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Papers - Ogawa, Kaoru

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Suitability of calcium phosphate cement for injection laryngoplasty in rabbits

Ikeda Asako, Shiotani Akihiro, Mori Yuko, Fujimine Takekatsu, Tomifuji Masayuki, Takaoka Takuji, Kameyama Kaori, Ogawa Kaoru

ORL 68 ( 2 ) 103 - 109 2006.03

ISSN 0301-1569

Calcium phosphate cement (CPC) consists of powder and liquid, which become an injectable paste after mixing, self-hardening and recrystallizing to calcium hydroxylapatite (CaHA) after injection into a living body. In this study, we investigated the suitability of CPC as an injectable material for injection laryngoplasty using rabbits. All rabbits underwent left recurrent laryngeal nerve section and injection laryngoplasty with CPC. At 7 days, scanning electron microscopic findings revealed that complete recrystallization from CPC to CaHA was achieved in the larynx. At 1, 3, and 6 months, injected CPC stayed in the paraglottic space and did not migrate, and the average remaining CPC volume percentage was 91.7%. Focal foreign body reaction to injected CPC was almost the same as that of autologous fat for all time periods observed. These results indicated that CPC appears to be biocompatible, nonabsorbable, nonmigratory, and suitable for injection laryngoplasty.

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Proinflammatory cytokines expression in noise-induced damaged cochlea

Fujioka Masato, Kanzaki Sho, Okano Hirotaka James, Masuda Masatsugu, Ogawa Kaoru, Okano Hideyuki

Journal of Neuroscience Research 83 ( 4 ) 575 - 583 2006.03

ISSN 0360-4012

Recent studies have showed that inflammatory responses occur in inner ear under various damaging conditions including noise-overstimulation. We evaluated the time-dependent expression of proinflammatory cytokines in noise-exposed rat cochlea. Among several detected cytokines, real-time RT-PCR showed that interleukin-1beta (IL-1β) and interleukin-6 (IL-6) were significantly induced 3 hr after noise exposure, and quickly downregulated to the basal level. Tumor necrosis factor-alpha (TNF-α) was also slightly upregulated immediately after noise exposure, Immunohistochemical analysis showed that IL-6 expression was distinctively induced within the lateral side of the spiral ligament. Sequential expression analysis showed that IL-6 immunoreactivity was initially found in the cytoplasm of lateral wall cells, including Type IV and III fibrocytes, and expanded broader throughout the lateral wall, finally to the stria vascularis. Because of the negative Iba-1 staining, IL-6 expression in the early-phase was not due to macrophage or microglia activation. IL-6 was also detected in spiral ganglion neurons at 12 and 24 hr after noise exposure. Our data demonstrates the production of proinflammatory cytokines, including TNF-α, IL-1β, and IL-6, in early phase of noise overstimulated cochlea. IL-6 expression was observed in the spiral ligament, stria vascularis, and spiral ganglion neurons. These cytokines, produced by the cochlear structure itself in response to noise exposure, may initiate an inflammatory response and have some role in the mechanism of noise-induced cochlear damage.

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Adenoviral GDNF gene transfer enhances neurofunctional recovery after recurrent laryngeal nerve injury

Araki K., Shiotani A., Watabe K., Saito K., Moro K., Ogawa K.

Gene Therapy 13 ( 4 ) 296 - 303 2006.02

ISSN 0969-7128

To assess the possibility of gene therapy for recurrent laryngeal nerve (RLN) injury, we examined functional and histological recovery after glial cell line-derived neurotrophic factor (GDNF) gene transfer in a rat RLN crush model. Adenoviral vector encoding β-galactosidase gene (AxCALacZ) or human GDNF gene (AxCAhGDNF) was injected into the crush site of the RLN. Neurons in the nucleus ambiguus on the crushed side were labeled with X-gal or GDNF immnohistochemistry after AxCALacZ or AxCAhGDNF injection. Reverse transcription-polymerase chain reaction analysis revealed expression of human GDNF mRNA transcripts in brainstem tissue containing the nucleus ambiguus on the crushed side after AxCAhGDNF injection. Animals injected with AxCAhGDNF displayed significantly improved motor nerve conduction velocity of the RLN and recovery rate of vocal fold movement at 2 and 4 weeks after treatment as compared to controls. AxCAhGDNF-injected animals showed a significantly larger axonal diameter and improved remyelination in crushed RLN as compared to controls. Adenoviral GDNF gene transfer may thus promote laryngeal function recovery after RLN injury. Inoculation of adenoviral vector containing the GDNF gene at the site of damage soon after nerve injury may assist patients with laryngeal paralysis caused by nerve injury during head and neck surgery.

