Nippon Jibiinkoka Gakkai Kaiho
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
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Volume 110, Issue 11
Displaying 1-5 of 5 articles from this issue
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Review article
Original article
  • Value of Diffusion-weighted MR Imaging in the Detection of Middle Ear Cholesteatoma
    Noriaki Nagai, Tetsuya Tono, Keiji Matsuda, Katsuhiro Toyama, Hirokazu ...
    2007 Volume 110 Issue 11 Pages 707-712
    Published: November 20, 2007
    Released on J-STAGE: December 25, 2008
    DOIhttps://doi.org/10.3950/jibiinkoka.110.707
    JOURNAL FREE ACCESS
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    [Objective] This study was conducted to determine the clinical value of diffusion-weighted MR imaging (DWI) in detecting the presence of cholesteatoma.
    [Subject and methods] Fifty-six patients (21 female and 35 male patients ; mean age, 43 years) who underwent middle ear surgery were referred to the radiology department for a preoperative DWI study.
    [Results] DWI depicted 41 out of 48 cholesteatomas involving the middle ear cavity (sensitivity, 85.4%). Seven patients with middle ear cholesteatoma who showed negative DWI findings (false-negative cases) had limited keratin accumulation due to simple atelectasis or meticulous evacuation of keratin debris before the MRI study. No false-positive cases were found in this study (specificity, 100%). The positive predictive value and negative predictive value were 100% and 53.3%, respectively. The minimum size of middle ear cholesteatoma detected by the current MRI system was 5mm.
    [Conclusion] Diffusion-weighted MR imaging was useful for the detection of middle ear cholesteatoma.
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  • Characteristics of Migrating Cells in Effusion of the Middle Ear in Patients of “Eosinophilic Otitis Media”
    Akiko Tokumaru, Tomonori Eguchi, Kensuke Watanabe
    2007 Volume 110 Issue 11 Pages 713-719
    Published: November 20, 2007
    Released on J-STAGE: December 25, 2008
    DOIhttps://doi.org/10.3950/jibiinkoka.110.713
    JOURNAL FREE ACCESS
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    Otitis media with effusion (OME) is known to be a disease that frequently afflicts children. Recently, numerous reports of intractable OME associated with bronchial asthma have been reported, generally referred to as “eosinophilic otitis media”. To comprehend the cause and pathogenesis of this disease, we conducted an electron-microscope analysis of the effusion.
    The subjects were 5 male and 1 female patients, 4 had aspirin-induced asthma and 2 had adult-onset asthma. The number of collapsed and intact eosinophils and other inflammatory cells in the middle ear effusion were counted, and their characteristics were reviewed. Most eosinophils in the middle ear effusion were collapsed, and a high percentage of eosinophils in the nasal discharge were also collapsed. The inflammatory cells were phagocytosed by macrophages at a high frequency in cases of otitis media with effusion, but only a low rate of phagocytosis was observed in cases with eosinophilic otitis media. It is known that necrotic cells are phagocytosed with difficulty, while apoptotic cells are phagocytosed easily by macrophages. Therefore, collapsed eosinophils persist for a long time in middle ear effusion and the released granule proteins from the eosinophils cause the tissue failure. Threfore, we believe that treatment directed at causing apoptosis of eosinophils can prevent exacerbation of the intractable inflammation in this condition.
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  • Dynamic Vestibular Compensation in Vestibular Peripheral Diseases
    Tadashi Kitahara, Arata Horii, Kazumasa Kondoh, Shin-ichi Okumura, Tak ...
    2007 Volume 110 Issue 11 Pages 720-727
    Published: November 20, 2007
    Released on J-STAGE: December 25, 2008
    DOIhttps://doi.org/10.3950/jibiinkoka.110.720
    JOURNAL FREE ACCESS
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    Vestibular compensation, or neuronal plasticity in the central vestibular system, is quite an important process in patients with acute unilateral peripheral vestibular disease, allowing them to lead a comfortable daily life when medical treatments fail to cure the peripheral vestibular function. Is the residual unilateral vestibular input from damaged vestibular endo-organs a positive or negative factor for the development of dynamic vestibular compensation in the central nervous system? To elucidate the true mechanism of vestibular compensation, we examined the ENG findings and dizziness handicap inventory questionnaire in patients with vestibular neuronitis (VN), sudden deafness with vertigo (SDV), Meniere's disease (MD) and acoustic tumor (AT) during remission of the vertigo attacks. We obtained neuro-otological findings from caloric tests and head shaking after nystagmus using ENG and information on motion-evoked dizziness in daily life using the questionnaire. There were no significant differences in the sex, age or canal paresis % (CP%) among the four groups.
    The results of the present study showed that dynamic vestibular compensation processes developed progressively in the order of patients with SDV, VN, MD and AT (Kruskal-Wallis : p<0.05). This finding suggests that processes of dynamic vestibular compensation could be accelerated in patients with fixed vestibular lesions caused by SDV and VN more than in those with fluctuating vestibular functions caused by MD and AT. In patients with fixed vestibular lesions caused by SDV and VN, patients with lower CP% showed dynamic vestibular compensation (i.e. disappearance of head shaking after nystagmus (chi-square : p<0.05) and motion-evoked dizziness (Mann-Whitney : p<0.0005)) more rapidly than those with higher CP%. In patients with fluctuating vestibular functions caused by MD and AT, patients with lower CP% did not always develop dynamic vestibular compensation more smoothly than those with higher CP%.
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Educational lecture
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