The etiologies of the majority of acute sensorineural hearing loss cases remain unknown or uncertain. Recent advances in diagnostic imaging techniques such as MRI have increased the likelihood of detecting characteristic findings in patients with acute sensorineural hearing loss. However, there are many uncertainties in the relationship between the etiology of hearing loss and the MRI findings. This article briefly summarizes four research points from a recently conducted study on the MRI findings of patients with various acute sensorineural hearing loss. The research foci include: 1) a profoundly hypointense rim at the surface of the brain on a T2*-weighted image and a hypointense rim around the root of the vestibular nerve on cisternography in patients with superficial siderosis, 2) a vascular loop of the AICA/PICA entering the internal acoustic canal in patients with idiopathic sudden sensorineural hearing loss, 3) the detection rate of endolymphatic hydrops in patients with various acute sensorineural hearing loss, and 4) an intense signal in the inner ear on four-hour delayed gadolinium-enhanced three-dimensional fluid-attenuated inversion recovery in patients with vestibular schwannoma and intralabyrinthine schwannoma.

Hearing devices including implantable hearing aids have been recently approved for conductive and mixed hearing loss. Since the number of available device types is increasing and some devices can have overlapping indications, it is important to summarize and compare their uses and features. Herein, I have proposed a treatment algorithm to help clinicians that may not be familiar with the newer auditory implants and hearing aids.

The World Health Organization (WHO) declared the coronavirus disease-2019 (COVID-19) as a pandemic in March 2020 due to its rapid spread around the world, beginning in early 2020. It has been reported that the incidence of acute otitis media and otitis media with effusion in children has decreased significantly. To evaluate the impact of COVID-19 in case of otitis media with effusion, pediatric cases of ventilation tube placement for the treatment of otitis media with effusion, between April 2019 and March 2020, were retrospectively reviewed.

The number of patients who underwent ventilation tube placement decreased from 106 to 63 (59.4%) when comparing pre-COVID-19 period (April 2019 to March 2020) to the post-COVID-19 period (April 2020 to March 2021). Among these, the number of cases with cleft palate remained almost unchanged (from 33 to 31). The number of patients who underwent ventilation tube placement except for cases with cleft palate decreased significantly, from 73 to 32 (43.8%). In the post-COVID-19 period, the number of young patients, other than cleft palate, significantly decreased. The median age at surgery increased from 4 to 5 years.

Although preventive measures against COVID-19 and avoidance of visits to medical institutions due to the COVID-19 pandemic contributed to the decrease in the number of ventilation tube placement, COVID-19 infection control seems to have had a significant impact on children with otitis media with effusion. On the other hand, the impact of COVID-19 on otitis media with effusion cases with cleft palate was lower, suggesting that the involvement of infection as a factor in the development and prolongation of otitis media with effusion could be limited and that the involvement of Eustachian tube dysfunction is more likely.

We introduced the endoscopic subannular tube technique (ESAT) for subannular tube insertion using an endoscope and curved drill for patients with atelectasis, adhesive otitis media, and pars tensa cholesteatoma and followed patients’ postoperative course.

We investigated patients (24 of 29 ears) who underwent ESAT between August 2016 and October 2020 at our department. The mean disease duration was 5.8 years, and the mean observation period was 31 months. The tube retention rate was 41.7%, the mean retention period was 17.2 months, and the mean retention period after subannular tube extrusion was 13.1 months.

Notably, 83% of patients showed unremarkable tympanic membrane findings; however, patients with pars tensa abnormalities (3 ears) were re-operated. Tympanoplasty was performed in 13 patients, and the success rate in the hearing judgment criteria of the Japan Otological Society was 84.6%. ESAT is recommended for intractable middle ear ventilation disorders, with attention to infection early postoperatively.

We report a case of a petrous apex cholesterol granuloma, which was treated using transcanal endoscopic ear surgery via the transcanal-infrapetrosal approach.