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Treatment of anxiety and depression-related vertigo and dizziness with SSRIs and SNRIs

Goto Fumiyuki, Araki Yasutomo, Saito Akira, Kunihiro Takanobu, Ogawa Kaoru

Equilibrium Research 65 ( 1 ) 17 - 23 2006.02

ISSN 0385-5716

Recently, vertigo or dizziness has been linked to abnormal serotonin regulation in the hippocampus. According to the DSM-VI and ICD-10, vertigo or dizziness is a common symptom of anxiety disorder, somatoform disorder, and depression. In today's stressful society, we are now observing record increases in the number of patients with depression. Because of this increase, otolaryngologists are now encountering an increasing number of patients with depression-related dizziness or vertigo. We treated 41 patients with depression-related vertigo or dizziness with a selective serotonin reuptake inhibitor (SSRI: paroxetine or fluvoxamine) or a selective norepinephrine reuptake inhibitor (SNRI: milnacipran). We graded the effects of treatment according to three levels: outstanding, effective, or not effective. Besides dizziness, the chief complaints of patients we treated were problems with sleep, headache, heavy headedness, shoulder stiffness, and loss of motivation. Drug effectiveness or the overall recovery rate was defined as the ratio of the number of patients showing outstanding and effective improvements to the total number of patients treated with a particular drug. The overall recovery rate for patients treated with paroxetine was 82% (14/17), for patients treated with fluvoxamine it was 90% (10/11), and for patients treated with milnacipran it was 62% (8/13). Side effects were observed in 22% (9/41) of the patients. Symptoms disappeared in about 2 weeks after drug treatment began. SSRIs and SNRIs are now the drugs-of-choice for treating anxiety- or depression-related vertigo because they are associated with fewer adverse effects than traditional antidepressants. Moreover, when compared to tranquilizers, SSRIs and SNRIs tend to be less habit-forming. As an adjunct to psychological counseling, dizziness associated with psychiatric disorders can also be treated in otolaryngological outpatient clinics with relevant drugs. To effectively treat these dizzy patients, collaboration between the patients' otolaryngologists and psychiatrists or psychological counselors is also important.

Nuclear factor-kappa B nuclear translocation in the cochlea of mice following acoustic overstimulation

Masuda Masatsugu, Nagashima Reiko, Kanzaki Sho, Fujioka Masato, Ogita Kiyokazu, Ogawa Kaoru

Brain Research 1068 ( 1 ) 237 - 247 2006.01

ISSN 0006-8993

There is increasing evidence to suggest that the expression of many molecules in the lateral wall of the cochlea plays an important role in noise-induced stress responses. In this study, activation of the nuclear transcription factor nuclear factor-kappa B (NF-κB) was investigated in the cochlea of mice treated with intense noise exposure (4 kHz, octave band, 124 dB, for 2 h). The present noise exposure led to remarkable auditory brainstem response threshold shifts and cochlear damage on surface preparations. To assess the effects of noise exposure on NF-κB/DNA binding activity in the cochlea, we prepared nuclear extracts from the cochlea at different time points after noise exposure and carried out an electrophoretic mobility shift assay using a probe specific to NF-κB. NF-κB/DNA binding was significantly enhanced in the cochlea 2-6 h after noise exposure and returned to basal levels after 12 h. Supershift analysis using antibodies against p65 and p50 proteins, which are components of NF-κB, demonstrated that enhancement of NF-κB/DNA binding was at least in part due to nuclear translocation of p65. An immunohistochemical study also showed that nuclear translocation of both p65 and p50 was observed in the lateral wall after noise exposure and that there may be a possible close association between p65 and enhanced inducible nitric oxide synthase expression. These results suggest that NF-κB may have a detrimental role in the response to acoustic overstimulation in the cochlea of mice.

