論文 - 西山　崇経

Cell-specific α and β subunit expression patterns of Na+/K+-ATPases in the common marmoset cochlea

Hosoya M., Ueno M., Shimanuki M.N., Nishiyama T., Oishi N., Ozawa H.

Scientific Reports 15 （ 1 ） 26814 2025年12月

　概要を見る

High potassium concentration in the cochlear endolymph electrically drives hair cell activity. Sodium potassium ATPase (Na⁺/K⁺-ATPase) is an essential pump for ion homeostasis in the cochlea. Most of our knowledge regarding Na⁺/K⁺-ATPase has been obtained from rodent models, and knowledge of its distribution in primates, including humans, is limited. This study investigated the distribution of Na⁺/K⁺-ATPase in a common marmoset primate model. We investigated expression patterns of Na⁺/K⁺-ATPase α1 (ATP1A1), Na⁺/K⁺-ATPase α2 (ATP1A2), Na⁺/K⁺-ATPase α3 (ATP1A3), Na⁺/K⁺-ATPase β1 (ATP1B1), Na⁺/K⁺-ATPase β2 (ATP1B2), and Na⁺/K⁺-ATPase β3 (ATP1B3) in the cochlea of the neonates and the embryos of the common marmoset. We have described the distributions of specific pairs of Na⁺/K⁺-ATPase α and β subunits in each cochlear part, including spiral ganglion neurons, stria vascularis, and the organ of Corti. We also described developmental changes in Na⁺/K⁺-ATPases in common marmosets. The distribution of Na⁺/K⁺-ATPases in the common marmoset is similar to that in humans and is suitable for furthering our understanding of human cochlear development. The distribution established in this report will aid the study of primate-specific ion homeostasis in the inner ear.

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Relationship between hearing thresholds and cognitive function in hearing aid non-users and long-term users post-midlife

Nishiyama T., Kimizuka T., Kataoka C., Tazoe M., Sato Y., Hosoya M., Shimanuki M.N., Wakabayashi T., Ueno M., Ozawa H., Oishi N.

Npj Aging 11 （ 1 ） 14 - 14 2025年12月

　概要を見る

The extent of hearing loss requiring hearing aid (HA) to prevent cognitive decline is unclear; we assessed this post-midlife along with the relationship between hearing thresholds and cognitive function in those who had never used HA (non-users) or used HAs for >3 years (long-term users). This study comprised 117 individuals ≥55 years with an average hearing threshold of ≥25 dB HL in their better ear and 55 of the non-users and 62 of the long-term users. The Mini-Mental State Examination, the Symbol Digit Modalities Test (SDMT), and pure-tone and sound-field audiometry were assessed. Mean ± SD hearing levels of the non-user and long-term user group were 40.83 ± 8.16 and 51.13 ± 14.80 dB HL. Non-users showed a significant association (P = 0.01) between the hearing thresholds and SDMT scores, with a cutoff value of above 38.75 dB HL identified as affecting cognitive function. There were no significant associations for long-term users.

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Course of a sudden sensorineural hearing loss case diagnosed as intra-labyrinthine hemorrhage with MRI in the early phase

Ide K., Hosoya M., Nishiyama T., Shimanuki M.N., Ueno M., Ozawa H., Oishi N.

Auris Nasus Larynx 52 （ 4 ） 479 - 483 2025年08月

ISSN  03858146

　概要を見る

Intralabyrinthine hemorrhage (ILH) is a rare differential diagnosis of sudden sensorineural hearing loss. Investigations using magnetic resonance imaging (MRI) in the early phase from the onset are inevitable to diagnose ILH. However, MRI is not usually performed during the early phases of sudden sensorineural hearing loss. Hence, ILH is rarely diagnosed, and the hearing prognosis and vestibular function in patients have been poorly understood. In the present study, we report the detailed course of ILH with relatively good hearing recovery. Additionally, vestibular function recovery was quantitatively examined using a video head impulse test. A 75-year-old man presented at our clinic with a chief complaint of dizziness, sudden hearing loss, left sensorineural hearing loss, and nystagmus. MRI 18 days after onset showed a left ILH. Following treatment with prednisone, the patient's hearing level partially recovered and nystagmus disappeared. Our experience emphasizes that MRI in the early phase is crucial for diagnosing ILH. Furthermore, MRI in the early phase should be considered in cases of sudden sensorineural hearing loss or dizziness and is beneficial for investigating ILH as a subpopulation of sudden sensorineural hearing loss.

