.1016/j.anl.2020.11.020

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The objective of our study was to clarify the clinical features of EGFR-mutated sinonasal squamous cell carcinoma (SNSCC) and human papilloma virus (HPV)-related SNSCC. Patients with SNSCC treated from April 2008 to June 2019 at our institution were retrospectively reviewed. We examined EGFR mutation and HPV status for all patients. Main outcomes were overall survival, recurrence, and outcome of each treatment modality. A total of 85 patients with SNSCC were enrolled in this study. EGFR mutations and HPV DNA were detected in 24 (28%) and 7 (8%) patients, respectively. Patients with EGFR-mutated SNSCC showed a worse overall survival (OS) than those with EGFR wild-type in the multivariate analysis (p = 0.037). No death was observed in HPV-positive SNSCC. The cumulative incidence of local recurrence was significantly higher in EGFR mutant than EGFR wild-type tumors (p = 0.03). In patients with EGFR mutations, treatment with induction chemotherapy significantly improved OS (p = 0.01). EGFR-mutated SNSCC have a high-risk feature for recurrence and requires intensive attention for treatment and observation. A new treatment approach, such as EGFR tyrosine kinase inhibitors, may be needed.

DOI： 10.1016/j.jcms.2021.02.016

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

OBJECTIVE: Tracheostomy is an important surgical procedure for coronavirus disease-2019 (COVID-19) patients who underwent prolonged tracheal intubation. Surgical indication of tracheostomy is greatly affected by the general condition of the patient, comorbidity, prognosis, hospital resources, and staff experience. Thus, the optimal timing of tracheostomy remains controversial. METHODS: We reviewed our early experience with COVID-19 patients who underwent tracheostomy at one tertiary hospital in Japan from February to September 2020 and analyzed the timing of tracheostomy, operative results, and occupational infection in healthcare workers (HCWs). RESULTS: Of 16 patients received tracheal intubation with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, five patients (31%) received surgical tracheostomy in our hospital. The average consultation time for surgical tracheostomy was 7.4 days (range, 6 - 9 days) from the COVID-19 team to the otolaryngologist. The duration from tracheal intubation to tracheostomy ranged from 14 to 27 days (average, 20 days). The average time of tracheostomy was 27 min (range, 17 - 39 min), and post-wound bleeding occurred in only one patient. No significant differences in hemoglobin (Hb) levels were found between the pre- and postoperative periods (mean: 10.2 vs. 10.2 g/dl, p = 0.93). Similarly, no difference was found in white blood cell (WBC) count (mean: 12,200 vs. 9,900 cells /µl, p = 0.25). After the tracheostomy, there was no occupational infection among the HCWs who assisted the tracheostomy patients during the perioperative period. CONCLUSION: We proposed a modified weaning protocol and surgical indications of tracheostomy for COVID-19 patients and recommend that an optimal timing for tracheostomy in COVID-19 patients of 2 - 3 weeks after tracheal intubation, from our early experiences in Japan. An experienced multi-disciplinary tracheostomy team is essential to perform a safe tracheostomy in patients with COVID-19 and to minimize the risk of occupational infection in HCWs.

DOI： 10.1016/j.anl.2020.11.004

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

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

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

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

DOI： 10.1016/j.anl.2020.03.003

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

OBJECTIVE: The aim of this study is to establish a unilateral tongue atrophy model by cutting the hypoglossal nerve and to evaluate the safety and feasibility of a fat injection of adipose-derived stem cells (ADSCs) to restore swallowing function. METHODS: A total of 12 rabbits were randomized to three groups; the ADSCs+fat group (n=4), the fat group (n=4) and the control group (n=4). All rabbits were treated with denervation of the left hypoglossal nerve and their conditions including body weight and food intake were checked during follow-up periods (8 weeks). At 4 weeks after the transection of the nerve, rabbits received the injection therapy into the denervated side of the tongue with 1.0mL fat tissue premixed with 0.5mL ADSCs in the ADSCs+fat group, 1.0mL fat tissue premixed with 0.5mL PBS in the fat group and 1.5mL PBS in the control group. Rabbits were euthanized 8 weeks post-treatment and resected tongues were collected, formalin-fixed and paraffin embedded. To evaluate the change of the intrinsic muscles of the tongue, muscle fibers around the treatment area was analyzed by evaluating 5 consecutive hematoxylin-eosin slides per rabbit. RESULTS: Food intake did not decrease upon nerve denervation, and none of the rabbits displayed adverse effect such as aspiration, surgical wound dehiscence or infection. No significant body weight changes were found between the three groups at 4 and 8 weeks after nerve transection (p>0.05). In the control group, the denervated side of tongue had significantly smaller muscle fiber areas and diameters compared to the non-denervated side (p<0.05). The ADSCs+fat group demonstrated a larger area of inferior longitudinal muscle fibers compared to the control and the fat groups (582±312µm2 vs. 405±220µm2 and 413±226µm2; p<0.05). A significant thicker lesser diameter of inferior longitudinal muscle fibers was found in the ADSCs+fat group compared to the control and the fat groups (24±8µm vs. 20±6µm and 20±7µm; p<0.05). CONCLUSION: The rabbit tongue atrophy model was found suitable for the assessment of muscle change after nerve transection. Fat injection therapy with ADSCs demonstrated great potential to prevent the muscle atrophy after denervation and to promote the muscle regeneration around the injection area.

DOI： 10.1016/j.anl.2020.08.003

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

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

DOI： 10.1016/j.ijom.2020.07.025

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Language：Japanese   Publisher：The Japan Broncho-esophagological Society  

<p>Percutaneous dilational tracheostomy (PDT) is commonly performed in intensive care units due to its shorter operation time and simpler surgical procedure than surgical tracheostomy (ST). We retrospectively assessed the surgical complications in patients who received a tracheostomy in our tertiary hospital between April 2016 and March 2018. In a total of 182 patients, PDT was performed in 25 cases and ST in 157 cases, in which the most common reason for tracheostomy was difficulty of extubation. The postoperative complications were wound infection in 12 cases, tube obstruction in 8 cases, prolonged bleeding in the wound bed in 6 cases, difficulty of incubation tube replacement in 4 cases, and granuloma in the airway in 5 cases. As for complications of PDT, we experienced 2 cases with severe surgical complications after PDT. One case suffered prolonged postoperative bleeding from the wound bed due to the granuloma around the trachea. The other case had severe damage at the anterior wall of the cricoid cartilage after cannula insertion. PDT in our hospital tends to be performed by the main department. In the 2 cases with severe complications after PDT we experienced, the first puncture site might not be appropriate. Therefore, ST is thought to be much safer in cases where cricoid cartilage and thyroid cartilage are difficult to identify from the body surface. Moreover, in order to perform the tracheostomy in safety, we recommend use of bronchoscopes or ultrasound during the procedure.</p>

DOI： 10.2468/jbes.72.10

CiNii Research

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

Meniere's disease (MD) characteristically presents with endolymphatic hydrops (EH), which can be visualized with gadolinium-enhanced inner ear magnetic resonance imaging (MRI). Inner ear membrane rupture has been suspected to cause MD attacks, but this remains controversial. We report a case of MD coincidentally evaluated the EH using 3-Tesla MRI during a vertigo attack. A 78-year-old man with bilateral definite MD visited the hospital outpatient department due to a vertigo attack. To evaluate of endolymphatic hydrops on the attack, inner ear MRI was obtained 4 hours after intravenous injection of gadolinium agent. Vestibular EH in each ear occupied almost all vestibular endolymphatic space in contact with the oval window and herniated into the horizontal semi-circular canal. The endolymphatic space was enlarged, without collapse or mixture of contrast agent. No difference was found between ears. EH on a vertigo attack was associated with significant swelling, without obvious evidence of membranous ruptures on magnetic resonance images.

DOI： 10.18999/nagjms.83.1.209

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

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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Publisher：(株)東京医学社  

DOI： 10.24479/j01814.2021102766

CiNii Research

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

Although nivolumab, a programmed cell death 1 (PD-1) inhibitor, is a standard therapy for platinum-refractory recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC), no definitive biomarkers have been reported thus far. This study aimed to select promising prognostic markers in nivolumab therapy and to create a novel prognostic scoring system. In this retrospective cohort study, we reviewed patients with R/M HNSCC who were treated with nivolumab from April 2017 to April 2019. We developed a prognostic score for immune checkpoint inhibitor (ICI) therapy that was weighed using hazard ratio-based scoring algorithms. Significant variables were selected from the multivariate Cox proportional hazard analyses on overall survival (OS). A total of 85 patients with HNSCC were analyzed in the present study. The relative eosinophil count (REC), the ratio of eosinophil increase (REI), and Eastern Cooperative Oncology Group Performance Status (ECOG PS) were selected as variables affecting the prognostic score. The patients were divided into four groups: very good (score = 0), good (score = 1), intermediate (score = 2), and poor (score = 3). The OS hazard ratios were 2.77, 10.18, and 33.21 for the good, intermediate, and poor risk groups compared with the very good risk group, respectively. The Eosinophil Prognostic Score is a novel prognostic score that is effective for predicting the prognosis of HNSCC patients treated with nivolumab. This score is more precise as it includes changes in biomarkers before and after the treatment.

