The purpose of this study was to clarify the condition of cochlear implant medical care and to obtain basic data to guide future implantations in cochlear implant candidates. The speech perception ability using three cochlear implant devices (Coclear^TM, Advanced Bionics, and Med-El) approved and operable in Japan were retrospectively examined using various factors (cochlear implant threshold, monosyllable, word, and sentence listening ability) routinely assessed in our department for adult cochlear implant users. The results of this study are summarized below. Regarding the mean (standard deviation) values for the Coclear^TM, Advanced Bionics, and Med-El devices, the cochlear thresholds were 26.3 dB (6.3 dB), 29.6 dB (6.6 dB), and 32.2 dB (5.4 dB) ; the monosyllable listening abilities were 64.1% (20.9%), 60.0% (23.1%), and 60.7% (20.6%) ; the word listening abilities were 71.6% (22.5%), 69.2% (22.5%), 69.2% (26.9%), and 72.7% (21.1%) ; and the sentence listening abilities were 79.7% (24.4%), 72.4% (23.5%), and 74.9% (25.4%), with no significant differences noted. There were significant differences in a few external variables. These findings suggest that specific external variables may have a greater influence on the differences in speech perception ability of cochlear implants than differences in the devices themselves.

Otorhinolaryngology and dentistry are closely associated when treating odontogenic maxillary sinusitis, including preoperative dental interventions (e.g. treatment of root tip lesions), consideration of the necessity and timing of tooth extraction, and postoperative outpatient care of remaining teeth in our hospital. We examined nine cases in which simultaneous surgery was attempted by otorhinolaryngology and dentistry. Simultaneous otorhinolaryngological and dental surgeries are completed in a single operation after a thorough preoperative consultation, and the patient burden is reduced because dental treatment, such as tooth extraction, is performed simultaneously under general anesthesia. In addition, the intraoperative findings can be shared, which facilitates a smooth transition to postoperative dental treatment.

In this retrospective study, we analyzed the data of 103 patients with parotid tumors who had undergone parotidectomy at our hospital from February 2017 to March 2020. We analyzed the relationship among the age, gender, medical history of diabetes mellitus, tumor site (superficial lobe or deep lobe), tumor size, skin incision, pathological diagnosis and postoperative complication (facial nerve palsy, salivary fistula and Frey syndrome). Of the 103 patients, postoperative complications were as follows: 9.7% for facial nerve palsy, 1.0% for salivary fistula and 3.9% for Frey syndrome. Postoperative facial nerve palsy and the pathological diagnosis were significantly associated, and the frequency of postoperative complication was high in malignant cases. In addition, facial nerve palsy was observed in all cases in which cancer malignancy was high. A sufficient preoperative explanation and careful operation are required, especially for cases in which malignant tumor is suspected at the preoperative pathological diagnosis.

We encountered a case of leptomeningeal carcinomatosis with bilateral progressive sensorineural hearing disturbance. The primary origin of the disease was deemed to be due to stomach carcinoma and such cases are only rarely detected as a result of neural symptoms, which was also observed in this case. Enhanced magnetic resonance imaging was considered a potentially useful diagnostic modality with a high detection rate of disease in spite of its low invasiveness. In cases with bilateral progressive sensorineural hearing loss or facial nerve palsy, with or without a history of malignant tumors, a focused examination should be performed when making a differential diagnosis.

Although cartilage conduction hearing aids are useful for patients with aural atresia, it is difficult to fix the transducer and body of the hearing aid, as these patients are likely to be complicated with microtia or anotia. Double-sided tape is mainly used to fix the transducer; however, it can be easily peeled off due to perspiration or heavy activity. In addition, if the transducer is not stably fixed, it tends to induce howling; these issues necessitate some degree of ingenuity to ensure the hearing aid is worn properly. In this report, the fitting of an ear prosthesis was performed on patients with aural atresia, and good hearing results were obtained. In addition, compared with the use of double-sided tape, the incidence of hearing aid peeling off was reduced with this approach. The hearing aid was able to be removed under direct vision, thereby reducing the risk of mechanical damage to the hearing aid. The use of an ear prosthesis as a stabilizing device may be suitable, especially for children who cannot immediately undergo otoplasty.