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A small vestibular schwannoma with preoperative facial palsy treated via retrolabyrinthine approach

Hatomi S., Hosoya M., Ueno M., Shimanuki M.N., Nishiyama T., Ozawa H., Oishi N.

Auris Nasus Larynx 52 （ 3 ） 216 - 221 2025年06月

ISSN  03858146

　概要を見る

Facial nerve paralysis caused by a vestibular schwannoma is a rare but critical symptom; however, few reports have focused on preoperative facial nerve palsy from the viewpoint of treatment. In addition, its mechanism is not fully understood. We report a rare case of preoperative facial nerve palsy that improved after the surgical resection of a small vestibular schwannoma with hearing preservation. A small vestibular schwannoma within the internal auditory canal caused acute deafness and facial paralysis in a 51-year-old woman. Conservative treatment was initially administered, but severe hearing loss and facial paralysis persisted for 3 months after onset. Subsequently, we performed tumor resection using the retrolabyrinthine approach. The tumor, which compressed the cochlear and facial nerves, was almost completely removed under continuous intraoperative monitoring to preserve the facial nerve function. “Wait and scan” is generally recommended for vestibular schwannomas within the internal auditory canal. However, this case suggests that early successful surgery, at least in selected cases, can improve paralysis without hearing deterioration and maintain the patient's quality of life.

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Noise-Induced Hearing Loss: Overview and Future Prospects for Research on Oxidative Stress

Kitama T., Nishiyama T., Hosoya M., Shimanuki M.N., Ueno M., You F., Ozawa H., Oishi N.

International Journal of Molecular Sciences 26 （ 10 ）  2025年05月

ISSN  16616596

　概要を見る

Noise-induced hearing loss (NIHL) is a common type of sensorineural hearing loss caused by exposure to high-intensity noise that leads to irreversible cochlear damage. Despite extensive research on cochlear pathophysiology, the precise mechanisms remain unclear, and no established treatment exists. This is due to the challenges in imaging and the inability to perform biopsies in human patients. Consequently, animal models, particularly mice, have been widely used to study NIHL. Clinically, NIHL presents as either a temporary threshold shift, in which hearing recovers, or a permanent threshold shift, which results in an irreversible loss. Histopathological studies have identified the key features of NIHL, including outer hair cell loss, auditory nerve degeneration, and synaptic impairment. Recent findings suggest that oxidative stress and inflammation are major contributors to NIHL, highlighting the potential for therapeutic interventions, such as antioxidants and anti-inflammatory agents. Given the increasing prevalence of NIHL owing to occupational noise exposure and personal audio device use, addressing this issue is a pressing public health challenge. This review summarizes the clinical features, underlying mechanisms, and emerging treatment strategies for NIHL while identifying current knowledge gaps and future research directions.

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Preoperative cVEMP Results Predict Developing Prolonged Dizziness After Vestibular Schwannoma Surgery

Ueno M., Hosoya M., Shimanuki M.N., Nishiyama T., Ozawa H., Oishi N.