DOI： 10.1111/cas.14706

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: To evaluate the feasibility for the detection of slight contrast effects after intravenous administration of single dose gadolinium-based contrast agent (IV-SD-GBCA), the time course of the GBCA distribution up to 24 h was examined in various fluid spaces and brain parenchyma using 3D-real IR imaging and MR fingerprinting (MRF).</p><p>Methods: Twenty-four patients with a suspicion of endolymphatic hydrops were scanned at pre-administration and at 10 min, 4 and 24 h post-IV-SD-GBCA. 3D-real IR images and MRF at the level of the internal auditory canal were obtained. The signal intensity on the 3D-real IR image of the cerebrospinal fluid (CSF) in the cerebellopontine angle cistern (CPA), Sylvian fissure (Syl), lateral ventricle (LV), and cochlear perilymph (CPL) was measured. The T₁ and T₂ values of cerebellar gray (GM) and white matter (WM) were measured using MRF. Each averaged value at the various time points was compared using an analysis of variance.</p><p>Results: The signal intensity on the 3D-real IR image in each CSF region peaked at 4 h, and was decreased significantly by 24 h (<i>P</i>< 0.05). All patients had a maximum signal intensity at 4 h in the CPA, and Syl. The mean CPL signal intensity peaked at 4 h and decreased significantly by 24 h (<i>P</i> < 0.05). All patients but two had a maximum signal intensity at 4 h. Regarding the T₁ value in the cerebellar WM and GM, the T₁ value at 10 min post-IV-GBCA was significantly decreased compared to the pre-contrast scan, but no significant difference was observed at the other time points. There was no significant change in T₂ in the gray or white matter at any of the time points.</p><p>Conclusion: Time course of GBCA after IV-SD-GBCA could be evaluated by 3D-real IR imaging in CSF spaces and in the brain by MRF.</p>

DOI： 10.2463/mrms.mp.2020-0030

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: To investigate the association between signal changes over time in perivenous cystic structures near the superior sagittal sinus and leakage of a gadolinium-based contrast agent (GBCA) into the subarachnoid space in patients with suspected endolymphatic hydrops.</p><p>Methods: Fifty-one cystic structures in 27 cases were evaluated. The signal intensity of the cystic structures was measured on 3D real inversion recovery (3D-real IR) images obtained at pre-, and at 10 min, 4 hrs and 24 hrs post-intravenous administration (IV) of GBCA. Signal enhancement of the cystic structures from the pre-contrast images at each time point was compared in subjects with leakage (positive) versus those without leakage (negative) using an ANOVA. Fisher’s exact probability test was used to compare the maximum contrast-enhanced time point between positive and negative groups. We used 5% as a threshold to determine statistical significance.</p><p>Results: In leakage positive subjects, mean signal enhancement of the cysts was significantly greater at 4 and 24 hrs compared to 10 min. However, although there was a trend of an increase from 4 to 24 hrs, the difference was not significant. In the leakage negative group, mean signal enhancement of the cysts was significantly higher at 4 hrs compared to 10 min and 24 hrs. There was no significant difference between 10 min and 24 hrs. In the positive group, the maximum signal increase was found in 10/38 and 28/38 cysts at 4 and 24 hrs after IV-GBCA, respectively. In the leakage negative group, the maximum signal increase was found in 10/13 and 3/13 cysts at 4 and 24 hrs, respectively (<i>P</i> = 0.0019).</p><p>Conclusion: There was an association between signal changes over time after IV-GBCA in perivenous cystic structures and leakage of GBCA. Further research to clarify the impact of cystic structures on the function of the waste clearance system of the brain is warranted.</p>

DOI： 10.2463/mrms.mp.2020-0138

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: The purpose of this retrospective study was to investigate the relationship between the number and size of cystic structures around the cortical veins near the superior sagittal sinus and the leakage of gadolinium-based contrast agent (GBCA) around the cortical veins.</p><p>Methods: Of 190 patients (91 male and 99 female), that were scanned at 4 h after an intravenous injection of GBCA as a diagnostic examination for endolymphatic hydrops, 6 patients with GBCA leakage were younger than the previously proposed threshold age of 37.3 years for leakage. Six age-matched patients without leakage were also included for reference. In addition, we included 8 cases without leakage that were older than the hypothesized threshold of 37.3 years, as well as 8 age-matched patients with GBCA leakage into the cerebrospinal fluid space. The number of cysts was counted and the sizes were measured in these 28 patients (age: 32–60 years old, 13 men and 15 women).</p><p>Results: The mean number of cysts surrounding the cortical veins in the parasagittal region was 4.29 ± 1.77 vs. 1.79 ± 1.05 (<i>P</i> = 0.0001) in the subjects with and without GBCA leakage, respectively. The mean size of the largest cysts was at 8.89 ± 3.49 mm vs. 5.69 ± 2.29 (<i>P</i> = 0.009) in the subjects with and without GBCA leakage, respectively.</p><p>Conclusion: The number and size of the perivenous cystic structures near the superior sagittal sinus is greater in subjects with GBCA leakage into the subarachnoid space compared with those without leakage. Future research regarding the histological and functional details of these parasagittal cystic structures is needed.</p>

DOI： 10.2463/mrms.mp.2020-0062

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: MRI of endolymphatic hydrops (EH) 4 h after intravenous administration of a single dose of gadolinium-based contrast agent is used for clinical examination in some institutions; however, further improvement in image quality would be valuable for wider clinical utility. Denoising using deep learning reconstruction (Advanced Intelligent Clear-IQ Engine [AiCE]) has been reported for CT and MR. The purpose of this study was to compare the contrast-to-noise ratio of endolymph to perilymph (CNR_EP) between the improved hybrid of reversed image of the positive endolymph signal and the native image of the perilymph signal multiplied with the heavily T₂-weighted MR cisternography (iHYDROPS-Mi2) images, which used AiCE for the three source images (i.e. positive endolymph image [PEI], positive perilymph image [PPI], MR cisternography [MRC]) to those that did not use AiCE. We also examined if there was a difference between iHYDROPS-Mi2 images with and without AiCE for degree of visual grading of EH and in endolymphatic area [EL] ratios.</p><p>Methods: Nine patients with suspicion of EH were imaged on a 3T MR scanner. iHYDROPS images were generated by subtraction of PEI images from PPI images. iHYDROPS-Mi2 images were then generated by multiplying MRC with iHYDROPS images. The CNR_EP and EL ratio were measured on the iHYDROPS-Mi2 images. Degree of radiologist visual grading for EH was evaluated.</p><p>Results: Mean CNR_EP ± standard deviation was 1681.8 ± 845.2 without AiCE and 7738.6 ± 5149.2 with AiCE (<i>P</i> = 0.00002). There was no significant difference in EL ratio for images with and without AiCE. Radiologist grading for EH agreed completely between the 2 image types in both the cochlea and vestibule.</p><p>Conclusion: The CNR_EP of iHYDROPS-Mi2 images with AiCE had more than a fourfold increase compared with that without AiCE. Use of AiCE did not adversely affect radiologist grading of EH.</p>

DOI： 10.2463/mrms.mp.2020-0082

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CiNii Research

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Society for Head and Neck Cancer  

There are few reports on the transition and prognosis of postoperative facial nerve paralysis in patients undergoing parotid gland cancer surgery that preserves the facial nerve. The treatment policy for parotid gland cancer in our department is, in principle, combined resection of the facial nerve and one-stage reconstruction of the nerve if there is facial nerve paralysis before surgery, and preservation of the nerve if there is no paralysis regardless of histological type. We examined 31 cases of parotid gland cancer surgery that preserved the facial nerve over the past 15 years. The median observation period was 60 months. Total resection was performed in 24 cases, and lobectomy was performed in 7 cases. The average score of postoperative facial nerve paralysis was 24 points, and the median score was 27 points. The transition of postoperative facial nerve paralysis, although there were cases of transient complete paralysis, eventually recovered to an average of 39.5 points. The recovery period was 6 months after surgery in many cases. The treatment results were good, with 5-year overall survival rate, 5-year disease-free survival rate, and local control rate of 96.0％, 89.5％, and 93.5％, respectively. In cases of parotid gland cancer without facial nerve paralysis, treatment results are considered to be guaranteed even if the nerve is preserved regardless of the pathological type.

