[in Japanese]

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[in Japanese]

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The bone-anchored hearing aid (BAHA) has proved to be a valuable alternative to conventional air and bone conduction hearing aids for patients suffering from chronic otitis media or bilateral aural atresia. The BAHA gave better sound quality and greater comfort than conventional hearing aids (HAs), but only 1 study has been done in Japan.
We implanted BAHAs in 6 hard-of-hearing patients in the last 2 years. One patient suffered skin problems around the abutment and used the BAHA only briefly. Free-field audiometry, the speech discrimination test (SDT), and the speech recognition test (SRT) were conducted in all subjects. They were evaluated either with the HA or BAHA. The SDT and SRT showed better hearing results in quiet for the BAHA than the conventional HA, but there was a minimum difference in SDT and SRT in noise.
Subjects assessed the HA and BAHA using questionnaires. Subjects reported that the BAHA offers a number of important advantages, including greater cosmetic acceptability, improved speech intelligibility, and better sound quality.

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We tested the methylation status of tazarotine-induced gene 1 (TIG1) in head and neck cancer cell lines and primary tumors by the methylation-specific polymerase chain reaction (MSP). MSP showed that the TIG1 promoter was methylated in all cell lines. We then used MSP to check the methylation status of TIG1 in primary head and neck cancer (n=50). MSP showed TIG1 methylation in 31 (62%) head and neck cancers and no methylation in any normal samples. To confirm MSP results, we directly sequenced dense CpG regions. We found that promoter regions contained methylated cytosines. We thus observed a cancer-specific pattern of TIG1 methylation in primary head and neck cancer. Ourresults support the notion that promoter methylation is an important mechanism of TIG1 gene inactivation and occurs frequently in head and neck cancer. TIG1 methylation represents a new molecular marker for targeting diagnostic and therapeutic approaches in these cancers.

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After treatments, several patients with sudden deafness (SD) continued to have symptoms, including hearing loss, tinnitus and dizziness. These unresolved symptoms and their effect on the quality of life (QOL) in SD patients have not been studied. We evaluated QOL using the Hearing handicap inventory (HHIA) and an original questionnaire in SD patients who had been treated more than 6 months prior to the study.
Compared to results in bilateral sensorineural hearing were significantly lower in SD patients (p<0.01). In bil-SNHL, this score peaked two to 10 years after onset of disease and decreased thereafter. The score peaked more than 10 years after onset of disease in patients with SD. While hearing and test scores were correlated in bil-SNHL, this was not observed in SD.
About half of patients were embarrassed by hearing loss and tinnitus after treatment. Among patients who scored more than 44 points on HHIA, all reported hearing loss and tinnitus. When asked about subjective changes in hearing after treatment, 27% believed their hearing had improved. 60% believed there was no change, and 13% believed their hearing had deteriorated. Cases believing deterioration in hearing also had high scores on HHIA. Sequelae of SD may worsen QOL, driving embarrassed patients to visit other medical facilities in to improve their QOL.
Even though hearing may not improve after initial treatment in ears affected by SD, informed consent about the clinical course and audiological follow-up should be done.

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Patients with head and neck cancers often require use of a tracheal cannula due to stenosis of the permanent tracheostoma following total laryngectomy. However. a cannula that is designed for a multi-purpose tracheotomy frequently presents a problem. when placed in a permanent tracheostoma.
To resolve this difficulty. we developed a straight cannula that fits most permanent tracheostomas. We achieved a straight design by removing the curvature of a cufled tracheostomy single cannula (size 12: Koken Co., Ltd.). To facilitate installation by the patient without assistance, silicone was used because it is softer than similar conventional products. By making the cannula diameter slightly larger, immobilization with a strap is lomger needed.
Our cannula was used in 14 patients following surgery for the laryngeal, hypopharyngel, esophageal carcinomas. The cannula fit well and reduced the respiratory discomfort in all patients.

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Fibromyalgia, which is relatively rare, may include symptoms of dizziness, vertigo and tinnitus. Subject was 38years old woman reporting vertigo and whole body pain. Cochleovestibular function was normal. Pain was gradually intensified during her outpatient clinic and she was admitted. Treatments including intramusclular injection of botulinus toxin and intravenous injection of steroid were applied. Psychological counseling and autogenic training were effective in relieving her pain and vertigo. During her admission, several spells of vertigo occurred but no nystagmus was found. The abnormality in proprioception and neural disintegration may be related to vertigo. Treatment should start as early as possible together with psychological therapy.

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