記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.65.428

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

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

DOI： 10.18999/nagjms.84.3.497

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記述言語：日本語   出版者・発行元：へるす出版  

CiNii Research

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

DOI： 10.1097/MAO.0000000000003328

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記述言語：日本語   出版者・発行元：一般社団法人　日本耳科学会  

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

DOI： 10.11289/otoljpn.32.136

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記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.64.391

CiNii Research

記述言語：英語  

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.

記述言語：英語  

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

CiNii Research

記述言語：英語   出版者・発行元：Elsevier  

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

DOI： 10.1016/j.anl.2020.03.003

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

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

DOI： 10.1080/00016489.2020.1827159

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

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

DOI： 10.1080/00016489.2020.1781927

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記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.367

CiNii Research

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

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

DOI： 10.1080/00016489.2020.1754460

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

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

DOI： 10.1097/MAO.0000000000002022

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記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.61.494

CiNii Research

記述言語：日本語   出版者・発行元：耳鼻と臨床会  

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

DOI： 10.11334/jibi.64.5_189

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記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.65.417

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.65.431

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.64.489

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.484

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.342

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.63.430

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.62.406

CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本聴覚医学会  

DOI： 10.4295/audiology.61.344

CiNii Research