Nishiyama, Takanori



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


Senior Assistant Professor (Non-tenured)/Assistant Professor (Non-tenured)

Career 【 Display / hide

  • 2011.04

    Saiseikai utsunomiya hospital

  • 2013.04

    Nasu red cross hospital

  • 2014.09

    Yokohama municipal citizens hospital

  • 2017.04

    Department of Otorhinolaryngology-Head and Neck Surgery

  • 2019.04

    Kawasaki Municipal Kawasaki Hospital

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Academic Background 【 Display / hide


    Kyorin University


Academic Degrees 【 Display / hide

  • Ph.D., Keio University, Dissertation, 2021.03

Licenses and Qualifications 【 Display / hide

  • 補聴器適合判定医

  • 日本耳鼻咽喉科学会専門医

  • Medical Doctor


Research Areas 【 Display / hide

  • Life Science / Otorhinolaryngology


Papers 【 Display / hide

  • Inner ear salivary gland choristoma extending to the middle ear with congenital profound hearing loss and facial palsy: a case report

    Yamanobe Y., Oishi N., Nishiyama T., Hosoya M., Ogawa K.

    Journal of Otolaryngology - Head and Neck Surgery (Journal of Otolaryngology - Head and Neck Surgery)  50 ( 1 ) 25 2021.12

    ISSN  1916-0208

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    Background: Salivary gland choristoma (SGCh) is a rare benign tumor reported in several unusual sites, such as the gastrointestinal tract, the optic nerve, and the internal auditory canal, but never reported in the inner ear. Case presentation: An 8-year-old girl with a history of left profound congenital hearing loss presented to us with ipsilateral progressive severe facial nerve palsy (House-Brackmann Grade VI). The left tympanic membrane was swollen with a pulsatile tumor. Radiological investigations revealed a multilocular tumor in the inner ear extending into the middle ear and internal auditory canal (IAC). We performed a partial resection of the tumor by transmastoid approach to preserve the anatomical structure of the facial nerve. The tumor was pathologically diagnosed as SGCh. Two years after surgery, her facial function recovered to House-Brackmann Grade II and the residual tumor did not show regrowth on MRI. Conclusions: Although the natural course of this rare tumor is unknown, a partial resection is an acceptable treatment procedure when functional recovery of the facial nerve is anticipated. Graphical abstract: [Figure not available: see fulltext.]

  • Three cases of otitis media caused by Mycobacterium abscessus subsp. abscessus: Importance of medical treatment and efficacy of surgery

    Nishiyama Y., Nishiyama T., Kanzaki S., Oishi N., Fujioka M., Yamada H., Ebisuno C., Kaiho M., Uwamino Y., Fukano H., Hoshino Y., Hasegawa N., Ogawa K.

    Journal of Infection and Chemotherapy (Journal of Infection and Chemotherapy)  27 ( 8 ) 1251 - 1257 2021.08

    ISSN  1341321X

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    This study aimed to assess the clinical presentation, antibiotic therapy, surgery, and outcomes in patients with otitis media caused by Mycobacterium abscessus subsp. abscessus and discuss the efficacy of surgery. This is a retrospective case review of three patients diagnosed with otomastoiditis caused by M. abscessus subsp. abscessus. All patients had refractory otorrhea. One patient had granulation tissue in the tympanic membrane. They received medical treatment and underwent surgery. Otorrhea was resolved several months after the initiation of long-term multiantibiotic therapy in all cases. The timing of surgery varied among patients. Before initiating antibiotic therapy, mastoidectomy was performed to achieve definitive diagnosis in two patients, and wound dehiscence developed in these patients. Two patients underwent debridement after the initiation of multiantibiotic therapy. After antibiotic administration, tympanoplasty was performed to improve hearing in one patient. All patients achieved culture negativity after treatment, and no recurrences have been noted. From three cases, it is suggested that the mainstay of treatment for M. abscessus subsp. abscessus is long-term multiantibiotic therapy, and surgery itself may have little effect on achieving ear dryness. Thus, in most patients, drug therapy should be prioritized. Considering postoperative complications, surgery before achieving ear dryness should be avoided, except in emergency cases. In addition, if the diagnosis is not confirmed by repeated bacteriological tests, mastoidectomy should be performed to collect specimens. Tympanoplasty for hearing loss or eardrum perforation is recommended after discontinuation of medications.

