Faculty Profiles - NISHIO Naoki

Papers - NISHIO Naoki

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The Clinical Application of Fluorescence-Guided Surgery in Head and Neck Cancer. Reviewed International coauthorship International journal

Stan van Keulen, Naoki Nishio, Shayan Fakurnejad, Andrew Birkeland, Brock A Martin, Guolan Lu, Quan Zhou, Stefania U Chirita, Tymour Forouzanfar, A Dimitrios Colevas, Nynke S van den Berg, Eben L Rosenthal

Journal of nuclear medicine : official publication, Society of Nuclear Medicine Vol. 60 ( 6 ) page： 758 - 763 2019.6

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

Although surgical resection has been the primary treatment modality of solid tumors for decades, surgeons still rely on visual cues and palpation to delineate healthy from cancerous tissue. This may contribute to the high rate (up to 30%) of positive margins in head and neck cancer resections. Margin status in these patients is the most important prognostic factor for overall survival. In addition, second primary lesions may be present at the time of surgery. Although often unnoticed by the medical team, these lesions can have significant survival ramifications. We hypothesize that real-time fluorescence imaging can enhance intraoperative decision making by aiding the surgeon in detecting close or positive margins and visualizing unanticipated regions of primary disease. The purpose of this study was to assess the clinical utility of real-time fluorescence imaging for intraoperative decision making. Methods: Head and neck cancer patients (n = 14) scheduled for curative resection were enrolled in a clinical trial evaluating panitumumab-IRDye800CW for surgical guidance (NCT02415881). Open-field fluorescence imaging was performed throughout the surgical procedure. The fluorescence signal was quantified as signal-to-background ratios to characterize the fluorescence contrast of regions of interest relative to background. Results: Fluorescence imaging was able to improve surgical decision making in 3 cases (21.4%): identification of a close margin (n = 1) and unanticipated regions of primary disease (n = 2). Conclusion: This study demonstrates the clinical applications of fluorescence imaging on intraoperative decision making. This information is required for designing phase III clinical trials using this technique. Furthermore, this study is the first to demonstrate this application for intraoperative decision making during resection of primary tumors.

DOI： 10.2967/jnumed.118.222810

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PubMed

Exploration of coping styles in male patients with head and neck cancer: a prospective cohort study. Reviewed

Naohiro Sato, Hiroyuki Kimura, Yasunori Adachi, Naoki Nishio, Masahiko Ando, Tatsuya Tokura, Wataru Nagashima, Shinichi Kishi, Aya Yamauchi, Keizo Yoshida, Mariko Hiramatsu, Yasushi Fujimoto, Norio Ozaki

Nagoya journal of medical science Vol. 81 ( 2 ) page： 249 - 258 2019.5

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

Majority of head and neck cancer (HNC) patients are male, and more than 85% of patients with HNC have the habit of smoking and drinking. Due to the specific demographic characteristics, HNC patients are anticipated to have specific coping styles, affecting psychological distress, survival, and quality of life. We explored the subscales of the Mental Adjustment to Cancer (MAC) Scale in male patients with HNC, and then examined the correlation between revised subscales of the MAC scale and anxiety/depression. Participants were 150 male inpatients with HNC, and their demographic and medical data were obtained. Coping style was assessed by MAC scale. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Out of 40 items in the original MAC scale, 19 items were excluded by factor analysis, and the remaining 21 items were divided into three factors: Negative Adjustment, Positive Adjustment, and Abandonment. Negative and Positive Adjustments were similar to the copings of mixed gender patients with heterogeneous cancers, and Abandonment was a new subscale specific to male patients with HNC. This subscale had a weak positive correlation with anxiety and depression. Male HNC patients revealed a specific coping style of Abandonment, related with psychological distress. We believe that an understanding of the Abandonment coping style revealed in our study will improve the psychological support offered to male patients with HNC.

