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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.

Adult T-cell leukemia/lymphoma (ATL) usually presents with node- and/or cutaneous-based diseases, with a leukemic picture. It is not clear whether ATL initially manifests with lesions in Waldeyer's ring (WR) in an ATL-endemic area. In the present study, we examined distributions of immunophenotypes and the presence of human T-cell leukemia virus type 1 (HTLV-1) and Epstein-Barr virus (EBV) genomes in 62 cases of non-Hodgkin's lymphoma (NHL) of WR (NHL-WR) from two areas of Japan: Osaka, an ATL-nonendemic area (25 cases), and Okinawa, an ATL-endemic area (37 cases). In both areas, age ranged from 10 to 94 years (median, 64 yr), with a male-to-female ratio of 1.81:1. Twelve patients were in Stage I, 34 in Stage II, and 6 in Stage III; stage was unknown in 10. The 25 Osaka cases were B-cell type (16 diffuse immunoblastic type (DIB), 8 diffuse large cell predominantly noncleaved cell (DLNC), 1 cleaved cell (DLC)). Of the 37 Okinawa cases, 20 were B-cell type (3 DIB, 10 DLNC, 2 DLC, 5 other). The remaining 17 cases showed T-cell phenotype (4 DIB, 3 DLC, 3 diffuse large cell not otherwise specified, 7 other). There was a significant difference in the distribution of immunophenotypes between these two areas (P < .001). Combined studies of polymerase chain reaction (PCR) and in situ hybridization revealed the presence of EBV genome in 1 (4%) of 24 Osaka cases, 2 (13%) of 16 B-cell NHLs from Okinawa, and 3 (23%) of 13 T-cell NHLs from Okinawa. HTLV-1 proviral genome was found in 11 (85%) of 13 T-cell lymphomas from Okinawa but could not be detected in B-cell lymphomas from Osaka and Okinawa. Combined clinical, histologic, serologic, and PCR findings suggest that NHL-WR in an ATL-endemic area could be an initial manifestation of ATL.

Background: Association between Epstein-Barr virus (EBV) and human malignancies, including sino-nasal lymphoma (SNL), has been suggested. EBV-associated malignancies have been reported to show distinct geographic distribution., Experimental Design: In the present study, the presence of an EBV genome and its subtypes (type A and B) were examined in 52 cases of sino-nasal lymphomas of B and T cell type collected from two areas of Japan: Osaka, situated on the mainland, and Okinawa, islands situated in a southwest part of Japan with a subtropical climate. Our previous epidemiologic study showed that the frequency of nasal T cell lymphoma was 3.5 times higher in Okinawa than in Osaka., Results: There were no prominent differences in age distribution or sex ratio between these two areas: age ranged 8 to 85 (median 54) years, with a male to female ratio of 1.26:1. Immunophenotypically, 27 cases were B cell type (20 Osaka, 7 Okinawa), 20 were T cell type (9 Osaka, 11 Okinawa), and 5 were undefined. By PCR, EBV positivity in throat washings of normal individuals in Osaka and Okinawa was 52 and 53%, respectively, with marked preponderance of subtype A in both areas. EBV genome was found in 6 of 15 cases (40%) and 4 of 5 cases (80%) of nasal B and T cell lymphomas in Osaka and in 3 of 7 cases (43%) and 7 of 7 cases (100%) in Okinawa, showing the different frequencies of positivity by immunophenotype but not by district. All but one patient had type A EBV. The in situ hybridization confirmed the results of PCR as positive signals in the nucleus of proliferating cells. Latent membrane protein-1 was expressed in 13 of 22 cases (59%)., Conclusions: These findings suggest that EBV, exclusively type A, might be a causative factor in sino-nasal lymphoma of not only T cell but also B cell type in Japan.