In order to establish experimental inner ear specific autoimmune labyrinthitis in mice, the present study was designed to recover inner ear specific proteins from crude inner ear proteins by SDS-PAGE technique and proteome profiling. Thirty partitioned inner ear proteins according to molecular size were harvested through elution of crude inner ear antigens on Whole Gel Eluter. Serum from mice sensitized with 19 out of 30 partitions produced antibodies against bovine inner ear proteins by western blotting and 7 positive different bands were recognized. Proteome profiling of the several partitions that demonstrated clear positive bands were selectively carried out. Partition number 3, 10 and 11 hit only COCH protein. Partition number 5 and 8 hit COCH protein together with non specific inner ear proteins. Partition number 18, 22 and 24 hit non specific inner ear proteins. The present study succeeded in isolation of inner ear specific proteins, suggesting that development of inner ear specific autoimmune animal model is possible to elucidate pathogenesis of autoimmune inner ear disease.
Recently, it has been reported that acid reflux might affect the sino-nasal tract and eustachian tube, but no reports are available on the relationship between gastro-esophageal reflux (GERD) and eustachian tube function. In this study, eustachian tube function (sonotubometry) was measured in 15 patients with chronic otitis media (COM), a GERD questionnaire administered, and pH measurements taken for the lower esophagus, hypopharynx, and nasopharynx were compared with those in 12 control subjects without ear disease to determine whether GERD impairs eustachian tube function. The incidence of GERD judged by questionnaire was 66.7% in COM and 41.7% in controls, but there was no significant difference. A 24-hour pH monitoring evaluated by time ratio revealed reflux in COM was 33.3% in the lower esophagus, 20% in the hypopharynx. 0% in the nasopharynx, respectively, while that in controls was 25%, 0%, 0%, respectively; no significant difference was observed. On the other hand, the number of subjects with nasopharyngeal reflux events accompanied by a minor pH drop in COM (5 cases) was significantly higher than that in controls (0 cases)(Fisher's exact test, p=0. 0470). However, no correlation was observed between eustachian tube function and nasopharyngeal acid reflux.
During otological surgery, levofloxacin was administered orally as a perioperative antimicrobial drug. The mean age of the subjects was 42.1 years old and the patients with chronic otitis media comprised 44%, followed by those with otitis media cholesteatoma of 33%. Other diseases included otoschlerosis, middle ear malformation, external acoustic meatus, ear canal tumor and middle ear tumor. Consequently, only 2 of 80 patients postoperatively prolonged purulent otorrhea exhibited, which was a successful outcome. However, considering the risk of the emergence of resistant strains, this method should not be applied to stapes surgery, which could be a clean surgery. The patient who exhibited prolonged purulent otorrhea postoperatively was one of the patients with otitis media cholesteatoma and had already developed purulent otorrhea prior to the operation. The mastoid cavity was filled up with bone pate after mastoidectomy. The surgery associated insertion of bone pate is beyond the application of this method. Therefore, patients who undergo this surgery should be fully protected from infection by intravenous administration of antimicrobial drugs and localized treatment.
Patients with Meniere's disease who suffer for long, rarely show complete recovery of advanced hearing loss. I reported a 67-year-old patient with a history of 24 years, whose 60 dB hearing loss lasting for 8 years was cured by continuous aerobic exercise. From the start of exercise, it took 4 months to the beginning of recovery and 7 months till normal hearing, respectively. Although the hearing temporarily became worse when he caught cold and stopped exercise for three weeks, it recovered completely to normal hearing 4 months later, and tinnitus disappeared. This state has been preserved for 8 months. I presumed that aerobic exercise increased local blood flow and prompted restoring processes of the inner ear function.
As the CT findings of the temporal bone of latent acute mastoiditis are really same to that of middle ear cholesteatoma, it is considered that both diseases may be homologous, in which the supratubal recess route in the tympanic diaphragm is narrow or closed. Latent mastoiditis develops by the excretory dysfunction, and cholesteatoma develops by the ventilatory dysfunction via the tympanic diaphragm respectively. From this standpoint, the mysterious clinical sings and postoperative course of latent mastoiditis are easily understandable. In the treatments, CT examination with axial slicing and anterior tympanotomy in addition to mastoidectomy are recommended.