著者

武田 憲昭

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.10, no.3, pp.147-149, 2000-07-25 (Released:2011-06-17)

参考文献数

17

---

For the treatment of patients with Meniere's disease in the acute period, randomized controlled trials showed that anti-vertigo drugs, such as diphenidol and betahistine, are significantly effective. In the chronic period, Meniere's disease is specifically managed by osmotic diuretic, isosorbide. The dose comparative study showed that its opitimal dose is 90ml/day. Despite many controversies against endolymphatic sac surgery, including the Danish sham surgery study suggesting a placebo effect of mastoidectomy, the efficacy of the procedure is widely accepted. However, it is not clear that endolymphatic sac surgery alters the natural history of Meniere's disease in a long term.

著者

高橋 正紘

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.18, no.2, pp.126-130, 2008-05-25 (Released:2011-06-17)

参考文献数

19

被引用文献数

3

---

Patients with Meniere's disease who suffer for long, rarely show complete recovery of advanced hearing loss. I reported a 67-year-old patient with a history of 24 years, whose 60 dB hearing loss lasting for 8 years was cured by continuous aerobic exercise. From the start of exercise, it took 4 months to the beginning of recovery and 7 months till normal hearing, respectively. Although the hearing temporarily became worse when he caught cold and stopped exercise for three weeks, it recovered completely to normal hearing 4 months later, and tinnitus disappeared. This state has been preserved for 8 months. I presumed that aerobic exercise increased local blood flow and prompted restoring processes of the inner ear function.

著者

末武 光子 入間田 美保子 高橋 辰 沖津 尚弘 大山 健二

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.10, no.2, pp.89-94, 2000-05-25 (Released:2011-06-17)

参考文献数

5

被引用文献数

5

---

Mucoud otitis is known to be caused by mucoid typeStreptococcus pneumoniae, and the most of them are serotype 3. As the result of the development of antibiotics this bacteria has once been regarded as an unimportant pathogen. However recently, there are found severe cases in which this pathogen is responsible.During the period from January 1998 to July 1999, we have treated 25 cases in which the mucoid typeStreptococcus pneumoniaewas isolated.Based on these experiences, we summarized the current status of the mucoid otitis media as follows.1. The distribution of patients suffering from mucoid otitis medid ranged infants to elderly people. 2. The patients presented with symptomes, such as severe earache, headache, high fever, profuse otorrhea, aggravation of sensorineural hearing. 3. The relief of the symptomes is usually better and earlier when penicillin was selected as a first choice, while when cephem antibiotics were selected, healing of the otitis media tend to be delayed. 4. As 13 out of 14 strains isolated in 1999 were found to be penicillin-insensitiveStreptococcus pneumoniae (PISP) withpbp2xgene, it is conceivable that the resistance of this pathogen against cephem is under a rapid progress, probably due to abuse cephem in the past in this country. 5. The antibiotics of the first choice against mucoid otitis media is penicillin. If the pathogen would acquire penicillin resistance, treatment of mucoid otitis media may become as difficult as it used be in old days of preantibiotics. We should pay enough attention to this disease as an important reemerging infectious disease in the otolaryngologic field.

著者

張 暁彦 伊藤 真人 渋谷 和郎 塚谷 才明 古川 仭

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.11, no.3, pp.232-234, 2001-07-25 (Released:2011-06-17)

参考文献数

14

---

Lyme disease is Borrelia infection that primarily affects the skin with a characteristic rash, erythemamigrans (EM), but recently the neurologic manifestations (Neuroborreliosis) of this disease have beenreported.A 27 year-old woman presented with unilateral acute sensorineural hearing loss and tinnitus in her leftear. These symptoms were progressive. Vision in her left eye has been hampered considerably after threeweeks, and it was diagnosed as post-ocular neuritis. And paralysis of the left side body was developed withina month. Because this patient didn't have a history of tick bite nor skin rash (EM), the diagnosis wasextremely difficult. After taking minocycline hydrochloride to treat atheroma with infection in her left auricle, incidentally the symptoms were improved.Systemic infection was considered and Borrelia burgdorferi serum antibodies was examined. IgM-antibodiesof B. garinii and B. afzelii were detected in her serum, so Lyme disease was diagnosed. The left sensorineuralhearing loss and other symptoms were recovered in some degree after treatment for Lyme disease.After half-year the left sensorineural hearing loss with other neurologic manifestations were recurred, and the periodical observation should be required.

