130 results on '"Mishiro Y"'
Search Results
2. Tympanoplasty with and without mastoidectomy for non-cholesteatomatous chronic otitis media
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Mishiro, Y., Sakagami, Masafumi, Takahashi, Yoshifumi, Kitahara, Tadashi, Kajikawa, Hiroshi, and Kubo, Takeshi
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- 2001
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3. Preoperative assessment of taste function in patients with middle ear disease.
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Sakaguchi A, Katsura H, Nin T, Adachi O, Mishiro Y, Daimon T, and Sakagami M
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- 2012
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4. Taste disturbance after stapes surgery - clinical and experimental study.
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Miuchi S, Sakagami M, Tsuzuki K, Noguchi K, Mishiro Y, and Katsura H
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Conclusion: Most of the clinical cases experienced taste disturbance after stapes surgery, and in a few cases this disturbance persisted for a long time. The animal experiment suggested the role of geniculate ganglion (GG) cells in nerve generation. Objectives: To clinically examine taste disorder and its recovery after stapes surgery and experimentally demonstrate a role of GG. Patients and methods: Taste function after preservation of chorda tympani nerve (CTN) in stapes surgery was prospectively investigated with a questionnaire and electrogustometry (EGM). Further, expression of neurotrophic factors in GG after injury of CTN was examined by in situ hybridization histochemistry (ISSH) and RT-PCR. Results: Among the cases, 15/18 (83.3%) were associated with taste disturbance and 6/18 (33.3%) were associated with tongue numbness 2 weeks after surgery; however, the symptoms ceased in 14/18 cases (77.8%). Two weeks after surgery, the EGM threshold was found to be elevated in 15/18 cases (83.3%), while in 10/18 cases (55.6%), it did not decrease until 1 year after surgery. Expression of ISSH and amplified bands of BDNF and GFR increased at 7 and 14 days after nerve injury in ipsilateral GGs and also increased at 7 days on the contralateral side. [ABSTRACT FROM AUTHOR]
- Published
- 2009
5. Eustachian tube function and habitual sniffing in middle ear cholesteatoma.
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Ohta S, Sakagami M, Suzuki M, and Mishiro Y
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- 2009
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6. The investigation of the recurrence rate of cholesteatoma using Kaplan-Meier survival analysis.
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Mishiro Y, Sakagami M, Kitahara T, Kondoh K, and Okumura S
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- 2008
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7. Long-term hearing outcomes after ossiculoplasty in comparison to short-term outcomes.
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Mishiro Y, Sakagami M, Kitahara T, Kondoh K, and Kubo T
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- 2008
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8. Surgical management of only hearing ears with positive indications.
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Sakagsami M, Muto T, Adachi O, Mishiro Y, and Fukazawa K
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Positive surgical indications for an only hearing ear were evaluated in order to improve patients' quality of life. Fifteen cases of surgery involving an only hearing ear over the past eight years were retrospectively reviewed. Of eight perforated chronic otitis media cases, seven underwent type one tympanoplasty and one underwent simple underlay myringoplasty regardless of otorrhoea at the time of surgery. Of six cholesteatoma cases, two received the canal wall up method and four received the canal wall down method. Ossiculoplasty was carefully performed in six cases. Hearing was improved in seven cases, whereas it remained unchanged in seven cases and deteriorated in one case. Of nine patients, two did not need a hearing aid after surgery. Five patients with severe combined hearing loss (>90 dB) were able to communicate with a hearing aid, alleviating their anxiety regarding hearing loss. Only hearing ears with chronic otitis media and cholesteatoma can be successfully treated by tympanoplasty with or without ossiculoplasty. [ABSTRACT FROM AUTHOR]
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- 2006
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9. Effect of laser-induced dissociation of SiH3 radicals in SiH4 plasmas during atomic hydrogen measurements using laser-induced fluorescence by a two-photon excitation.
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Miyazaki, K., Mishiro, Y., Kajiwara, T., Uchino, K., Muraoka, K., Okada, T., and Maeda, M.
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- 1999
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10. Unusual left ventricular wall motion and a loud added sound during the isovolumic relaxation period in a patient with hypertensive heart disease.
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Mishiro, Y., Oki, T., and Fukuda, N.
- Abstract
A 69 year old woman with hypertensive heart disease had a loud added sound which coincided with a sudden interruption of the early diastolic motion of the left ventricular posterior wall, as visualised by M mode echocardiography, and came just before early diastolic transmitral flow, as measured by a pulsed Doppler echocardiogram. Early diastolic motion velocity from the base to the middle of the posterior wall, assessed by pulsed Doppler tissue imaging, was markedly high and sharp, and its peak coincided with the sound. A notch, similar to that in the posterior wall motion, occurred in the left ventricular pressure curve during early diastole. No intraventricular flow signal was detected during the isovolumic relaxation period, as measured by pulsed and colour Doppler imaging. The added sound was probably produced by impact between the dilated heart, with a relaxation abnormality, and the extracardiac structures during the isovolumic relaxation period. [ABSTRACT FROM AUTHOR]
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- 1997
11. General instability of ring-stiffened cylindrical shells under external pressure
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Yamamoto, Y., Homma, Y., Oshima, K., Mishiro, Y., Terada, H., Yoshikawa, T., Morihana, H., Yamauchi, Y., and Takenaka, M.
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- 1989
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12. Effect of a Dipeptide, Aspartame, on Lactic Acid Production in Human Whole Saliva.
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MISHIRO, Y. and KANEKO, H.
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ASPARTAME ,SALIVA ,LACTIC acid ,PEPTIDES ,ACID basicity - Abstract
The article investigates the impact of aspartame on the production of lactic acid in human whole saliva. An experiment is described and results are discussed. Findings indicate that aspartame promotes lactate production from glucose, but suppresses pH levels in the presence of a supplemental sugar.
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- 1977
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13. Promotion of Lactate Production by Oligopeptides of Partial Hydrolysate of Bovine Serum Albumin.
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MISHIRO, Y. and KANEKO, H.
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DENTAL research ,SALIVA ,LACTATES ,DENTAL chemistry ,SERUM albumin ,OLIGOPEPTIDES - Abstract
The article reports on the results of research which was conducted in an effort to promote lactate production in human saliva by oligopeptides of partial hydrolysate of bovine serum albumin. researchers determined that additional research was needed to elucidate the exact mechanisms involved in the lactate promoting process and the biomedical significance in the oral cavity.
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- 1974
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14. Lactate Production from Glucose in Preincubated Saliva.
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MISHIRO, Y. and MORINAGA, K.
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SALIVA microbiology ,LACTATES ,GLUCOSE ,STREPTOCOCCUS salivarius ,MICROORGANISMS - Abstract
The article presents research which explored the lactate production of various salivary microorganisms in preincubated saliva. The effect of glucose on lactate production is examined and the response of the salivary samples to heating is explored. The lactate production of Streptococcus salivarius is also researched.
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- 1974
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15. Effect of Dipicolinate on the Heat Denaturation of Proteins.
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MISHIRO, Y. and OCHI, M.
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- 1966
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16. Effect of Protein Hydrolysates on the Fermentative Activity of Streptococcus salivarius.
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KIRIMURA, K., MORITA, M., and MISHIRO, Y.
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SALIVA ,BODY fluids ,EXOCRINE secretions ,PROTEIN hydrolysates ,DENTAL research - Abstract
The article discusses the effect of protein hydrosylates on the fermentative activity of streptococcus salivarius. The authors detail the experimental methods used in a study that shows that saliva peptides promote the fermentative activity of salivary sediment as well as the aerobic lactate production of streptococcus salivarius.
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- 1970
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17. Promoting effect of saliva dialyzate on the lactate production of Streptococcus salivarius
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Mishiro, Y., Morita, M., and Kirimura, K.
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- 1970
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18. Earlier recovery of lingual dysfunction after middle ear surgery in pediatric versus adult patients.