  • Who are good adult candidates for cartilage conduction hearing aids?

    Nishiyama T., Oishi N., Ogawa K.

    European Archives of Oto-Rhino-Laryngology (European Archives of Oto-Rhino-Laryngology)  278 ( 6 ) 1789 - 1798 2021.06

    ISSN  09374477

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    Purpose: Cartilage conduction hearing aids (CC-HAs) are novel hearing aids using the third hearing pathway of cartilage conduction. We assessed the efficacy of CC-HAs in adult hearing-loss patients who had various anatomical conditions of their ear canal(s) and determined who are good candidates for CC-HAs. Methods: Patients (n = 37) were categorised into three groups of participants based on ear canal anatomy: (1) canal stenosis; (2) abnormal canal; (3) normal canal. After a 1-month free trial of normal usage, CC-HA-aided and unaided hearing thresholds (43 fitted ears) were determined using standard audiograms, after which participants could choose to purchase the device or not. Group and subgroup purchase rates were calculated along with the purchase reason (or not). Subgroup binary analysis of purchase rates was done according to hearing loss severity (< 70 dB and ≥ 70 dB) of unaided average air conduction (AC) hearing thresholds. Results: CC-HA provided hearing improvements in all frequencies within each group. Overall, 60.47% of participants purchased a CC-HA after the trial. Over 70% participants with canal stenosis purchased CC-HAs, regardless of their AC hearing thresholds (severe vs. mild), and significantly more mild-loss participants in the abnormal canal group purchased their trial CC-HA compared to severe-loss participants (85.71% vs. 20%). Conclusion: Adult patients with ear canal stenosis or closure are the best candidates for CC-HAs, regardless of their hearing thresholds. Patients with more severe hearing loss accompanied by ear canal anomalies and patients with normal canal anatomy may not be good candidates.

  • Efficacy of cartilage conduction hearing aids in children

    Nishiyama T., Oishi N., Ogawa K.

    International Journal of Pediatric Otorhinolaryngology (International Journal of Pediatric Otorhinolaryngology)  142   110628 2021.03

    ISSN  01655876

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    Objectives: Cartilage conduction hearing aids (CC-HAs) are novel hearing aids that use the third hearing pathway of cartilage conduction. We assessed the efficacy of CC-HAs and the hearing effects and safety of additional tape compression over the transducer in children with hearing loss. Methods: The patients (n = 42) underwent a one-month free trial of CC-HAs. Forty of them were patients with auditory canal atresia or stenosis. CC-HA-aided and unaided hearing thresholds (48 fitted ears) were determined using standard audiograms, after which participants could choose to purchase the device or not. We calculated the purchase rates and compared the patient characteristics between the purchase and non-purchase groups along with the purchase reason (or not). We applied additional tape compression over the CC-HA transducer and assessed the hearing effects and side effects. Results: CC-HA led to hearing improvements at all frequencies. Overall, 72.92% of participants purchased a CC-HA after the trial. By applying additional tape compression over the CC-HA transducer, the stability and hearing gains were improved mainly at low frequencies, and no side effects such as dermatitis were observed. Conclusions: CC-HAs are efficacious in producing hearing improvements in children, especially in patients with atresia or canal stenosis who cannot use air conduction hearing aids. Furthermore, we found that the additional tape compression over the transducer was an easy and a safe method for improving the hearing effects and stability of the CC-HA.