DOI： 10.18999/nagjms.81.2.249

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Mixed cellular inflammation is increased in adult asthma with severe chronic rhinosinusitis

Nishio Tomoko, Wakahara Keiko, Suzuki Yoshihiro, Majima Suguru, Nishio Naoki, Teranishi Masaaki, Sone Michihiko, Hasegawa Yoshinori

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY Vol. 143 ( 2 ) page： AB189 - AB189 2019.2

Rapid, non-invasive fluorescence margin assessment: Optical specimen mapping in oral squamous cell carcinoma. Reviewed International coauthorship International journal

Stan van Keulen, Nynke S van den Berg, Naoki Nishio, Andrew Birkeland, Quan Zhou, Guolan Lu, Han-Wei Wang, Lyle Middendorf, Tymour Forouzanfar, Brock A Martin, A Dimitrios Colevas, Eben L Rosenthal

Oral oncology Vol. 88 page： 58 - 65 2019.1

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

OBJECTIVE: Surgical resection remains the primary treatment for the majority of solid tumors. Despite efforts to obtain wide margins, close or positive surgical margins (<5 mm) are found in 15-30% of head and neck cancer patients. Obtaining negative margins requires immediate, intraoperative feedback of margin status. To this end, we propose optical specimen mapping of resected tumor specimens immediately after removal. MATERIALS AND METHODS: A first-in-human pilot study was performed in patients (n = 8) after infusion of fluorescently labeled antibody, panitumumab-IRDye800 to allow surgical mapping of the tumor specimen. Patients underwent standard of care surgical resection for head and neck squamous cell carcinoma (HNSCC). Optical specimen mapping was performed on the primary tumor specimen and correlated with pathological findings after tissue processing. RESULTS: Optical mapping of the specimen had a 95% sensitivity and 89% specificity to detect cancer within 5 mm (n = 160) of the cut surface. To detect tumor within 2 mm of the specimen surface, the sensitivity of optical specimen mapping was 100%. The maximal observed penetration depth of panitumumab-IRDye800 through human tissue in our study was 6.3 mm. CONCLUSION: Optical specimen mapping is a highly sensitive and specific method for evaluation of margins within <5 mm of the tumor mass in HNSCC specimens. This technology has potentially broad applications for ensuring adequate tumor resection and negative margins in head and neck cancers.

DOI： 10.1016/j.oraloncology.2018.11.012

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Association between Uncoupling Protein 2 Gene Ala55val Polymorphism and Sudden Sensorineural Hearing Loss. Reviewed International journal

Yusuke Koide, Masaaki Teranishi, Saiko Sugiura, Yasue Uchida, Naoki Nishio, Ken Kato, Hironao Otake, Tadao Yoshida, Rei Otsuka, Fujiko Ando, Hiroshi Shimokata, Yasuhisa Hasegawa, Tsutomu Nakashima, Michihiko Sone

The journal of international advanced otology Vol. 14 ( 2 ) page： 166 - 169 2018.8

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

OBJECTIVES: The pathology of sudden sensorineural hearing loss, which is known as sudden deafness (SD), remains unknown. The purpose of this study was to investigate the association between mitochondrial uncoupling protein 2 (UCP2) polymorphism and SD risk. MATERIALS AND METHODS: We compared 83 patients suffering from SD and 2048 controls who participated in the Longitudinal Study of Aging at the National Institute for Longevity Sciences. Multiple logistic regression was used to calculate the odds ratios (ORs) for SD with a polymorphism of the UCP2 (rs660339) gene. RESULTS: Under the additive model of inheritance, UCP2 polymorphisms showed significant association with a SD risk. The OR was 1.468 (95% confidence interval, 1.056-2.040) with an adjustment for any past history, such as diabetes, dyslipidemia, or hypertension, and for age and sex. CONCLUSION: Our results imply that the UCP2 (rs660339) polymorphism has a significant association with the risk of developing SD.

DOI： 10.5152/iao.2018.5442

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Study Protocol: Prospective Study of Concurrent Chemoradiotherapy with S-1 and Hypofractionated Radiotherapy for Outpatients with Early Glottic Squamous Cell Carcinomas Reviewed International journal

Kana Kimura, Yoshiyuki Itoh, Tohru Okada, Seiji Kubota, Mariko Kawamura, Rie Nakahara, Yumi Oie, Yuka Kozai, Yuuki Takase, Hidenori Tsuzuki, Naoki Nishio, Mariko Hiramatsu, Yasushi Fujimoto, Takefumi Mizutani, Akihiro Hirakawa, Shinji Naganawa

Asian Pacific journal of cancer prevention : APJCP Vol. 19 ( 5 ) page： 1195 - 1199 2018.5