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Nishii T, Nin T, Maeda E, Fukunaga A, Mishiro Y, and Sakagami M
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- Adolescent, Adult, Aged, Child, Chorda Tympani Nerve injuries, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Taste Disorders etiology, Time Factors, Young Adult, Chorda Tympani Nerve physiopathology, Ear, Middle surgery, Otologic Surgical Procedures adverse effects, Recovery of Function physiology, Taste Disorders physiopathology, Taste Threshold physiology, Tongue physiopathology
- Abstract
Objectives: It is generally thought that the recovery of damaged chorda tympani nerve (CTN) function after middle ear surgery is different in pediatric patients from that in adult patients. The purpose of this study was to investigate the changes and the progress of taste and somatosensory functions of the tongue after middle ear surgery in pediatric patients compared with those of adult patients., Study Design: Prospective study., Methods: Fifty-nine pediatric patients and 106 adult patients underwent middle ear surgery. Taste and somatosensory functions of the anterior tongue, the so-called CTN functions, were assessed using electrogustometry (EGM), a 2-point discriminator, an electrostimulator, and a questionnaire before and 2 weeks and 6 months after surgery., Results: Two weeks after surgery, there was no significant difference in the incidence of dysgeusia and abnormal EGM thresholds between the patient groups. The incidence of tongue numbness was significantly lower in pediatric patients than in adult patients regardless of CTN manipulation. Although the lingual somatosensory thresholds of adult patients were significantly increased, those of pediatric patients were not increased. Six months after surgery, the incidences of dysgeusia and an abnormal EGM threshold were lower in pediatric patients than in adult patients. Tongue numbness disappeared, and the thresholds of lingual somatosensory tests returned to normal in most pediatric patients., Conclusion: Not only taste function but also lingual somatosensory function was damaged after middle ear surgery even in pediatric patients. Pediatric patients complained of tongue numbness less frequently and showed earlier recovery than adult patients., Level of Evidence: 2 Laryngoscope, 130:1016-1022, 2020., (© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)
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- 2020
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19. Change of somatosensory function of the tongue caused by chorda tympani nerve disorder after stapes surgery.
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Maeda E, Katsura H, Nin T, Sakaguchi-Fukunaga A, Mishiro Y, and Sakagami M
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- Adult, Chorda Tympani Nerve physiopathology, Dysgeusia diagnosis, Dysgeusia etiology, Facial Nerve Diseases diagnosis, Facial Nerve Diseases physiopathology, Female, Humans, Male, Prospective Studies, Tongue physiopathology, Chorda Tympani Nerve injuries, Dysgeusia physiopathology, Facial Nerve Diseases etiology, Sensory Thresholds physiology, Stapes Surgery adverse effects, Taste Threshold physiology, Tongue innervation
- Abstract
Objectives: Patients after middle ear surgery often complain of taste disturbance and a lingual numbness. The purpose of this study was to objectively assess changes in the somatosensation of the tongue and taste function in patients undergoing stapes surgery., Study Design: Prospective study., Methods: Symptoms of taste disturbance and tongue numbness after surgery were investigated before and after surgery in 41 patients (13 males, 28 females; mean age 41.8 years) who underwent stapes surgery. Twenty-eight patients (9 males, 19 females; mean age 43.1 years) underwent sensory and taste function tests before and after surgery. Sensory function of the tongue was measured at the operated side and the nonoperated side using the 2-point discrimination test and an electrostimulator test. Taste function was assessed with electrogustometry (EGM)., Results: The chorda tympani nerve (CTN) was gently touched or stretched in all patients. Postoperative thresholds on the operated side were significantly higher than preoperative thresholds in all tests in the patients who underwent all three kinds of tests. Tongue somatosensory symptoms improved significantly earlier than the taste disturbance postoperatively, and the sensory thresholds returned to the baseline along with recovery of symptoms., Conclusion: These findings suggest that dysfunction of the CTN occurred following surgery even when the CTN was preserved, and that the sensory nerve threshold of the tongue correlated with the symptom of lingual numbness. The CTN may play a role not only in taste function but also in the somatosensory function of the tongue., Level of Evidence: 4. Laryngoscope, 128:701-706, 2018., (© 2017 The American Laryngological, Rhinological and Otological Society, Inc.)
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- 2018
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20. Usefulness of our proposed olfactory scoring system during endoscopic sinus surgery in patients with chronic rhinosinusitis.
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Okazaki K, Tsuzuki K, Hashimoto K, Nishikawa H, Takebayashi H, Oka H, Kojima Y, Yukitatsu Y, Mishiro Y, and Sakagami M
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- Chronic Disease, Endoscopy, Female, Humans, Male, Middle Aged, Multivariate Analysis, Olfaction Disorders surgery, Paranasal Sinuses surgery, Prognosis, Rhinitis diagnosis, Rhinitis surgery, Sinusitis diagnosis, Sinusitis surgery, Smell, Olfaction Disorders complications, Olfaction Disorders diagnosis, Rhinitis complications, Sinusitis complications
- Abstract
Introduction: The primary aim of the current study was to examine the usefulness of our proposed olfactory scoring system in chronic rhinosinusitis (CRS) patients with olfactory disorders (n = 213) receiving endoscopic sinus surgery (ESS)., Materials and Methods: Analyzed patients were divided into two groups: an eosinophilic CRS (ECRS) group (n = 153); and a non-ECRS group (n = 60). The T&T recognition threshold test was used to evaluate olfaction at baseline and at 3 and 12 months after ESS. Patients with mean recognition threshold < 2.0 at 3 or 12 months or with a decrease of ≥ 1.0 as compared with baseline were defined as showing clinical improvement. We scored mucosal conditions as normal (0 points), edema (1 point), and polyp (2 points) at the canopy of olfactory cleft (OC), middle and superior turbinates, superior nasal meatus, and sphenoethmoidal recess during ESS. The total score of OCs (SOCs) was calculated (range 0-20 points). We compared SOCs between ECRS and non-ECRS groups. Factors related to olfactory improvement were also investigated using uni- and multivariate analyses., Results: SOCs in the ECRS and non-ECRS groups showed significant correlations with mean recognition thresholds at baseline and at 3 and 12 months. In the multivariate analysis for predicting improvement of mean recognition threshold, lower SOCs were significantly associated with olfactory improvement factors at 3 and 12 months postoperatively in the ECRS group., Conclusion: SOCs appears promising for estimating olfactory prognosis after ESS in CRS patients.
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- 2018
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21. Practicality analysis of the staging system proposed by the Japan Otological Society for acquired middle ear cholesteatoma: A multicenter study of 446 surgical cases in Japan.
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Matsuda K, Tono T, Kojima H, Yamamoto Y, Sakagami M, Mishiro Y, Hinohira Y, and Okuno T
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- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Cholesteatoma, Middle Ear diagnostic imaging, Cholesteatoma, Middle Ear pathology, Cholesteatoma, Middle Ear surgery, Female, Humans, Japan, Male, Mastoid diagnostic imaging, Mastoid pathology, Middle Aged, Retrospective Studies, Severity of Illness Index, Stapes pathology, Tomography, X-Ray Computed, Cholesteatoma, Middle Ear classification
- Abstract
Objective: The Objective of this study was to assess the practicality of the cholesteatoma staging system proposed by the Japan Otological Society (JOS) for acquired middle ear cholesteatoma (the 2010 JOS staging system)., Methods: Between 2009 and 2010, 446 ears with retraction pocket cholesteatoma underwent primary surgery at 6 institutions in Japan. The extent of cholesteatoma was surgically confirmed, and classified into three stages., Results: The cholesteatoma affected the pars flaccida in 325 ears (73%), the pars tensa in 100 ears (22%), and both regions combined in 21 ears (5%). The hearing outcome (postoperative air-bone gaps dB) worsened as follows (Stage I, II, III): 84%, 68%, 53% in pars flaccida; 71%, 62%, 30% in pars tensa, and 42% at Stage II, and 50% at Stage III in the combined group. The incidence of residual cholesteatoma increased as follows (Stage I, II, III): 2%, 12%, 23% in pars flaccida; 7%, 30%, 21% in the pars tensa group. The severity of disease was reflected in postoperative hearing and increasing incidence of recurrence rate., Conclusion: The 2010 JOS staging system is suitable for evaluating initial pathology. It is particularly practical for standardizing reporting of retraction pocket cholesteatoma and for adjusting for the severity of the condition during outcome evaluations. It may also provide information that is useful for counseling patients., (Copyright © 2017 Elsevier B.V. All rights reserved.)