  • 外耳道癌症例22耳の検討

    鈴木 成尚, 大石 直樹, 小澤 宏之, 神崎 晶, 藤岡 正人, 西山 崇経, 野口 勝, 細谷 誠, 関水 真理子, 斎藤 真, 小川 郁

    日本耳鼻咽喉科学会会報 ((一社)日本耳鼻咽喉科頭頸部外科学会)  124 ( 3 ) 197 - 204 2021.03

    ISSN  0030-6622

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Papers, etc., Registered in KOARA 【 Display / hide

Reviews, Commentaries, etc. 【 Display / hide

  • 聴神経腫瘍診療の未来 聴神経腫瘍診療における「早期発見、早期治療」 小・中型腫瘍に対する聴力温存手術の役割

    大石 直樹, 細谷 誠, 野口 勝, 西山 崇経, 鈴木 成尚, 粕谷 健人, 鈴木 法臣, 宮崎 日出海, 小川 郁

    Otology Japan ((一社)日本耳科学会)  29 ( 3 ) 211 - 214 2019.09

    ISSN  0917-2025

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  • 【ビギナーのための耳鳴・聴覚過敏診療】診断の進め方 聴覚過敏

    西山 崇経, 新田 清一

    JOHNS ((株)東京医学社)  35 ( 1 ) 23 - 26 2019.01

    ISSN  0910-6820

  • Preoperative electrophysiological analysis predicts preservation of hearing and facial nerve function following vestibular schwannoma surgery with continuous intraoperative neural monitoring: Clinical outcomes of 22 cases

    Hosoya M., Oishi N., Nishiyama T., Noguchi M., Kasuya K., Suzuki N., Miyazaki H., Ogawa K.

    Clinical Otolaryngology (Clinical Otolaryngology)  44 ( 5 ) 875 - 880 2019

    ISSN  17494478

  • 【内視鏡下耳科手術】当科での経外耳道的内視鏡下耳科手術における工夫 3 hands techniqueを中心に

    藤岡 正人, 小澤 宏之, 野口 勝, 粕谷 健人, 石川 徹, 猪狩 雄一, 西山 崇経, 細谷 誠, 神崎 晶, 大石 直樹, 小川 郁

    Otology Japan ((一社)日本耳科学会)  28 ( 5 ) 659 - 662 2018.12

    ISSN  0917-2025

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    光学機器の進歩と各種器具の上市を背景に、昨今急速に普及している経外耳道的内視鏡下耳科手術(TEES)は、その近接した広い視野角による死角の減少と微細で鮮明な映像情報とを利点とする反面、片手操作ゆえの不便さが常に伴う。一方、鼻科領域で標準術式となっている内視鏡下鼻副鼻腔手術は経鼻内視鏡頭蓋底手術(EESBS)へと発展を見せており、EESBSでは二人の術者による"4 hands surgery"が一般的である。当科ではEESBSの手法をTEESに導入し、助手が内視鏡を持ち視野を作る、"3 hands surgery"によるTEESを積極的に行っている。術者が両手操作で作業を行うことができ、かつ内視鏡が術野の変化に合わせて迅速に移動できるため、出血をコントロールしながら、近接した死角の少ない視野を確保することが可能である。一方で、TEESでは鼻副鼻腔以上に狭いスペースで手術が展開されるため、スコーパーの臨機応変、迅速かつ的確な内視鏡操作により、視野とワーキングスペースを同時に確保することがEESBS以上に厳しく要求される。内視鏡操作と術操作を異なる術者が行うと、術者の遠近感の把握感覚が異なるため、EESBS同様、特殊な手技として修練を経験することが望ましい。術者とスコーパーが相補的な手技を同時に行うチームワークが手術の円滑な進行には不可欠であり、EESBSの手術教育を基盤とした手技習得と、cadaver dissectionによる十分なトレーニングが肝要と私達は考えている。(著者抄録)