DOI： 10.5981/jjhnc.47.316

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CiNii Research

Publisher：Acta Oto Laryngologica  

Background: Usher syndrome (USH) typically leads to deaf-blindness, requiring the provision of extensive education and rehabilitation services. Therefore, investigating the prevalence is crucial to requests for proper government support for USH patients. Objective: The aim was to perform a nationwide epidemiologic survey of USH in Japan to estimate the prevalence of USH and reveal the relative frequency and characteristics of the three USH subtypes. Methods: To estimate the number of USH patients visiting hospitals over a 1-year period, 1,628 hospitals were randomly selected from all Departments of Otorhinolaryngology and Ophthalmology in Japan. Subsequently, we collected data regarding the clinical characteristics of each patient treated and the results of genetic testing, if performed. Results: We found that the prevalence of USH was at least 0.4 per 100,000 population. The frequency of clinical subtypes and causal genes for USH were consistent with previous reports. Also, we demonstrated the feasibility of genetic counseling for USH patients based on the results of genetic testing. Conclusion: USH is a rare disease, but requires social support due to the severity of symptoms. To minimize these issues, understanding the clinical characteristics and performing comprehensive genetic testing could allow early and accurate diagnosis as well as medical intervention.

DOI： 10.1080/00016489.2021.1966500

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Society of Practical Otolaryngology  

<p>Subglottic cyst is a rare disorder and predominantly occur in premature infants with a history of endotracheal intubation. Formation of these cysts could be induced by blockage of the subglottic ducts resulting from erosion and subsequent scarring of the subglottis following endotracheal intubation.</p><p>A male infant, weighing 3240 grams, was admitted to our hospital with respiratory distress at the age of 4 months. He had been born at 23 weeks and 1 day of gestation. He had needed tracheal intubation on the day of birth, and received mechanical ventilation for 39 days. Subsequently, he developed breathing difficulties that worsened gradually until respiratory distress and biphasic stridor became apparent on day 143. Both flexible fiberoptic laryngoscopy and computed tomography revealed cyst-like masses just below the vocal cords, causing airway narrowing. Emergent subtotal cystectomy was planned on the admission day. Under general anesthesia, an endotracheal tube was introduced into the space posterior to the cystic lesions. A Miller laryngoscope and flexible laryngoscope for adults offered an optimal surgical view, the cyst-like masses were resected with wire-guided forceps. Extubation was performed with no trouble, 9 days after the surgery. Histopathological examination revealed that the cyst walls were lined with respiratory epithelial cells. A second surgery was performed 5 months after the first surgery because recurrence of the cysts. No recurrence has been observed for 5 months after the second operation.</p><p>Subglottic cysts should be considered in the differential diagnosis in premature infants with a history of endotracheal intubation presenting with symptoms of upper airway obstruction. When the patient is too small to allow insertion of a rigid laryngoscope, a Miller laryngoscope, flexible laryngoscope, and wire-guided forceps are useful alternatives for diagnosis and treatment.</p>

DOI： 10.5631/jibirin.114.297

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本耳鼻咽喉科頭頸部外科学会  

DOI： 10.3950/jibiinkoka.123.1270

CiNii Research

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

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

Objective  This study was aimed to evaluate health-related quality of life in patients undergoing anterolateral craniofacial resection (AL-CFR) with orbital exenteration (OE) for malignant skull base tumors and to investigate the effects of early psychiatric intervention. Design  Present study is a prospective, observational study. Setting  The study took place at the hospital department. Participants  Twenty-six consecutive patients were selected who underwent AL-CFR with OE at our hospital between 2005 and 2015. Main Outcome Measures  Health-related quality of life was assessed preoperatively and 3, 6, 12, and 24 months after surgery using the Hospital Anxiety and Depression Scale (HADS) and medical outcomes study 8-items Short Form health survey (SF-8). In all cases, psychiatric intervention was organized by the consultation liaison psychiatry team preoperatively and postoperatively. Results  Ten (38.0%) of the 26 patients died and 16 (62.0%) were alive and disease-free at the end of the study. The 3-year overall and disease-free survival rates were 64.9% and 53.3%, respectively. Twenty-one patients (80.8%) developed psychiatric complications after surgery and needed treatment with psychotropic medication. Before surgery, 28% of patients had HADS scores ≥8 for anxiety and 20% had scores ≥8 for depression. Seven of the eight items in the SF-8 were significantly lower than those for the general Japanese population. However, scores for all the SF-8 items gradually improved during postoperative follow-up, reaching approximately 50 points, which is the national standard value, at 2 years after surgery. Conclusions  Craniofacial resection with OE was feasible and well tolerated in patients with malignant skull base tumors who received early psychiatric intervention to decrease the considerable psychological impact of this procedure.

DOI： 10.1055/s-0039-1694010

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Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.484

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.430

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.342

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.367

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.286

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.306

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CiNii Research

Publisher：(株)東京医学社  

DOI： 10.24479/j01814.2021010070

CiNii Research

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会  

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society of Otorhinolaryngology-Head and neck surgery  

<p>　Hearing changes have been reported in patients with hydrocephalus. Most authors have hypothesized that hearing changes in patients with hydrocephalus are due to relative endolymphatic hydrops. We examined the hearing changes in 53 elderly patients who underwent shunt surgery for normal pressure hydrocephalus between January 2012 and March 2018. More than half of the patients already had moderate to severe hearing loss before the surgery. Significant hearing loss after the surgery was observed at 500 Hz in the right ear, and at 125 Hz and 250 Hz in the left ear. Twelve patients (22.6%) showed hearing change by 10 dB or more were at average hearing thresholds of 250, 500, 1,000, 2,000 and 4,000 Hz. Of all the patients, 8 (15.1%) showed hearing loss, and 4 (7.5%) showed hearing improvement after the surgery. The age, sex, shunt technique, side of shunt, shunt system, valve pressure, cognitive functions, physical functions, and body mass index were compared among the groups showing no change, hearing loss, and hearing improvement, and no significant differences were found. The hearing thresholds prior to the surgery were not different between the hearing loss group and the group that showed no hearing change; however the hearing thresholds for low frequencies worsened significantly in the left ear in hearing loss group. The hearing thresholds in the low, middle, and high frequencies were worse prior to the surgery in the hearing improvement group as compared to the group that showed no hearing change, but there were no significant differences between the two groups after the surgery. We agree with previous reports that hearing loss after surgery is due to relative endolymphatic hydrops. We also hypothesize that hearing improvement is due to release from the relative increase of the perilymphatic pressure. One half of the patients with hearing loss showed no improvement, and 3 patients needed to start using hearing aids after the surgery. We think that it is necessary to pay attention to hearing problems as one of the risks of shunt surgery.</p>

DOI： 10.3950/jibiinkoka.123.737

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：W.B. Saunders Ltd  

DOI： 10.1016/j.rmed.2020.106024

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

DOI： 10.1080/00016489.2020.1754460

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Language：English   Publisher：Iscience  

Neuroscience; Behavioral Neuroscience; Molecular Neuroscience; Transcriptomics

DOI： 10.1016/j.isci.2020.101183

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

PURPOSE: Although performed inside a laboratory, attended polysomnography (PSG) has long been the gold standard for the diagnosis of sleep apnea. However, high costs and long wait times have led to the development of home-based portable monitoring devices. A bed sheet-shaped device called SD102 (Suzuken Co., Nagoya, Japan) has been developed, and its accuracy in evaluating sleep apnea is becoming evident. The purpose of this study was to confirm the accuracy of SD102 in evaluating sleep apnea and to investigate patient characteristics that may contribute to inaccurate test results in patients with suspected obstructive sleep apnea (OSA). METHODS: One hundred and eighty-nine patients simultaneously underwent PSG and portable monitoring by using a home sleep apnea testing (HSAT) device. A blinded, experienced technologist using the American Academy of Sleep Medicine criteria versions 2.1 and 2.3 scored the PSG data and HSAT device data, respectively. RESULTS: The respiratory event index (REI) by HSAT significantly correlated with the apnea-hypopnea index (AHI) by PSG (r = 0.974, p < 0.001). HSAT sensitivity, specificity, and positive and negative predictive values of 0.99, 0.83, 0.95, and 0.97, respectively. Body mass index and arousal index were significantly associated with the difference between REI from SD102 HSAT and AHI from PSG. CONCLUSIONS: This study demonstrates the good agreement between REI and AHI in patients with suspected OSA and suggests that understanding the limitations of different testing methods may help in the accurate detection of OSA.

