In our previous study, we investigated the changes in the cerebral blood flow in patients with acute stage vestibular neuritis, by analyzing brain perfusion single photon emission computed tomography (SPECT) images using the easy Z-score imaging system (eZIS). The aim of this study was to compare the changes in the cerebral blood flow between the recovery stage and the acute stage of vestibular neuritis, and to evaluate the association between the cerebral blood flow and the clinical findings, that are namely, nystagmus, canal paresis and subjective symptoms. The investigation was based on the data of 3 patients who underwent a repeat brain perfusion SPECT at 6 months after the onset of the disease. In the acute stage, the blood flow to the parieto-insular vestibular cortex (PIVC) was increased on the side contralateral to the affected side. In the recovery stage, the increased blood flow to the PIVC showed a tendency to return to normal, in response to alleviation or disappearance of spontaneous nystagmus and positional nystagmus. On the other hand, the decreased blood flow to the visual cortex of either side showed no change in the acute or the recovery stage. The significant decrease of blood flow seen in Brodmann area 40 (BA40) on the left side improved only in patients in whom the nystagmus disappeared within 6 months of onset of the disease. It was considered that there may be some relationship between normalization of the increased blood flow in the PIVC or disappearance of nystagmus and normalization of the decreased blood flow in BA40.

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There is a high prevalence of children with disabilities, including hearing loss, and the causes of or primary conditions underlying hearing loss vary among children with disabilities. We enrolled 326 children treated at the National Rehabilitation Center for Children with Disabilities during the 30-year period from 1980 to 2011, classified the diseases and causes and compared them by age group to investigate the changes in the types and complications of disabilities in disabled children with hearing loss. In addition, we investigated the presence or absence of hearing loss in children with chromosomal abnormalities. Then, we examined the current state of and issues pertaining to hearing disorder in children and adults with disabilities. The diseases complicated by hearing loss varied, including cerebral palsy, congenital anomalies, mental retardation, chromosomal abnormalities, meningitis, and encephalitis. In addition, low birth weight, congenital cytomegalovirus infection, and auditory neuropathy have been encountered in recent years. Hearing loss was detected in 33 of 64 children with chromosomal abnormalities (51.6%) and in 27 of 56 children with trisomy 21 (48.2%). The frequency of concomitant hearing loss was extremely high in children with chromosomal abnormalities. For children with disabilities, hearing is an extremely important communication method, and early detection and treatment of hearing loss are necessary. The diagnosis, examination, and treatment of hearing loss have advanced. Consequently, the characteristics of disabled children with hearing loss are also becoming more diverse. Therefore, it is necessary to customize aids for hearing and treatment that is tailored to each affected child.

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We examined 30 ears of 30 patients who underwent ossiculoplasty under the diagnosis of direct traumatic injury of the ossicles at the Jikei University Hospital between 1984 and 2011, and evaluated the pathologic condition and surgical results. The surgical findings induced dialysis of the incudostapedial joint in 18 patients, and abnormal stapes in 21 patients, including 14 patients with a perilymphatic fistula. In the patients, the position of the auditory ossicle was reduced and the perilymphatic fistula closed, with ossicular reconstruction depending on the state of the stapes. The surgical results were satisfactory, with the auditory acuity improving in 96.7% of patients. We propose that in cases of injury of the stapes with a perilymphatic fistula, surgical treatment must be considered with careful attention paid to the timing of the procedure and the surgical method, according to the condition in individual patients.

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We attempted to investigate the subjective symptoms of patients with unilateral sinusitis. The subjects were patients with unilateral sinusitis who were examined at the endoscopic sinus surgery facility at any of the five hospitals affiliated to our department from April 2007 to March 2008. The patients with unilateral sinusitis were divided into the chronic rhinosinusitis group, odontogenic maxillary sinusitis group, mycetoma group, antrochoanal polyp group, and allergic fungal rhinosinusitis group. The allergic fungal rhinosinusitis group was excluded because of the small number of cases. The incidence of “nasal obstruction” was significantly higher in the group with antrochoanal polyp and chronic rhinosinusitis than in the group with mycetoma. The frequency of “postnasal drip” was higher in the odontogenic maxillay sinus group than in the chronic rhinosinusitis group. The results revealed that patients with unilateral sinusitis may not present with uniform symptoms, and that this is necessary to bear in in mind while selecting the appropriate treatment.

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Here, we report the case of a 23-year-old woman who was diagnosed as having papillary thyroid cancer based on the initial manifestation, and later received the additional diagnosis of familial adenomatous polyposis following the manifestation of abdominal symptoms. The patient was referred to our hospital with an anterior neck mass. Contrast-enhanced computed tomography and ultrasonography of the neck showed the presence of a mass with a maximum diameter of 15 mm in the right lobe of the thyroid gland. The diagnosis of papillary carcinoma of the thyroid was made based on the findings of fine needle aspiration biopsy, and right thyroid lobectomy with D1 dissection was performed. Histopathological examination of the resected specimen revealed a well-differentiated papillary thyroid cancer. During the postoperative period, the patient presented with abdominal distention, and comprehensive examination revealed the presence of sigmoid colon cancer, metastatic right ovarian cancer, and metastases in the para-aortic and left supraclavicular lymph nodes. The patient was also diagnosed as having familial adenomatous polyposis based on the finding of numerous polyps in the colon.

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