Tomisato, Shuta

写真a

Affiliation

School of Medicine, Otorhinolaryngology, Head and Neck Surgery (Shinanomachi)

Position

Instructor

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Papers 【 Display / hide 】

  • Characteristic Laryngeal Findings in Patients with Pemphigus Vulgaris

    Hosoya M., Tomisato S., Matsumoto N., Yabe H., Takaoka T., Ozawa H., Kono T.

    Laryngoscope 134 ( 8 ) 3719 - 3725 2024.08

    ISSN  0023852X

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    Objective: Pemphigus Vulgaris (PV) is a rare autoimmune disease that could cause laryngeal lesions; however, only a few studies have described the localization of the laryngeal lesions associated with this disease owing to its rarity. Therefore, this study aimed to determine the localization of laryngeal lesions in patients with PV. Methods: Fourteen patients with PV accompanied by laryngeal or pharyngeal lesions, who underwent flexible laryngeal endoscopy performed by laryngologists, were examined retrospectively. Results: The arytenoid area was the most frequently affected site in the larynx, followed by the epiglottis and aryepiglottic folds. Vocal folds and ventricular bands were the least affected. Conclusion: Lesions in the arytenoid area were observed more frequently in this study than in previous studies. This result suggests that a more careful inspection of arytenoid lesions in patients with PV is required under laryngeal fiber observation. Moreover, we proposed a novel classification system for laryngeal findings in patients with PV and a systematic observation method. This novel classification and method would be useful not only for determining the lesions but also for careful inspection in this field. Level of Evidence: 4 Laryngoscope, 134:3719–3725, 2024.

  • Low-Dose Cisplatin-Based Radiation Therapy for Refractory Recurrent Respiratory Papillomatosis

    Takatsuki E., Kono T., Tomisato S., Ozawa H.

    Laryngoscope 134 ( 5 ) 2335 - 2337 2024.05

    ISSN  0023852X

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    Recurrent respiratory papilloma (RRP) often presents multiple lesions in the respiratory tract and sometimes becomes fatal because of severe airway obstruction. We report the case of a 69-year-old woman who had juvenile-onset RRP in the trachea that was refractory to surgical treatment, and complete remission was achieved by low-dose cisplatin combined with de-escalated radiotherapy without any side effects. This case report is the first to illustrate the data on low-dose cisplatin for refractory benign RRP, and our experience reinforces the opinion that low-dose cisplatin combined with de-escalated radiotherapy can be an effective and safe treatment alternative for uncontrollable and lethal RRP. Laryngoscope, 134:2335–2337, 2024.

  • Validity and utility of the Japanese version of the brief unhelpful thoughts and beliefs about stuttering scale: UTBAS-6-J

    Tomisato S., Yada Y., Wasano K., Kono T., Ozawa H.

    Frontiers in Psychology 15 2024

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    Do adults who stutter have abnormally high social anxiety? Is it related to maladaptive cognition? As these are persistent, unresolved questions in stuttering research, it behooves clinicians to at least assess and attempt to identify social anxiety in patients who stutter and its basis before decisions are made about stuttering treatment. The Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scale is a self-administered questionnaire that measures the degree of non-adaptive cognition in people who stutter (PWS) due to social anxiety. The 66-item UTBAS is time-consuming to complete, prompting the development of a shorter 6-item version, the UTBAS-6, which is in English. Here, we aimed to assess some psychometric properties of the Japanese version of the UTBAS-6, the UTBAS-6-J, which has not been done to date. In 56 adult patients (mean 32.6 ± 11.1 years) who stutter, we quantified the reliability, the internal consistency, and the concurrent validity of the UTBAS-6-J. Along with the UTBAS-6-J, patients also were administered the Overall Assessment of the Speaker’s Experience of Stuttering – Japanese version (OASES-A-J), the Modified Erickson Communication Attitude Scale – Japanese version (S-24-J), and the Liebowitz Social Anxiety Scale – Japanese version (LSAS-J). Cronbach’s alpha for UTBAS-6-J total scores was 0.974, indicating excellent internal consistency. UTBAS-6-J scores were significantly correlated with scores on the OASES-A-J, the S-24-J, and the LSAS-J (all p < 0.005). Concurrent validity of the UTBAS-6-J with these three questionnaires was confirmed. The UTBAS-6-J has good internal consistency and concurrent validity, which will aid clinical decision-making about stuttering treatments.

