The air conduction threshold (AC) (average of 0.5, 1, and 2 kHz) and the speech discrimination score (SDS) were examined in 522 ears classified into conductive, mixed, and sensorineural hearing loss groups. In the conductive hearing loss group, the AC of was significantly lower while the SDS was significantly higher in comparison the other groups. There were no significant differences in the AC or SDS between the mixed and sensorineural hearing loss groups. Regarding the relationship between the AC and SDS, there was no correlation between the AC and SDS in the conductive hearing loss group: the SDS remained high as the AC increased. There was a weak correlation between the AC and SDS in the mixed hearing loss group: the SDS decreased as the AC increased. There was a strong correlation between the AC and SDS in the sensorineural hearing loss group: the SDS decreased as the AC increased. In the sensorineural hearing group, the equation "AC + SDS = 123" was valid, suggesting that the AC is useful for predicting the SDS.

At our clinic, ear-nose-throat physicians, speech-language pathologists, and certified hearing aid technicians collaborate with each other, and we have hearing aid-fitting software programs from many manufacturers available. In this study, we examined two patients who visited our clinic complaining of dissatisfaction with the effectiveness of their hearing aids and readjusted the devices while investigating the causes of their inadequate fitting. The results of the fit evaluation based on (1) the measurement of the speech intelligibility curve, (3) the measurement of the real ear insertion gain, and (5) the measurement of the functional gain in the Guidelines for Hearing Aid Fitting Tests (2010) suggested that the cause of inadequate fitting in both cases in this study was due to incorrect selection of the hearing aid receiver and earplugs as well as improper adjustment. After changing the type of earplugs and receiver and adjusting the output power, both cases successfully passed the hearing aid fitting evaluations, and the effectiveness of the hearing aids therefore improved. These findings suggest that one reason patients visit a medical institution for dissatisfaction with the effectiveness of their hearing aids is insufficient gain and output of the hearing aids, which may be caused by incorrect selection of the receiver and earplugs of the hearing aids as well as improper adjustment.

Between June 2022 and February 2023, in our clinic, 1,222 patients sought medical attention for dizziness. Among them, 205 patients screened positive for migraine, accounting for 16.8% of all dizziness cases. Of these migraine cases, 60 were confirmed as vestibular migraine (VM), representing 4.9% of all dizziness cases. A prospective study was conducted on 28 confirmed VM cases, tracking their progress for 4 weeks. The study aimed to assess the effectiveness of Migsis^® monotherapy. The headache evaluation relied on the frequency of analgesic use before and after treatment initiation. The study revealed a 28.6% improvement rate in headaches. However, the effect was considered insufficient, highlighting the need for combination therapy and long-term treatment. Dizziness was assessed using the Dizziness Handicap Inventory (DHI) score, measuring the impact on daily life. DHI scores averaged 44.2 ± 23.2 points at the initial visit and 25.1 ± 23.4 points at week 4, showing a significant improvement (p=0. 001). Based on Jacobson et al.’s report, a 46. 4% significant improvement was observed. Therefore, comprehensive and long-term treatment is necessary for VM, as monotherapy with migraine preventive drugs alone is inadequate. Vestibular rehabilitation has shown promise for VM, suggesting its inclusion as a future treatment option.

Intracranial complications of rhinosinusitis are conditions in which inflammation of the paranasal sinuses spills over into the cranium, and even today it can be fatal. We herein report a case of intracranial complication arising from frontal sinusitis that resulted in extensive cerebral venous sinus thrombosis. The patient was an 82-year-old woman who was referred to our department because of left periorbital erythema. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed left frontal sinusitis and associated left superior ophthalmic vein thrombosis and cerebral venous sinus thrombosis. In addition to receiving systemic antibiotic therapy, the patient consulted the neurosurgery department and started continuous heparin administration, but there was no improvement. Endoscopic sinus surgery (ESS) was performed for drainage of the frontal sinus, and the patient responded well and was discharged from the hospital without sequelae. The patient had been treated with glucocorticoids for rheumatoid arthritis for a long time, which may have increased the risk of intracranial thrombosis. In cases of severe infection in patients receiving long-term steroid therapy, it is important to keep in mind the risk of thrombosis and to promptly collaborate with other departments for nasal intracranial complications so as not to miss the opportunity to perform surgical treatment of sinus drainage.

We report three cases with idiopathic neck bleeding from a parathyroid mass without any episode of injury. In all cases, acute-onset neck swelling, cervicothoracic subcutaneous hemorrhage and laryngopharyngeal submucosal hemorrhage were observed, and CT and blood test findings suggested a deep neck hematoma derived from a parathyroid mass. Their symptoms improved with conservative treatment. In case 3, parathyroidectomy was performed electively due to persistent hypercalcemia and high intact-PTH. It is important to note that a parathyroid mass can cause deep cervical hematoma due to sudden hemorrhage without any trigger (e.g., trauma).

Congenital laryngeal atresia is one of the causes of congenital high airway obstruction syndrome (CHAOS). In recent years, there have been an increasing number of cases in which patients with CHAOS could be rescued by tracheotomy without cutting the umbilical cord (ex utero intrapartum treatment: EXIT). We report a case of congenital laryngeal atresia in which tracheostomy was performed without cutting the umbilical cord. CHAOS was suspected based on fetal ultrasonography at 20 weeks of gestation, and fetal MRI showed a nodular structure measuring 7 × 5 mm on the caudal side of the epiglottis. Based on these findings, a diagnosis of CHAOS was made. The infant was delivered at 35 weeks and 0 days of gestation by caesarean section with tracheotomy under EXIT. She had a birth weight of 1,945g and an Apgar score of 4 at 1 minute and 5 at 5 minutes. A postnatal examination revealed no complications other than laryngeal atresia, and she was discharged home at 190 days of age. At 1 year and 3 months of age, the patient had repeated colds, her respiratory condition worsened, and she was discharged from the hospital after her death.