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

Background: The recommended treatment strategies for early glottic carcinoma with intent of larynx preservation are
primarily radiotherapy. However, the outcomes of radiotherapy for bulky T1 or T2 glottic carcinoma are unsatisfactory.
We designed a protocol consisting of concurrent chemoradiotherapy using S-1 as the radiosensitizer. We have performed
this protocol in patients with favorable T2 lesions and demonstrated its efficacy and safety. In contrast, we have
treated non-bulky T1 glottic carcinomas with 2.25 Gy per fraction, for a total of 25-28 fractions, starting in 2011 to
improve efficacy and shorten the treatment period. Since this treatment strategy was implemented for T1 disease, no
local failure has occurred to date, and it appears to be almost as safe as radiotherapy using 2.0 Gy per fraction. With
the aim of improving the local control rate and shortening the treatment period primarily for favorable T2 disease, we
changed the dose of radiation in our protocol from 2.0 Gy to 2.25 Gy per fraction, for a total of 25 fractions (from 30
fractions). The present study aims to evaluate the efficacy and safety of this new protocol. Methods: This study will
be conducted as a clinical, prospective, single-armed, non-randomized trial. Patients are to receive S-1 (55.3 mg /m2
/day, once daily) and radiotherapy (2.25 Gy per fraction, for a total of 25 fractions). S-1 and radiotherapy are started
on the same day that radiotherapy is performed, 3-6 hours after oral administration of S-1. The primary study aim is
the 3-year local control rate. The secondary study aims are overall survival, voice-preservation survival, disease-free
survival, complete response rate, completion rate, and toxicity. Result and conclusion: This is the first single-center,
non-randomized, prospective study of concurrent chemoradiotherapy with S-1 and hypofractionated radiotherapy to
be conducted. The trial will evaluate the efficacy and safety of our protocol.

DOI： 10.22034/APJCP.2018.19.5.1195

PubMed

＜Editors' Choice＞ Maxillary sinus carcinoma outcomes over 60 years: experience at a single institution. Reviewed

Naoki Nishio, Yasushi Fujimoto, Mariko Hiramatsu, Takashi Maruo, Hidenori Tsuzuki, Nobuaki Mukoyama, Mariko Shimono, Michihiko Sone, Yoshitaka Kawabe, Kiyoshi Saito, Masazumi Fujii, Tsutomu Nakashima

Nagoya journal of medical science Vol. 80 ( 1 ) page： 91 - 98 2018.2

Authorship：Lead author 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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Sonographic detection of a lingual node metastasis from early squamous cell cancer of the tongue. Reviewed International journal

Naoki Nishio, Yasushi Fujimoto, Mariko Hiramatsu, Yoko Yamamoto, Michihiko Sone

Journal of clinical ultrasound : JCU Vol. 46 ( 1 ) page： 69 - 72 2018.1

Authorship：Lead author 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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A case of large ectopic hamartomatous thymoma of the neck Reviewed International journal

Sayaka Yokoi, Naoki Nishio, Yasushi Fujimoto, Nobuaki Mukoyama, Wakako Kinoshita, Michihiko Sone

Practica Oto-Rhino-Laryngologica Vol. 111 ( 9 ) page： 645 - 649 2018

Authorship：Corresponding author Publishing type：Research paper (scientific journal)

© 2018 Society of Practical Otolaryngology. All rights reserved. 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.

DOI： 10.5631/jibirin.111.645

Scopus

Computed tomographic assessment of autologous fat injection augmentation for vocal fold paralysis. Reviewed International journal

Naoki Nishio, Yasushi Fujimoto, Mariko Hiramatsu, Takashi Maruo, Kenji Suga, Hidenori Tsuzuki, Nobuaki Mukoyama, Mariko Shimono, Kazuhiro Toriyama, Keisuke Takanari, Yuzuru Kamei, Michihiko Sone

Laryngoscope investigative otolaryngology Vol. 2 ( 6 ) page： 459 - 465 2017.12

Authorship：Lead author,　Corresponding author 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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Optimized treatment strategy of radiotherapy for early glottic squamous cell carcinomas: An initial analysis. Reviewed

