Auris Nasus Larynx最新文献

{"title":"Clinical and pathological characteristics of CRS with nasal polyps in patients with asthma–COPD overlap","authors":"Masayoshi Mukai ,&nbsp;Haruka Nakanishi ,&nbsp;Kanako Matsui ,&nbsp;Emiri Sato ,&nbsp;Manabu Nonaka ,&nbsp;Naoko Yanagisawa","doi":"10.1016/j.anl.2025.10.007","DOIUrl":"10.1016/j.anl.2025.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>Bronchial asthma (BA) and Chronic Obstructive Pulmonary Disease (COPD) have been considered as independent diseases, but in recent years, Asthma and COPD Overlap (ACO), which combines characteristics of BA and COPD, has been defined. Chronic rhinosinusitis (CRS) with nasal polyps and BA, both caused by similar type 2 inflammation, often coexist and are considered to have a “one airway, one disease” relationship. In ACO, airway inflammatory cells of BA (eosinophils and CD4⁺ lymphocytes) and COPD (neutrophils, CD8+ lymphocytes and macrophages) coincide, theoretically leading to steroid resistance compared to BA alone. Based on the “one airway, one disease” concept, we hypothesized that clinical and pathological characteristics of CRS differs depending on its comorbidity with ACO or with BA alone.</div></div><div><h3>Methods</h3><div>Sixty-two CRS patients with BA who underwent endoscopic surgery for CRS with nasal polyp at our hospital between January 2014 and December 2022 were included in this study, and were followed at our hospital until December 2023. The patients were categorized by pulmonologists into 21 patients of CRS-ACO and 41 patients of CRS-BA according to the Japanese guidelines for the Management of ACO 2018. We compared recurrence-free period of nasal polyps between these two groups. Nasal polyps from CRS-ACO (<em>n</em> = 11) and CRS-BA (<em>n</em> = 13) those who consented to this study were subjected to histologic examination and the numbers of eosinophils, and cell positive for CD4, CD8, elastase (a marker for neutrophils), and CD163 (a marker for macrophages) were counted.</div></div><div><h3>Results</h3><div>CRS-ACO had a significantly faster recurrence time, compared to the recurrence time in CRS-BA, and was a risk factor for recurrence. Nasal polyps from CRS-ACO and CRS-BA those who consented to this study were subjected to histologic examination. Elastase, CD8, and CD163 positive cell numbers were significantly higher in CRS-ACO than in CRS-BA patients.</div></div><div><h3>Conclusion</h3><div>CRS-ACO patients were prone to recurrence of nasal polyps, and the pathology of nasal polyps in CRS-ACO patients were significantly infiltrated with neutrophilic inflammatory cells. CRS-ACO patients revealed inflammatory cell infiltration in the upper airway (nasal polyps) and similar cell types was confirmed to coexist in the lower airway, suggests the possibility of a “one airway, one disease” concept, not only in BA, but also in ACO as well.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 744-749"},"PeriodicalIF":1.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of intratympanic administration of glucocorticoids on the guinea pig inner ear","authors":"Akinobu Kakigi ,&nbsp;Makoto Kinoshita ,&nbsp;Yuki Katsutani ,&nbsp;Toshihito Sahara ,&nbsp;Shinji Yamashita ,&nbsp;Kenji Kondo","doi":"10.1016/j.anl.2025.09.005","DOIUrl":"10.1016/j.anl.2025.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates the effects of intratympanic glucocorticoid administration on the inner ear.</div></div><div><h3>Methods</h3><div>Fifteen Hartley guinea pigs were used and divided into five groups: dexamethasone-treated (<em>n</em> = 5), contralateral dexamethasone-treated (<em>n</em> = 5), hydrocortisone-treated (<em>n</em> = 5), contralateral hydrocortisone-treated (<em>n</em> = 5), and control (<em>n</em> = 5). In the control group, 1 ml of saline was injected into the right tympanic cavity via a ventral approach. In the dexamethasone-treated group, 1 ml of dexamethasone at a concentration of 3.3 mg/ml was injected into the right tympanic cavity using the same method, while the left ear of the dexamethasone-treated group remained intact. In the hydrocortisone-treated group, 1 ml of hydrocortisone at a concentration of 50 mg/ml was injected into the right tympanic cavity using the same technique, with the left ear of the hydrocortisone-treated group also remaining intact.</div><div>To assess the effects of glucocorticoids on the inner ear, we measured a cross-sectional area analysis of the scala media at three hours post-corticosteroids treatment using optical coherence tomography (OCT). The degree of a cross-sectional area change was quantitatively measured using a video digitizer.</div></div><div><h3>Results</h3><div>Ears treated with either dexamethasone or hydrocortisone showed extension of Reissner's membrane and endolymphatic hydrops. Statistical analysis indicated that a cross-sectional area of the scala media increased significantly compared to the contralateral hydrocortisone-treated and control groups.</div></div><div><h3>Conclusions</h3><div>This is the first report to investigate the effects of intratympanic administration of glucocorticoids on the guinea pig cochlea. Dilated endolymphatic space was observed in the steroid-treated ears. Although the underlying mechanism of these histological changes remains unclear, great care must be taken when administering steroids to patients with endolymphatic hydrops-related diseases, such as Meniere's disease.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 729-734"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of esophageal fistula induced by lenvatinib in thyroid cancer using deltopectoral flap","authors":"Yuji Kanazawa ,&nbsp;Yoshiharu Kitani ,&nbsp;Maki Kitatsuji ,&nbsp;Yusuke Yamamoto ,&nbsp;Aya Matsubara ,&nbsp;Makoto Suzuki","doi":"10.1016/j.anl.2025.10.005","DOIUrl":"10.1016/j.anl.2025.10.005","url":null,"abstract":"<div><div>Lenvatinib, a multi-target tyrosine kinase inhibitor, has demonstrated efficacy in the treatment of various solid tumors, including thyroid cancer. However, life-threatening complications such as fistula formation have been observed in some cases. We report the case of a 47-year-old woman who developed an esophageal fistula following lenvatinib treatment for recurrent thyroid cancer. The patient initially underwent limited resection of the muscular layer of the cervical esophagus and preservation of the mucosa, followed by prophylactic radiotherapy because of inadequate surgical margins. Locoregional and pulmonary metastases developed 8 months postoperatively, and lenvatinib therapy was initiated at a dose of 24 mg. Subsequently, a fistula developed from the esophagus to the cervical skin. Esophageal fistula reconstruction was performed using a deltopectoral (DP) flap. Lenvatinib was resumed at a reduced dose of 14 mg two months after reconstruction. At 18 months after resuming lenvatinib, progression-free survival and adequate oral intake were achieved. The success of the DP flap reconstruction in this case highlights its potential as a durable solution for esophageal fistulas in patients receiving lenvatinib treatment. The robust blood supply provided by the DP flap may counteract the antiangiogenic effects of lenvatinib, thereby enabling continued treatment for locoregional recurrence.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 725-728"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of perioperative oral care on postoperative infections in patients with head and neck cancer: A retrospective study comparing before and during the coronavirus disease 2019 pandemic","authors":"Azusa Kai ,&nbsp;Kimie Fujita ,&nbsp;Naohisa Wada ,&nbsp;Takashi Nakagawa","doi":"10.1016/j.anl.2025.10.003","DOIUrl":"10.1016/j.anl.2025.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>Infection prevention is crucial in head and neck cancer surgery due to the high risk of surgical site contamination by oral bacteria and pharyngeal secretions. The coronavirus disease 2019 (COVID-19) pandemic has introduced significant challenges to infection control in medical settings, including restrictions on patient care and changes to perioperative management. This study investigated the incidence of postoperative pneumonia (PP) and surgical site infection (SSI) before and during the COVID-19 pandemic, and examined how perioperative oral care and oral hygiene status were associated with the occurrence of postoperative infections.