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- 2018
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22. Usefulness of the Saccharin Test for Assessment of Eustachian Tube Function in Patients With Chronic Otitis Media With Perforation.
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Ikehata M, Ohta S, Mishiro Y, Katsura H, Miuchi S, Tsuzuki K, and Sakagami M
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- Adult, Chronic Disease, Ear, Middle physiopathology, Female, Humans, Male, Middle Aged, Prospective Studies, Saccharin, Tympanic Membrane pathology, Diagnostic Techniques, Otological, Eustachian Tube surgery, Otitis Media surgery
- Abstract
Objective: The eustachian tube (ET) has two important functions, ventilation and clearance of the middle ear. We evaluated the ET ventilator function by the sonotubometry and the inflation-deflation test that are widely used today, and the ET clearance function by the saccharin test. Results of both tests were compared with surgical outcomes, and assessed which test was more closely related to the surgical outcomes., Study Design: Prospective case series., Setting: A single university hospital., Patients and Intervention: One hundred four ears of 95 patients with chronic otitis media with perforation underwent type I tympanoplasty., Main Outcomes and Measures: Based on sonotubometry and the inflation-deflation test, the patients were divided into normal, stenosis, and patulous types. Based on the saccharin test, they were divided into a normal function group and a partial/gross dysfunction group. Surgical outcomes about the hearing results and the condition of the eardrum were assessed 1 year postoperatively. Preoperative evaluation of ET function was compared with the surgical outcome., Results: Sonotubometry and inflation-deflation tests showed there was no significant difference among the groups about the hearing improvement and the surgical success rate. The saccharin test showed that the rate of the hearing improvement was significantly lower in the gross dysfunction group and that the success rate of Type I tympanoplasty was significantly higher in the normal group than in the dysfunction group., Conclusion: There is a relationship between the saccharin test results and surgical outcomes.
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- 2017
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23. Chronic otitis media with cholesteatoma with canal fistula and bone conduction threshold after tympanoplasty with mastoidectomy.
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Kitahara T, Kamakura T, Ohta Y, Morihana T, Horii A, Uno A, Imai T, Mishiro Y, and Inohara H
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- Adult, Aged, Audiometry, Pure-Tone, Auditory Threshold, Cholesteatoma complications, Chronic Disease, Female, Fistula etiology, Humans, Male, Middle Aged, Otitis Media complications, Pitch Discrimination, Retrospective Studies, Treatment Outcome, Tympanoplasty adverse effects, Young Adult, Bone Conduction, Cholesteatoma surgery, Fistula surgery, Mastoid surgery, Otitis Media surgery, Tympanoplasty methods
- Abstract
Objective: To understand the third mobile window effect of chronic otitis media with cholesteatoma with inner ear fistula on the bone conduction threshold, we examined changes in the bone conduction audiogram after tympanoplasty with mastoidectomy for chronic otitis media with cholesteatoma with canal fistula., Study Design: Retrospective case review., Setting: Tertiary referral center., Patients: According to the intraoperative classification of Dornhoffer and Milewski, we focused especially on Type IIa (anatomic bony fistula with no perilymph leak). We checked the bone conduction threshold at least 3 times: just before, just after, and 6 months after surgery in 20 ears with Type IIa lateral semicircular canal fistula., Intervention: Tympanoplasty with mastoidectomy., Main Outcome Measure: Bone conduction thresholds before and after tympanoplasty with mastoidectomy., Results: Compared with the preoperative bone conduction threshold, 6 cases were better, 12 cases were unchanged, and 2 cases were worse within the first postoperative week. Finally, 1 case was better, 15 cases were unchanged, and 4 cases were worse at the sixth postoperative month. Patients with a better bone conduction threshold in the low-tone frequencies immediately after surgery had a tendency to show no preoperative fistula symptoms. Postoperative spontaneous nystagmus had a tendency to be observed in patients with a worse bone conduction threshold in the high-tone frequencies., Conclusion: The better bone conduction threshold at low-tone frequencies immediately after tympanoplasty with mastoidectomy and no preoperative fistula symptoms might imply the third mobile window theory. The worse bone conduction threshold in high-tone frequencies with spontaneous nystagmus after surgery might indicate inner ear damage.
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- 2014
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24. Long-term deterioration of bone-conduction hearing level in patients with labyrinthine fistula.
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Katsura H, Mishiro Y, Adachi O, Ogino K, Daimon T, and Sakagami M
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- Aged, Cohort Studies, Female, Hearing Loss, Conductive, Hearing Tests, Humans, Longitudinal Studies, Male, Middle Aged, Treatment Outcome, Bone Conduction, Cholesteatoma, Middle Ear surgery, Fistula surgery, Labyrinth Diseases surgery, Semicircular Canals surgery, Tympanoplasty methods
- Abstract
Objective: Although many reports describe the short-term hearing outcomes of surgically managed labyrinthine fistulae, the long-term results remain unknown. We reviewed the long-term postoperative hearing outcomes of 14 ears of patients with cholesteatoma and labyrinthine fistulae., Methods: Between 1996 and 2010, 84 patients with cholesteatoma and labyrinthine fistula underwent tympanoplasty at Hyogo College of Medicine Hospital. Fistulae were located in the lateral semicircular canal in all patients and in the superior semicircular canal in one. Fourteen patients were followed up for more than 5 years., Results: The postoperative air-bone gap was ≤10dB in one patient, between 11 and 20dB in seven, between 21 and 30dB in four, and ≥31dB in two. Mean bone-conduction hearing levels on the operated side had deteriorated by 3, -1 and -2dB at 1, 2 and 4kHz, respectively at 1 year postoperatively, and by 8, 6 and 2dB at 1, 2 and 4kHz, at 5 years postoperatively. Bone-conduction hearing levels at 1 and 2kHz were significantly deteriorated at 5 years postoperatively, compared with baseline and 1 year (P<0.05)., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)
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- 2014
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25. Longitudinal follow-up after pediatric myringoplasty: long-term outcome is defined at 12 months.
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Takahashi-Tatsumi E, Mishiro Y, Katsura H, Sakaguchi A, and Sakagami M
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- Adult, Audiometry, Child, Follow-Up Studies, Humans, Otitis Media with Effusion pathology, Retrospective Studies, Treatment Outcome, Tympanic Membrane pathology, Tympanic Membrane Perforation pathology, Myringoplasty, Otitis Media with Effusion surgery, Tympanic Membrane surgery, Tympanic Membrane Perforation surgery
- Abstract
Objectives: To determine the true success rate of pediatric myringoplasty., Materials and Methods: This retrospective study analyzed 67 pediatric myringoplasties performed at Hyogo College of Medicine between 2000 and 2009. We divided the pediatric population into a younger group (<10 yr old, n = 41) and an older group (≥10 yr old, n = 26). We also compared the pediatric group (n = 67) with a group of adult patients (n = 63) who underwent myringoplasty between 2008 and 2009., Results: In the pediatric group, graft success was achieved in 81% of the cases. The pathologic success rate, which was based on the presence of an intact membrane without adhesion, retraction, or effusion, was 73%. Furthermore, an intact membrane with successful hearing was achieved in 67% of the cases at 12-month follow-up. The graft success rate of the adult group was 90%, and there was no significant difference with the pediatric group. However, when success was defined as pathologic success or pathologic success with hearing improvement, there were significant differences in success rates between pediatric and adults groups (p < 0.05). The success rate of pathologic success with hearing improvement was significantly lower in children with abnormal contralateral ears or poor contralateral air cell development than in children with healthy contralateral ears (p < 0.01) or good contralateral air cell development (p < 0.05)., Conclusion: These findings suggest that the success of pediatric myringoplasty should be defined as an intact tympanic membrane without evidence of adhesions, retraction, or effusion, together with hearing improvement at the 12-month follow-up.
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- 2014
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26. [Vestibular-evoked myogenic potential in response to bone-conducted sound in patients with otosclerosis].
