著者

中島 務 寺西 正明 片山 直美 加藤 正大

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.3, pp.197-203, 2011 (Released:2011-08-01)

参考文献数

28

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The first visualization of endolymphatic hydrops in patients with Ménière's disease was performed using three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging with a 3 Tesla MRI unit after gadolinium contrast agent (Gd) was injected intratympanically. The 3D-FLAIR MRI could differentiate the endolymphatic space from the perilymphatic space, but not from the surrounding bone. By optimizing the inversion time, the endolymphatic space, perilymphatic space and surrounding bone could be separately visualized on a single image using three-dimensional real inversion recovery (3D-real IR) MRI. Using 3D-FLAIR and 3D-real IR MRI, various degrees of endolymphatic hydrops were observed in the basal and upper turns of the cochlea and in the vestibular apparatus after intratympanic Gd injection. Recently, visualization of endolymphatic hydrops became possible 4 h after intravenous Gd injection in patients with Ménière's disease. We applied a heavily T(2)—weighted 3D-FLAIR technique to detect Gd more sensitively for evaluation of endolymphatic hydrops after an ordinary amount of Gd was administered intravenously. Thus, newly developed MRI techniques have contributed significantly to the evaluation of endolymphatic hydrops. The intravenous administration of an ordinary amount of Gd is routinely done clinically. The relationship between endolymphatic hydrops and clinical symptoms will be investigated widely using new techniques.

著者

中島 務 中田 隆文 片山 直美 杉浦 彩子 内田 育恵 寺西 正明 吉田 忠雄

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.79, no.3, pp.156-163, 2020-06-30 (Released:2020-08-05)

参考文献数

32

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We investigated the risk factors for vertigo from the results of health checkups conducted in Yakumo town. The subjects of this investigation included 525 persons (299 women and 226 men), aged 40 to 88 years (average 63.78 years). Among these, 397 persons (75.6%) had no vertigo, 116 persons (22.1%) had vertigo sometimes, and 12 persons (2.3%) suffered from vertigo frequently. Ninety-four women (31.4%) and 34 men (15.0%) had vertigo. Twenty-one (51.2%) of the 41 women in their 40s had vertigo. Logistic regression analysis revealed that subjective hearing loss, a low value of the mean corpuscular hemoglobin concentration (MCHC), headache, high level of serum creatinine and frequent urination were significantly associated with the risk of vertigo, after adjustments for age and sex. Listening difficulties in conversations between four or five people were reported more frequently than those in one-to-one conversations. Anemia should be considered in the differential diagnosis of vertigo. In the diagnosis of vertigo, information about the presence/absence of headache and the status of the headache, if any, may be necessary. In our study, migraine and headache on the ipsilateral side were associated with vertigo, but bilateral headache was not associated with vertigo. Our analysis, did not reveal smoking, drinking, exercise habit, sleep time, body mass index (BMI), body fat percentage, hemoglobin A1c, blood glucose, serum triglyceride, serum LDL cholesterol, or serum HDL cholesterol as being significantly associated with the risk of occurrence of vertigo, after adjustments for age and sex.

著者

杉本 賢文 曾根 三千彦 大竹 宏直 寺西 正明 杉浦 淳子 吉田 忠雄

出版者

一般社団法人 日本聴覚医学会

雑誌

AUDIOLOGY JAPAN (ISSN:03038106)

巻号頁・発行日

vol.59, no.4, pp.218-223, 2016-08-30 (Released:2017-03-18)

参考文献数

12

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要旨: 10歳時に初めて高度難聴を指摘できた人工内耳手術症例を経験したので報告する。 5歳時より難聴を疑わせる症状を呈していたが, 耳鼻咽喉科診療所や総合病院耳鼻咽喉科にて複数回純音聴力検査を受けても難聴は指摘されなかった。 当院初診時の純音聴力検査による聴力レベル (4分法) は右 98.8dB, 左 92.5dB と 500Hz 以上の中高音域にて高度な難聴を認めたが, 右耳の 125, 250Hz では 30~40dB の残存聴力を有していた。 初診10ヶ月後には, 補聴器装用効果不十分のため, 左耳へ人工内耳植込術を実施した。 10歳まで高度難聴を把握できなかった要因としては, 難聴が徐々に進行した可能性, 低音域に残存聴力が存在したこと, 不十分な聴力評価により繰り返し難聴を否定されてきたことなどが考えられた。 小児の聴力検査を行う際は, 他覚的聴覚検査の併用も考慮し, 慎重に診断を行うべきである。

著者

寺西 正明 曾根 三千彦

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.76, no.2, pp.85-92, 2017-04-30 (Released:2017-06-01)