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the medical records of patients who underwent head and neck cancer surgery between January 2018 and March 2022. The incidences of PP and SSI were compared before and during the COVID-19 pandemic. In addition, variables identified by univariate analysis as predictors of postoperative infection were incorporated and examined using logistic regression analysis.</div></div><div><h3>Results</h3><div>A total of 213 patients were included in this study. The incidence rates of PP and SSI were 15.0% and 24.4%, respectively, with no statistically significant difference before and during the pandemic. The risk factors for PP included preoperative oral dryness (odds ratio [OR] = 2.65; 95% confidence interval [CI] = 1.14–6.17; <em>p</em> = 0.024), and diabetes (OR = 2.65; 95% CI = 1.04–6.72; <em>p</em> = 0.040), while for SSI, the risk factors included lack of postoperative oral care (OR = 0.29; 95% CI = 0.10–0.86; <em>p</em> = 0.026), prolonged operative time (OR = 1.80; 95% CI = 1.09–2.99; <em>p</em> = 0.022), and preoperative radiotherapy (OR = 2.25; 95% CI = 1.02–4.95; <em>p</em> = 0.044).</div></div><div><h3>Conclusion</h3><div>Appropriate perioperative oral care remains essential, even in the post-COVID-19 era. This study highlights the importance of preventing oral dryness before surgery and ensuring continuous professional oral care before and after surgery to prevent postoperative infections.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 735-743"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of Japanese clinical practice guidelines for head and neck cancer - 2025 update edited by the Japan Society for Head and Neck Cancer","authors":"Nobuhiro Hanai ,&nbsp;Mizuo Ando ,&nbsp;Hiroto Ishiki ,&nbsp;Nobuhiro Ueda ,&nbsp;Susumu Okano ,&nbsp;Isaku Okamoto ,&nbsp;Hiroyuki Ozawa ,&nbsp;Satoshi Kano ,&nbsp;Tomonori Kanda ,&nbsp;Yuki Saito ,&nbsp;Hirotaka Shinomiya ,&nbsp;Keisuke Takanari ,&nbsp;Toshifumi Tomioka ,&nbsp;Hiroshi Fuseya ,&nbsp;Yoshitaka Honma ,&nbsp;Atsushi Motegi ,&nbsp;Koichi Yasuda ,&nbsp;Takeshi Kodaira ,&nbsp;Hiroshi Kurita ,&nbsp;Ken-ichi Nibu ,&nbsp;Akihiro Homma","doi":"10.1016/j.anl.2025.09.004","DOIUrl":"10.1016/j.anl.2025.09.004","url":null,"abstract":"<div><div>The Japanese Clinical Practice Guidelines for Head and Neck Cancer – 2025 Edition were developed to provide clear evidence-based recommendations that reflect recent advancements and evolving clinical needs in head and neck cancer care. Advances in immunotherapy, targeted therapies, surgical techniques, and genomic medicine have expanded treatment options and added new complexities. This edition offers practical, up-to-date guidance to support consistent decision making across diverse clinical scenarios. Compared with the 2022 edition, the guidelines have been substantially expanded to 63 clinical questions (CQs) across 14 categories. A new feature is the inclusion of commentary columns that address clinically important topics not suited to the CQ format, such as special patient populations, novel therapies, and rare malignancies. To reflect the growing role of precision oncology, updated recommendations for molecular-targeted treatments have been added based on specific genomic alterations, in alignment with the current approvals in Japan. While maintaining the structure of previous editions, this edition addresses the changing clinical environment while also helping to inform future discussions and directions in head and neck cancer care.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 709-724"},"PeriodicalIF":1.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative symptom-guided plug size selection in sitting position Kobayashi plug surgery for patulous eustachian tube","authors":"Takeshi Oshima ,&nbsp;Marin Yoshida ,&nbsp;Hideshi Shindo ,&nbsp;Hidetoshi Oshima ,&nbsp;Ryoji Hirai","doi":"10.1016/j.anl.2025.09.007","DOIUrl":"10.1016/j.anl.2025.