Cases of inverted teeth involve the displacement of a tooth growing in the opposite direction to the normal teeth. Inverted teeth occasionally erupt in the maxillary sinus and cause sinusitis. For the treatment of sinusitis with inverted teeth, tooth extraction is indispensable. We herein report a 45-year-old man who presented with inverted teeth in the maxillary sinus with sinusitis. He had previously undergone endoscopic sinus surgery for the sinusitis, but his condition had not been improved. Computed tomography revealed a soft tissue shadow in the maxillary sinus with bone destruction, and two inverted teeth were detected in the maxillary sinus floor and the alveolar bone. We performed endoscopic sinus surgery, and inverted teeth that had entered the maxillary sinus floor via the inferior nasal passage were extracted. After the surgery, his sinusitis was completely cured.

We experienced a rare case of malignant lymphoma of the larynx that was difficult to differentiate from squamous cell carcinoma of the supraglottic region. A 60-year old man presented with a chief complaint of a sore throat. He had a smoking history and severe cardiac hypofunction due to congenital heart disease. An ulcerated tumor of the left side of the supraglottic region, which showed finding similar to those of squamous cell carcinoma, was observed by a laryngoscopic examination. However, no lymphadenopathy was detected by enhanced computed tomography (CT) of the neck or positron emission tomography (PET). Endoscopic biopsies were performed twice under local anesthesia for confirmation of the pathological diagnosis, which was diffuse large B-cell lymphoma arising from the larynx. He maintained a disease-free status for one year after receiving chemotherapy (R-COP-E therapy) and radiotherapy.

The patient was a 31-year-old man with a right neck mass that had persisted for four to five years, but which had grown in the two weeks prior to his presentation. We diagnosed a venous aneurysm originating from the external jugular vein based on the results of ultrasonography, contrast-enhanced CT, and MRI. We also thought that a thrombus might have formed inside. Surgery was performed with consideration of the patient's appearance and the risk of pulmonary embolism. The mass was actually filled with a thrombus. Venous aneurysm is a relatively rare cause of neck masses. Although there are few reports related to the head and neck, the most important complication is that an internal thrombus causes pulmonary embolism. If a soft neck mass is found, as in this case, it is necessary to confirm the blood flow in the mass and the positional relationship between the mass and the blood vessels, with consideration of the risk of rupture and thrombus formation due to puncture.

We herein report two cases in which closing a tracheoesophageal fistula proved difficult after removing a Provox due to a lack of utility. In Case 1, the patient was an 87-year-old man. At 8 months and again at 13 months after the removal of a Provox, fistulas appeared, and suturing was needed each time. In Case 2, the patient was a 74-year-old man. After the removal of a Provox, repeated suturing was performed, but the fistula could not be closed. The patient developed pulmonary aspiration twice while a nasogastric tube was inserted for nutrition. The fistula was finally closed 2 months later with a percutaneous endoscopic gastrostomy in position. Given the progressive aging of the population, it is a matter of concern that the patients who either cannot speak or who do not want to speak with a Provox will increase. We must carefully consult each patient's medical history and completely explain before the placement of a Provox that they may require repeated suturing and possible experience serious complications, such as pulmonary aspiration, with the removal of the device.

Despite good control of apnea and hypopnea using continuous positive airway pressure (CPAP) and nasal obstruction remediation surgery for obstructive sleep apnea syndrome, a patient's hypopnea became drastically aggravated with Cheyne-Stokes respiration 12 years after the start of CPAP. We herein report our experience of relatively rare sleep-disordered breathing where ASV was applied for persistent central sleep apnea even after coronary artery surgery with a diagnosis of old myocardial infarction and chronic heart failure. The patient was a 77-year-old man who presented with a chief complaint of daytime drowsiness. His apnea-hypopnea index was 44.0 on a simple apnea test, so CPAP was started. A slow increase in pulse pressure and aggravated hypopnea with Cheyne-Stokes respiration had been observed eight years earlier, leading to a diagnosis of transition to central sleep apnea due to old myocardial infarction and chronic heart failure. His cardiac function and apnea failed to recover despite coronary artery surgery. His apnea-hypopnea index became 9.9 due to auto continuous positive airway pressure (ASV) and has remained stable. These findings suggest that patients using CPAP require a careful examination for life-threatening respiratory conditions, such as changes in hypopnea and Cheyne-Stokes respiration, in addition to monitoring their apnea-hypopnea index.