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Saka N, Seo T, Fujimori K, Mishiro Y, and Sakagami M
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- Adult, Aged, Female, Humans, Male, Middle Aged, Otosclerosis diagnosis, Bone Conduction, Otosclerosis physiopathology, Vestibular Evoked Myogenic Potentials, Vestibule, Labyrinth physiopathology
- Published
- 2013
27. Trigeminal and taste sensations of the tongue after middle ear surgery.
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Sakaguchi A, Nin T, Katsura H, Mishiro Y, and Sakagami M
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- Adolescent, Adult, Aged, Child, Chorda Tympani Nerve physiopathology, Chorda Tympani Nerve surgery, Discrimination, Psychological physiology, Female, Humans, Male, Middle Aged, Prospective Studies, Taste Disorders physiopathology, Tongue innervation, Chorda Tympani Nerve injuries, Ear, Middle surgery, Taste physiology, Taste Disorders diagnosis, Taste Threshold physiology, Tongue physiology
- Abstract
Objective: To establish clinical tests for measurement of trigeminal sensitivity on the human tongue and objectively assess changes in oral trigeminal sensitivity and taste ability after chorda tympani nerve (CTN) injury., Study Design: Prospective study., Setting: University hospital., Patients: One-hundred and twenty-six patients with unilateral middle ear diseases who underwent primary middle ear surgery., Main Outcomes and Measures: Trigeminal sensation was measured each operated side as well as nonoperated side both before and 14 days after surgery using 3 kinds of tests: Semmes-Weinstein sensory test (SW test), 2-point discrimination test, and the electrostimulator test. Taste function was assessed with electrogustometry (EGM) similarly., Results: The patients which the CTN was not touched (n = 6) showed no differences between preoperative and postoperative thresholds in any tests. In the patients with sectioned CTN (n=30), postoperative thresholds on the operated side were significantly higher than preoperative thresholds on the electrostimulator test, 2-point discrimination test, and EGM. In the patients with manipulated but not sectioned CTN (n = 90), postoperative thresholds were significantly higher than preoperative thresholds on the electrostimulator test and EGM. The patients with manipulated but not sectioned CTN and abnormal EGM postoperative thresholds (n = 48) showed that postoperative thresholds were significantly higher than preoperative thresholds in all tests., Conclusion: These findings suggest that the electrostimulator test was most useful to objectively assess small changes of trigeminal sensation among the 3 tests. The finding that trigeminal sensitivity of the tongue deteriorated on the operated side after CTN injury suggests that CTN function affected both taste sensation and trigeminal sensation of the tongue.
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- 2013
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28. Psychological condition in patients with intractable Meniere's disease.
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Furukawa M, Kitahara T, Horii A, Uno A, Imai T, Ohta Y, Morihana T, Inohara H, Mishiro Y, and Sakagami M
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- Depression etiology, Depressive Disorder etiology, Humans, Meniere Disease complications, Meniere Disease surgery, Prospective Studies, Regression Analysis, Meniere Disease psychology
- Abstract
Conclusions: Physicians should consider additional treatment strategies for Meniere's disease patients with a long history of disease and hearing loss in the secondary affected ear and also provide psychological support regarding future progressive bilateral hearing loss., Objectives: To treat intractable Meniere's disease patients effectively, we need to understand the psychological condition of each patient. We examined the state of neurosis and depression in patients and correlated this with demographic and background information., Methods: Between 1998 and 2009, we enrolled 207 patients with intractable Meniere's disease in this prospective study. We used the Cornell Medical Index and the Self-rating Depression Scale to evaluate their psychological condition. We also obtained demographic and background information relating to sex, age, duration of disease, vertigo frequency, hearing level in bilateral sides, and plasma vasopressin level., Results: Neurosis and depression was diagnosed in 40.1% and 60.4%, respectively, of patients with intractable Meniere's disease. Our results showed that surgical treatment significantly improved vertigo and hearing ability in patients with no psychological symptoms compared with those exhibiting psychological symptoms. Patients with a longer duration and worse hearing level in the secondary affected ear had a significantly higher incidence of mental illness than those with a shorter duration and better level of hearing.
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- 2013
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29. Vestibular-evoked myogenic potential in response to bone-conducted sound in patients with otosclerosis.
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Saka N, Seo T, Fujimori K, Mishiro Y, and Sakagami M
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- Adult, Aged, Female, Humans, Male, Middle Aged, Otosclerosis complications, Bone Conduction, Otosclerosis physiopathology, Postural Balance, Vestibular Evoked Myogenic Potentials
- Abstract
Conclusion: Saccular dysfunction is a major cause of balance problems in patients with otosclerosis. Vestibular-evoked myogenic potential in response to bone-conducted sound (BC-VEMP) testing is useful for diagnosis of these patients., Objectives: The purpose of this study was to elucidate the origin of balance problems in patients with otosclerosis using BC-VEMP., Methods: Subjects comprised 25 patients with unoperated otosclerosis (9 men and 16 women). They were divided into two groups depending on type of balance problems. Results of cochleo-vestibular functions including pure-tone audiometry, caloric testing, and BC-VEMP testing were compared between the two groups., Results: Ten patients had complained of dizziness and/or vertigo (disequilibrium group), and the other 15 patients had not (Non-disequilibrium group). Nine patients showed abnormal results on BC-VEMP testing in the disequilibrium group, while one patient had abnormal results in the non-disequilibrium group (p < 0.001).
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- 2012
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30. [Staging-based surgical results in chronic otitis media with cholesteatoma].
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Kitahara T, Mishiro Y, Sakagami M, Kamakura T, Morihana T, and Inohara H
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- Adolescent, Adult, Aged, Cholesteatoma classification, Chronic Disease, Female, Humans, Male, Middle Aged, Treatment Outcome, Cholesteatoma surgery, Otitis Media surgery
- Abstract
Discussions of surgical results in chronic otitis media involving cholesteatoma usually include hearing improvement, side effects, and cholesteatoma recurrence, although such talks could easily involve the influence on surgical results of the intraoperative extension of the cholesteatoma-affected area around the tympanomastoid cavity. Based on intraoperative chronic otitis media staging involving cholesteatoma proposed by the Japan Otological Society in 2010, we studied our tympanoplasty results between April 1997 and March 2010. Hearing improvement in all subjects with pars flaccida cholesteatoma was 79.0% (n= 100) and that with pars tensa 73.3% (n = 30)--results not significantly influenced by intraoperative staging grade but significantly dependent on stapes presence (tympanoplasty type I and III) or absence (type IV). Nine cases of recurrence were seen in pars flaccida and four in pars tensa. Intraoperative side effects and postoperative recurrence often occurred in advanced cases. These findings suggest that intraoperative chronic otitis media staging involving cholesteatoma may make it important to be aware of the need for more careful procedures during surgery and in follow-up.
- Published
- 2012
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31. Low-tone air-bone gaps after endolymphatic sac surgery.
- Author
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Kitahara T, Horii A, Mishiro Y, Kawashima T, Imai T, Nishiike S, and Inohara H
- Subjects
- Administration, Topical, Adult, Aged, Anti-Inflammatory Agents administration & dosage, Delayed-Action Preparations, Dexamethasone administration & dosage, Female, Humans, Male, Meniere Disease physiopathology, Middle Aged, Audiometry, Pure-Tone, Bone Conduction physiology, Endolymphatic Sac surgery, Meniere Disease surgery, Pitch Perception physiology, Postoperative Complications physiopathology
- Abstract
Objectives: We detected chronic low-tone air-bone gaps (LTABGs) in some patients with Meniere's disease after endolymphatic sac surgery. The aim of the present study was to elucidate the mechanism of LTABGs after endolymphatic sac surgery., Methods: We investigated 50 patients with Meniere's disease, who underwent surgery more than two years prior. LTABGs were defined as the three-tone-average=20dB formulated by (a+b+c)/3, where a, b, and c are ABGs at 0.25, 0.5, and 1kHz, respectively (ABG ±). The intra-operative finding was focused on identifying operculum (OPC ±)., Results: The ratio of post-operative ABG(+) was 50.0% (25/50). The ratio of intra-operative OPC(+) was 72.0% (36/50). The surgery results were as follows: the ratio of complete vertigo suppression (VS(+)) was 84.0% (42/50), air-conduction hearing gain (aHG(+)) was 40% (20/50), bone-conduction hearing gain (bHG(+)) was 64% (32/50), and speech discrimination gain (SDG(+)) was 28% (14/50). The post-operative ABG(+) was commonly observed in patients with intra-operative OPC(+) (chi-square test, p=0.013). aHG(+) and SDG(+) results were related to the post-operative ABG(+) (chi-square test, p=0.021 and p=0.0018, respectively)., Conclusions: These data suggest that intra-operative OPC(+) may be causative for post-operative ABG(+), resulting in post-operative aHG(+) and SDG(+). Thus, as enlarged vestibular aqueduct syndrome and superior semicircular canal deficiency syndrome exhibit LTABGs due to the third mobile inner ear window, endolymphatic sac surgery with adequate endolymphatic sac decompression and exposure to high doses of steroids, might induce LTABGs and the beneficial results of endolymphatic sac surgery., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2011
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32. Effects of additional administration of low-dose indapamide on patients with hypertension treated with angiotensin II receptor blocker.
