Acta oto-laryngologica. Supplementum最新文献

Conclusion: Hydrogen gas effectively protected against the morphological and functional vestibular hair cell damage by reactive oxygen species (ROS).

Objective: ROS are generally produced by oxidative stress. In the inner ear, ROS levels increase as a result of noise trauma and ototoxic drugs and induce damage. It is thus important to control ROS levels in the inner ear. The protective effects of hydrogen gas in cochlear hair cells have been reported previously.

Methods: This study examined the effects of hydrogen gas on mouse vestibular hair cell damage by ROS using antimycin A.

Results: In the group *exposed to hydrogen gas, vestibular hair cells were morphologically well preserved and their mechano-electrical transduction activities were relatively well maintained when compared with controls. Hydroxyphenyl fluorescein (HPF) fluorescence in vestibular tissue was also reduced by hydrogen gas.

Conclusions: Most ears that were treated with a new surgical method were rendered dry and safe, with cavity problems minimized by this simple technique. This technique is also valid in terms of medical economy because it shortens the hospitalization period and subsequent outpatient care is not required frequently.

Objectives: Canal wall-down tympanomastoidectomy was a well established procedure for severe chronic otitis media, especially cholesteatoma. However, this procedure has some defects, so-called cavity problems, caused by non-epithelialized bony wall. The aim of this study was to evaluate the early epithelialized technique for the surface of widely formed external acoustic meatus after canal wall-down tympanomastoidectomy.

Methods: Twenty-five patients who had been diagnosed with cholesteatoma were divided into two groups. Group I consisted of 15 patients who underwent a new method in which the open cavity was lined with a pedicle periosteal flap of the postauricular region together with free temporal fascia grafts. As a control, 10 patients in group II underwent the standard operation that uses only free temporal fascia grafts.

Results: A comparison of the two groups showed that it took only 1 month on average for the entire surface of the external auditory meatus of the patients in group I to epithelialize and dry up perfectly, although the same area in all the patients in group II was not dried up perfectly until over 80 days.

Conclusion: The present findings indicate that conventional nasal packing is not required for endoscopic endonasal surgery.

Objectives: To evaluate the routine use of packing in endoscopic endonasal surgery.

Methods: From January 2006 through January 2009, 146 consecutive patients who underwent endoscopic endonasal surgery performed by the same surgeon in Kyoto University Hospital were evaluated. The surgical procedure was ended with conventional gauze packing in 70 consecutive patients from January 2006 through August 2007 (Packing group), and placing of oxidized cellulose on operative sites was performed in 76 consecutive patients from September 2007 to January 2009 (Non-packing group). We analyzed demographic characteristics, comorbidities, surgical procedures, incidence of packing the nose after excessive postoperative bleeding, and occurrence of postoperative adhesion.

Results: No significant differences in the demographic characteristics, except for gender, and in comorbidities were found between the two groups. The number of endoscopic sinus surgery procedures with septoplasty and/or turbinoplasty, or tumor extirpation in the Non-packing group was significantly larger than that in the Packing group. There was no significant difference in the incidence of postoperative bleeding or postoperative adhesion between the two groups.

Conclusion: The epidemiology of vertigo remains unclear. This study might contribute to an understanding of the mechanisms underlying vestibular disease.

Objective: To investigate the epidemiological features of patients with vertigo.

Methods: A retrospective study on 612 patients with vertigo who visited Kyoto University Hospital.

Results: Elderly individuals comprised > 30% of patients presenting with vertigo, with more female patients than male patients.

Conclusion: Organ preservation surgery with partial pharyngectomy preserving the larynx is feasible for the treatment of advanced hypopharyngeal cancer with comparable local control and preservation of function.

Objectives: To examine the feasibility and therapeutic effects of organ preservation surgery for advanced hypopharyngeal cancer.

Methods: Fourteen patients with stage III/IV hypopharyngeal cancer were treated by partial pharyngectomy with or without partial laryngectomy to preserve the larynx. Ten cases were T1/2 primary while four cases had T3/4 tumors. Reconstruction of the pharyngolarynx was completed by primary mucosal suture in six, while free forearm flap was used in eight cases. Induction chemotherapy was administered for six cases including three with T3/4 tumors.

