History of idiopathic sudden sensorineural hearing loss (sudden deafness) was described in association with Menière's disease. Criteria for the diagnosis of sudden deafness was established by the Research Committee of the Japanese Ministry of Health and Welfare in 1973. Using the criteria, three nationwide epidemiological surveys on sudden deafness have been conducted by the Research Committee. In 1998, the Research Committee established a grading system based on the severity of hearing loss regarding sudden deafness. The grading system will be useful for evaluation of the outcome of sudden deafness. Because the number of patients with sudden deafness has been increasing in Japan, further study to elucidate the pathophysiology will be necessary.

View full abstract

We studied the anti-growth and apoptotic effects of paclitaxel and epidermal growth factor receptor (EGFR) antisense gene therapy in a head and neck squamous cell carcinoma model (SCC 1483). An in vitro study showed paclitaxel at a low concentration of 5 nM for 24 hours effectively blocks cell proliferation. Downmodulation of EGFR in head and neck cancer cell by antisense EGFR effectively inhibits cell proliferation compared to sense EGFR. The combination of paclitaxel and antisense EGFR gene therapy in vitro showed a synergistic effect and suppressed tumor growth most effectively. Tumor cells treated with antisense EGFR showed a higher percentage of apoptopic cells compared to cells treated with sense EGFR. Compared to individual effects, the combination of paclitaxel and antisense EGFR gene therapy suppressed tumor growth more effectively. Our results indicate antisense EGFR gene therapy and paclitaxel are useful for clinical chemotherapy in head and neck squamous cell carcinoma.

View full abstract

We evaluated the effect of nasal surgery 10 obstructive sleep apnea sydrome (OSAS) patients using nasal continuous pocitive airway pressure (n-CPAP) daily and diagnosed with nasal septum deviation.
Before and after nasal deviatomy and conchotomy, patients used auto-CPAP with memory function for 10-20 days. We calculated usage and device pressure using a personal computer. Mean device pressure decreased statistically from 11. 33 ± 2.83 cm H₂O to 9.92 ± 2.32 cmH₂O.
We concluded that nasal surgery effectively decreases n-CPAP device pressure, and that nasal disease must be diagnosed and treated before n-CPAP therapy is started.

View full abstract

We report a patient with traumatic ossicular disruption and perilymphatic fistula caused by indirect force. Computed tomography (CT) findings showed the ossicular disruption to be at the malleoincudial joint. Exploratory tympanotomy was conducted on day 3 after injury because sensory hearing loss progressed rapidly during conservative therapy. During surgery, the malleoincudial joint was dislocated and perilymphatic leakage from the oval window observed. The window membrane was repaired with temporal fascia and ossicular chain continuity was reconstructed using adhesive glue. Postoperative hearing and vestibular symptoms improved. This suggests that CT has advantages in the diagnosis of ossicular disruption and that immediate surgery is needed in progressive sensory hearing loss caused by perilymph fistula.

View full abstract

Acquired benign tracheoesophageal fistula (TEF) is an uncommon, difficult problem to manage. A 81-year-old woman who had undergone abdomisnal surgery underwent tracheostomy to control respiration and had a nasogastric tube put in place. She reported food aspiration and prolonged cough and sputum. Endoscopic examisnatiton detected the TEF between the trachea and esophagus at 1.5 cm below the stoma. Simple division and closure of the fistula was done. The esophageal defect was closed in 2 layers and a sternocleidomastoid muscle flap was interposed to separate the tracheal and esophageal lines. A small amount of esophageal mucosa can be left with tracheal side of the fistula to minimize tracheal narrowing. TEF can be managed safely after weaning the patient from the ventilator. The cause of TEF is pressure necrosis of the membrane trachea and adjacent esophageal wall at the cuff. Based on our experience and a review of the literature, it seems important to understand the occurrence and pathogenesis of TEF to lead to its prevention.

View full abstract

The usefuluess of multislice conputed tomography (MSCT) has been widely recognized in the middle ear. To determine the result of tympanoplasty type III with columella, we studied MSCT images after tympanoplasty and its clinical use. We had autologous ossicles or autologous bone and artificial ossicles as columella and for both, so it was possible to determine the conditions of ossicular joints after tympanoplasty. MSCT proved quite useful. Three-dimensional (3 D) images reconstructed from a perspective that allows the surgeon to visualize the condition of the middle ear preoperatively provide the surgeon with valuable information and also provide patients with visual information on their disease.

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract