We report five patients who underwent surgery and cochlin-tomoprotein (CTP) testing for suspected exolymphatic fistula in our department over an eight-month period. Triggers were identified in two cases, including one case of nasal biting (category 3) and one case of diving (category 2). CTP was negative in three cases and intermediate in two cases. Two cases showed leakage of extraglottic lymphatic fluid from the fossa rotunda. All four patients with vertigo showed improvement; hearing improved by > 10 dB in three cases. In category 4 cases, fluctuating hearing loss, fistula symptoms, and alternating directional nystagmus led to the suspicion of an exolymphatic fistula, and clinical findings of acute sensorineural hearing loss with dizziness should not be overlooked. Although the CTP test is minimally invasive, objective, and useful, the low positivity rate, the time required to obtain results (several weeks), and collection technique should be considered.

For the successful fitting of hearing aids in Japan, physicians, speech-language-hearing therapists, and hearing aid technicians must share background information about the patient's reasons for seeking hearing healthcare, as well as their test results, such as their pure tone audiogram and speech audiogram. In other words, people who adjust hearing aids should organize the patient's subjective and objective data in chronological order. We constructed a database (hereafter referred to as DB) to organize this vast amount of information. This system allows users to view the patient's comprehensive case history, the initial assessment of their hearing difficulty, the subjective assessment of hearing aid sounds, and how the medical staff responded to patient complaints on a single screen. In this DB, we can switch the screen with one click to easily view chronological changes in hearing aid adjustment. The use of this DB has made it easier for medical staff to assess a patient's condition and encourage active discussions at conferences. This DB is expected to support hearing aid adjustments and multi-professional collaboration, leading to more efficient and satisfactory fittings.

Otorhinolaryngology-head and neck surgery and dental and oral surgery are anatomically and physiologically similar. Collaboration with dental surgery is essential for the perioperative management of the oral function when treating head and neck cancer and dental infections, such as odontogenic maxillary sinusitis. In the present study, we investigated the specific diseases associated with otorhinolaryngology-head and neck surgery and dental and oral surgery at Kyushu Medical Center. A total of 150 patients were referred for otorhinolaryngology-head and neck surgery or dental and oral surgery, and 29 of them (15 males and 14 females; mean age 59.1 years old) were referred from dental surgery to otorhinolaryngology-head and neck surgery. Of these, nine cases were referred for suspected malignancy, five for suspected parotid gland, four for arthrodesis for odontogenic maxillary sinusitis, three for chronic sinusitis, two for metal ingestion, and one each for chronic sinusitis, metal misuse, postoperative maxillary cyst, ear discomfort, abnormal pharyngeal sensation, suspected necrosis of the external auditory canal, soft palate ulcer, and hyperaccumulation of thyroid on fluorodeoxyglucose-positron emission tomography. Conversely, 121 patients were referred from otorhinolaryngology-head and neck surgery to dental surgery (71 males and 50 females, mean age 62.2 years old), including 51 patients for perioperative oral function management, 55 with dental infection, 12 with dental diseases other than infection, and 1 case each of fracture of the anterior wall of the external auditory canal, follow-up observation after removal of a maxillary foreign body, and pemphigus vulgaris. There have been cases in which patients were diagnosed by a dentist but had dental problems, so it is necessary for otorhinolaryngologists to have knowledge of dental diseases.

We herein report a 50-year-old woman with recurrent giant cholesteatoma. She visited the clinic with a complaint of swelling on the right side of her head, which she had noticed for five years but had left untreated because of a lack of symptoms. Recently, an increase in size has been observed. Her medical history included surgery for cholesteatoma-related otitis media 20 years prior, raising concerns regarding recurrence. An examination and imaging confirmed a multiloculated cystic mass, which necessitated surgical excision. Typically, cholesteatomas expand within the temporal bone and are often involved in bone destruction. However, in this case, the mass extended subcutaneously, without accompanying bone destruction. This unusual progression may indicate that the thickened membrane of cholesteatoma acts as a defensive barrier. Through this case, we aim to deepen our understanding of the pathological characteristics and clinical course of cholesteatoma while reaffirming the importance of surgical approaches to prevent recurrence.

We report a case of atypical skull base osteomyelitis with few signs of inflammation in the middle or outer ear. A 73-year-old man with a history of diabetes visited our hospital complaining of right earache and headache. A decreased bone marrow signal was observed on T1-weighted MRI, and skull base osteomyelitis was suspected. It is thought that the inflammation of the temporal bone was partially resolved due to inadequate treatment of the malignant external otitis; however, the inflammation that remained in the deep part of the skull base led to the development of skull base osteomyelitis. MRI evaluation is important in cases of skull base osteomyelitis without intra-aural findings, as in the present case. Fortunately, the patient responded well to antimicrobial treatment.

Follicular carcinoma, a rare differentiated thyroid carcinoma in children, poses challenges when determining treatment strategies including surgery and radioactive iodine therapy (RAI). We report a case of pulmonary metastasis after hemithyroidectomy treated with completion thyroidectomy and RAI. A 10-year-old girl presented to a local physician with anterior neck swelling and was referred to our department. Ultrasonography revealed a well-defined, 22-mm tumor with a hypoechoic rim in the right thyroid lobe. Fine-needle aspiration cytology suggested follicular neoplasm. Conservative observation was performed after obtaining informed consent. Eight months later, ultrasonography showed tumor invasion into the anterior neck muscles, raising suspicion of follicular carcinoma. Right thyroid lobectomy and central neck dissection were performed. Three years postoperatively, computed tomography revealed suspected pulmonary metastasis. Completion thyroidectomy was performed followed by RAI. One year has passed since the two rounds of postoperative RAI. Neither tumor recurrence nor elevated thyroglobulin (Tg) levels were observed.