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Surgical management of parapharyngeal space tumors

Tomita Toshiki, Ogawa Kaoru, Tagawa Takamasa, Fujii Masato, Nameki Hideo

Journal of Otolaryngology of Japan 109 ( 2 ) 88 - 95 2006

ISSN 0030-6622

Despite its rarity, information on the diagnosis of parapharyngeal space tumors such as through imaging and aspiration biopsy cytology, is slowly accumulating. Little detailed examination has been conducted, however, on surgical approach, complications, and sequelae. We report the results of a retrospective review of 27 patients with primary parapharyngeal space tumors-25 with benign disease and 2 with malignant lesions-treated surgically. Surgical approach, postoperative complications, sequelae, and operative indications of parapharyngeal space tumors were examined in 28 operations on the 27 patients. Tumors found in the prestyloid region in CT or MRI are treated as salivary gland or malignant tumors. Those found in the poststyloid region are treated as shwannoma or paraganglioma. The transcervical approach is often used in patients with shwannoma, while a variety of approaches are selected for patients with salivary gland tumors. Complications occur in 50% of patients, however, bias based on pathological diagnosis has not been examined to the degree needed. Sequelae in our series occurred in 46.4% of our patients. Sequela in the patients with shwannoma, however, is 81.8%, compared to 9.1% in patients with salivary gland tumors. Prestyloid parapharyngeal space tumors seem to be "automatically" indicated for surgery, because the surgical risk is lower than the risk of inaction. In poststyloid parapharyngeal space tumors, however, it appears necessary to judge indication for surgery more carefully while considering the social background, age, and occupation of prospective surgical candidates.

Evaluation of 11 dacryocystorhinostomies

Saito Hideyuki, Ogawa Kaoru, Yamashita Taku, Fujii Ryouichi, Habu Noboru

Practica Oto-Rhino-Laryngologica 99 ( 3 ) 211 - 216 2006

ISSN 0032-6313

We reviewed 11 patients (7 women and 4 men) with acquired dacryostenosis who underwent a dacryo-cysto-rhinostomy (DCR) at Saiseikai Utsunomiya Hospital between May 2000 and April 2004. The etiology was considered chronic inflammation in six, trauma in two and complications of paranasal sinus surgery in two. In addition to lacrymal probing and irrigation, we investigated all patients by anterior rhinoscopy and CT. One patient showed pneumatization in the lacrymal sac on CT and dacryoatresia was confirmed with irrigation. We diagnosed the common canaliculi as the site of atresia, and this was confirmed intraoperatively. We treated 7 cases by traditional extenal DCR (EXT-DCR) and 4 by endonasal endoscopic DCR (EE-DCR). We treated one case of relapsed obstruction with EE-DCR but treated well with the same method. The EXT-DCR cases have not show any recurrence to date. There were two cases of stenosis at the common canaliculi and both were improved after EE-DCR with silicone tube insertion. With EE-DCR, the duration of surgery was shorter and there was no scar formation or facial deformity. We suggest that ENT doctors should pay more attention to diseases of the naso-lacrymal system and cooperate with ophthalmologist when designing treatment regimens.

Infantile congenital petrosal cholesteatoma

Yamazaki Kazuharu, Sato Hiroaki, Murai Kazuo, Ogawa Kaoru

International Journal of Pediatric Otorhinolaryngology 69 ( 12 ) 1703 - 1707 2005.12

ISSN 0165-5876

Congenital cholesteatoma of the middle ear is frequently seen in younger children including infant. By contrast, that of the petrous bone is rarely seen in younger children. We report an exceptional case occurring in 23-month-old infant who presented with unilateral facial nerve paralysis at about 18-month-old. Computed tomography and magnetic resonance imaging revealed congenital cholesteatoma measuring approximately 2 cm in the area of the right geniculate ganglion. The mass was completely eradicated via the middle fossa approach, which allowed for preservation of hearing. The facial nerve maintained intact during surgery and paralysis showed partial recovery after the operation. To our knowledge, the present case seems to be the youngest case of congenital petrosal cholesteatoma reported, and also demonstrates congenital petrosal cholesteatoma could exhibit facial nerve paralysis in early childhood.

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Isolated vagus nerve paralysis caused by varicella zoster virus reactivation

Nakagawa Hideki, Satoh Mami, Kusuyama Toshiyuki, Fukuda Hiroyuki, Ogawa Kaoru

Otolaryngology - Head and Neck Surgery 133 ( 3 ) 460 - 461 2005.09

ISSN 0194-5998

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Permanent threshold shift caused by acute cochlear mitochondrial dysfunction is primarily mediated by degeneration of the lateral wall of the cochlea

Okamoto Yasuhide, Hoya Noriyuki, Kamiya Kazusaku, Fujii Masato, Ogawa Kaoru, Matsunaga Tatsuo