著者

八木 昌人 川端 五十鈴 近藤 玲子 川村 理恵

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.2, no.2, pp.234-239, 1992-05-20 (Released:2011-06-17)

参考文献数

5

被引用文献数

1

---

Forty patients of an acute low-tone sensorineural hearing loss (ALHL) were studied based on their clinical diary in which the patients described six subjective symptoms such as tinnitus, ear fullness, autophonia, headache and dizziness.Twenty-one patients complained of fluctuation of subjective symptoms in during a day. In seven cases, decrease of the fluctuation of subjective symptoms were observed as ALHL has been improved.The fluctuation of hearing or the relapse of hearing loss was indicated by audiograms in twenty-two patients. Audiograms in some cases did not correlate to their subjective symptoms.As it is difficult to perform frequent audiograms in the patients of ALHL, the clinical diary as well as the audiogram are very useful to study the clinical course of ALHL.

著者

松本 真吏子 星野 知之 木倉 幹乃 黄川田 啓子 黄川田 徹

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.15, no.5, pp.633-638, 2005-12-25 (Released:2011-06-17)

参考文献数

8

被引用文献数

1

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Objective: To examine measurements of the vestibular aqueduct on axial CT figures and to examine the cases with borderline EVA.Design: The width of the vestibular aqueduct was measured in two places, the midpoint of the duct and the external aperture in the posterior cranial fossa. Criteria was as follow: Enlargement ;≥1.5mm at the midpoint, ≥2mm at the aperture, Borderline; 1-1. 4mm at the midpoint, 1.5-1.9mm at the aperture.Participants: 345 cases with CT scans of the temporal bones taken during July 2003 to June 2004 in the secondary ENT referral center. Those Patients include sensorinearal, mixed or conductive deafness, vertigo, ear infections and other ear diseases.Result: Enlarged vestibular aqueduct was found in 10 ears with sensorinearal deafness (SD) and 2 ears without SD. Borderline measurements were found in 19 ears with SD and 33 ears without SD. The enlarged midpoint measurement was not seen in the cases without SD.Conclusions: More than 1. 5mm of the definition for the enlargement at the midpoint of the vestibular aqueduct seemed to be appropriate in the clinical situation. The measurement at the midpoint of the duct is more reliable than at the external aperture. The conductive component in EVA Syndrome with mixed hearing loss is present only at the lower frequencies (250, 500Hz), not at the middle and higer frequencies. Long-term follow-up of hearing should be done in the borderline cases with check-up of PDS gene anomaly if necessary.

著者

鈴木 幹男 北西 剛 山名 高世 北野 博也 矢澤 代四郎 北嶋 和智

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.8, no.5, pp.526-530, 1998-12-25 (Released:2011-06-17)

参考文献数

16

被引用文献数

1

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Several point mutations of mitochondrial DNA have recently been identified as a cause of hearing loss. In Japan, there are considerable number of patients with A-to-G mutations at nucleotide position 3243 and at 1555. We investigated the prevalence of these mutations in patients with hearing loss using polymerase chain reaction method (PCR). We identified 3243 point mutation in 2 of 72 patients (2.8%) and 1555 point mutation in one of 57 patients (1.8%). The clinical neuro-otologic findings in patients with point mutations were consistent with those previously reported. The number of patients examined was composed of 9% of a total in our outpatient clinic. Therefore, we estimated 0.4% of patients in our clinic have a point mutation at nucleotide position 3243 or 1555.

著者

香山 智佳子 後藤 友佳子 長谷川 信吾 藤田 岳 丹生 健一

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.18, no.1, pp.39-44, 2008-03-21 (Released:2011-06-17)

参考文献数

20

被引用文献数

1

---

Gentian violet (Pyoktanin) is known to have a potent antibacterial activity against Gram-positive bacteria including methicillin-resistantStaphylococcus aureus (MRSA).From November 2000 to August 2006, we have treated 91 patients for intractable ear infected with MRSA by topical treatment with gentian violet. There were 99 infected ears: 44 chronic otitis media, 11 otitis media with effusion treated with tympanostomy tube, 10 repetitive suppurative otitis media, 10 otitis externa, 8 postoperative discharging mastoid cavity for cholesteatoma, 6 cholesteatoma, 4 eosinophilic otitis media, 3 acute otitis media, 3 myringitis. The pathogens detected in those ears during the treatment period were as follows: MRSA in 92 ears, MRSA andP. aeruginosa7 ears. Topical treatment with gentian violet was performed 7.5 times on average. In the 92 ears (92.9%), topical treatment was performed 5.4 times on average. Noteworthily, 23 ears required only one treatment and 16 ears required twice, and this fact was suggesting that frequent treatments were not necessary to control the pathogens sensitive to gentian violet. This high cure rate (92/99) of the ear infected with MRSA also suggested that this treatment was especially effective for the treatment of MRSA infected ears.