  • 耳鼻咽喉科医主導の補聴器診療

    西山 崇経

    耳鼻咽喉科臨床 (耳鼻咽喉科臨床学会)  111 ( 10 ) 724 - 725 2018.10

    ISSN  0032-6313

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

  • 一側伝音・混合難聴に対し軟骨伝導と骨伝導が与える聴覚利得の差とその起源の研究


    基盤研究(C), Principal investigator

  • LATS1キナーゼ欠損で起きる先天性難聴の原因および聴毛機能解析


    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Early-Career Scientists , Principal investigator

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    Hippo経路は細胞周期を調節し、組織の大きさや形態、硬さや脆弱性などを規定する細胞内シグナル伝達経路である。細胞の骨格を維持する分子としてLATS1/2キナーゼがあり、そのうちLATS1のみが内耳コルチ器に存在すること、LATS1の欠損によって先天性内耳有毛細胞障害を引き起こすことを見出している。本研究では、胎生期から出生までにおけるLATS1のコルチ器形成における生理的意義を明らかにするべく、LATS1ノックアウト (KO) マウスを用いて、LATS1 KOがPCP蛋白に与える影響やHippo経路における働きを解明する。
    本年度までの研究結果からLATS1 KOマウスは、体格の小型化および内外有毛細胞の配列不整や聴毛の異常を伴う先天性内耳性難聴を呈していた。内耳性難聴の原因としては、発生段階でのKinociliumの分布異常を呈しており、Planar Cell Polarity (PCP) の異常を疑う所見が得られた。本年度は、出生後の体重とABR閾値の時系列の追跡およびPCPと関連が疑われたGαiやPar3などへのLATS1 KOによる影響を研究した。
    出生後の体重は出生早期から体格は小さく、その後6ヶ月齢までの成長でも体格の小ささは維持される結果であった。出生後のABR閾値は、正確な計測が可能となる4週齢から6ヶ月齢までにおいて、KOマウスは一貫して70dB程度の高度聴力障害を示し、野生型やヘテロマウスは正常な聴力から徐々に加齢性変化に伴う聴力障害を生じていた。このことから、LATS1 KOに伴う体格や聴力への影響は先天性非進行性の変化であることが確認された。
    胎生マウスや新生マウスを用い、GαiとPar3をKOおよび同腹のマウスコルチ器の免疫染色を行い検討した。GαiとPar3共にKOマウスは野生型やヘテロマウスと同様の分布を示していた。このことからLATS1 KOはGαiやPar3とは異なった経路を介した内耳発生障害を起こしていると考えられ、前立腺における先行論文とは異なるメカニズムが、内耳には存在することが示唆された。
    前立腺の先行論文では、細胞配列を決定づける段階でLATS1とGαi、Par3が共役しており、Par3が障害されることでLATS1とGαiの分布に異常を来たし細胞配列が乱れるというものであった。当初の予想では内耳においても同様の変化が起きており、それに伴い有毛細胞の配列異常が説明可能と考えていたが、内耳においては異なるメカニズムが示唆される結果となっており、内耳表現系を説明することが出来なかった。そのため、表現系を説明するためのLATS1 KOが影響を与えているメカニズムを再度探索する必要が生じている。

  • Regulation of hair cell microstructure and auditory function by Hippo pathway


    MEXT,JSPS, Grant-in-Aid for Scientific Research, Takanori Nishiyama, FUJIOKA Masato, OISHI Naoki, SAYA Hideyuki, Grant-in-Aid for Young Scientists (B), Principal investigator

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    Hippo pathway regulates organ size, self-renewal of stem cells, and cell differentiation. LATS1 and LATS2 participate in Hippo signaling pathway. We examined expression pattern of LATS1 and LATS2 in the mouse cochlea, particularly in the organ of Corti. Because we only found LATS1 expression in the organ of Corti, we next investigated Lats1 deficiency mice. We found LATS1 deficiency caused congenital hearing loss with abnormal polarity and stereocilia bundles in both inner and outer hair cells. Those phenotypes indicate the possibility of LATS1 relating to the inner ear development.


Courses Taught 【 Display / hide