Nippon Jibiinkoka Gakkai Kaiho
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
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Volume 119, Issue 3
Displaying 1-19 of 19 articles from this issue
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Review article
Original article
  • Clinical Features of the Pediatric Acquired Cholesteatoma Based on the Staging Criteria for Cholesteatoma 2010 Japan
    Nobuyuki Miyahara, Noriyuki Fukushima, Tomohisa Hirai, Ayako Miyoshi, ...
    2016 Volume 119 Issue 3 Pages 181-186
    Published: March 20, 2016
    Released on J-STAGE: April 19, 2016
    DOIhttps://doi.org/10.3950/jibiinkoka.119.181
    JOURNAL FREE ACCESS
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    　In this study, we retrospectively evaluated the clinical features of the pediatric acquired cholesteatoma based on the staging criteria for cholesteatoma 2010 Japan. Between 2001 and 2012, total of 36 pediatric patients underwent otologic surgery at our hospital, 29 patients (29 ears) with pars flaccida cholesteatoma and 7 patients (7 ears) with pars tensa cholesteatoma. The age range was 4 to 15 years, (median was 10.5 years). Stage ll was the most common for both the pars flaccida and pars tensa. A staged operation was performed in 24 ears with pars flaccida cholesteatoma, and 4 ears with pars tensa cholesteatoma. The success rate of hearing improvement was 72% (21/29) in pars flaccida cholesteatoma and 57% (4/7) in pars tensa cholesteatoma. Hearing improvement decreased in advanced cases. In staged operations, residual cholesteatoma was found in 11 ears (46%) with pars flaccida cholesteatoma and 2 ears (50%) with pars tensa cholesteatoma. These results suggest that the residual rate of cholesteatoma in the pediatric population is high.
    　In conclusion, a high rate of residual cholesteatoma in the pediatric population was observed in our study. Thus a staged operation would be the recommended treatment approach in pediatric acquired cholesteatoma.
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  • Newborn Hearing Screening and Subsequent Diagnostic Evaluation: Analysis and Outcomes of 6,063 Infants Born in a Community Hospital
    Yasuko Tanaka, Hiroyuki Enomoto, Kentaro Takada, Maki Inoue, Noboru Og ...
    2016 Volume 119 Issue 3 Pages 187-195
    Published: March 20, 2016
    Released on J-STAGE: April 19, 2016
    DOIhttps://doi.org/10.3950/jibiinkoka.119.187
    JOURNAL FREE ACCESS
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    　A retrospective study was conducted to examine the implementation status of newborn hearing screening (NHS) of 6,063 infants born in a single community hospital in Japan between 2005 and 2013. An automated auditory brainstem response device was used for NHS and an auditory brainstem response was mainly used for further diagnostic evaluation. Although the participation rate in the NHS was 88.8% in 2013, increasing year by year, it failed to reach 100% probably because NHS is a charged option under the current Japanese healthcare system. Among 40 (0.66%) infants who finally failed their NHS, 34 were referred for subsequent diagnostic evaluation and the remaining 6 were lost to follow-up. Thirty-one of these 34 were diagnosed as having hearing impairment and 3 (0.05%) were identified as having normal hearing, which is considered as a false positive. Both the final referral rate and the hearing impairment rate were significantly higher in the high-risk than in the low-risk group. Compared to the previous national report, the rate of bilateral hearing impairment (0.33%) was significantly higher in this study. Ten (38.5%) out of 26 in the high-risk group were most often diagnosed with otitis media with effusion (OME), while 4 (50%) out of 8 in the low-risk group were diagnosed as having sensorineural hearing loss. Seven (35%) out of 20 with bilateral hearing impairment attained a normal hearing level at a median age of 18 months. Although the primary aim of NHS is early detection of congenital permanent hearing loss, OME is observed commonly in NHS-failed infants. It is therefore important to examine the middle ear status carefully as part of the diagnostic evaluation. Thirty-four infants underwent further diagnostic evaluation at a median age of 46 days, and hearing aids were given in 10 of them at a median age of 5.6 months without delay. Because high-risk patients often tend to be lost to follow-up, otolaryngologists have to give a detailed explanation to caregivers and to build a solid support system for children with hearing impairment.