DOI： 10.1007/s11325-019-01963-8

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

OBJECTIVE: The ongoing pandemic coronavirus disease-2019 (COVID-19) infection causes severe respiratory dysfunction and has become an emergent issue for worldwide healthcare. Since COVID-19 spreads through contact and droplet infection routes, careful attention to infection control and surgical management is important to prevent cross-contamination of patients and medical staff. Tracheostomy is an effective method to treat severe respiratory dysfunction with prolonged respiratory management and should be performed as a high-risk procedure METHOD: The anesthetic and surgical considerations in this case involved difficult goals of the patient safety and the management of infection among health care workers. Our surgical procedure was developed based on the previous experiences of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). RESULTS: We described the management procedures for tracheostomy in a patient with COVID-19, including the anesthesia preparation, surgical procedures, required medical supplies (a N95 mask or powered air purifying respirator, goggles, face shield, cap, double gloves, and a water-resistant disposable gown), and appropriate consultation with an infection prevention team. CONCLUSION: Appropriate contact, airborne precautions, and sufficient use of muscle relaxants are essential for performing tracheostomy in a patient with COVID-19.

DOI： 10.1016/j.anl.2020.04.002

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

DOI： 10.1007/s00535-020-01677-9

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Publisher：株式会社医学書院  

DOI： 10.11477/mf.1411202359

CiNii Research

Language：Japanese   Publisher：Japan Audiological Society  

<p>　　Medical treatment for tinnitus in contemporary Japan has evolved based on TRT (Tinnitus Retraining Therapy). We think there are two main challenges to TRT:</p><p>　　1) In many cases, acoustic therapy for silence avoidance at night cannot reduce the distress unless concrete proposals.</p><p>　　2) While hearing aids are highly effective for tinnitus patients with hearing impairment, they are not easy to use.</p><p>　　Our treatment for tinnitus is focused on gradual counseling for proper implementation of acoustic therapy (mainly night silence avoidance and hearing aids), as well as concrete methods for acoustic therapy.</p><p>　　We considered the effects of our treatment for tinnitus, and the problems associated with the treatment. We examined the effects of our therapy using the THI (Tinnitus Handicap Inventory) score in 66 patients with tinnitus.</p><p>　　The mean score on the THI decreased significantly from the first ENT consultation to the first visit to the tinnitus outpatient department, from the first visit to the tinnitus outpatient department to one month later, and from one month to three months after the first visit. The proportion of patients with “severe handicap” (58-100 scores) decreased from 48.5% at the first consultation to 4.5% after 6 months of treatment.</p><p>　　The THI scores improved in 50 (75.8%) of the 66 patients studied, especially in 26 (81.3%) of the 32 patients with severe handicap. We think that mainly the acoustic therapy for silence avoidance at night and the hearing aids were effective.</p><p>　　 I feel that cooperation between doctor and speech therapist is the key to successful treatment of tinnitus.</p>

DOI： 10.4295/audiology.63.149

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CiNii Research

Language：Japanese   Publisher：The Japan Broncho-esophagological Society  

DOI： 10.2468/jbes.71.82

CiNii Research

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

BACKGROUND: Anti-programmed cell death-1 (PD-1) antibodies can cause thyroid dysfunction. However, no predictive biomarkers enabling stratification of thyroid dysfunction risk have been identified. METHODS: A total of 209 patients treated with an anti-PD-1 antibody were evaluated for anti-thyroid antibodies at baseline and prospectively for thyroid function every 6 weeks for 24 weeks after treatment initiation, and then observed until the visits stopped. Thyroid ultrasonography was performed if the patient was positive for anti-thyroid antibodies at baseline. RESULTS: Of the 209 patients, 19 (9.1%) developed thyroid dysfunction (destructive thyroiditis or hypothyroidism). The cumulative incidence of thyroid dysfunction was significantly higher in patients who were positive vs. negative for anti-thyroid antibodies (15/44 [34.1%] vs. 4/165 [2.4%], p < 0.001). Forty-two patients positive for anti-thyroid antibodies at baseline were divided into two groups according to the presence of an irregular echo pattern. The cumulative incidence of thyroid dysfunction was significantly higher in those with an irregular vs. a regular echo pattern (13/23 [56.5%] vs. 1/19 [5.3%], p = 0.001). None of the patients developed thyroid dysfunction after the initial 24-week period. CONCLUSIONS: The risk of thyroid dysfunction induced by anti-PD-1 antibodies can be predicted by evaluation of anti-thyroid antibodies and the thyroid echo pattern at baseline. TRIAL REGISTRATION: UMIN000019024.

DOI： 10.1038/s41416-020-0736-7

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Publisher：(株)東京医学社  

DOI： 10.24479/j01814.2020118845

CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>Purpose: It has been reported previously that intravenously administered gadolinium-based contrast agent (GBCA) leaks into the subarachnoid space around the cortical veins at 4 h after injection in all old people over 37 years, but not in younger people up to 37 years of age in 3D-real IR images. The purpose of this study was to investigate whether there was a strict threshold of 37 years of age for the leakage of the GBCA into the subarachnoid space.</p><p>Methods: The subjects included 190 patients, that were scanned for 3D-real IR images at 4 hours after intravenous injection of GBCA as a diagnostic test for endolymphatic hydrops. The patient’s age ranged from 14 to 81 years. Two experienced neuroradiologists evaluated the images to determine whether the GBCA leakage around the cortical veins was positive or negative. Any discrepancies between the two observers were discussed and a consensus was obtained.</p><p>A Mann–Whitney <i>U</i> test and receiver operating characteristic (ROC) curve analysis were used to compare the positive and the negative group and to set the age cut-off value for the prediction of GBCA leakage.</p><p>Results: The GBCA leakage around the cortical veins was negative in 35 patients and positive in 155 patients. The average age was 33 ± 11 years in the negative group, and 55 ± 12 years in the positive group (<i>P</i> < 0.01). In the ROC analysis for the age and leakage of the GBCA, an area under the curve was 0.905 and the cut-off age was 37.317 years (sensitivity of 0.942 and specificity of 0.771).</p><p>Conclusion: Intravenously administered GBCA leaks into the subarachnoid space around the cortical veins in most patients over 37 years of age. However, it should be noted that it can be found occasionally in patients under 37 years of age.</p>

DOI： 10.2463/mrms.mp.2019-0182

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

<p>We currently obtain pre- and post-contrast enhanced whole brain 3D-real inversion recovery images for the evaluation of endolymphatic hydrops. We noticed that the space between the pial sheath surrounding the cortical veins and the cortical venous wall is enhanced and this enhancement seems to connect to the meningeal lymphatics along superior sagittal sinus. This new anatomical concept regarding the outflow from the glymphatic system might be important for the future research in neuroscience.</p>

DOI： 10.2463/mrms.bc.2019-0099

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CiNii Research

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

BACKGROUND: Several immune-related adverse events (irAEs) are reported to be associated with therapeutic efficacy of immune checkpoint inhibitors, yet whether pituitary dysfunction, a life-threatening irAE, affects overall survival (OS) in patients with malignancies is unclear. This prospective study examined the association of pituitary dysfunction (pituitary-irAE) with OS of patients with non-small cell lung carcinoma (NSCLC) or malignant melanoma (MM). METHODS: A total of 174 patients (NSCLC, 108; MM, 66) treated with ipilimumab, nivolumab, pembrolizumab, or atezolizumab at Nagoya University Hospital were evaluated for OS and the development of pituitary-irAE. Kaplan-Meier curves of OS as a function of the development of pituitary-irAE were produced with the log-rank test as a primary endpoint. RESULTS: Pituitary-irAE was observed in 16 patients (4 (3.7%) with NSCLC, 12 (18.2%) with MM) having two different disease types: hypophysitis with deficiency of multiple anterior pituitary hormones accompanied by pituitary enlargement, and isolated adrenocorticotropic hormone (ACTH) deficiency without pituitary enlargement. Among these patients, 6 developed pituitary-irAE while being treated with ipilimumab (6/25 patients (24.0%) treated with ipilimumab) and 10 developed pituitary-irAE during treatment with nivolumab or pembrolizumab (10/167 (6.0%)). All 16 patients had ACTH deficiency and were treated with physiological doses of hydrocortisone. The development of pituitary-irAE was associated with better OS in patients with NSCLC (not reached vs 441 (95% CI not calculated) days, p<0.05) and MM (885 (95% CI 434 to 1336) vs 298 (95% CI 84 to 512) days, p<0.05). CONCLUSIONS: In our study cohort, the incidence of pituitary-irAE was higher than previously reported and the development of pituitary-irAE predicted better prognosis for both NSCLC and MM when patients were treated with physiological doses of hydrocortisone. CLINICAL TRIALS REGISTRATION: UMIN000019024.