Nagoya journal of medical science Vol. 79 ( 3 ) page： 331 - 338 2017.8

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

The purpose of this study was to evaluate the clinical outcomes of radiotherapy for patients with T1/T2 glottic carcinoma. Patients with T1/T2 glottic carcinoma histopathologically diagnosed with squamous cell carcinoma and treated at our hospital between 2007 and 2015 were analyzed retrospectively. Our strategy for T1/T2 glottic carcinoma was as follows: radiotherapy alone with 2.25 Gy per fraction to a total of 25-28 fractions for patients with non-bulky T1 glottic carcinoma; concurrent chemoradiotherapy with oral S-1 and radiotherapy with 2 Gy per fraction to a total of 30 fractions for patients with T1 bulky/T2 favorable glottic carcinoma; or chemoradiotherapy with high-dose cisplatin and radiotherapy with 2 Gy per fraction to a total of 35 fractions for T2 unfavorable glottic carcinoma. Forty-eight patients were eligible. The median follow-up period among surviving patients was 38 months (range, 11-107). The disease was T1a in 23%, T1b in 13%, and T2 in 65% of patients. The 3-year local control rate in all patients, T1a, T1b, and T2 was 96.7%, 100%, 100%, and 96.0%, respectively. Of the 46 patients, one with T2 glottic carcinoma developed recurrent disease at the primary site, and one with T2 glottic carcinoma had lymph node recurrences in the neck. Acute Grade 3 dermatitis occurred in 8 (17%) patients and late Grade 2 hypothyroidism occurred in 2 (4%) patients. This retrospective study shows that our optimized treatment strategy of radiotherapy depending on the stage of early glottic carcinoma is not only effective but also well-tolerated.

DOI： 10.18999/nagjms.79.3.331

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Preoperative surgical simulation and validation of the line of resection in anterolateral craniofacial resection of advanced sinonasal sinus carcinoma Reviewed

Nishio Naoki, Fujii Masazumi, Hayashi Yuichiro, Hiramatsu Mariko, Maruo Takashi, Iwami Kenichiro, Kamei Yuzuru, Yagi Shunjiro, Takanar Keisuke, Fujimoto Yasushi

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK Vol. 39 ( 3 ) page： 512-519 2017.3

Preoperative surgical simulation and validation of the line of resection in anterolateral craniofacial resection of advanced sinonasal sinus carcinoma Reviewed

Nishio N, Fujii M, Hayashi Y, Hiramatsu M, Maruo T, Iwami K, Kamei Y, Yagi S, Takanari K, Fujimoto Y

Head and Neck Vol. 39 ( 3 ) page： 512-519 2016.12

Autologous fat injection therapy including a high concentration of adipose-derived regenerative cells in a vocal fold paralysis model: Animal pilot study Reviewed International journal

N. Nishio, Y. Fujimoto, K. Suga, Y. Iwata, K. Toriyama, K. Takanari, Y. Kamei, T. Yamamoto, M. Gotoh

Journal of Laryngology and Otology Vol. 130 ( 10 ) page： 914 - 922 2016.10

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Cambridge University Press

Objectives: To verify the effectiveness and safety of the addition of adipose-derived regenerative cells to autologous fat injection therapy. Methods: Unilateral vocal fold paralysis models were made by cutting the right recurrent laryngeal nerve in two pigs. At day 30, 0.5 ml adipose-derived regenerative cells mixed with 1 ml autologous fat was injected into the right vocal fold of one pig, with the other receiving 0.5 ml Ringer's solution mixed with 1 ml autologous fat. At day 120, fibrescopy, laser Doppler flowmeter, computed tomography, vocal function evaluation and histological assessment were conducted. Results: Although histological assessment revealed atrophy of the thyroarytenoid muscle fibre in both pigs, there was remarkable hypertrophy of the thyroarytenoid muscle fibre in the area surrounding the adipose-derived regenerative cells injection site. Conclusion: The addition of a high concentration of adipose-derived regenerative cells to autologous fat injection therapy has the potential to improve the treatment outcome for unilateral vocal fold paralysis.

DOI： 10.1017/S0022215116008707

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Salvage pharyngolaryngectomy with total esophagectomy following definitive chemoradiotherapy Reviewed International journal

Y. Niwa, M. Koike, Y. Fujimoto, H. Oya, N. Iwata, N. Nishio, M. Hiramatsu, M. Kanda, D. Kobayashi, C. Tanaka, S. Yamada, T. Fujii, G. Nakayama, H. Sugimoto, S. Nomoto, M. Fujiwara, Y. Kodera

Diseases of the Esophagus Vol. 29 ( 6 ) page： 598 - 602 2016.8

Language：English Publishing type：Research paper (scientific journal) Publisher：John Wiley and Sons Inc.