Audiology and Neurotology 10 ( 4 ) 220 - 233 2005.07

ISSN 1420-3030

Mitochondrial dysfunction in the cochlea is thought to be an important cause of sensorineural hearing loss. Recently, we have established a novel rat model with acute hearing impairment caused by exposure to the mitochondrial toxin 3-nitropropionic acid (3-NP) to analyze the mechanism of cochlear mitochondrial dysfunction. Both permanent and temporary threshold shifts were observed in this model depending on the amount of 3-NP used to induce hearing impairment. In this study, we demonstrate cochlear morphological changes in the permanent threshold shift model. Marked degeneration was detected in type 2 fibrocytes in the spiral prominence, type 4 fibrocytes in the spiral ligament, marginal cells and intermediate cells in the stria vascularis 3 h after 3-NP administration; these changes were progressive for at least 14 days. Less prominent degeneration was detected in type 1 and type 3 fibrocytes in the spiral ligament. These results indicate that permanent threshold shift caused by acute cochlear mitochondrial dysfunction is primarily mediated by cellular degeneration in the lateral wall of the cochlea, and suggest that therapy of cochlear hearing loss due to acute energy failure may be achieved through protection and regeneration of the cochlear lateral wall.

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The relationship between subjective visual vertical and roll vection under visual stimulation

Kobayashi Hironari, Goto Fumiyuki, Kunihiro Takanobu, Ogawa Kaoru, Saito Akira, Kanzaki Jin

Equilibrium Research 64 ( 2 ) 57 - 63 2005.04

ISSN 0385-5716

Previous experiments have established that visual stimulation in the roll plane causes people to feel roll vection. However, few experiments have been aimed at characterizing the relationship between changes in the subjective visual vertical (SVV) and the generation of vection. In this experiment we investigate the relationship between SVV, a quasi-subjective parameter, and vection, the visually induced perception of self-motion. We observed three different patterns of change in SVV. Even with fixed visual stimuli, in many cases SVV changed continuously. These results suggest that conflicts among different sensory inputs produce dynamic changes in the priority of these sensory inputs. The longer vection is perceived, the more predominant the visual sensory input becomes.

A case of cavernous hemangioma presenting acute hearing loss with vertigo

Asama Yohji, Goto Fumiyuki, Kunihiro Takanobu, Ogawa Kaoru

Equilibrium Research 64 ( 2 ) 71 - 75 2005.04

ISSN 0385-5716

The origin of vertigo is difficult to identify since a similar symptom occurs in either central or peripheral impairment. An initial evaluation of the patient's clinical history, as well as his clinical manifestations are important for correct diagnosis. Final diagnosis typically depends on conventional imaging techniques, such as CT and MRI. Here, we describe a patients whose functional examination was quite helpful to identify the lesion. The patient was case a 44-year-old man with cavernous hemangioma in the brainstem presenting acute hearing loss with vertigo. Initially he was diagnosed as having peripheral vertigo by neurological examinations together with CT images. Later a rare cavernous hemangioma was identified by head MRI. In the process of diagnosis, the result of auditory brainstem response (ABR) strongly suggested brainstem impairment. This case reveals that conventional imaging procedures, such as CT, are inadequate for diagnosis, whereas functional exams, such as the auditory brain stem response (ABR), are quite helpful for clinical evaluation. ABR can work as a screening examination for patients with vertigo to rule out brainstem lesion even in patients with normal hearing.

Local complications in head and neck surgery and the diagnosis procedure combination/prospective payment system

Tomita Toshiki, Ogawa Kaoru

Toukeibu Gan 31 ( 3 ) 357 - 362 2005

ISSN 1349-5747

The diagnosis procedure combination/prospective payment system (DPC/PPS) that was begun in university hospitals in fiscal 2003 is outlined. The DPC in the 2004 version concerning head and neck cancer was analyzed, and the handling of local complications in postoperative head and neck surgery patients in the DPC/PPS was examined. If major surgery of the head and neck cancer was performed, it often turned out to fall outside the scope of the inclusive evaluation. Moreover, it is understood that the presence of complication is not reflected in the classification in head and neck cancer even though it is common in other diseases to subdivide the diagnosis group classification by the presence of complication. The problem of local complication was examined in the case of oral cancer treatment by our department in 2004. It was clarified that the decision on whether complication was a negative factor of the DPC/PPS depended on the medical treatment expense concerning complication and the balance of the hospitalization period. Moreover, it seemed that cases which did not have complication and were quickly discharged from hospital were a minus in the DPC/PPS, and so improvement plans are necessary.