- Author
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Yamada H, Mishiro Y, Kusunose K, and Sata M
- Subjects
- Age Factors, Aged, Antihypertensive Agents administration & dosage, Antihypertensive Agents adverse effects, Blood Pressure, Diuretics administration & dosage, Diuretics adverse effects, Drug Administration Schedule, Drug Therapy, Combination, Female, Humans, Indapamide administration & dosage, Indapamide adverse effects, Male, Middle Aged, Uric Acid blood, Angiotensin II Type 2 Receptor Blockers, Antihypertensive Agents therapeutic use, Diuretics therapeutic use, Hypertension drug therapy, Indapamide therapeutic use
- Abstract
Background: Low-dose thiazide or thiazide-like diuretics have proven useful for the management of blood pressure in patients older than 65 years (elderly group). However, there are few reports about the antihypertensive effects of antihypertensive diuretic agents in patients younger than 65 years (middle-aged group). So, we evaluated the efficacy of low-dose indapamide on blood pressure., Methods: Indapamide(1 mg) was given daily for 3 months and was then given every other day for 3 months to patients whose hypertension was poorly controlled with angiotensin II receptor blocker (ARB)-based treatment., Results: After daily administration of indapamide, blood pressure was significantly decreased in both the middle-aged and elderly groups. Blood pressure was not significantly changed by every-other-day administration compared with that observed after daily administration in either group. The rate of attainment of the target blood pressure was 90.3% and 85.7% in the middle-aged and elderly groups, respectively. The serum uric acid levels were reduced after every-other-day administration compared to daily administration but tended to be higher than the levels at the baseline in both groups., Conclusions: The addition of low-dose indapamide is a useful strategy for the management of hypertension, as it reduced blood pressure without marked side effects.
- Published
- 2010
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33. Prognostic factors of long-term outcomes after ossiculoplasty using multivariate analysis.
- Author
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Mishiro Y, Sakagami M, Kitahara T, and Kakutani C
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Ossicular Prosthesis, Prognosis, Prosthesis Design, Retrospective Studies, Young Adult, Auditory Threshold, Bone Conduction, Multivariate Analysis, Ossicular Replacement statistics & numerical data, Outcome Assessment, Health Care statistics & numerical data, Postoperative Complications etiology
- Abstract
The objective of the retrospective study is to investigate the prognostic factors of long-term outcomes following ossiculoplasty. The setting was a tertiary referral and academic center. The series consisted of 269 patients, who underwent ossiculoplasty by the same surgeon between 1989 and 2003 and were followed for more than 5 years. Postoperative hearing outcomes were considered successful, if the postoperative air-bone gap was <20 dB. Prognostic factors were analyzed using multivariate analysis with logistic regression. Successful hearing was achieved in 143 patients (53.2%). The presence of the stapes and primary surgery was significantly favorable predictive factors. Better knowledge of these predictive factors may contribute to improve the surgeon's judgement and the information given to the patients preoperatively.
- Published
- 2010
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34. Case of refractory otitis media with high-titer positive serum MPO-ANCA value.
- Author
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Azuma N, Kanda C, Nishioka A, Tanaka J, Mishiro Y, Takehara J, Sawada H, Kitano M, Okabe M, Morimoto M, Sekiguchi M, Kuroiwa T, Hashimoto N, Matsui K, Iwasaki T, and Sano H
- Subjects
- Biomarkers blood, Drug Therapy, Combination, Female, Hearing Loss drug therapy, Hearing Loss etiology, Humans, Methicillin-Resistant Staphylococcus aureus isolation & purification, Middle Aged, Treatment Outcome, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis complications, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis diagnosis, Antibodies, Antineutrophil Cytoplasmic blood, Azathioprine administration & dosage, Methylprednisolone administration & dosage, Otitis Media with Effusion drug therapy, Otitis Media with Effusion etiology, Peroxidase immunology
- Abstract
A 56-year-old-woman presented a local otolaryngologist with a complaint of hearing loss. She was treated with antibiotics as acute otitis media, however her symptom did not improved. She admitted to our hospital because of hearing loss on both sides, fever, otorrhea and vertigo. On admission, an audiogram showed bilateral mixed conductive-sensorineural hearing loss, and CT image revealed the exudates in bilateral middle ear cavities and mastoid air cells. Moreover, serum level of myeloperoxidase anti-neutrophil cytoplasmic autoantibody (MPO-ANCA) elevated (133EU). Although pulmonary, renal and cutaneous involvements were not noted and the histopathological examination of operated specimen taken from otitis media revealed non-specific inflammatory changes, in the absence of any other obvious causes of otitis media, these findings might be associated with positive serum MPO-ANCA value itself. After the initiation of therapy with methylprednisolone and azathioprine, her symptoms and hearing ability ameliorated and both CRP value and the titer of ANCA became normalized. But, after the improvement by the immunosuppressive treatment, MRSA in the otorrhea persisted. This case suggests that otitis media may be one of the symptoms of vasculitis, and some previous cases described otitis media or hearing loss as rare manifestations of vasculitis. It is important to make an early diagnosis for good prognosis of hearing ability, and we have to consider the differential diagnosis including of ANCA-related vasculitis.
- Published
- 2010
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35. Prognostic factors for short-term outcomes after ossiculoplasty using multivariate analysis with logistic regression.
- Author
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Mishiro Y, Sakagami M, Adachi O, and Kakutani C
- Subjects
- Adolescent, Audiometry, Female, Humans, Logistic Models, Male, Multivariate Analysis, Ossicular Replacement, Prognosis, Retrospective Studies, Treatment Outcome, Young Adult, Ear Ossicles surgery, Otologic Surgical Procedures methods
- Abstract
Objective: To investigate prognostic factors for short-term hearing outcomes after ossiculoplasty., Design: Retrospective study., Setting: Tertiary referral and academic center., Patients: Seven hundred twenty patients who underwent ossiculoplasty performed by a single surgeon from January 1, 1989, through December 31, 2006, and who were followed up for longer than 1 year., Main Outcome Measures: Hearing outcomes were considered successful if the postoperative air-bone gap was 20 dB or less. The prognostic factors were analyzed using multivariate analysis with logistic regression., Results: Hearing outcomes were successful in 505 patients (70.1%). Presence of the stapes superstructure, presence of the malleus handle, normal mucosa, normal stapes mobility, and use of local anesthesia were significantly favorable predictive factors., Conclusions: Multivariate analysis should be performed to investigate prognostic factors of favorable short-term hearing outcomes after ossiculoplasty. Better knowledge of these predictive factors may contribute to the surgeon's judgment and the information given to patients.
- Published
- 2009
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36. Long-term outcomes after tympanoplasty with and without mastoidectomy for perforated chronic otitis media.