Otology and Neurotology 46 （ 4 ） 453 - 459 2025年04月

ISSN  15317129

　概要を見る

Objective: To assess pretreatment factors including preoperative vestibular function tests evaluated using cVEMP and caloric tests, which correlate with the development of prolonged dizziness after vestibular schwannoma resection. Study Design: Retrospective cohort study. Setting: Academic tertiary referral centers. Patients: Patients with vestibular schwannoma who underwent surgery and completed preoperative vestibular function tests and questionnaires. Intervention: Diagnostic. Main Outcome Measures: Participants were divided into prolonged dizziness and nonprolonged dizziness groups according to their postoperative DHI scores. The rates of abnormal results of preoperative vestibular function tests (caloric test, cVEMP), including other factors such as preoperative HADS scores, were compared. Furthermore, univariate logistic regression analysis was performed with the DHI score at 3 months as the dependent variable. Results: Of the whole 45 participants, 14 (31%) developed prolonged dizziness postoperatively. The proportion of participants with abnormal cVEMP results was significantly lower in the prolonged dizziness group (7.1%) than in the nonprolonged dizziness group (42%). Other factors did not show any significant differences. Univariate analysis showed that only the cVEMP results correlated with the postoperative DHI score (OR = 9.39, 95% CI [1.56, 181.3], p < 0.05). About 70% of patients with prolonged dizziness continued to exhibit high DHI scores at 6 months after surgery; however, about half of them recovered by 1 year. Conclusion: Vestibular schwannoma patients with normal preoperative cVEMP results tended to develop prolonged dizziness after resection compared to those with abnormal results. Preoperative cVEMP results enable physicians to predict whether vestibular schwannoma patients undergoing resection would likely develop prolonged dizziness postoperatively.

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Closedness of Acoustic Coupling and Audiological Measures Are Associated with Individual Speech-in-Noise Benefit From Noise Reduction in Hearing Aids *

Jürgens T., Ihly P., Tchorz J., Nishiyama T., Tanaka C., Suzuki D., Shinden S., Kitama T., Ogawa K., Zaar J., Laugesen S., Jones G., Vatti M., Santurette S.

Trends in Hearing 29   23312165251325983 2025年01月

　概要を見る

The combination of directional microphones (DIR) and spectral noise reduction (NR) is a common technique in hearing aid signal processing, for improving speech intelligibility in spatial acoustic scenarios. The benefit from DIR + NR varies considerably across individuals, which impedes prescribing the optimal strength of such processing during hearing aid fitting. The goal of this study was to investigate the correlation of four audiological factors with the benefit of speech reception thresholds (SRTs) from DIR + NR: the closedness of the acoustic coupling in the ear canal, audible contrast thresholds test (ACT™), the audiogram, and age. As part of a larger field study, 123 experienced hearing aid users in two centers in Germany and Japan were fitted bilaterally with the same hearing aids. SRTs were obtained with and without strong DIR + NR in a spatial speech-in-noise scenario before and after the field trials. Closedness of acoustic coupling was found to have the strongest correlation with SRT benefit from DIR + NR (most likely dominated by DIR rather than NR processing), followed by audible contrast thresholds (ACT) and the audiogram, both with the same significantly weaker correlation. Age was not correlated with the benefit from DIR + NR. The results suggest fitting hearing aid users irrespective of age with as-closed-as-possible acoustic coupling to maximize the benefit of DIR + NR. Furthermore, the closedness of acoustic coupling in combination with ACT or the audiogram may serve audiologists in predicting individual speech intelligibility benefits from strong DIR + NR for better guidance to set its strength during hearing aid fitting.

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Novel continuous and quantitative intraoperative facial nerve-monitoring system for temporal bone lesions

Hosoya M., Iwabu K., Wakabayashi T., Shimanuki M.N., Nishiyama T., Ueno M., Ozawa H., Oishi N.