Historically, total pharyngolaryngectomy with total esophagectomy has been the standard radical surgical treatment for synchronous cancer of the thoracoabdominal esophagus and pharyngolaryngeal region, and for cancer of the cervical esophagus that has invaded as far as the thoracic esophagus. Although definitive chemoradiotherapy that enables preservation of the larynx has often been the first choice of treatment for cancers involving the cervical esophagus, total pharyngolaryngectomy with total esophagectomy is required as a salvage therapy for cases involving failure of complete remission or locoregional recurrence after chemoradiotherapy. However, salvage esophageal surgery after definitive high-dose chemoradiotherapy is generally associated with high morbidity and mortality. The aim of this study was to examine the short-term outcome of salvage total pharyngolaryngectomy with total esophagectomy. From 2001 to 2014, nine patients underwent salvage total pharyngolaryngectomy with total esophagectomy at the Department of Gastroenterological Surgery, Nagoya University. The mortality and morbidity rates were high at 22% and 89%, respectively. Four patients (44%) developed tracheal necrosis, which in two patients eventually led to lethal hemorrhage. Salvage total pharyngolaryngectomy with total esophagectomy is an uncommon and highly demanding surgical procedure that should be carefully planned and conducted in selected centers of excellence. Measures must be taken to preserve the tracheal blood supply, thus avoiding fatal complications.

DOI： 10.1111/dote.12362

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Relationship between BMI and Postoperative Complications with Free Flap in Anterolateral Craniofacial Reconstruction. Reviewed International journal

Yang Hoi Heo, Shunjiro Yagi, Kazuhiro Toriyama, Keisuke Takanari, Yasushi Fujimoto, Naoki Nishio, Masazumi Fujii, Kiyoshi Saito, Masakatsu Takahashi, Yuzuru Kamei

Plastic and reconstructive surgery. Global open Vol. 4 ( 3 ) page： e636 2016.3

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

BACKGROUND: Although we have seen tremendous advancement in microsurgery over the last 2 decades and free tissue transfer has become standard for head and neck reconstruction, surgeons still struggle to prevent postoperative complications. We examined the relationship between body mass index (BMI) and postoperative complications in patients undergoing rectus abdominis free flap transfer after anterolateral craniofacial resection. METHODS: This was a retrospective review of reconstructive surgery using rectus abdominis musculocutaneous free flap in patients with locally advanced maxillary sinus carcinoma from 2003 to 2014 (n = 35, 27 men and 8 women; average age, 60.9 ± 7.8 years). All patients underwent craniofacial reconstruction after anterior and middle cranial fossa skull base resection and maxillectomy (class IV, subtype a) with palatal resection. Patients were categorized based on sex, BMI, and other parameters. RESULTS: Recipient-site infection occurred in 11 patients (31.4%), cerebrospinal fluid leakage in 6 (17.1%), partial flap necrosis in 2 (5.7%), total flap necrosis in 1 (2.9%), and facial fistula in 4 (11.4%). Women showed partial flap necrosis significantly more frequently (P = 0.047), probably owing to poor vascular supply of the subcutaneous fat layer. Patients with low BMI (<20 kg/m(2)) showed recipient-site infection (P = 0.02) and facial fistula (P = 0.01) significantly more frequently owing to insufficient tissue volume and poor vascular supply. CONCLUSION: Postoperative recipient-site infection and facial fistula occurred mainly in low-BMI patients. Surgeons should take care to achieve sufficient donor tissue on low-BMI patients. Using a prosthetic obturator in low-BMI patients for craniofacial reconstruction can be a good alternative option to reduce postoperative complications due to insufficient donor tissue volume.