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of Kobayashi Plug Surgery (KPS) for patulous Eustachian tube (PET) performed under local anesthesia in the sitting position, using intraoperative subjective symptoms to guide plug size selection, and to investigate its effect on revision surgery rates.</div></div><div><h3>Methods</h3><div>This retrospective study included 61 patients (73 ears) with refractory PET who underwent KPS between December 2023 and June 2025. All procedures were performed under local anesthesia with patients in the sitting position, allowing for real-time assessment of subjective symptoms immediately after plug placement. If symptoms persisted, the plug size was increased intraoperatively. Clinical data, surgical outcomes, plug sizes, and postoperative complications were analyzed. Long-term outcomes were assessed in 29 ears with follow-up exceeding 180 days using PHI-10, Eustachian tube function tests, and revision surgery rates.</div></div><div><h3>Results</h3><div>Plug placement was successful in 66 of 73 ears (90.4%). Plug size adjustment during initial surgery was performed in 5 ears (7.6%) based on persistent symptoms. Among 29 ears with long-term follow-up (median: 297.5 days), the overall revision surgery rate due to upsizing was 10.3%. However, among the 41 ears that presented with subjective symptoms at the time of surgery, only 1 case (2.4%) required revision surgery during follow-up. PHI-10 scores significantly improved from a median of 30 to 10 (p &lt; 0.001), and sonotubometry sound pressure levels increased from 85 dB to 99 dB (p &lt; 0.005). Tympanic membrane perforation was observed in one ear (preexisting), and ventilation tube placement for otitis media with effusion was required in 4 ears (13.8%).</div></div><div><h3>Conclusion</h3><div>KPS under local anesthesia in the sitting position allows for intraoperative symptom-based plug size selection, which may help reduce the need for revision surgery, especially in patients with active symptoms at the time of surgery. While the overall revision rate was 10.3%, it was markedly lower (2.4%) among symptomatic cases. Although the findings should be interpreted with caution due to the small sample size and retrospective design, this technique represents a promising approach for improving surgical outcomes in patients with refractory PET.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 704-708"},"PeriodicalIF":1.5,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145326411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of hearing impairment in unilateral hearing loss: A multicenter study of standardized sound localization tests in Japan","authors":"Takashi Ishino ,&nbsp;Tadao Yoshida ,&nbsp;Satoshi Iwasaki ,&nbsp;Naoki Oishi ,&nbsp;Yusuke Matsuda ,&nbsp;Tetsuya Tono ,&nbsp;Kazuma Sugahara ,&nbsp;Hiroshi Yamazaki ,&nbsp;Sumito Jitsukawa ,&nbsp;Hiroshi Nakanishi ,&nbsp;Ryosuke Kitoh ,&nbsp;Takashi Sato ,&nbsp;Kazuki Nishida ,&nbsp;Takashi Oda ,&nbsp;Rikuto Fujita ,&nbsp;Tomohiro Kawasumi ,&nbsp;Chie Ishikawa ,&nbsp;Manabu Nishida ,&nbsp;Nobuyuki Chikuie ,&nbsp;Yuichiro Horibe ,&nbsp;Sachio Takeno","doi":"10.1016/j.anl.2025.09.010","DOIUrl":"10.1016/j.anl.2025.09.010","url":null,"abstract":"<div><h3>Objective</h3><div>This study had two primary objectives: first, to standardize a sound localization test across multiple facilities in Japan, and second, to use this standardized test to analyze sound localization ability in patients with unilateral hearing loss (UHL) and identify related clinical and demographic factors.</div></div><div><h3>Methods</h3><div>Sound localization tests were conducted at 11 facilities, enrolling 59 UHL subjects and 77 normal-hearing controls (Ctrl). The first part of the study focused on standardizing the test protocol and establishing reference ranges and cut-off values. The second part analyzed the sound localization ability in UHL patients, measured by the root mean squared (RMS) error. The association between RMS values and factors such as residual hearing, contralateral routing of signal (CROS) hearing aid use, and Hearing Handicap Inventory for Adults (HHIA) scores were analyzed.