European Archives of Oto Rhino Laryngology 2025年

ISSN  09374477

　概要を見る

Objective: Intraoperative systems for monitoring facial nerve function, in which temporal electrical stimulation is applied to the facial nerve through electrodes, are used in many surgeries requiring facial nerve preservation; however, continuous stimulation or quantitative evaluation of facial nerve function is difficult with this approach. We examined the usefulness of a continuous and quantitative facial nerve-monitoring system for temporal bone lesions by using our experience to modify the existing methods used for cases involving vestibular schwannomas. Study design: Retrospective observational study. Setting: Department of Otorhinolaryngology-Head and Neck Surgery at our hospital. Methods: We modified the electrode placement and examined the usefulness of the modified system under several conditions. The study population consisted of patients who were operated on for temporal bone lesions at our department and underwent continuous nerve monitoring using the modified system. Case details, electrode-placement sites, and facial nerve function data before and after the surgery were obtained and retrospectively evaluated. Results: Electrodes were placed safely during surgery in all cases. No obvious deterioration in facial nerve function was observed, except in one case. Conclusion: The advantages of this system include its ability to perform quantitative intraoperative evaluations and prevent unexpected nerve damage in cases where the facial nerve shows complicated pathways. This monitoring system is useful, even in complex temporal bone surgeries.

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A primate model animal revealed the inter-species differences and similarities in the subtype specifications of the spiral ganglion neurons

Hosoya M., Ueno M., Shimanuki M.N., Nishiyama T., Oishi N., Ozawa H.

Scientific Reports 14 （ 1 ） 25166 2024年12月

　概要を見る

Type I spiral ganglion neurons are peripheral neurons essential for hearing perception. While they can be subdivided in mice based on characteristic gene expression patterns, detailed examinations of these subtypes in primates and humans are lacking. In this study, we investigated the developmental subtypes of spiral ganglion neurons in the common marmoset (Callithrix jacchus). We confirmed that Type I spiral ganglion can be divided based on the characteristic gene expression patterns of several marker genes. However, some combinations of these genes differ from those in rodents, suggesting common marmoset's suitability for advancing our understanding of human cochlear development. Additionally, identifying the essential time points for subtype specifications and subsequent maturation will aid in studying the primate-specific developmental biology of the inner ear. This could lead to new treatment strategies for hearing loss in humans and be valuable for studying age-related hearing loss, as well as designing regenerative therapies.

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Detailed characterization of auditory neuropathy in Perrault syndrome with TWNK variants

Shimanuki M.N., Hosoya M., Nishiyama T., Wakabayashi T., Ueno M., Ozawa H., Mutai H., Nara K., Matsunaga T., Oishi N.

Auris Nasus Larynx 51 （ 6 ） 933 - 939 2024年12月

ISSN  03858146

　概要を見る

Perrault syndrome is an autosomal recessive condition characterized by hearing loss and ovarian failure. Hearing loss in Perrault syndrome has been reported as sensorineural; however, only two cases in a single report have comprehensively investigated hearing in Perrault syndrome with TWNK variant, and the association between this variant and auditory neuropathy has not been established. The proband presented with hearing difficulties and primary amenorrhea. Hearing tests revealed mild hearing loss. Maximum speech intelligibility score was 95 % with normal otoacoustic emission. However, no auditory brainstem responses were observed, leading to the diagnosis of auditory neuropathy. Genetic tests identified compound heterozygous variants of TWNK (p.Ile253Met and p.Arg391His), which lead to the genetic diagnosis of Perrault syndrome. Electrocochleography suggests a decreased cochlear nerve function. The patient's sister was also subsequently genetically diagnosed with Perrault syndrome upon identification of the same TWNK variant and had auditory neuropathy with low-tone hearing loss on pure-tone audiometry. These cases highlight the importance of detailed hearing tests, including auditory brainstem response and genetic tests in patients with Perrault syndrome, even in cases of mild hearing loss, for accurate diagnosis and appropriate management.