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Two cases of Meniere's disease with drop attacks

Goto Fumiyuki, Kunihiro Takanobu, Araki Yasutomo, Saito Akira, Ogawa Kaoru

Journal of Otolaryngology of Japan 108 ( 3 ) 222 - 225 2005

ISSN 0030-6622

Drop attacks are sudden falls without concurrent vertigo whose etiology may be unknown. Drop attacks are also associated with cardiac, cerebrovascular, psychogenic, and vestibular disorders, in addition to seizures. Vestibular-based drop attacks without loss of consciousness can occur in patients with Meniere's disease. We present 2 cases of drop attack in patients with Meniere's disease. Case 1, a 65-year-old man, experienced 4 such attacks and case 2, a 55-year-old woman, experienced 20 within 2 years of Meniere's disease onset. Case 1 enjoyed spontaneous remission. In case 2, selective serotonin reuptake inhibitor (SSRI) administration suppressed attack frequency. Anxiety may predispose individuals to drop attack. Etiologically, inadequate stimulation of otolith organs may induce a sudden vestibule spinal reflex that, in turn, causes sudden falls. To correctly diagnose drop attacks, the patient must exhibit sudden falls, and transient ischemic attack should be carefully ruled out.

Evaluation of the quality of life in sudden deafness patients by HHIA (hearing handicap inventory) and questionnaire

Sato Minako, Ogawa Kaoru, Saito Hideyuki, Yamashita Daisuke, Yuge Isamu, Masuda Masatsugu, Okamoto Yasuhide, Kurita Akihiro

Journal of Otolaryngology of Japan 108 ( 12 ) 1158 - 1164 2005

ISSN 0030-6622

After treatments, several patients with sudden deafness (SD) continued to have symptoms, including hearing loss, tinnitus and dizziness. These unresolved symptoms and their effect on the quality of life (QOL) in SD patients have not been studied. We evaluated QOL using the Hearing handicap inventory (HHIA) and an original questionnaire in SD patients who had been treated more than 6 months prior to the study. Compared to results in bilateral sensorineural hearing were significantly lower in SD patients (p<0.01). In bil-SNHL, this score peaked two to K) years after onset of disease and decreased thereafter. The score peaked more than 10 years after onset of disease in patients with SD. While hearing and test scores were correlated in bil-SNHL, this was not observed in SD. About half of patients were embarrassed by hearing loss and tinnitus after treatment. Among patients who scored more than 44 points on HHIA, all reported hearing loss and tinnitus. When asked about subjective changes in hearing after treatment, 27% believed their hearing had improved, 60% believed there was no change, and 13% believed their hearing had deteriorated. Cases believing deterioration in hearing also had high scores on HHIA. Sequelae of SD may worsen QOL, driving embarrassed patients to visit other medical facilities in to improve their QOL. Even though hearing may not improve after initial treatment in ears affected by SD, informed consent about the clinical course and audiological follow-up should be done.

Two cases of pulmonary embolism after head and neck surgery

Kanzaki Sho, Kunihiro Takanobu, Imanishi Tomohisa, Yamashita Daisuke, Ogawa Kaoru

Auris Nasus Larynx 31 ( 3 ) 313 - 317 2004.09

ISSN 0385-8146

Pulmonary embolism (PE) is a prominent cause of morbidity and mortality in surgical patients. Here, we report two cases of PE following head and neck surgery: (1) in case 1, the patient underwent endoscopic sinus surgery (ESS), and (2) in case 2, the patient was suspected PE after resection of the parotid gland and radical neck dissection. Prophylactic compression devices were used during the operation in both cases. In case 1, PE was diagnosed 3 days following surgery after the patient complained of dyspnea while walking. PE was successfully treated by intravenous administration of heparin. In case 2, PE was strongly suspected 13 days following surgery after the patient experienced syncope and chest pain and exhibited abnormal findings on a cardiac echogram. This patient died 18 h after the onset of cardiac symptoms. Despite prophylactic measures taken during surgery, the prognosis was poor for this patient due to numerous high-risk factors (e.g., advanced age, obesity, prolonged immobilization). Although the incidence of postoperative PE in our department during the last 7 years is very low (0.04%), the frequency of postoperative PE in Japan has steadily increased in recent years. PE still is one of the most significant complications leading to morbidity and mortality following surgery. Given the gaining prominence of PE, we conclude that otolaryngologists including those in Japan should be reminded of high-risk factors associated with PE and be made aware of prophylactic treatments newly aimed at reducing the frequency of PE.