</div></div><div><h3>Results</h3><div>Reference ranges and cut-off values for the standardized sound localization test were successfully established. UHL subjects exhibited significantly higher RMS values (i.e., poorer localization) compared to controls. The use of CROS hearing aids did not improve performance, and the contribution of pinna-induced spectral cues was limited. Significant associations were found between RMS values and both sound presentation position and the number of audiogram frequencies with thresholds better than 40 dB and 50 dB, with the 50 dB threshold criterion being a more prominent factor. HHIA emotional and social scores were significantly associated only with age and not with sound localization performance or other audiological factors.</div></div><div><h3>Conclusions</h3><div>The standardized sound localization test proved to be a reliable tool for multicenter studies. Patients with UHL have significantly impaired sound localization. Residual hearing in the impaired ear, even if limited, was found to aid localization, whereas the benefits of CROS hearing aids and monaural spectral cues were negligible in our cohort. Since only age influenced the self-perceived hearing handicap (HHIA scores), it is crucial to consider restoring binaural hearing not just to improve sound localization but also to address the broader quality-of-life issues associated with UHL.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 690-703"},"PeriodicalIF":1.5,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145326424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New method; continuous water perfusion method during endoscopic resection for the superficial pharyngeal squamous cell carcinoma","authors":"Naohiro Nakamura ,&nbsp;Tomofumi Sakagami ,&nbsp;Kensuke Suzuki ,&nbsp;Takuo Fujisawa ,&nbsp;Takuya Shijimaya ,&nbsp;Sanshiro Kobayashi ,&nbsp;Masataka Masuda ,&nbsp;Yu Takahashi ,&nbsp;Tomomitsu Tahara ,&nbsp;Makoto Naganuma","doi":"10.1016/j.anl.2025.10.002","DOIUrl":"10.1016/j.anl.2025.10.002","url":null,"abstract":"<div><div>Recent development in endoscopic imaging has led to the detection of superficial laryngopharyngeal carcinomas and the effectiveness of endoscopic resection for superficial pharyngeal squamous cell carcinoma have been reported. However, the en bloc and complete resection rates were not sufficient. To identify the precise incision and dissection lines, ensuring a clear operating view is important. Although underwater condition during dissection is useful, saliva, bleeding, and produced floating matter make the operating view worse as the dissection process continues. We presented new method; continuous water perfusion method (CWPM) may contribute to ensuring a clear operating view during dissection of endoscopic resection for superficial pharyngeal squamous cell carcinomas.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 687-689"},"PeriodicalIF":1.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing a comprehensive national auditory implant registry in Japan: Trends and demographics from the first two years (2023–2024)","authors":"Ayu Akazawa ,&nbsp;Takeshi Fujita ,&nbsp;Kensuke Uraguchi ,&nbsp;Megumi Kitayama ,&nbsp;Taku Ito ,&nbsp;Yasuhiro Osaki ,&nbsp;Kyoko Shirai ,&nbsp;Haruo Yoshida ,&nbsp;Norio Yamamoto ,&nbsp;Katsumi Doi ,&nbsp;Satoshi Iwasaki ,&nbsp;Naoki Oishi","doi":"10.1016/j.anl.2025.09.009","DOIUrl":"10.1016/j.anl.2025.09.009","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the establishment and initial findings of Japan’s first comprehensive nationwide registry covering cochlear implants (CIs), active middle ear implants (AMEIs), and bone conduction implants (BCIs), launched in 2023. The registry aims to improve national data collection, support evidence-based policymaking, and track trends in surgical practice and patient demographics.</div></div><div><h3>Methods</h3><div>A web-based electronic data capture (EDC) system was implemented to replace the previous paper-based reporting system. Between January 2023 and December 2024, data were voluntarily submitted by participating facilities across Japan. Collected data included patient demographics, implant types, hearing thresholds, etiologies, and manufacturer information. Registry completeness was assessed by comparison with Japan’s National Database of Health Insurance Claims (NDB).