DOI： 10.1136/jitc-2020-000779

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Language：Japanese   Publisher：日本鼻科学会  

DOI： 10.7248/jjrhi.59.92

CiNii Research

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

OBJECTIVE: The purpose of this study was to evaluate the usefulness of ultrasound (US) volume measurement of the cervical lymph nodes for diagnosing nodal metastasis in patients with head and neck cancer using a node-by-node comparison. METHODS: Thirty-four consecutive patients with head and neck cancer from one tertiary university hospital were prospectively enrolled from 2012 to 2017. Patients with histologically proven squamous cell primary tumors in the head and neck region scheduled to undergo a therapeutic neck dissection were eligible. For each patient, 1-4 target lymph nodes were selected from the planned neck dissection levels. Lymph nodes with thickness >20 mm or in a cluster were excluded. Node-by-node comparisons between the pre-operative US assessment, the post-operative actual measurements and histopathological results were performed for all target lymph nodes. Quantitative measurements, such as three diameters, ratios of the three diameters and volume were analyzed in this study. Lymph node volume was calculated using the ellipsoid formula. RESULTS: Patients comprised 28 men and 6 women with a mean age of 60.0 years (range, 29-80 years) at the time of surgery. In total, 67 target lymph nodes were analyzed in this study and the thickness ranged from 3.9 to 20.0 mm (mean 8.0 mm). There was a strong correlation between the US volume and post-operative actual volume (ρ = 0.87, p < 0.01). The US volume measured 2156 ± 2156 mm3 for the tumor positive nodes, which was significantly greater than the US volume of 512 ± 315 mm3 for tumor negative nodes (p < 0.01). Significant differences between tumor positive and tumor negative nodes were found in five variables (volume, thickness, major axis, minor axis and ratio of minor axis to thickness) for total lymph nodes. To identify predictors of lymph node metastasis, ROC curves of the US variables of target lymph nodes were compared, of which 4 variables were considered acceptable for predicting the lymph node metastasis: volume (AUC 0.86), thickness (AUC 0.86), major axis (AUC 0.79), and minor axis (AUC 0.79) for total lymph nodes. The optimal cut-off level for US volume in total lymph nodes was found to be 1242 mm3, whereby a 62% sensitivity and 98% specificity was reached (likelihood ratio: 25.2). CONCLUSION: Pre-operative ultrasonic volume measurement of the cervical lymph nodes was useful for early detection of cervical nodal metastasis in head and neck cancer.

DOI： 10.1016/j.anl.2019.02.003

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Language：Japanese   Publisher：Japanese Society of Otorhinolaryngology-Head and neck surgery  

DOI： 10.3950/jibiinkoka.122.1464

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.62.406

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.62.505

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.62.402

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society of Allergology  

<p><i>Background:</i> Asthma often coexists with chronic rhinosinusitis (CRS). Recent studies revealed that sinus inflammation in asthmatic patients was related to eosinophilic inflammation. However, the relationship between the severity of CRS and four different sputum inflammatory phenotypes as defined by the proportion of eosinophils and neutrophils is unknown. The aim of this study was to examine the impact of the severity of CRS on lower airway and systemic inflammation in asthmatic patients.</p><p><i>Methods:</i> We enrolled 57 adult asthmatic patients who underwent sinus computed tomography (CT). The severity of CRS was evaluated by the Lund-Mackay score (LMS). The induced sputum inflammatory phenotype was defined by eosinophils (≥/<2%) and neutrophils (≥/<60%). Peripheral blood mononuclear cells (PBMC) were collected to examine cytokine productions.</p><p><i>Results:</i> The median LMS of subjects was 6 (interquartile range, 0-11.5). The sputum inflammatory cell phenotype was categorized as paucicellular (n = 14), neutrophilic (n = 11), eosinophilic (n = 20), or mixed (n = 12). LMS was positively correlated with the percentage of blood eosinophils, sputum eosinophils, and mean fluorescence intensity (MFI) of IL-5 on CD4⁺ T cells. In the severe CRS group (LMS, 12-24), the number of mixed cellular phenotypes was higher than that in the group without CRS (LMS, 0-4) and mild-to-moderate CRS group (LMS, 5-11).</p><p><i>Conclusions:</i> In asthmatic patients with severe CRS, the proportion of the mixed cellular inflammatory phenotype was increased as well as eosinophilic inflammation.</p>

DOI： 10.1016/j.alit.2019.05.004

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Language：Japanese   Publisher：Japan Audiological Society  

<p>　　In 2017, district welfare officers met the elderly living alone and performed a questionnaire survey about subjective hearing loss, usage of hearing aids, knowledge of recent news, and so on, in the Daitoku area (population 11000) in Ichinomiya City, Aichi Prefecture, Japan. There were 161 persons who hoped looked forward to the visits of the district welfare officer to their home, and the response rate was 100%. The subjects ranged in age from 66 to 99 years (average 80.7 years) and 85% were female. The subjective hearing was significantly worse in the elderly in their nineties than in those in their eighties, and similarly worse in the elderly in their eighties than in those in their seventies. Fourteen persons reported using hearing aids - a half of them continuously and a half of them sometimes. Only seven of the hearing aid users had consulted otolaryngologists about their hearing loss.</p><p>　　When they are unaware of any recent news, the possibility of social isolation or dementia should be considered. The incorrect reply rate to questions about recent news was closely associated with aging and significantly higher in the subjects in their nineties than in those in their eighties. It was found that the incorrect reply rate was influenced independently by subjective hearing loss.</p>

DOI： 10.4295/audiology.62.134

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CiNii Research

Publisher：(株)東京医学社  

DOI： 10.24479/j01814.2019197206

CiNii Research

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

OBJECTIVE: Endolymphatic hydrops (EH) has been reported in ears with otosclerosis. The objective of this study was to investigate the clinical features of ears with otosclerosis and EH on magnetic resonance imaging (MRI) and identify predictors for the presence of EH. STUDY DESIGN: Retrospective study. SETTING: University hospital. MATERIALS AND METHODS: Forty-six ears from 37 patients with otosclerosis were included in the present study. INTERVENTIONS: The subjects were divided into three groups, those with no, mild, or significant EH, based on 3-T MRI with intravenous injection of gadolinium. Hearing levels and the extent of otosclerotic lesions graded based on the computed tomography (CT) findings were compared among the groups. Moreover, to examine the vascular activity of the disease, intraoperative measurements of blood flow were also evaluated. MAIN OUTCOME MEASURES: Imaging, hearing levels, and blood flow values. RESULTS: The overall rate of EH was 58.7% (27 of 46 ears); cochlear EH (52.2%) was more frequent than vestibular EH (26.1%). Average thresholds in ears with significant EH were significantly higher at several frequencies, both on air and bone conduction, than those with no or mild EH. Significant EH was more frequently observed in ears with advanced stages on CT than in those without advanced stages. The values of blood flow in the area anterior to the oval window were higher in some ears with EH than in ears without EH. CONCLUSION: EH was frequently present in ears with otosclerosis, especially those with severe hearing loss or advanced disease on CT.

DOI： 10.1097/MAO.0000000000002175

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Language：Japanese   Publisher：(一社)日本聴覚医学会  

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00125&link_issn=&doc_id=20190523370002&doc_link_id=%2Fdm7audio%2F2019%2F006202%2F002%2F0134-0141%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdm7audio%2F2019%2F006202%2F002%2F0134-0141%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Society for Equilibrium Research  

<p>　We performed a questionnaire survey to evaluate the feeling of dizziness in the general population?. The participants were community dwellers who voluntarily participated in the Yakumo Study and managed their everyday lives by themselves. We compared the answers of female participants with those of male participants and found that the perception of dizziness in daily life was worse in female participants than in male participants. Feeling of dizziness of the female participants that those were not a dizziness sense came to feel dizziness newly ten years later, particularly 40 years old. Is in its 70s by comparing the result ten years later, the feeling of dizziness, it was statistically significantly to come feel dizziness newly in female participants. [Not corrected because the meaning of these sentences unclear] We propose to increase the number of items in the questionnaire in the future, in an attempt to better understand the perception of dizziness.</p>

DOI： 10.3757/jser.77.557

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CiNii Research

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Society for Equilibrium Research  

<p>　Imaging examinations, such as computed tomography (CT) or magnetic resonance imaging (MRI), could provide useful information in the diagnosis of peripheral disequilibrium. Visualization of the endolymphatic hydrops (EH) by 3-T MRI with gadolinium injection has contributed to the diagnosis of Meniere's disease. Investigation of the relationships between EH and the results of physiological examinations such as vestibular evoked myogenic potential, electrocochleography, and caloric response demonstrated that the results were related not only to the degree of EH, but also to the persistence and formation of EH. EH has also been detected in patients with superior canal dehiscence or large vestibular aqueduct syndrome. Moreover, we encountered a case in which EH was detected in the non-affected ear of a patient suffering from acute sensorineural hearing loss and disequilibrium, and such imaging analysis provided us with clues for treating her symptoms.</p>

DOI： 10.3757/jser.77.579

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CiNii Research

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

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.