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Intramuscular myxoma of scalene muscle

Ozawa Hiroyuki, Fujii Masato, Tomita Toshiki, Ogawa Kaoru

Auris Nasus Larynx 31 ( 3 ) 319 - 322 2004.09

ISSN 0385-8146

Intramuscular myxoma is a benign mesenchymal tumor that commonly occurs in the larger skeletal muscles, and is rare in the head and neck. A case of intramuscular myxoma in the scalene muscle is described. This is the first report of this tumor arising in that muscle. It is difficult to diagnose pre-operatively from clinical features, CT scan and ultrasonography of the neck because of the lack of characteristic manifestation or radiographic features. Intramuscular myxoma has an infiltrative tendency, so there are several reports of recurrence because of incomplete excision or enucleation. In our case no recurrence was observed for 4 years, since the tumor was removed with the muscle adherent to it.

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A case of Paget's disease presenting hearing loss and vertigo examined by continuous audiometry

Goto Fumiyuki, Kunihiro Takanobu, Ogawa Kaoru

Equilibrium Research 63 ( 3 ) 194 - 201 2004.06

ISSN 0385-5716

We reported a case of Paget's disease presenting fluctuating hearing loss together with repeated dizziness and vertigo attacks. Pure tone audiometry in this patient was performed successively during follow-up periods. She visited our hospital 13 years ago with slight low tone sensorineural hearing loss in her left ear. Sensorineural hearing loss in her right ear and sensorineural and conductive hearing loss in left side deteriorated. Results of her latest examinations were as follows. Glycerol test was positive and inverted reflex was recorded in her right ear. CT showed severe calcification in skull bone and stenos of bilateral internal auditory canal. Endolymphatic hydrops, compression of VIII nerve in internal auditory canal, damage of cochlear hair cell and changes in middle ear conductive system were possible etiology of hearing loss and vertigo. Oral bisphosphonate is used to prevent deterioration of these symptoms. Evaluation of auditory and vestibular function should be continued.

Hypertrophic chronic pachymeningitis associated with chronic otitis media and mastoiditis

Kanzaki Sho, Inoue Yasuhiro, Watabe Takahisa, Ogawa Kaoru

Auris Nasus Larynx 31 ( 2 ) 155 - 159 2004.06

ISSN 0385-8146

We describe the case history of a 70-year-old female patient presenting with bilateral hearing disturbance, facial paralysis, and vertigo. Radiological tests of temporal bone revealed soft tissue in the mastoid and tympanic cavities, and T1 weighted MRI revealed prominent Gd enhancement of the middle skull basal meninges. Middle ear inflammation appeared to induce pachymeningitis and to exacerbate associated symptoms, leading to a decline in the patient's overall condition. Bilateral mastoidectomies were effective in improving her general condition. Her hearing improved only on the right side because ossiculoplasty was performed only on that side. Her facial movement progressively improved and pachymeningitis diminished over time. We speculate that removal of the infectious granulation within the middle ears and mastoids ameliorated the acute inflammation. The etiology remains unknown in this case.

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Adaptation of Japanese version of the Hearing Handicap Inventory for Adults (HHIA)

Sato Minako, Ogawa Kaoru, Inoue Yasuhiro, Masuda Masatsugu

Nippon Jibiinkoka Gakkai kaiho 107 ( 5 ) 489 - 493 2004.05

ISSN 0030-6622

We used social and emotional approaches to psychologically evaluate hearing disorders, translating the Hearing Handicap Inventory for Adults (HHIA) into Japanese and using it to evaluate Japanese adults with sensorineural hearing loss. The HHIA is a 25-item self-assessment scale composed of 2 subscales, emotional and social/situational, which has been used to evaluate adult patients with hearing disorders in Europe and North America. The test-retest reliability of the Japanese version and its screening version (HHIA-S) were excellent (kappa coefficients were 0.912 and 0.842). Due to the limitation of social/situational items, test-retest reliability was only good (0.6 < kappa coefficient < 0.8), possibly because of problems in translating these items. We discovered that the average of scores of the HHIA Japanese version was higher in bilateral hearing disorder patients than in those with unilateral hearing disorder. This score peaked in 2 to 10 years after onset and decreased thereafter in bilateral hearing disorder patients. The correlation coefficient between the average hearing level of 7 frequencies and scores of the test was highest among the 4 audiological evaluations. The HHIA Japanese version is thus useful for following up patients with hearing disorders.

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