</div></div><div><h3>Results</h3><div>A total of 1880 patients were registered, and 1809 patients with surgical information entered from 104 facilities were selected for analysis, comprising 1723 CI cases and 86 AMEI or BCI cases (11 VSB, 22 BB, 53 Baha). Among 605 pediatric CI recipients, early-age implantation was increasingly observed, with 58 patients (10 %) aged under 1 year and 183 (30 %) aged 1 year. Among adult CI recipients, 271 patients were aged 75 years or older, including 40 patients aged 85 years or older. Additionally, simultaneous bilateral CI surgery was performed in 265 patients, of whom 175 were children, reflecting the expanding indications. Patients with better ear thresholds &lt;90 dB HL accounted for 33 % of adults and 29 % of children. Congenital hearing loss predominated in children, while acquired causes were more common in adults. Among cases with a known etiology, hereditary deafness was the most common (24.5 %), although 39.6 % of etiologies were unknown. CI data completeness reached 73 % compared with NDB, indicating strong nationwide participation and a high level of data reliability.</div></div><div><h3>Conclusion</h3><div>This is the first comprehensive report from the national registry in Japan that includes not only CIs but also AMEIs and BCIs. The registry demonstrated reliable data capture and highlighted important trends in patient demographics and surgical practices. Continued data collection will enhance clinical decision-making and support policy development, ultimately improving care for auditory implant recipients.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 679-686"},"PeriodicalIF":1.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of cochlear implantation in Japan and factors affecting postoperative infection","authors":"Megumi Koizumi ,&nbsp;Akinori Kashio ,&nbsp;Miho Ishimaru ,&nbsp;Hiroki Matsui ,&nbsp;Kiyohide Fushimi ,&nbsp;Hideo Yasunaga ,&nbsp;Tatsuya Yamasoba","doi":"10.1016/j.anl.2025.09.001","DOIUrl":"10.1016/j.anl.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the clinical features in a large cohort of patients who underwent cochlear implantation in Japan, including the number of simultaneous bilateral cochlear implantation, proportion of postoperative infectious complications, and factors associated with postoperative infectious complications.</div></div><div><h3>Methods</h3><div>This retrospective cohort study extracted data of 7893 patients who underwent 9427 cochlear implantations from a Japanese national inpatient database between July 2010 and March 2021. We determined the number of cochlear implantations, patient age, number of simultaneous bilateral surgeries, and incidence of infectious complications. The factors associated with postoperative infection were analyzed using a multivariate logistic regression model.</div></div><div><h3>Results</h3><div>Pediatric cases were predominant until 2016, whereas adult cases surpassed pediatric cases beginning in 2017. The proportion of patients aged &gt; 1 year and 6 months decreased gradually since 2014. The number of simultaneous cochlear implantations increased steadily since 2016. The incidence of postoperative infection was 4.8 %. Postoperative infectious complications were significantly associated with age &lt; 2 years at surgery, inner ear malformations, and medium hospital volumes in pediatric patients. In adults, chronic otitis media and comorbid diabetes mellitus without complications were associated with postoperative infectious complications.</div></div><div><h3>Conclusions</h3><div>The trends in patient age and the number of simultaneous surgeries in Japan are consistent with the revised guidelines. The incidence of postoperative infections was 4.8 %. The factors associated with postoperative infection differed between pediatric and adult patients. These findings may help surgeons in the management of cochlear implantation.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 672-678"},"PeriodicalIF":1.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}