DOI： 10.1097/MAO.0000000000002022

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

To investigate whether peripheral blood biomarkers predict the outcome of anti-PD-1 antibody treatment for head and neck squamous cell carcinoma (HNSCC). Patients treated with nivolumab for platinum-refractory recurrent or metastatic HNSCC were retrospectively reviewed. Fifty-three patients treated between April 2017 and March 2018 were included in the study. The median progression-free survival (PFS) and overall survival (OS) were 2.5 and 8.7 months, respectively. In the univariate analysis, performance status (PS) ≥ 3, relative neutrophil count ≥ 0.65, relative lymphocyte count ≥ 0.17, and relative eosinophil count (REC) ≥ 0.015 were significantly associated with both PFS and OS. On multivariate analysis, PS ≥ 3 and REC ≥ 0.015 were significantly associated with PFS and OS. Low REC and poor PS were independent poor prognostic factors for both PFS and OS in patients with recurrent or metastatic HNSCC treated with nivolumab.

DOI： 10.3390/cancers10120466

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society of Otorhinolaryngology-Head and neck surgery  

<p>　As the benefit of binaural hearing has become increasingly apparent, the use of binaural hearing aids and cochlear implants should be considered when possible. We report two cases in which the patients had poor maximum discrimination scores at their first visit but showed an improvement to a sufficiently practical discrimination level after using binaural hearing aids for 1 year. The maximum discrimination scores for the two subjects were 30% and 55%, respectively, at the time of their first visits, and these scores improved to 80% and 95%, respectively, with the use of binaural hearing aids. The hearing loss in each case was characteristic of a bilateral horizontal type, in pure tone audiogram, with severe tinnitus. The improvement was due primarily to the use of binaural hearing aids, proper fitting of the hearing aids, and hearing training.</p>

DOI： 10.3950/jibiinkoka.121.1273

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CiNii Research

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

A growing body of literature has demonstrated that dementia and hearing loss are interrelated. Recent interest in dementia research has expanded to brain imaging analyses with auditory function. The aim of this study was to investigate the link between hearing ability, which was assessed using pure-tone audiometry, and the volume of brain regions, specifically the hippocampus, entorhinal cortex, Heschl's gyrus, and total gray matter, using Freesurfer software and T1-weighted brain magnetic resonance imaging. The data for 2082 samples (age range = 40-89 years) were extracted from a population-based cohort of community dwellers. Hearing-impaired individuals showed significantly smaller hippocampal volumes compared with their non-hearing-impaired counterparts for all auditory frequency ranges. In addition, a correlational analysis showed a significant dose-response relationship for hearing ability and hippocampal volume after adjusting for potential confounding factors so that the more degraded the peripheral hearing was, the smaller the hippocampal volume was. This association was consistent through the auditory frequency range. The volume of the entorhinal cortex, right Heschl's gyrus and total gray matter did not correlate with hearing level at any frequency. The volume of the left Heschl's gyrus showed a significant relationship with the hearing levels for some auditory frequencies. The current results suggested that the presence of hearing loss after middle age could be a modifier of hippocampal atrophy.

DOI： 10.3389/fnagi.2018.00319

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Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.61.316

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.61.344

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.61.494

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.61.332

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CiNii Research

Language：Japanese   Publisher：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.61.428

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CiNii Research

Language：Japanese   Publisher：JIBI TO RINSHO KAI  

<p>Thyroplasty type Ⅰ and Ⅲ (TP Ⅰ + Ⅲ) has improved dysphonia with severe vocal fold atrophy in cases of oculopharyngeal muscular dystrophy (OPMD). The patient was a 68-year-old man who had been diagnosed with OPMD 10 years before the operation. He underwent cricopharyngeal myotomy three years after the diagnosis, and his swallowing function improved. Three years later, he became annoyed by his altered voice. Autologous fat injections twice and collagen injections twice to the right vocal cord were performed over the subsequent few years;however, his voice quality was not improved due to the absorption of fat and collagen and the marked progression of vocal fold atrophy. TP Ⅰ + Ⅲ was performed to improve his breathy voice, while an endoscopic examination of swallowing showed that his swallowing function had deteriorated steadily. After the operation, each vocal cord was shifted toward the midline successfully, although the vocal cord closure was not perfect. TP Ⅰ + Ⅲ seems to be an effective phonosurgical technique for the treatment of dysphonia due to severe vocal fold atrophy.</p>

DOI： 10.11334/jibi.64.5_189

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本耳鼻咽喉科頭頸部外科学会  

<p>　メニエール病の病態は内リンパ水腫とされている. 従来からメニエール病の診断は, 聴覚および前庭症状とそれに関する機能検査さらには内リンパ水腫推定検査によって行われてきた. 世界的には長年1995年の AAO-HNS 診断基準が用いられてきたが, 2015年バラニー学会主導で新たなメニエール病の診断基準が作成され, definite および probable Meniere's disease の2つが定義された. 本邦ではめまい平衡医学会の診断基準化委員会により診断基準2017年改定が公表され, メニエール病定型例のみならずメニエール病非定型例として蝸牛型と前庭型の診断基準も作成された. この診断基準の特徴として, 確実例に加えて検査所見として聴覚症状のある耳に造影 MRI で内リンパ水腫を認める症例は確定診断例と定義された. この診断基準に基づき, 今後新たな展開も期待されている.</p>

DOI： 10.3950/jibiinkoka.121.1051

CiNii Research

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

DOI： 10.5152/iao.2018.5442

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

The present study examined whether the pathological tumor volume (PTV) was correlated with the survival outcomes in patients with oral squamous cell carcinoma (SCC) and clinical lymph node metastasis. Forty-seven patients who underwent radical surgery without preoperative treatment were enrolled. The PTV of the primary tumor, which was surgically resected without preoperative treatment, was calculated based on the diameters in three dimensions. A survival analysis was performed using a Cox proportional hazards model. A PTV of ≥18 cm3 was significantly correlated with shorter overall survival (P<0.01) and local recurrence-free survival (P<0.01) in a univariate analysis. A multivariate analysis with adjustment for the pathological stage (stage I-II/III-IV), primary site (tongue/others) and positive surgical margin and/or extracapsular extension (absent/present) showed that a PTV of ≥18 cm3 was significantly correlated with shorter overall survival (P<0.01) and local recurrence-free survival (P<0.01). The present findings suggested that PTV in oral SCC provides a prognostic parameter that may predict shorter or longer overall and local recurrence-free survival.

DOI： 10.3892/ol.2018.8951

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

OBJECTIVES/HYPOTHESIS: To investigate the relationship between endolymphatic hydrops and hearing level, focusing on significant vestibular endolymphatic hydrops adjacent to the stapes footplate and low-frequency air-bone gaps. STUDY DESIGN: Retrospective study. METHODS: The study included 1,548 ears from 775 patients who underwent magnetic resonance imaging examination in our university hospital to investigate possible endolymphatic hydrops between January 2012 and December 2015. Ears were evaluated by magnetic resonance imaging 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. Comparison of hearing thresholds on pure-tone audiometry was performed between ears having endolymphatic hydrops adjacent to the stapes footplate and those having nonadjacent endolymphatic hydrops. RESULTS: Forty-one ears (22 men and 19 women, mean age 48.4 years) showed significant cochlear and vestibular endolymphatic hydrops adjacent to the stapes footplate, and 79 ears (30 men and 49 women, mean age 45.0 years) showed significant nonadjacent cochlear and vestibular endolymphatic hydrops. The average air-bone gap at 250 Hz was significantly higher in the group of ears with adjacent hydrops than in those with nonadjacent hydrops. CONCLUSIONS: The appearance of low-frequency air-bone gaps suggests deterioration of endolymphatic hydrops, particularly in ears with Ménière's disease, and could be a useful indicator for evaluating and treating patients with endolymphatic hydrops. LEVEL OF EVIDENCE: 4. Laryngoscope, 128:1658-1662, 2018.