- Author
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Mishiro Y, Sakagami M, Kondoh K, Kitahara T, and Kakutani C
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Chronic Disease, Female, Humans, Logistic Models, Male, Mastoid surgery, Middle Aged, Prognosis, Retrospective Studies, Treatment Outcome, Otitis Media surgery, Tympanic Membrane Perforation surgery, Tympanoplasty methods
- Abstract
The objectives of the retrospective study, performed at a tertiary referral center, were to examine the prognostic factors predicting long-term outcomes of tympanoplasty for perforated chronic otitis media (COM) and to determine whether mastoidectomy can be avoided during tympanoplasty for perforated COM. Between 1987 and 2002, 213 patients with perforated COM underwent tympanoplasty by the same surgeon and were followed for more than 5 years. Postoperative hearing outcomes were considered successful, if the postoperative air-bone gap was within 20 dB. Closure of perforation by a single surgery was considered a successful graft. Long-term outcomes were analyzed using logistic regression analysis. Normal ossicular chain was the only factor that showed a significantly favorable relation to long-term hearing outcomes. There were no significant predictors of long-term successful graft outcomes. Mastoidectomy was not a significant factor predicting long-term outcomes. Our long-term outcomes showed that mastoidectomy can be an avoidable surgical procedure in tympanoplasty for perforated COM, even if the ear is infected.
- Published
- 2009
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37. [Delayed facial nerve palsy after otologic surgery].
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Kitahara T, Kubo T, Doi K, Mishiro Y, Kondoh K, Horii A, Okumura S, and Miyahara H
- Subjects
- Adult, Aged, Child, Preschool, Cochlear Implantation, Endolymphatic Sac, Female, Humans, Male, Middle Aged, Stapes Surgery, Time Factors, Tympanoplasty, Facial Paralysis etiology, Otologic Surgical Procedures, Postoperative Complications
- Abstract
Delayed facial nerve palsy (DFP) is rarely experienced after otologic surgeries that do not directly touch the facial nerves, such as tympano-mastoidectomy, cochlear implants, and stapes surgery, and is troublesome to both surgeons and patients if it happens. Here, we report 7 cases of DFP, including one case that developed DFP after endolymphatic sac surgery. The ratios of occurrence were as follows: 0.7% (2/305) for tympano-mastoidectomy, 0.8% (3/354) for cochlear implant, 0.4% (1/260) for stapes surgery and 1.0% (1/98) for endolymphatic sac surgery. All otologic surgeries, except for endolymphatic sac surgery, exposed the chorda tympani, and all surgeries, except for stapes surgery, underwent drilling for a mastoidectomy. Furthermore, DFP was always observed ipsilaterally to the operated ear after otologic surgeries and was never seen after benign parotid tumor surgery or total laryngectomy. Therefore, there may be a strong relationship between DFP and the procedures, used during otologic surgeries.
- Published
- 2006
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38. Magnetic resonance imaging of syringocystadenoma papilliferum of the external auditory canal.
- Author
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Kamakura T, Horii A, Mishiro Y, Takashima S, and Kubo T
- Subjects
- Contrast Media, Ear Neoplasms surgery, Ear, External surgery, Gadolinium DTPA, Hearing Loss, Conductive etiology, Humans, Male, Middle Aged, Sweat Gland Neoplasms surgery, Syringoma surgery, Ear Neoplasms pathology, Ear, External pathology, Magnetic Resonance Imaging, Sweat Gland Neoplasms pathology, Syringoma pathology
- Abstract
Syringocystadenoma papilliferum (SCAP) usually occurs on the face or the scalp and is very rare in the external auditory canal (EAC). There has been no information on magnetic resonance (MR) imaging of this tumor irrespective of its site. We report here a case of 57-year-old man having this tumor, which was surgically removed and its histopathology was confirmed. MR imaging demonstrated a lobulated 4-cm mass with clearly defined margins in the EAC. Although the tumor was bulky, these MR findings were different from the malignancies. The mass lesion showed intermediate signal intensity both on T1- and T2-weighted MR images and showed slight enhancement on gadolinium-enhanced T1-weighted images. Signal intensities on T2-weighted images of this tumor were low compared to those of pleomorphic adenoma. All ceruminous gland tumors including SCAP are thought to be potentially malignant; therefore, pre-operative biopsy should not be performed. Even though incisional biopsy is sometimes needed as in our case, the current MR features would be helpful for differential diagnosis of this rare condition and assessing the extension of the tumor.
- Published
- 2006
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39. Taste function after section of chorda tympani nerve in middle ear surgery.
- Author
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Nin T, Sakagami M, Sone-Okunaka M, Muto T, Mishiro Y, and Fukazawa K
- Subjects
- Adolescent, Adult, Aged, Child, Cholesteatoma, Middle Ear surgery, Female, Follow-Up Studies, Humans, Hypesthesia etiology, Male, Middle Aged, Otitis Media surgery, Prospective Studies, Recovery of Function, Surveys and Questionnaires, Tongue innervation, Chorda Tympani Nerve surgery, Ear, Middle surgery, Postoperative Complications, Taste Disorders etiology
- Abstract
Objective: To investigate prospectively the clinical manifestations and the functional recovery of taste after section of chorda tympani nerve (CTN) during middle ear surgery, the subjective and objective study on the patients was performed., Methods: Thirty-five patients underwent surgery with unilateral (n=32) or bilateral (n=3) section of CTN between January 2000 and April 2002. The patients were asked about taste symptoms before surgery and 2 weeks and 2 years after surgery. The CTN function was also measured with electrogustometry (EGM) at the same time points., Results: In unilateral section of CTN, 19/32 (59.4%) complained of taste disorder and 11/32 (34.4%) tongue numbness. Most of these taste symptoms disappeared within 2 years although the EGM threshold did not recover. 16/17 patients (94.1%) who used to cook everyday had little difficulty in flavoring dishes. In bilateral section of CTN, the patients had no problem of taste at 2 years after surgery, either., Conclusion: These findings help explain the potential complications to the patients before surgery, although the number of cases was small in this series.
- Published
- 2006
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40. Reevaluation of bilateral same-day surgery for bilateral perforated chronic otitis media.
- Author
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Katsura H, Sakagami M, Tsuji K, Muto T, Okunaka M, Mishiro Y, and Fukazawa K
- Subjects
- Adolescent, Adult, Aged, Audiometry, Pure-Tone, Child, Child, Preschool, Chronic Disease, Evaluation Studies as Topic, Female, Hearing Loss, Conductive diagnosis, Hearing Loss, Conductive etiology, Humans, Male, Middle Aged, Myringoplasty, Otitis Media surgery, Prospective Studies, Treatment Outcome, Tympanic Membrane Perforation etiology, Ambulatory Surgical Procedures, Auditory Threshold, Otitis Media complications, Tympanic Membrane Perforation surgery
- Abstract
Objective: To evaluate the results of bilateral same-day surgery for bilateral perforated chronic otitis media in comparison with our previous report., Study Design: Prospective study., Patients: Seventeen patients ranging in age from 5 to 70 years (mean, 52.5 yr), with bilateral perforated chronic otitis media., Methods: Two hundred cases of chronic otitis media were operated on at the Department of Otolaryngology, Hyogo College of Medicine from December 1998 to November 2002. Fifty-nine patients (29.5%) had bilateral disease and 17 patients (8.5%) underwent bilateral same-day surgery., Results: The postoperative air-bone gap was less than 10 dB on both sides in 5 of 17 (29%) and less than 20 dB in 15 of 17 (88%). The postoperative hearing level was less than 20 dB in both ears in 4 of 17 (24%), less than 30 dB in 7 of 17 (41%), and less than 40 dB in 10 of 17 (59%). The rate of closure of the ear drum was 20 of 22 (91%) in the simple underlay myringoplasty series and 9 of 12 (75%) in the conventional myringoplasty/tympanoplasty series. The rate of closure of the ear drum on both sides was successful in 4 of 5 (80%) that underwent simple underlay myringoplasty/simple underlay myringoplasty and 8 of 12 (67%) that underwent simple underlay myringoplasty/conventional myringoplasty/tympanoplasty, whereas that on at least one side was successful in 100%., Conclusion: Bilateral same-day surgery for bilateral perforated chronic otitis media is possible if operative indications are considered. Furthermore, it will help patients save time and money.
- Published
- 2005
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41. Management of hemorrhagic high jugular bulb with adhesive otitis media in an only hearing ear: transcatheter endovascular embolization using detachable coils.