Results: Five-year overall survival and disease-specific survival rates were 57.1% and 66.7%, respectively. The 5-year locoregional control rate was 66.7% and the larynx preservation rate was 100%. No patients presented with local recurrence at the pharyngolaryngeal segment, while two cases showed nodal recurrence, from which they died. Tracheal stoma was closed in 9 of 14 cases. Vocal function was excellent in five cases, moderate in five, and poor in three. Swallowing function was excellent to moderate in eight cases and poor in six.

Conclusion: Bone marrow-derived cells (BMDCs) are constitutively present in the vestibular end organs and in the endolymphatic sac, and may play a role in the maintenance of inner ear homeostasis.

Objectives: The aim was to examine the distribution and characteristics of BMDCs in the vestibular end organs and in the endolymphatic sac.

Methods: Bone marrow-chimeric mice were generated by bone marrow transplantation from mice genetically labeled with enhanced green fluorescent protein to C57 Bl/6 mice to visualize BMDCs. Three months after bone marrow transplantation, inner ear specimens were processed for histochemical analyses.

Results: BMDCs were widely distributed in the vestibular end organs and the endolymphatic sac, whereas there were differences in the phenotype and the distribution between the vestibular end organs and the endolymphatic sac. A subpopulation of BMDCs in the vestibular end organs expressed antigen-presenting protein MHC class II. Moreover, the density of BMDCs in the vestibular end organs increased in response to local mechanical stress.

Conclusion: We performed ossiculoplasty under conditions preventing inflammation by adopting a planned staged operation, which is suitable for ossiculoplasty using an artificial prosthesis. We identified the presence of chorda tympani nerve as a candidate predictive factor for successful ossiculoplasty.

Objectives: We aimed to summarize the outcome of ossiculoplasty and to find factors to improve the success rate.

Methods: This was a retrospective chart review of 96 patients who underwent ossiculoplasty in Kyoto University Hospital from 2001 to 2008. Patients' backgrounds, hearing outcomes, and surgical procedures were analyzed. To find predictive factors for successful ossiculoplasty, we performed logistic regression analysis.

Results: The improvement in the mean air conduction level was 12.9 dB. The mean postoperative air-bone gap (ABG) was 25.0 dB. The ABG decreased to within 20 dB in 40.7% of the cases. As a result of univariate logistic regression analysis, primary or planned second stage surgery, closed mastoid cavity, and presence of the chorda tympani nerve were identified as favorable factors for successful ossiculoplasty.

Conclusions: It is suggested that radiotherapy might be the first choice for stage I/II hypopharyngeal cancer, and that adjuvant treatment might be necessary for stage II patients to prevent distant metastasis.

Objectives: To update the therapeutic outcome of early hypopharyngeal cancer.

Methods: Twenty-eight patients with stage I/II hypopharyngeal cancer (8 in stage I, 20 in stage II) were treated at Kyoto University Hospital between 1995 and 2007. Of 8 cases in stage I, radiotherapy was applied for 4 cases, and surgical treatment for another 4, while 13 of 20 cases in stage II underwent radiotherapy and the remaining 7 cases underwent surgery.

Results: The 5-year cumulative disease-specific survival and larynx preservation rates were 74.6% and 73.2%, respectively. Recurrent tumors were found in two cases in stage I treated by surgery and in five cases in stage II treated with radiotherapy. Two of five recurrent cases in stage II were rescued by salvage surgery. Distant metastasis to the lung appeared in two cases in stage II after initial treatment.

Conclusion: The average age at the time of cochlear implantation is progressively being reduced. While cochlear obstruction and perilymph/cerebello-spinal fluid gusher were found in some cases, preoperative MRI and CT scans were predictive of such occurrences. The preoperative developmental quotient in the Cognitive-Adaptive Area was strongly correlated to the postoperative development in the Language-Social Area.

Objective: To summarize the background, implant devices, intraoperative findings, and postoperative developmental quotients of prelingually deafened patients who underwent cochlear implantation.

Methods: We conducted a retrospective chart review of 134 prelingually deafened cochlear implant recipients.

Results: The median age at implantation was 3 years and 5 months. Most patients were born deaf without any known etiologies. In most cases, the transmastoid facial recess approach was utilized. Cochlear obstruction was identified in four patients, all of whom lost their hearing as a result of meningitis. Perilymph/cerebello-spinal fluid gusher was observed in six patients with inner ear anomalies. The preoperative developmental quotient for the Cognitive-Adaptive Area showed significant correlation with the postoperative developmental quotient in the Language-Social Area with a correlation coefficient of 0.71.