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  • Surgical Management for Benign Parotid Tumors: Review of a 16-year Experience with 633 Patients
    Ryo Kawata, Tetsuya Terada, Kotetsu Lee, Masaaki Higashino, Shinpei Ic ...
    2016 Volume 119 Issue 3 Pages 196-203
    Published: March 20, 2016
    Released on J-STAGE: April 19, 2016
    DOIhttps://doi.org/10.3950/jibiinkoka.119.196
    JOURNAL FREE ACCESS
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    　Objective: The objective of this study was to analyze the diagnosis and postoperative complications of benign parotid tumors for a series of 633 patients who underwent the same diagnostic methods and operation procedure in a single institute.
    　Materials & Methods: A series of 633 patients who underwent parotidectomy for benign parotid tumors over a 16-year period was reviewed.
    　Results: There were 345 female and 288 male patients. The site of the tumors was divided among three groups, superficial, deep, and lower pole tumors. The numbers of each type of above tumors were 342, 122, and 169 cases, respectively. The most common pathology of the parotid tumor was a pleomorphic adenoma (372 cases) followed by a Warthin tumor (166 cases). Pleomorphic adenomas and Warthin tumors accounted for 85% of all benign tumors. The accuracy rate of fine needle aspiration cytology (FNAC) for all benign tumors was 71%, 84% for pleomorphic adenomas and 72% for Warthin tumors. Transient facial nerve dysfunction was observed in 130 patients (21%) in 612 cases of primary benign parotid tumors, and only one patient developed a permanent weakness. The incidence of transient facial nerve dysfunction was 18% in superficial tumors, 39% in deep tumors, and 15% in lower pole tumors. Significant risk factors for development of a transient facial palsy were the site of the tumors, the size of the tumors, operation time, and bleeding volume. Among these risk factors, for the site of the tumors, the deep lobe was the most important factor associated with transient facial nerve dysfunction. Transient facial nerve dysfunction recovered within 6 months in 90% of all cases.
    　Conclusions: The accuracy rate of FNAC for benign parotid tumors was 72%. The incidence of transient facial nerve dysfunction in deep tumors was significantly higher compared to that in superficial and lower pole tumors. According to the rate of facial palsy, operation time, and bleeding volume, benign parotid tumor should be divided among three groups, namely superficial, deep, and lower pole tumors.
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  • A Case of Pneumocystis Pneumonia after Cetuximab-based Bioradiotherapy
    Asano Shinohara, Ryunosuke Kogo, Hideoki Uryu, Ryuji Yasumatsu, Torahi ...
    2016 Volume 119 Issue 3 Pages 204-209
    Published: March 20, 2016
    Released on J-STAGE: April 19, 2016
    DOIhttps://doi.org/10.3950/jibiinkoka.119.204
    JOURNAL FREE ACCESS
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    　Reports of drug-induced interstitial pneumonia caused by Cetuximab have been increasing. Pneumocystis pneumonia is important as a differential diagnosis of drug-induced interstitial pneumonia. We report herein on a 64-year-old man with pneumocystis pneumonia after cetuximab-based bioradiotherapy for laryngeal cancer. After radiotherapy, the patient developed multi-drug resistant pneumonia. Chest CT imaging revealed diffuse ground-glass opacities in the lung field. He was diagnosed as having pneumocystis pneumonia based on the bronchoalveolar lavage (BAL) findings, and then his symptoms improved after treatment with Trimethoprim/Sulfamethoxazole. It is important to assess the risk factor for pneumocystis pneumonia for early its detection and treatment.
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Skill up lecture
Lifelong learning for Board Certified Otorhinolaryngologist
State of the Art Courses for Board Certified Otorhinolaryngologists
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