An examination of auditory processing was conducted in 12 adults without hearing loss who complained of difficulty hearing in their everyday lives in order to analyze the cause of their hearing difficulties. A neuropsychological examination and evaluation of their developmental and mental issues were also conducted to examine the background factors underlying their hearing difficulties, such as their attention and memory. Our results showed that some auditory processing issues existed in 11 of the 12 total cases. In the remaining one case, the neuropsychological examination score was not lower than the average, and no developmental disorders or mental disorders were found. This indicated a high probability of auditory processing disorder. For the cases in which the score of neuropsychological examination was lower than the average or developmental or mental issues existed, it was suspected that the auditory processing ability declined due to other factors. These results confirmed the importance of investigating the background factors in cases of hearing difficulties by conducting a neuropsychological examination to evaluate the auditory information processing function.
Laryngeal papillomatosis (LP) has a high rate of recurrence. The main treatment is surgical excision, and various medicines have been administered as adjuvant therapy. Yokuinin, a Chinese medicine, has long been used as an adjuvant therapy for LP in Japan; however, there have been few reports on this topic. We studied the effects of the administration of Yokuinin as adjuvant therapy for LP. The subjects included 67 patients who were diagnosed with LP and who underwent surgery at Kyushu University Hospital from July 2000 to March 2018. Twenty-seven patients (40%) developed recurrent disease after surgery. Eight patients with recurrence were treated with oral Yokuinin as adjuvant therapy, while 19 patients with recurrent disease were treated without Yokuinin. The relapse-free periods of the Yokuinin treatment group and non-treatment group were compared; however, the difference was not statistically significant. We compared the period before therapy with that after treatment. Both the relapse-free and operation-free period was prolonged after the administration of Yokuinin. The administration of Yokuinin was found to extend the periods until recurrence and re-operation. These results suggested the potential usefulness of adjuvant therapy with Yokuinin.
Congenital nasal stenosis, which causes breathing disorder in newborns and infants, may affect the growth and development. However, there is no standard for its diagnosis or treatment. We herein report a case of congenital nasal stenosis that showed a good course following the placement of an intubation tube in the nose. A female infant was delivered without trouble. Sudden dyspnea occurred on the second day after birth, and thereafter she was transferred to our pediatric department. She was introduced to our department on the ninth day of life to investigate the cause of her respiratory disorder. When we examined her by a nasal flexible endoscope, the posterior nasal cavity was found to not be closed, but significant bilateral nasal stenosis was noted. We therefore concluded that the nasal stenosis was the cause of the dyspnea. After inserting an intubation tube into the nasal cavity, the general condition and respiratory condition stabilized, and we were ultimately able to remove this tube later. The long-term placement of an intubation tube is a low-invasive approach for managing congenital nasal stenosis, as in this case. In addition, we should consider the possibility of congenital nasal stenosis when encountering cases of infant dyspnea.
A 75-year-old woman reported pain on swallowing and a cough for 1 month, for which conservative treatment with fluoroquinolones yielded no improvement. Laryngoscopy revealed white granulomatous masses in the epiglottis and bilateral arytenoids. A sputum examination revealed positive findings for acid-fast bacilli in the smear, so she was diagnosed with nontuberculous mycobacterial infection by the pulmonologist. At the first biopsy examination of the laryngeal lesion, necrotizing granuloma was diagnosed. A second biopsy of the laryngeal lesion was performed, and simultaneous polymerase chain reaction (PCR) of the laryngeal lesion was positive for tuberculosis. The second sputum examination revealed acid-fast bacilli in the smear and a positive PCR for tuberculosis. Because laryngeal tuberculosis is typically complicated with lung tuberculosis, it is important to diagnose lung tuberculosis based on the findings of a sputum examination, smear, culture, and PCR for tuberculosis over three consecutive days as well as Quanti FERON TB (QFN) or T-SPOT and radiological examinations, such as chest X-ray. It is also necessary to examine the smear, culture, and PCR findings for tuberculosis at the time of the biopsy of the laryngeal lesion. Fluoroquinolones should not be administered before making a diagnosis of tuberculosis, as Mycobacterium tuberculosis is sometimes sensitive to these antibiotics.