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

---

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

川瀬 哲明

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.10, no.2, pp.72-77, 2000-05-25 (Released:2011-06-17)

参考文献数

18

---

It is known that the olivocochlear (OC) efferent fibers innervated to the outer hair cells (OHCs) can modulate the active process in the cochlea which is related to the motile response of the OHCs.The basic known effect of the activation of this OC efferent neurons is suppression of the auditory system. On the other hand, when tones are presented with background noise, the OC activation can enhance the responses of the auditory nerve.In the respect of the effective signal perception in the cochlea, the OC-system should not act during the signal perception in the background quiet, however, should be activated when the signals are perceived in the masking situation.In the present study, the practical role of this system is discussed by observing the effects of the severance as well as the stimulation of the OC-neurons on the auditory responses. The results obtained suggest that the OC system are not activated in the signal (short duration) perception in quiet. That is, in this situation, the benefit from the active mechanism is not disturbed by the OC efferent system. On the other hand, in the condition of the signal perception in the background continuous noise, OC system is activated effectively by the noise and can improve the perception of the newly presented signal in the cochlea.

著者

川瀬 哲明 Liberman M. Charles 高坂 知節

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.5, no.2, pp.105-111, 1995-05-15 (Released:2011-06-17)

参考文献数

20

---

Anti-masking effects mediated by the sound-evoked efferent activity were discussed in the present paper. In the cats, masked auditory responses were enhanced by adding the noise to the contralateral ear both in the compound action potential (CAP) and in the responses of single auditory nerve fibers. These anti-masking effects were disappeared when the olivocohlear bundle (OCB) was interrupted. It has been suggested that classic suppressive effects of OCB on the auditory-nerve responses to the back ground masker are an important component of this OC mediated anti-masking phenomenon. Similar anti-masking phenomena were observable in the human subjects as well. Small but significant enhancements of masked CAP in amplitude were seen in some patients with facial palsy, in which acoustic reflexes of middle ear muscles (MEMs) had disappeared or were impaired.

著者

草野 英昭 立木 孝 村井 和夫 千葉 秀樹 石川 健

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.5, no.5, pp.621-626, 1995-12-25 (Released:2011-06-17)

参考文献数

15

---

The patients with noises in the head were studied and compared with those who have monaural or binaural tinnitus.The subjects were 299 patients, from September 1993 to October 1994, with sensorineural hearing loss with tinnitus. They were divided into three groups.Group A: 20 (9 males and 11 females) patients with noises in the head.Group B: 70 (45 males and 25 females) patients with binaural tinnitus.Group C: 209 (96 males and 113 females) patients with monaural tinnitus.The results were as follows, 1) The mean age in group A was more than 10 years higher than that in group B and group C.2) There was no difference in the average hearing level between three groups.3) The audiograms in group A showed a high tone gradual loss more than those in group B and group C.4) There was no significant difference in the mean age and average hearing level between group B and group C.As the results above, noises in the head were somewhat different from tinnitus and were often found in the elderly people. So it is likely that noises in the head have something with degenerative changes with aging.

著者

立本 圭吾 久 育男 出島 健司 西山 康之 任 書嘉 増田 有加里

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.5, no.1, pp.54-59, 1995-03-30 (Released:2011-06-17)

参考文献数

19

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A 60-year-old male suffered from left temporalgia and developed mastoiditis. A jugular foramen syndrome (cranial nerve IX, X and XII deficit) that occurred in spite of mastoidectomy was improved by means of dissection of petrosal part.One month later. at the contra-lateral side of the jugular foramen syndrome, Gradenigo syndrome originated from mastoiditis occurred. Mastoidectomy resulted in improvement of clinical symptoms.Five months after the surgery, the patient developed left superior orbital fissure syndrome (cranial nerve II, III and V palsy) with thickening of the dura mater which was demonstrated by Gd-DTPA MRI.Corticosteroid therapy was effective except for blindness.These clinical findings of cranial nerve palsies were suspected to be associated with the migrating disseminated multiple cranial neuropathy.