DOI： 10.1097/GOX.0000000000000645

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Craniofacial Resection for T4 Maxillary Sinus Carcinoma: Managing Cases with Involvement of the Skull Base. Reviewed International journal

Naoki Nishio, Yasushi Fujimoto, Masazumi Fujii, Kiyoshi Saito, Mariko Hiramatsu, Takashi Maruo, Kenichiro Iwami, Yuzuru Kamei, Shunjiro Yagi, Masakatsu Takahashi, Yuichiro Hayashi, Atsushi Ando, Tsutomu Nakashima

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery Vol. 153 ( 2 ) page： 231 - 238 2015.8

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

OBJECTIVE: The objective of this study was to clarify the outcomes of craniofacial resection for locally advanced maxillary sinus carcinoma classified as T4 and to present methods for managing cases involving the skull base. STUDY DESIGN: Case series with chart review. SETTING: Tertiary university hospital. SUBJECTS AND METHODS: We performed anterolateral craniofacial resection in en bloc fashion for locally advanced maxillary sinus carcinoma at stage T4. Participants comprised 40 patients with T4 maxillary sinus carcinoma treated between 1992 and 2011. Surgical outcomes were analyzed retrospectively. RESULTS: Forty patients with stage T4a (n = 26) or stage T4b (n = 14) were included in this study. Five-year overall and disease-free survival rates for the 40 patients with T4 maxillary sinus carcinoma were 62.7% and 52.6%, respectively. Cavernous sinus involvement correlated significantly with worse prognosis (P = .012). In 35 cases without cavernous sinus involvement, previous treatment (P = .017) and positive margins (P = .019) correlated significantly with worse prognosis, and 5-year overall and disease-free survival rates were 72.4% and 55.3%, respectively. CONCLUSION: This study only included cases of locally advanced maxillary sinus carcinoma classified as T4. Considering the advanced stage, our study suggests relatively favorable outcomes and the importance of managing the cavernous sinus in en bloc resections of malignant skull base tumors. Craniofacial resection in en bloc fashion achieved good survival rates.

DOI： 10.1177/0194599815586770

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Craniofacial Resection for T4 Maxillary Sinus Carcinoma :Managing Cases with Involvement of the Skull Base. Reviewed

Nishio N, Fujimoto Y, Fujii M, Saito K, Hiramatsu M, Maruo T, Iwami K, Kamei Y, Yagi S, Takahashi M, Hayashi Y, Ando A, Nakashima T.

Otolaryngology Head and Neck Surgery Vol. 153 ( 2 ) page： 231-238 2015.6

Changes in endolymphatic hydrops in patients with Ménière's disease treated conservatively for more than 1 year. Reviewed International journal

Kenji Suga, Masahiro Kato, Tadao Yoshida, Naoki Nishio, Takafumi Nakada, Saiko Sugiura, Hironao Otake, Ken Kato, Masaaki Teranishi, Michihiko Sone, Shinji Naganawa, Tsutomu Nakashima

Acta oto-laryngologica Vol. 135 ( 9 ) page： 866 - 870 2015

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

CONCLUSION: This study revealed that endolymphatic hydrops (EH) reduced in some cases with Ménière's disease (MD) treated conservatively. It appears that the EH reduction was associated with improvement of the clinical symptoms. OBJECTIVES: The relationship between the degree of EH and clinical symptoms is not clear at present. The purpose of the present study was to investigate the time course of the relationship in patients with MD treated conservatively. PATIENTS: Twelve patients with MD treated conservatively for more than 1 year in a university hospital. METHODS: Twenty ears of 12 patients with MD treated conservatively were evaluated. The presence or absence of vertigo, tinnitus and ear fullness was confirmed when magnetic resonance imaging (MRI) was performed. Using a 3 T MRI scanner, three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MRI was performed 2 or 3 times 24 hours after intra-tympanic gadolinium injection or 4 hours after intravenous gadolinium injection. RESULTS: In the three ears in which the symptoms alleviated, EH was reduced in two ears, but EH was reduced in only one of 17 ears in which the symptoms did not alleviate. The Fisher exact test revealed that EH reduction occurred more frequently in ears with alleviation of the symptoms (p < 0.05).

DOI： 10.3109/00016489.2015.1015607

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良好な嚥下機能温存を目指した中咽頭・下咽頭再建良好な機能温存を目指した下咽頭部分切除に対する再建の経験

八木俊路朗, 鳥山和宏, 高成啓介, 蛯沢克巳, 澤村尚, 神戸未来, 中村優, 藤本保志, 西尾直樹, 亀井譲

日本マイクロサージャリー学会学術集会プログラム・抄録集 Vol. 41回 page： 124 - 124 2014.12

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Papers - NISHIO Naoki