DOI： 10.1002/lary.26898

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

DOI： 10.1002/1873-3468.13066

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PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Society for Equilibrium Research  

DOI： 10.3757/jser.77.99

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CiNii Research

Language：Japanese   Publisher：Japan Audiological Society  

<p>　Tinnitus, hearing loss, and depression have all been reported as symptoms of zinc deficiency. However, few studies have examined the association of all these three symptoms developing at the same time. Thus, we studied the association between serum zinc level and tinnitus, hearing loss, depression in community-dwelling middle-aged and elderly Japanese subjects. The subjects of this study were 734 men and 695 women who participated in both the 2^nd wave and 4^th wave of the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA). Multiple logistic regression analysis with adjustments for the age, sex, tinnitus, hearing loss, depression, history of noise exposure, history of ear disease, low income, smoking habits, and alcohol intake of the baseline revealed that zinc deficiency at the baseline (2^nd wave) was significantly associated with the development of depressive symptoms 4 years later (odds ratio 1.66, p=0.025), but not with that of tinnitus, tinnitus annoyance or hearing loss 4 years later. Our results confirmed previous suggestions that zinc deficiency is a significant risk factor for depression, and suggested that the serum zinc levels should be checked in patients with tinnitus and depression.</p>

DOI： 10.4295/audiology.61.154

Open Access

CiNii Research

Language：Japanese   Publisher：(一社)日本聴覚医学会  

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00125&link_issn=&doc_id=20180514370004&doc_link_id=%2Fdm7audio%2F2018%2F006102%2F004%2F0154-0159%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdm7audio%2F2018%2F006102%2F004%2F0154-0159%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

OBJECTIVE: To examine endolymphatic hydrops (EH) using magnetic resonance imaging (MRI) in patients with definite Ménière's disease (MD) and those with nonotological diseases. METHODS: We studied 32 patients with unilateral MD, 10 patients with bilateral MD and 21 patients with control ears who had other benign diseases not associated with hearing or vestibular dysfunction. The mean age of the subjects was 54.0 years (range 27-74) in the MD group and 56.1 years (range 24-79) in the control group. Using MRI, the degree of EH was classified as none, mild and significant in the cochlea and vestibule separately. The ratio of the area of endolymphatic space to the vestibular fluid space was calculated for the vestibule. The duration of MD was defined as the months between the first attack of MD and the MRI study. RESULTS: EH was present in the cochlea of 45/52 affected ears of patients with MD (87%) and in 16/42 control ears (38%). Significant cochlear hydrops was present in 37/52 affected ears (71%) and in 4/42 control ears (10%). EH in the vestibule was present in 49/52 affected ears (94%) and in 3/42 control ears (7%). Significant vestibular hydrops was present in 40/52 affected ears (77%) and in none of the 42 control ears. There was no relationship between the degree of EH and its duration. Using a cut off value for the relative size of EH in the vestibule of 41.9%, the test had a sensitivity of 88.5% and a specificity of 100% to diagnose definite MD. CONCLUSION: Cochlear EH was occasionally observed in control ears on MRI, as in normal temporal bone specimens. The presence or absence and degree of vestibular EH were significantly different between ears with MD and control ears. EH in the vestibule might be a specific predictor of definite MD.

DOI： 10.1016/j.anl.2017.02.002

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

Advances in the diagnosis and treatment of patients with maxillary sinus carcinoma have improved patient prognosis. This study investigated changes in demographic and clinical characteristics, treatment methods, and outcomes of patients with maxillary sinus carcinomas during three different 10-year periods spanning 60 years at our university hospital. Of the 233 patients with maxillary sinus carcinomas managed at Nagoya University Hospital, 135 were treated between 1951 and 1960 (first period), 35 between 1981 and 1990 (second period), and 63 between 2003 and 2012 (third period). Patient age, sex, TN classifications, treatment methods, and survival rates were compared among patients treated during these time periods. Of the 135, 35, and 63 patients with maxillary sinus carcinomas treated during these time periods, 86 (63.7%), 21 (51.4%), and 48 (76.2%), respectively, were men; 14 (10.4%), six (17.1%), and 14 (22.2%), respectively, were aged ≥70 years; and 135 (100%), 28 (80.0%), and 43 (68.3%), respectively, were treated surgically. The 5-year overall survival rates in patients treated during the first, second, and third periods were 29.7%, 44.3%, and 57.5%, respectively. These findings indicated that advances in the diagnosis and treatment of patients with maxillary sinus carcinoma, including computed tomography and craniofacial resection, have contributed to improvements in patient survival rates.

DOI： 10.18999/nagjms.80.1.91

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

Lingual node metastasis from early-stage squamous cell carcinoma of the tongue is uncommon and difficult to detect. We present a case of a lingual lymph node metastasis from an early tongue cancer. Sonography demonstrated a small nonpalpable lingual node on the floor of the mouth. The patient underwent complete surgical resection and had no evidence of recurrence 5 years later. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 46:69-72, 2018.

DOI： 10.1002/jcu.22486

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

The aims of this study were to determine the prevalence of MRI abnormalities which were suspected as sinusitis in community-dwelling middle-aged and elderly Japanese and to identify risk factors for the MRI abnormality. Brain magnetic resonance imaging (MRI) data from the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA) were used for the analysis. Among the 2330 subjects in the NILS-LSA, 1933 participants were categorized as having no MRI abnormality or MRI abnormality using the Lund-Mackay (LM) score. The mean LM score of the participants was 0.88±1.92, and 144 (7.4%) participants had MRI abnormalities which were suspected as sinusitis when it was classified as an LM score greater than or equal to 4. The prevalence of MRI abnormality was significantly higher in participants of older age and the male sex, in participants with obesity, hypertension, bronchial asthma, chronic bronchitis, gout, or hyperuricemia and in ex- or current smokers. A multivariate logistic regression revealed that older age (odds ratio [OR] = 1.17), obesity (OR = 1.54), a smoking habit (OR = 1.71), history of asthma (OR = 3.77), and chronic bronchitis (OR = 2.66) were significant risk factors for MRI abnormality.

DOI： 10.1155/2018/4096845

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Society of Practical Otolaryngology  

<p>An ectopic hamartomatous thymoma (EHT) is an extremely rare benign soft tumor most commonly occurring in the lower neck region, that can be difficult to differentiate (preoperatively) from malignant tumors. We report a case of EHT of the neck diagnosed in a 42-year-old man. The patient presented with a 10-year history of a tumor in the lower neck region that had rapidly increased in size over the previous 3 years. Fine-needle aspiration biopsy findings suggested lipoma. As the clinical findings and CT/MRI images indicated the possibility of a malignant tumor, an open biopsy was performed. The biopsy revealed EHT and resection of the tumor was performed. Although there were slight adhesions between the tumor and mediastinum, the tumor had not invaded the thymus or thyroid, and could be successfully resected. Histopathological examination of the tumor revealed the characteristic features of EHT, including spindle cells, epithelial cells, and fat tissue mixed. The postoperative course was uneventful, and there was no evidence of recurrence during the 18-month follow up period. When encountering lesions in the lower neck, it is important to consider EHT in the differential diagnosis.</p>

DOI： 10.5631/jibirin.111.645

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CiNii Research

Publisher：Journal of Otolaryngology of Japan  

DOI： 10.3950/jibiinkoka.121.1223

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Publishing type：Research paper (scientific journal)  

DOI： 10.5631/jibirinsuppl.152.70

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Language：Japanese   Publisher：Japan Otological Society  

<p>Surgical treatment of middle ear cholesteatoma is necessary for cholesteatoma resection, hearing improvement or preservation, and recurrence prevention.</p><p>We decide the type of surgical approach; staged or one-stage tympanoplasty, based on preoperative CT scan findings that mastoid cavity contains air or not.</p><p>We retrospectively reviewed the data of 119 ears with middle ear cholesteatoma that underwent tympanoplasty at the Japan Red Cross Nagoya First Hospital between January 2011 and December 2015.</p><p>Preoperative CT scan showed that 32 ears contained air in the mastoid cavity, and 87 ears did not. The type of procedure was varied one ear and another because of intraoperative findings and patient’s status; extension of cholesteatoma, preservation of the middle ear mucosa, age and comorbidity. Successful postoperative hearing outcomes were observed in 72.9% of the cases and the recurrence rate was 6.5%. Hearing results did not significantly depend on preoperative aeration of mastoid cavity but also on status of stapes.</p><p>These findings suggest that both preoperative mastoid cavity aeration and intraoperative findings are important for the choice of the surgical procedure (staged or one-stage tympanoplasty, canal wall up, or canal wall down mastoidectomy).</p>