参考文献数

31

被引用文献数

1

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The characteristic symptoms of Meniere's disease are recurrent vertigo, fluctuating hearing loss and tinnitus, and the principal underlying pathology is endolymphatic hydrops (ELH). Imaging of endolymphatic hydrops is now possible by 3-Tesla MRI after intratympanic (IT) or intravenous injection (IV) of gadolinium (Gd). 3D-FLAIR and 3D-real IR are obtained in the case of IT injection of contrast, while heavily T2-weighted 3D-FLAIR and HYbriD of Reversed image Of Positive endolymph Signal and native image of positive perilymph signal (HYDROPS) are obtained in the case of IV injection of contrast, to visualize the endolymphatic space. Higher concentrations of the contrast agent can be introduced into the perilymph by IT injection than by IV injection. However, the IV method is preferable in the clinical setting, as the endolymphatic spaces of both ears can be evaluated after a single intravenous injection of Gd. ELH is observed more frequently in patients with definite Meniere's disease than in those with possible Meniere's disease. ELH is observed in both the cochlea and the vestibule in patients with atypical Meniere's disease. The vestibular Meniere's disease patients show significant vestibular predominance in the distribution of ELH. ELH is observed more frequently in patients with fluctuating tinnitus than in patients with stable tinnitus. Examination of ELH can be performed as part of preoperative evaluation prior to stapes surgery in patients with otosclerosis; the presence of ELH is a risk factor for the development of severe vertigo after stapes surgery. Examination to detect vestibular ELH can be helpful in the differential diagnosis between vestibular migraine and vestibular Meniere's disease. MRI is a sensitive technique for detecting ELH and the relationships between ELH and clinical symptoms are expected to be widely investigated using this technique.

著者

木全 由佳理 原 大介 吉田 忠雄 杉本 賢文 小林 万純 福永 有可里 水野 知美 寺西 正明 曾根 三千彦

出版者

一般社団法人 日本聴覚医学会

雑誌

AUDIOLOGY JAPAN (ISSN:03038106)

巻号頁・発行日

vol.63, no.5, pp.430, 2020-09-30 (Released:2020-11-10)

著者

寺西 正明 片山 直美 内田 育恵 戸田 潤二 中島 務 喜多村 健

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.17, no.5, pp.621-626, 2007-12-25 (Released:2011-06-17)

参考文献数

12

被引用文献数

1

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In the present study, we investigated the distribution of patients with sudden deafness in Japan using the data obtained by the fourth nationwide epidemiological survey on sudden deafness conducted by the Research Committee of the Ministry of Health Labour and Welfare in 2001. We investigated the distribution of patients by dividing the whole country into 9 districts and 47 prefectures. The annual number of patients with sudden deafness per 100, 000 was from 17 (Shikoku) to 42 (Chugoku) and from 3 (Yamanashi, Nagasaki) to 48 (Osaka), respectively. More patients tend to be reported in densely-populated areas judging from the data concerning the distribution of patients per 100, 000 in each prefecture.

著者

寺西 正明 加藤 健 大竹 宏直 片山 直美 曾根 三千彦 中島 務

出版者

日本聴覚医学会

雑誌

AUDIOLOGY JAPAN (ISSN:03038106)

巻号頁・発行日

vol.53, no.5, pp.355-356, 2010 (Released:2013-12-05)

著者

加藤 健 大竹 宏直 吉田 忠雄 寺西 正明 曾根 三千彦 朝日 清光 中島 務

出版者

Japan Audiological Society

雑誌

Audiology Japan (ISSN:03038106)

巻号頁・発行日

vol.56, no.5, pp.389-390, 2013-09-30

著者

吉田 忠雄 加藤 正大 大竹 宏直 加藤 健 寺西 正明 片山 直美 中島 務

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium research (ISSN:03855716)

巻号頁・発行日

vol.72, no.4, pp.247-253, 2013-08-01

被引用文献数

3

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Development of 3-tesla enhanced magnetic resonance imaging (MRI) provides a tool for the visualization of endolymphatic hydrops (EH). This technique was first developed in animal experiments and adapted in patients with inner ear diseases including Menieres disease (MD). Up to the present, we have demonstrated EH in many MD patients. Recently, we have succeeded in obtaining a 3D-real IR-like image even after intravenous standard-dose gadolinium administration. This type of image was named the HYDROPS (HYbriD of Reversed image Of Positive endolymph Signal and native image of positive perilymph signal). The relationship between unilateral MD and EH has not yet been explored. We studied 76 patients with unilateral MD who were evaluated using MRI. The mean age of the subjects was 53.4 years (range 17 to 80 years). Forty-two were women and 34 were men. Symptomatic and non-symptomatic ears were categorized into 4 groups (healthy, 76; possible, 48; Probable, 13; and definite, 15) based on AAO-HNS definitions. MRI was performed 4 hours after intravenous gadolinium administration. Overall, 152 ears were evaluated. EH in the cochlea was present in 57 of 76 symptomatic ears (73.7%) and 34 of 76 (44.7%) non symptomatic ears. Ears with definite MD had EH more frequently in the cochlea than ears in the healthy ears groups. Furthermore, EH in the vestibule with definite MD was larger than ears in any of the other groups. Our reports showed for the first time that there was Ba relationship between the degrees of EH and the stage of MD. Moreover, in fewer than half of unilateral MD patients EH was seen in the cochlea with non-symptomatic ears. EH in healthy ears may be an indicator of bilateral MD. Using MRI to identify this covert EH in asymptomatic patients may offer the possibility of early detection or prevention of MD.