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小児症例における軟骨伝導補聴器の有用性・臨床的特徴の検討

小口 慶悟, 西山 崇経, 文入 悠, 大石 直樹

小児耳鼻咽喉科 （日本小児耳鼻咽喉科学会）  45 （ 2 ） 149 - 154 2024年12月

ISSN  0919-5858

　概要を見る

軟骨伝導補聴器は成人と小児で適応や購入理由・価格が異なるため別々に検討することが望ましいが,小児単一の報告は極めて少ない.今回我々は,軟骨伝導補聴器を試聴した20歳以下の小児症例68例を振り返り,対象における補聴器の継続率,継続群・返却群における臨床的特徴,装用効果などを検討した.全体の継続率は72%で,疾患別では両側外耳道閉鎖/狭窄群63%,片側外耳道閉鎖/狭窄群79%,外耳道開放群25%であった.年齢が上がるにつれて継続率が低下する傾向が見られた.継続群と返却群のファンクショナルゲインに有意差はなかった.購入・継続の判断には装用効果だけでなく,費用や装用感も影響していた.片側例では両耳聴効果や方向感の改善が高い継続率につながった.一方,外耳道開放例では気導補聴器との比較で継続率が低かった.本研究により,小児症例に対する軟骨伝導補聴器の有用性が示され,積極的に試聴してもらうことの重要性が示唆された.(著者抄録)

TRT(tinnitus retraining therapy)18年間の統計から　治療器の推移について

伊藤 まり, 小川 郁, 大石 直樹, 西山 崇経, 田路 正夫

耳鼻咽喉科・頭頸部外科 （(株)医学書院）  96 （ 13 ） 1166 - 1169 2024年12月

ISSN  0914-3491

　概要を見る

＜文献概要＞はじめに　耳鳴再訓練法(tinnitus retraining therapy:TRT)とは1980年後半にPawel Jastreboffによって提唱された音響療法と教育カウンセリングで成り立っている治療法である。TRTは耳鳴を消失させることが目的ではなく脳に順応を起こすことで耳鳴の苦痛を減少させる治療である。耳鳴治療器(tinnitus control instrument):サウンドジェネレーター(sound generator:SG)の作用機序は,静寂を避け,耳に雑音を与えることにより大脳皮質における耳鳴の信号のコントラストを減弱させ耳鳴に対する過敏性を減らすように働きかけ,耳鳴に対する順応を起こすとされている。また補聴器の作用機序は,補聴器による外界音の入力によって(1)耳鳴を紛らわせること,(2)蝸牛障害による末梢入力低下により上昇した聴覚中枢での神経活性を抑制することとされている。Jastreboffが提唱するプロトコールでは難聴の自覚のない耳鳴症例ではSGを,難聴の自覚のある耳鳴症例では補聴器を推奨している(表1)。本邦においては2001年の松田による報告以来,TRTを行う施設は増加した。筆者が2004年4月～2022年3月の18年間でTRTを施行し購入された治療器は,SG,補聴器,SG付き補聴器,一側性難聴に対するCROS補聴器であった。本稿では購入された治療器の個数の推移について報告する。

Sarcopenia as a predictive factor for febrile neutropenia during induction chemotherapy in head and neck squamous cell cancer

Kasahara K., Shigetomi S., Sato Y., Imanishi Y., Ikari Y., Nishiyama T., Matsui Y., Shinden S., Ozawa H., Kono T.

Auris Nasus Larynx 51 （ 6 ） 971 - 975 2024年12月

ISSN  03858146

　概要を見る

Objective: Febrile neutropenia (FN) is the most serious toxicity in patients with head and neck squamous cell carcinoma (HNSCC) treated with induction chemotherapy (IC). Although it is well-known that sarcopenia is a risk factor for severe toxicity of (chemo)radiotherapy, the data on the association between sarcopenia and FN during IC in HNSCC patients is rare. This study determined the impact of sarcopenia on FN during IC. Methods: IC-treated patients with HNSCC were enrolled in this study. Skeletal muscle mass (SMM) at the C3 vertebral body was used to define sarcopenia from computed tomography (CT) scans. To determine the predictive effect of low SMM on FN, logistic regression analysis was performed. Results: In this study, 71 patients were included, of whom 28 had low SMM and 14 experienced FN. In multivariate analysis, low SMM and high CRP were the independent predictive factors for FN. The combination index of sarcopenia and CRP showed a greater odds ratio than sarcopenia alone suggesting a more significant predicting indicator. Conclusions: Sarcopenia defined by CT imaging is associated with FN in patients with HNSCC treated with IC. The combination of sarcopenia and high CRP is a more significant risk factor, and it helps determine patients at risk of FN during IC.