- Author
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Kondoh K, Kitahara T, Mishiro Y, Okumura S, and Kubo T
- Subjects
- Ear, Middle pathology, Female, Hearing Loss, Mixed Conductive-Sensorineural etiology, Hemorrhage etiology, Humans, Middle Aged, Ear Diseases therapy, Embolization, Therapeutic instrumentation, Embolization, Therapeutic methods, Hemorrhage therapy, Jugular Veins abnormalities, Otitis Media complications
- Abstract
A 51-year-old woman had a hemorrhagic high jugular bulb protruding into the posterosuperior part of the tympanic cavity in her left ear. This (only hearing) ear had severe adhesive otitis media resulting in repetitive hemorrhage from the jugular bulb. Therefore, treatment to stop the bleeding was required. Since invasive middle ear surgery in an only hearing ear would involve a high risk of hearing loss and massive bleeding, transcatheter endovascular embolization using detachable coils was selected for this special case; it safely blocked the blood flow and preserved the patient's hearing level. This is the first such report in the otosurgical field, showing that transcatheter endovascular embolization using detachable coils was quite effective in a difficult case of a hemorrhagic high jugular bulb with severe adhesive otitis media in an only hearing ear.
- Published
- 2004
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42. Taste function in elderly patients with unilateral middle ear disease.
- Author
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Terada T, Sone M, Tsuji K, Mishiro Y, and Sakagami M
- Subjects
- Adolescent, Adult, Aged, Aging physiology, Child, Child, Preschool, Cholesteatoma, Middle Ear physiopathology, Cholesteatoma, Middle Ear surgery, Chorda Tympani Nerve physiology, Chorda Tympani Nerve physiopathology, Electrophysiology methods, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Otitis Media physiopathology, Otitis Media surgery, Taste Threshold, Chorda Tympani Nerve pathology, Ear, Middle surgery, Otologic Surgical Procedures adverse effects, Taste Buds physiology, Taste Disorders etiology
- Abstract
Objective: It is generally said that taste function deteriorates naturally with age. Taste function after middle ear surgery in elderly patients has not been clarified., Material and Methods: The taste function of the chorda tympani nerve on the normal and diseased sides was examined before and after middle ear surgery using electrogustometry in 79 patients aged>60 years, and the findings were compared with those in 228 young and middle-aged patients., Results: The threshold of electrogustometry on the normal side increased significantly with increasing age (p<0.0001). The rate of thresholds that were off the scale was highest in the>70 years age group. The preoperative threshold on the diseased side increased significantly with increasing age in patients with chronic otitis media (p=0.0029) and cholesteatoma (p<0.0001). In patients with chronic otitis media, the postoperative threshold of the>60 years age group tended to be higher than that of the<60 years age group., Conclusions: These findings suggest that the taste function of the chorda tympani nerve deteriorated on the diseased side as much as on the normal side in elderly patients. Therefore, in most cases, we do not have to pay as much attention to the chorda tymapani nerve when performing surgery in elderly patients compared to young and middle-aged patients.
- Published
- 2004
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43. Surgical management of special cases of intractable Meniere's disease: unilateral cases with intact canals and bilateral cases.
- Author
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Kitahara T, Kondoh K, Morihana T, Okumura S, Mishiro Y, and Kubo T
- Subjects
- Dexamethasone administration & dosage, Drainage, Electronystagmography, Endolymphatic Sac physiology, Glucocorticoids administration & dosage, Humans, Instillation, Drug, Meniere Disease psychology, Middle Aged, Prednisolone administration & dosage, Semicircular Canals physiology, Time Factors, Vestibular Function Tests, Meniere Disease surgery
- Abstract
If a clinician seeks to allow patients with vertigo to return to work as soon as possible, it is very important to determine the appearance of vestibular symptoms during convalescence just after treatment, as well as the long-term results. Apprehensive patients with vertigo may undergo severe psychological torment if treatment requires long-term rest in bed before they can return to daily life. In this paper, we observed postoperative vestibular symptoms (subjective sensation and objective nystagmus) in 50 patients with intractable Meniere's disease, including cases from our previous preliminary report, during the period of convalescence just after endolymphatic sac drainage and steroid instillation surgery (EDSS). All symptoms were eliminated within 8 days after EDSS. There was no significant difference in the duration of any vestibular symptoms between bilateral (n = 8) and unilateral cases (n = 42). This result indicates that EDSS could be as safe a treatment for bilateral Meniere's disease as for unilateral disease. In unilateral cases with intact semicircular canal function (n = 17), postoperative evoked vestibular sensation, positional, and positioning (Dix-Hallpike) nystagmus disappeared significantly earlier than in those with canal paresis (n = 25). This result indicates that EDSS could keep the vestibular peripheral function of patients with unilateral Meniere's disease with intact canals quite stable after surgery. Therefore, EDSS could be recommended as an initial, less-invasive surgical treatment for intractable Meniere's disease, especially in unilateral cases with intact canals and in bilateral cases.
- Published
- 2004
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44. Up-regulation of cochlear aquaporin-3 mRNA expression after intra-endolymphatic sac application of dexamethasone.
- Author
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Kitahara T, Fukushima M, Uno Y, Mishiro Y, and Kubo T
- Subjects
- Acoustic Stimulation, Animals, Aquaporin 3, Aquaporins metabolism, Brain Stem drug effects, Brain Stem physiology, Cochlea metabolism, Dose-Response Relationship, Drug, Endolymphatic Sac metabolism, Evoked Potentials, Auditory, Functional Laterality, Male, RNA, Messenger metabolism, Rats, Rats, Wistar, Reverse Transcriptase Polymerase Chain Reaction methods, Time Factors, Up-Regulation, Anti-Inflammatory Agents pharmacology, Aquaporins genetics, Cochlea drug effects, Dexamethasone pharmacology, Endolymphatic Sac drug effects, Gene Expression Regulation drug effects
- Abstract
The final aim of the present study is to see if the endolymphatic sac is really available as a drug delivery system to have effect on the inner ear organs. In the present study, we examined effects of a single insertion of dexamethasone into the rat unilateral endolymphatic sac on mRNA expression of the inner ear aquaporin (AQP) family, transmembrane water transporters and putative endolymphatic fluid modulators, by means of real-time quantitative PCR. Only AQP-3 mRNA expression in the ipsilateral cochlea was significantly up-regulated in comparison with controls and the up-regulation was demonstrated both in dose-dependent and time-dependent manners. These findings suggest that the intra-endolymphatic sac steroids could make regulatory effects on the inner ear AQP-3 expression via vestibular aqueduct and modulate the homeostasis of endolymphatic fluids, encouraging the possibility that the endolymphatic sac could be a therapeutic window for the inner ear disease.
- Published
- 2003
- Full Text
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45. Horizontal canal type BPPV: bilaterally affected case treated with canal plugging and Lempert's maneuver.
- Author
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Horii A, Imai T, Mishiro Y, Yamaji Y, Mitani K, Kawashima T, and Kubo T
- Subjects
- Electronystagmography, Female, Head, Humans, Labyrinth Diseases complications, Labyrinth Diseases physiopathology, Middle Aged, Nystagmus, Pathologic physiopathology, Physical Therapy Modalities, Vertigo complications, Vertigo physiopathology, Labyrinth Diseases therapy, Posture, Semicircular Canals pathology, Vertigo therapy
- Abstract
A 54-year-old woman complained of positional vertigo. During 3 months' observation, the patient showed mostly geotropic or apogeotropic nystagmus due to right canalolithiasis or cupulolithiasis, however, she sometimes showed nystagmus which suggested left horizontal canalolithiasis. We suspected that she suffered from bilateral horizontal canal type benign paroxysmal positional vertigo (BPPV) and performed Lempert's maneuver for both directions, however, they were ineffective. She underwent canal plugging for right horizontal canal. After surgery she showed no positional nystagmus of right horizontal canal origin. However, apogeotropic nystagmus of the left horizontal canal origin was still observed. This nystagmus changed to geotropic nystagmus and finally disappeared following Lempert's maneuver for the left side. Bilateral horizontal canal BPPV is difficult to be resolved, probably because physical treatment for one side would move debris to the cupula in the other canal. Canal plugging combined with Lempert's maneuver to the other side is one treatment option for intractable bilateral horizontal canal BPPV., (Copyright 2003 S. Karger AG, Basel)
- Published
- 2003
- Full Text
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46. Magnetic resonance imaging of pleomorphic adenoma arising from the external auditory canal.