DOI： 10.11289/otoljpn.28.668

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本耳鼻咽喉科頭頸部外科学会  

DOI： 10.3950/jibiinkoka.121.242

CiNii Research

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

Objective: To perform a quantitative computed tomography (CT) assessment of short- and long-term outcomes of autologous fat injection augmentation in patients with unilateral vocal fold paralysis. Study Design: Retrospective case series. Methods: Twelve patients who had undergone autologous fat injection augmentation for unilateral vocal fold paralysis in our hospital between 2011 and 2015 were enrolled in this study. The autologous fat for injection was acquired from periumbilical subcutaneous tissue and was injected orally using a special-purpose laryngeal injection needle. To evaluate the injected fat at the follow-up assessments, CT was performed at several times after surgery in clinical practice. All thin-section CT images were transferred to a workstation, and the volume of the injected fat was calculated. Results: Patients comprised 6 men and 6 women with a mean age at the time of surgery of 62.9 years (range, 46-82 years). The actual injected fat volume was 1.1-2.5 ml (mean, 1.6 ml). In seven patients assessed by CT two days after surgery, the average residual rate of the injected fat was 63.9%. The mean residual rates of the injected fat were 30.0% at 3 months, 33.7% at 6 months, 29.2% at 12 months, and 32.0% at 24 months. Conclusions: Although the injected fat volume decreased within the first three months and the residual rate of the injected fat was 30.0% at three months after injection, the residual fat volume remained at the same level for 24 months after injection. Level of Evidence: 4.

DOI： 10.1002/lio2.125

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Language：Japanese   Publisher：(一社)日本耳科学会  

Language：English  

DOI： 10.4193/Rhin17.026

PubMed

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

OBJECTIVE: The purpose of this study was to investigate the existence of endolymphatic hydrops (EH) in affected and unaffected ears in patients with unilateral sensorineural hearing loss (SNHL) using contrast-enhanced magnetic resonance imaging (MRI), and to evaluate the significance of EH in various otological diseases. STUDY DESIGN: Retrospective study. SETTING: University hospital. METHODS: One hundred eighty-two ears from 91 patients with unilateral SNHL were studied. The endolymphatic space was evaluated using 3-Tesla MRI with gadodiamide hydrate. Imaging data about the degree of EH in the cochlea and vestibule were analyzed and compared between ears with various otological diseases. RESULTS: All affected ears with delayed endolymphatic hydrops had EH. In affected ears with definite Menière's disease, cochlear EH was observed in all ears and vestibular EH in 93% of ears, and these rates were significantly higher in the affected than in the unaffected ears. EH was also observed in the cochlea and vestibule in 66% and 41%, respectively, of the affected ears with idiopathic sudden SNHL; however, these percentages did not differ significantly from those in the unaffected ears (52% and 38%, respectively). CONCLUSION: MRI showed that a high percentage of ears affected by Menière's disease or delayed endolymphatic hydrops had EH. Further studies should evaluate the implications of EH in ears, especially in those with sudden SNHL, in terms of secondary or pre-existing EH.

DOI： 10.1097/MAO.0000000000001499

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

DOI： 10.4193/Rhino17.026

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

DOI： 10.1016/j.amjoto.2017.06.014

PubMed

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

OBJECTIVES: We investigated a possible correlation between the maximum standardized uptake value (SUVmax), which is assessed by pretreatment 18F-fluorodeoxyglucose positron emission tomography with computed tomography, and the overall survival (OS) in patients with hypopharyngeal squamous cell carcinoma from two institutions on long-term follow-up, and examined whether SUVmax is correlated with several survival outcomes, including lung metastasis-free survival. METHODS: A total of 81 patients were enrolled. The survival rate was calculated by the Kaplan-Meier method. Both univariate and multivariate survival analyses were assessed by a Cox proportional hazards model. RESULTS: SUVmax ≥15.2 in institution A (p = 0.0306) or SUVmax ≥8 in institution B (p = 0.0132) was significantly predictor of a lower OS. We disaggregated the data by high SUVmax (SUVmax ≥15.2 from institution A and SUVmax ≥8 from institution B) and low SUVmax (SUVmax <15.2 from institution A and SUVmax <8 from institution B). Patients with a high SUVmax exhibited a significantly lower OS in both univariate (p = 0.001) and multivariate (p = 0.0046) analyses for adjusted for the clinical stage and treatment group. The patients with a high SUVmax exhibited significantly shorter disease-specific (p = 0.0068), distant metastasis-free (p = 0.0428), and lung metastasis-free (p = 0.0328) survivals. CONCLUSIONS: High SUVmax was significantly correlated with a lower OS, disease-specific survival, distant metastasis-free survival, and lung metastasis-free survival in a multi-institutional retrospective study.

DOI： 10.1007/s12149-017-1176-1

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PubMed

Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01099&link_issn=&doc_id=20170804320004&doc_link_id=%2Fdz0jibik%2F2017%2F012007%2F004%2F0923-0931%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz0jibik%2F2017%2F012007%2F004%2F0923-0931%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

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

CONCLUSIONS: The presence of endolymphatic hydrops (EH) in the vestibule on magnetic resonance imaging (MRI) might be a high-risk factor for complications in cases that are candidates for stapes surgery. OBJECTIVE: Pre-operative detection of EH could be valuable in cases that are candidates for stapes surgery to prevent unpredictable complications following surgery. Pre-operative MRI findings and post-operative findings following stapes surgery were compared to evaluate the efficacy of such MRI evaluation for the management of cases with otosclerosis. SUBJECTS AND METHODS: Sixteen cases who underwent pre-operative evaluation by 3T MRI performed 4 h after intravenous injection of gadolinium and stapes surgery for otosclerosis were recruited. Imaging data concerning the degree of EH in the vestibule and cochlea were compared with post-operative clinical findings for all cases. RESULTS: Mild EH in the cochlea or the vestibule was observed in eight ears and one ear, respectively, whereas one ear showed significant EH both in the cochlea and the vestibule. The post-operative course was uneventful in 12 of 14 cases with no EH in the vestibule, and the other two cases had a short period of dizziness, but two cases with EH in the vestibule had a long period of dizziness.

DOI： 10.1080/00016489.2016.1232862

Web of Science

Scopus

PubMed

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

DOI： 10.1016/j.carbpol.2016.11.049

PubMed

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

The inner and middle ear are connected mainly through round and oval windows, and inflammation in the middle ear cavity can spread into the inner ear, which might induce a disturbance. In cases with intractable otitis media, attention should also be paid to symptoms related to the inner ear. In this paper, middle ear inflammation and related inner ear disturbances are reviewed with a focus on representative middle ear diseases (such as acute otitis media, chronic otitis media, otitis media with anti-neutrophil cytoplasmic antibody-associated vasculitis, eosinophilic otitis media, cholesteatoma with labyrinthine fistula, and reflux-related otitis media). Their clinical concerns are then discussed with reference to experimental studies. In these diseases, early diagnosis and adequate treatment are required to manage not only middle ear but also inner ear conditions.

DOI： 10.18999/nagjms.79.1.1

Open Access

Web of Science

Scopus

PubMed

DOI： 10.11477/mf.1411201150

CiNii Research

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

CONCLUSION: All definite Meniere's disease (MD) had endolymphatic hydrops (EH) at least in the cochlea or the vestibule. Symptoms of MD may appear after formation of EH. It is assumed that the probability of immediate progression to bilateral MD from unilateral MD is very low in patients without EH on the non-affected side. OBJECTIVE: To evaluate the EH on both sides in patients with unilateral and bilateral MD, and to investigate factors with progression to bilateral MD including the degree of EH, hearing level, and the duration of MD. PATIENTS AND METHODS: The study included 29 patients with unilateral definite MD and 12 patients with bilateral definite MD. The endolymphatic space size was visualized by using 3-Tesla magnetic resonance imaging. RESULTS: All patients with unilateral and bilateral MD had significant or mild EH at least in the cochlea or the vestibule on the affected side. On the non-affected side, EH was not observed at all in eight patients, but asymptomatic EH was observed in the cochlea in 14 patients and in the vestibule in 16 patients. There was no relationship between the EH on the non-affected side and the duration of MD.

DOI： 10.1080/00016489.2016.1217042

Web of Science

Scopus

PubMed