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Long-term hearing prognosis after vestibular schwannoma surgery with retrolabyrinthine approach

Hosoya M., Nishiyama T., Shimanuki M.N., Ueno M., Ozawa H., Miyazaki H., Oishi N.

European Archives of Oto Rhino Laryngology 281 （ 11 ） 5699 - 5707 2024年11月

ISSN  09374477

　概要を見る

Purpose: The retrolabyrinthine approach is a surgical method designed to preserve hearing after surgery. When paired with intraoperative monitoring and an endoscope, this approach has demonstrated high rates of postoperative hearing preservation. However, the long-term prognosis of hearing preservation after utilizing this approach for vestibular schwannomas remains unexplored. This study aimed to examine the long-term outcomes of preserved hearing, providing insights into the suitability of the retrolabyrinthine approach for hearing preservation surgery. Methods: This study included 34 patients with preserved hearing after vestibular schwannoma surgery using the retrolabyrinthine approach at a single center. Long-term hearing prognosis and requirement for additional interventions were retrospectively examined. Results: Immediate after post-operative hearing preservation rate was 71.7%. Among the 34 patients with preserved hearing post-vestibular schwannoma surgery, four (11.8%) required additional interventions. Other patients experienced a gradual deterioration in their hearing status, with an approximate 10 dB decline during the 5-year follow-up; however, a serviceable hearing level persisted long after the surgery in these individuals. Conclusions: This study indicated the rationale for the retrolabyrinthine approach as a hearing preservation surgery for vestibular schwannomas, emphasizing its long-term hearing prognosis.

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Characteristics of pure tone audiogram in patients with untreated sporadic vestibular schwannoma: Analysis of audiometric shape and interaural differences stratified by age and mode of onset

Tsuzuki N., Kitama T., Wasano K., Wakabayashi T., Hosoya M., Nishiyama T., Ozawa H., Oishi N.

Auris Nasus Larynx （Auris Nasus Larynx）  51 （ 2 ） 347 - 355 2024年04月

ISSN  03858146

　概要を見る

Objective: Asymmetric sensorineural hearing loss (ASHL) is the most common symptom of sporadic vestibular schwannoma (VS). However, there is still no universally accepted MRI protocol for diagnosing VS. This study identified the characteristics of pure tone audiogram (PTA) in patients with VS. Methods: We conducted a retrospective chart review of patients diagnosed with sporadic unilateral VS. In the analysis, we focused on the shape and interaural differences of PTA, stratified by the mode of onset and patient age. Results: In total, 390 patients met the inclusion criteria. The U-shaped audiogram showed the highest proportion in patients with the onset of sudden sensorineural hearing loss (SSNHL). In patients with SSNHL, U-shaped audiograms were younger than other audiograms, and 86.7 % of patients under 40 had U-shaped audiograms. Patients with VS were more likely to have interaural differences at higher frequencies than at lower frequencies. Patients with SSNHL had a significantly higher percentage of interaural differences at 500–4000 Hz than those with onset other than SSNHL (non-SSNHL patients). In addition, non-SSNHL patients had a significant trend toward a higher percentage of interaural differences at all frequencies with increasing age. Conclusion: MRI screening can be considered in patients with SSNHL with U-shaped audiograms under 40 years of age. In ASHL, not SSNHL, MRI screening can be considered for older patients with interaural differences at wider continuous frequencies. Patients with interaural differences at high frequencies had a higher priority than those with interaural differences at low frequencies as indications for MRI screening for VS.