  • Speech characteristics that differentiate stuttering and cluttering in Japanese speakers

    Tomisato S., Mori T., Asano K., Iimura D., Yada Y., Takahashi S., Wasano K., Kono T., Ozawa H.

    Frontiers in Psychology 15 2024

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    Background: Cluttering is a speech disorder distinct from stuttering. Despite this distinction, there is no established method to clearly differentiate the two disorders. This study aimed to use objective criteria to differentiate cluttering from stuttering in Japanese speakers. Methods: Participants were 32 consecutive native-Japanese speakers who visited the Keio University Hospital between July 2020 and January 2023 with a chief complaint of speech disfluency. One physician and two speech-language-hearing therapists concurred on a stuttering or cluttering diagnosis of the 32 patients based on recordings of the Kitsuon kensa-ho test. The frequencies of stuttering-like disfluencies (SDF) and normal disfluencies (NDF) were calculated from the Kitsuon kensa-ho, and the ratio of disfluencies (RDF) was calculated as the ratio of SDF to NDF. Differences between the cluttering and stuttering groups in the RDF and the mean articulatory rate (MAR) for oral reading and a monologue task were tested using the Mann–Whitney U test. ROC curves were used to determine the sensitivity and specificity that well-distinguished subjects with cluttering from those with stuttering; the experts’ diagnosis was the gold standard. Results: Of the 32 participants, 12 (38%) were diagnosed with cluttering and 20 (62%) with stuttering. The cluttering and stuttering groups were comparable in demographic characteristics. The RDF on monologue task had the highest sensitivity in diagnosing cluttering, and the MAR on monologue task had the highest specificity. Adopting provisional criteria of a monologue RDF greater than 1.2 and a monologue MAR greater than 7.5 produced a sensitivity of 0.92 and a specificity of 0.95. Conclusion: We conclude that combining monologue RDF and monologue MAR well-distinguished cluttering from stuttering. This method provides new objective diagnostic criteria, which can aid clinicians, therapists, and basic researchers.

  • Effectiveness of vocal fold medialization surgery on the swallowing function of patients with unilateral vocal fold paralysis

    Kono T., Tomisato S., Ozawa H.

    Laryngoscope Investigative Otolaryngology 8 ( 4 ) 1007 - 1013 2023.08

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    Objectives: Vocal fold medialization surgery is generally considered a phonosurgical procedure for improvement of vocal function in patients with glottic insufficiency. However, the literature describing this procedure for the management of dysphagia is limited. This study aims to assess the effects of medialization surgery on swallowing function in patients with unilateral vocal fold paralysis (UVFP). Methods: We enrolled 32 patients with UVFP undergoing vocal fold medialization surgery (medialization laryngoplasty combined with arytenoid adduction [ML + AA], 12 cases; injection laryngoplasty [IL], 20 cases). We assessed the aerodynamic vocal function including maximum phonation time and mean flow rate to evaluate glottal closure status. The Hyodo score determined by flexible endoscopic evaluation and Functional Oral Intake Scale (FOIS) were evaluated pre- and postoperatively. Results: Almost 60% of patients with UVFP had dysphagia, and one-third were at high risk for aspiration. Aerodynamic parameters effectively improved after IL and ML + AA. With regard to swallowing, both the FOIS and total Hyodo score were significantly improved postoperatively. We found a particularly significant improvement in pharyngeal clearance. However, patients with high vagal nerve paralysis and postoperative insufficient glottal closure showed poor swallowing benefits after the interventions. In patients with recurrent laryngeal nerve palsy, there were no significant differences in postoperative swallowing function between the ML + AA and IL groups. Conclusion: Vocal fold medialization surgery was effective in improving swallowing function in most cases with UVFP, except for those with high vagal paralysis and insufficient postoperative glottal closure. Both IL and ML + AA showed an equivalent effect on swallowing improvement. Level of evidence: 3b.

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

  • 吃音症と早口言語症（クラタリング）の鑑別診断の確立と脳画像解析による病態研究

    2022.04
    -
    2025.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, 基盤研究(C), Principal investigator

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