- Author
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Masumura C, Horii A, Mishiro Y, Inohara H, Kitahara T, Takashima S, and Kubo T
- Subjects
- Diagnosis, Differential, Humans, Magnetic Resonance Imaging methods, Male, Middle Aged, Adenoma, Pleomorphic diagnosis, Ear Canal pathology, Ear Neoplasms diagnosis
- Abstract
Pleomorphic adenoma arising from the external auditory canal is a very rare neoplasm, and there has been no report on magnetic resonance (MR) imaging of pleomorphic adenoma of the external auditory canal. We report here a case of 65-year-old male with this tumour, measuring 12 mm in a diameter. Histopathology was confirmed from the specimen obtained at the surgical excision. MR revealed that the tumour had a well-defined margin showing hypointensity on T1-weighted images and hyperintensity on T2-weighted images relative to the parotid gland. The tumour was well enhanced by contrast material. No invasion to the surrounding tissue was observed. These MR findings were compatible with pleomorphic adenoma of the salivary gland origin. In treating pleomorphic adenoma of the external auditory canal, complete surgical excision is essential for the prevention of recurrence. It can be concluded that MR imaging is helpful for making a differential diagnosis of external auditory canal tumours and selection of adequate treatment.
- Published
- 2003
- Full Text
- View/download PDF
47. Rate of recovery of taste function after preservation of chorda tympani nerve in middle ear surgery with special reference to type of disease.
- Author
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Sakagami M, Sone M, Tsuji K, Fukazawa K, and Mishiro Y
- Subjects
- Adolescent, Adult, Age Factors, Audiometry, Child, Child, Preschool, Cholesteatoma, Middle Ear surgery, Cochlear Implants, Data Interpretation, Statistical, Ear, Middle abnormalities, Electrodiagnosis, Female, Follow-Up Studies, Humans, Male, Middle Aged, Otitis Media surgery, Otosclerosis surgery, Taste Threshold, Time Factors, Tympanic Membrane injuries, Chorda Tympani Nerve, Ear, Middle surgery, Stapes Surgery, Taste physiology
- Abstract
To study the recovery of function of the chorda tympani nerve, we examined by electrogustometry 79 patients (83 ears) with both preoperative normal function of the nerve and operative preservation of the nerve, every 2 days during hospitalization and at 6 months after surgery. For symptoms such as tongue numbness and taste disturbance, patients with noninflammmatory (NI) diseases (13/20 or 65.0%) showed a significantly higher rate of symptoms than did patients with chronic otitis media (COM; 13/35 or 37.1%) at 2 weeks after surgery (p = .032). The patients with NI diseases (5/20 or 25.0%) tended to show a higher rate of symptoms than did the COM patients (2/35 or 5.7%) or cholesteatoma patients (2/28 or 7.1%) at 6 months after surgery. The rate of recovery of the EGM threshold to normal at 2 weeks after surgery was significantly lower in NI disease patients (6/20 or 30.0%) than in COM patients (23/ 35 or 62.9%) or cholesteatoma patients (19/28 or 67.9%; p = .015 and .008, respectively). Thus, the patients with NI diseases had postoperative symptoms and elevation of EGM threshold more frequently than did the patients with inflammatory diseases.
- Published
- 2003
- Full Text
- View/download PDF
48. [Audiological assessment of hearing-impaired children under age 3 and their later pure tone audiometry].
- Author
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Takahashi Y, Sawada A, Mori Y, Iwaki T, Kawashima T, Miyazaki Y, Sumi M, Mishiro Y, and Kubo T
- Subjects
- Auditory Threshold, Child, Child, Preschool, Evoked Potentials, Auditory, Brain Stem, Female, Hearing Tests, Humans, Infant, Infant, Newborn, Male, Audiometry, Pure-Tone, Hearing Loss physiopathology
- Abstract
We analyzed the first audiological assessment and latest pure tone audiometry (PTA) in 29 hearing-impaired children (58 ears) visiting Osaka University for their first audiological assessment at the ages of 0, 1, and 2. We evaluated their hearing thresholds with PTA during follow-up and compared them to their first assessments. We combined auditory brain-stem response (ABR), behavioral audiometry, and conditioned orientation reflex (COR) for audiological evaluation of infants. Hearing thresholds assessed by 2 or 3 of these methods were sufficiently precise for hearing aid fitting. Thresholds of recorded ABR waves in 14 ears at loud sound pressure correlated well with later pure tone thresholds at high frequencies. Pure tone thresholds of those in whom no ABR waves were observed at 100 dB, were often out of scale at high frequencies--14% at 4000 Hz and 73% at 8000 Hz. Because of residual hearing at low frequencies, 4-frequency-averaged hearing at 500 Hz, 2 x 1000 Hz, 2000 Hz was better than 100 dB in 7 of 44 ears (16%), and 4 of 22 children (18%) did not fit the severest rank, 2, of the Disabled Persons, Welfare Law in Japan.
- Published
- 2002
- Full Text
- View/download PDF
49. [A rare case of the high jugular bulb associated with only hearing ear].
- Author
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Kondoh K, Kitahara T, Mishiro Y, Morihana T, Okumura S, and Kubo T
- Subjects
- Cochlea blood supply, Ear Canal blood supply, Female, Hearing Loss, Bilateral prevention & control, Hemorrhage etiology, Hemorrhage therapy, Humans, Jugular Veins pathology, Middle Aged, Otitis Media complications, Tympanic Membrane blood supply, Hearing Loss, Jugular Veins abnormalities
- Abstract
The jugular bulb may be present in different positions and dimensions within the temporal bone. In general, high jugular bulbs were classified into 2 types: lateral in which the jugular bulb protrudes into the middle ear and up into the tympanic cavity and medial in which the jugular bulb is abnormally placed more superiorly and medial to the cochlea. We report, a unique case of a high jugular bulb which came round from behind of the internal auditory canal and the cochlea protruding into the posterosuperior part of the mesotympanum. It was a very rare pattern of a high jugular bulb which varies in position. The occurrence of adhesive otitis media caused the high jugular bulb to bleed easily in the only hearing ear. There would be risks of making the patient suffer severe bilateral healing impairment due to only one hearing ear and excessive hemorrhage in surgical treatment. With only one hearing ear, we should therefore select transcatheter interventional angiography when the quantity and frequency of bleeding from the jugular bulb increase so.
- Published
- 2002
- Full Text
- View/download PDF
50. [Changes in plasma inner ear hormones after endolymphatic sac drainage and steroid-instillation surgery (EDSS)].
- Author
-
Kitahara T, Horii A, Mishiro Y, Fukushima M, Kondoh K, Okumura S, Takeda N, and Kubo T
- Subjects
- Aldosterone blood, Endolymphatic Shunt methods, Humans, Instillation, Drug, Meniere Disease physiopathology, Natriuretic Peptide, Brain blood, Treatment Outcome, Anti-Inflammatory Agents administration & dosage, Drainage methods, Ear, Inner physiopathology, Endolymphatic Sac surgery, Meniere Disease therapy, Prednisolone administration & dosage, Vasopressins blood
- Abstract
We treated 33 cases of intractable Meniere's disease with endolymphatic sac drainage and steroid-instillation surgery (EDSS), attaining good long-term results in vertigo and hearing. To elucidate how EDSS affects the diseased inner ear, we examined changes in plasma inner ear hormones after EDSS. Among inner ear hormones, plasma vasopressin was significantly decreased after EDSS compared to after mastoidectomy. In cases with good long-term results in vertigo and hearing, postoperative plasma vasopressin remained lower over the long term than in cases with poor results. In cases with negative glycerol test results one year after surgery, postoperative plasma vasopressin also remained significantly lower over the long term than in cases with positive results. Previous studies reported that vestibular neurons projected into hypothalamic supraoptic and paraventricular nuclei and that changes in the inner ear pressure were related to plasma vasopressin. Taken together with present findings, this suggests that EDSS may reduce plasma vasopressin through modification of the diseased inner ear environment, resulting in improved inner ear function.
- Published
- 2002
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