A drainage route was endoscopically created through the middle ear to the cholesterol granuloma in a 13-year-old male adolescent who presented with hearing loss and otorrhea.

We observed favorable aeration of the middle ear and tubal inflation postoperatively. Additionally, computed tomography revealed that the cholesterol granuloma had reduced in size. Endoscopic ear surgery via the transcanal-infrapetrosal approach is useful for treatment of a petrous apex cholesterol granuloma that extends to the outside of the carotid artery.

Traumatic stapes luxation into the vestibule with perilymph fistula due to a cotton swab injury is relatively rare. A 36-year-old female with severe vertigo and aural fullness in the left ear after using a cotton swab was transported to our hospital by an ambulance. On physical examination, perforation of the posterior tympanic membrane was confirmed. The stapes was luxated into the oval window when observed through the site of the perforation. An audiogram revealed a moderate degree of mixed hearing loss in the left ear. Spontaneous rightward nystagmus was observed, and the result of a fistula test conducted with a Politzer bulb was positive. Temporal bone computed tomography revealed that the stapes was luxated into the oval window. She was diagnosed with traumatic luxation of the stapes into the oval window, and perilymph fistula in the left ear. To control the severe vertigo and reconstruct the ossicular chain, left tympanoplasty was performed under general anesthesia. The patient was informed of the possibility of postoperative deafness if perilymphatic gusher occurred before the surgery. She consented to undergo the procedure, and the operation was performed on the same day. The stapes was luxated into the oval window with detached stapedial tendon, and perilymph flowed out of the oval window. The luxated stapes was carefully removed, assisted by an ear endoscope. Perilymphatic gusher did not occur. The fascia of the temporalis muscle was placed on the oval window, and ossicular reconstruction was performed by inserting Apacerum-C between the fascia and long process of the incus. Immediately after surgery, vertigo improved and nystagmus disappeared. The patient was able to walk with mild dizziness on postoperative day 1, and she was discharged on postoperative day 2. Hearing function gradually improved, and floating dizziness disappeared on postoperative day 7. Taste disorder was not observed. In this case, we achieved good results for both hearing and vestibular symptoms after surgery. However, in past literatures, the hearing outcomes of the cases that require stapes removal are sometimes unsatisfactory after surgery. We believe that providing adequate preoperative explanation on the possibility of poor hearing improvement is important.

In the present study, we investigated the usefulness of, and problems associated with, cochlear implant (CI) in the late-stage elderly. The participants included 21 post-lingually deafened CI users aged ≥65 years who underwent CI surgery at our department 10 years ago. We retrospectively examined the current use of CI in these patients, the effectiveness of CI 10 years after surgery, and changes in speech perception over time. Overall, 15/21 patients still use CI, and could maintain good speech perception in the long term. Three patients died during the study period, but all continued to use CI until the end. Three patients who stopped using CI had poor speech perception and were not able to fully utilize their CI. The age-related changes in the speech perception revealed that the results were stable and good until the late elderly stage. However, an age-related decline in speech perception may occur in the late elderly stage.

Migration of the receiver/stimulator (R/S) device is one of the major complications after cochlear implantation surgery. We herein report a case of a 19-month-old infant in whom the R/S migrated in the cranial direction after simultaneous bilateral cochlear implantation surgery was performed using a subperiosteal tight pocket without suture. We compressed the wound to prevent the development of a hematoma by using a rolled gauze and an elastic bandage. The patient was discharged on postoperative day 4 without any complications such as wound infection or hematoma formation. However, we observed migration of the R/S device in the cranial direction for a second time on postoperative day 10. Consequently, a correction surgery was performed to replace the R/S device and fix it using the tie-down suturing technique to prevent further migration. Therefore, in cases of cochlear implantation in infants, especially simultaneous bilateral surgery, fixation of the device using tie-down sutures might be useful to prevent migration of the R/S device.