著者

南場 淳司 阿部 尚央 木谷 令 武田 育子 宇佐美 真一 新川 秀一

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.16, no.3, pp.183-188, 2006-07-25 (Released:2011-06-17)

参考文献数

20

被引用文献数

2

---

An enlarged vestibular aqueduct, high frequency hearing loss, and fluctuating hearing loss are characteristics of enlarged vestibular aqueduct syndrome. Causes of fluctuating hearing loss include contusion or extreme movement of the head. In addition, mutations in the PDS gene have been reported as responsible for this condition.Case 1 began to have fluctuating hearing loss after a contusion in September 1999.After a decrease in hearing ability in the right ear in July 2001, recovery was not seen. However, two years and four months later, hearing recovery occurred suddenly.Case 2 began to have fluctuating hearing loss after a school athletic event in May 1998. After a decrease in hearing ability in the left ear in July 2003, immediate recovery was not seen but hearing was regained gradually over an eight-month period. Hearing loss was seen in the right ear in November 2004 and recovery occurred four months later.Fluctuating hearing is thought to be caused by the backward flow of low potassium fluid from the endolymphatic sac, following a sudden increase in pressure on the brain. The lowered potassium of the endolymphatic fluid contributes to a lowered endocochlear potential that causes the hearing impairment. On the other hand, it has been reported that in PDS gene knockout mouse, the expression of KCNJ 10, which is a potassium channel in the stria vascularis, is lacking and there is a markedly lowered voltage of endocochlear potential, suggesting that the inhibition of KCNJ10 is involved in hearing loss. Accordingly, the current two cases, in which long-term hearing impairment gradually or suddenly recovered, suggest that acute hearing impairment is not due to damage of the hair cells.

著者

神崎 晶

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.17, no.3, pp.168-172, 2007-07-25 (Released:2011-06-17)

参考文献数

15

被引用文献数

2

---

Bone mineral density and morphology of the three auditory ossicles, malleus, incus, and stapes, are maintained by osteoclasts and osteoblasts. However, correlation between bone resorptive changes in the ossicles and hearing loss has not been established. In this review, we discuss osteoporotic changes of the auditory ossicles and pathology of middle ear diseases through the study of mice lacking osteoprotegerin (Opg-/-mice), a soluble decoy receptor for the osteoclastogenic cytokine RANKL. All three ossicles in Opg-/-mice showed thinning and shortening compared to wild-type controls. Most notably, the junction between the stapes and the otic capsule was fused in Opg-/-mice unlike in wild-type mice. Furthermore, progressive hearing loss was detected in Opg-/-mice starting at 6 to 15 weeks of age. These data suggest that OPG plays a crucial role as “audioprotegerin” in hearing by protecting the auditory ossicles and otic capsule from osteoclastic bone resorption. We also discuss clinical implications of resorption of the ossicles for middle ear diseases including otosclerosis and cholesteatoma.

著者

田中 克彦 福田 諭

出版者

Japan Otological Society

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.4, no.2, pp.130-136, 1994-07-08 (Released:2011-06-17)

参考文献数

30

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Viral infections are assumed to play an important etiologic role in sudden deafness but most evidence so far has been circumstantial. Correlating the cochlear locations and symptomes of sudden deafness, it is assumed that lesions of stria vascularis, primary neurons and tectorial membrane are able to accout for sudden onset and reversibility of the perceptive deafness.The survey of the previous reports on the experimental viral labyrinthitis suggests that paramyxoviruses such as mumps and Sendai viruses are the candidate of etiologic agents because of selective involvement of stria vascularis in a rather localized segment of the cochlea.Serological studies of the patients revealed that seroconversion was most frequent in 5 viral infections, e. g. mumps, rubeola, varicella-zoster, CMV and influenza B.In addition to primary viral infection, reactivation of herpes virus family is deemed as another possibility of sudden deafness.Detection of HSV-1 and varicella-zoster virus DNA or RNA in the human spiral ganglia appears a supportive evidence for reactivation of those viruses.