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Binaural hearing aid intervention for a patient with nonserviceable hearing loss after surgery for vestibular schwannoma: A case report

Hosoya M., Iwabu K., Hasebe N., Nishiyama T., Wakabayashi T., Shimanuki M., Ueno M., Ozawa H., Oishi N.

Science Progress 107 （ 2 ） 368504241262195 - 368504241262195 2024年04月

ISSN  00368504

　概要を見る

A vestibular schwannoma is a benign tumor; however, the schwannoma itself and interventions can cause sensorineural hearing loss. Most vestibular schwannomas are unilateral tumors that affect hearing only on one side. Attention has focused on improving the quality of life for patients with unilateral hearing loss and therapeutic interventions to address this issue have been emphasized. Herein, we encountered a patient who was a candidate for hearing preservation surgery based on preoperative findings and had nonserviceable hearing after the surgery, according to the Gardner–Robertson classification. Postoperatively, the patient had decreased listening comprehension and ability to localize sound sources. He was fitted with bilateral hearing aids, and his ability to localize sound sources improved. Although the patient had postoperative nonserviceable hearing on the affected side and age-related hearing loss on the unaffected side, hearing aids in both ears were useful for his daily life. Therefore, the patient was able to maintain a binaural hearing effect and the ability to localize the sound source improved. This report emphasizes the importance of hearing preservation with vestibular schwannomas, and the demand for hearing loss rehabilitation as a postoperative complication can increase, even if hearing loss is nonserviceable.

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前庭神経鞘腫の耳鼻咽喉科的な臨床症状と治療 文献レビュー(Otological clinical symptoms and management of vestibular schwannoma: literature review)

Oishi Naoki, Nishiyama Takanori, Hosoya Makoto, Ueno Masashi, Shimanuki Marie, Wakabayashi Takeshi, Tsuzuki Nobuyoshi, Kitamura Mitsuru, Ozawa Hiroyuki

日本耳鼻咽喉科頭頸部外科学会会報 （(一社)日本耳鼻咽喉科頭頸部外科学会）  127 （ 4 ） 493 - 493 2024年04月

ISSN  2436-5793

Prediction of Cochlear Implant Effectiveness with Surface-Based Morphometry

Minami S., Takahashi M., Shinden S., Shirai K., Oishi N., Nishimura H., Masuda M., Masuda S., Nishiyama T., Hosoya M., Ueno M., Kashio A., Yamada H., Matsunaga T., Kaga K., Shintani A., Nemoto K.

Otology and Neurotology （Otology and Neurotology）  45 （ 2 ） 114 - 120 2024年02月

ISSN  15317129

　概要を見る

Objective This study aimed to determine whether surface-based morphometry of preoperative whole-brain three-dimensional T1-weighted magnetic resonance imaging (MRI) images can predict the clinical outcomes of cochlear implantation. Study Design This was an observational, multicenter study using preoperative MRI data. Setting The study was conducted at tertiary care referral centers. Patients Sixty-four patients with severe to profound hearing loss (≥70 dB bilaterally), who were scheduled for cochlear implant (CI) surgery, were enrolled. The patients included 19 with congenital hearing loss and 45 with acquired hearing loss. Interventions Participants underwent CI surgery. Before surgery, high-resolution three-dimensional T1-weighted brain MRI was performed, and the images were analyzed using FreeSurfer. Main Outcome Measures The primary outcome was monosyllable audibility under quiet conditions 6 months after surgery. Cortical thickness residuals within 34 regions of interest (ROIs) as per the Desikan-Killiany cortical atlas were calculated based on age and healthy-hearing control regression lines. Results Rank logistic regression analysis detected significant associations between CI effectiveness and five right hemisphere ROIs and five left hemisphere ROIs. Predictive modeling using the cortical thickness of the right entorhinal cortex and left medial orbitofrontal cortex revealed a significant correlation with speech discrimination ability. This correlation was higher in patients with acquired hearing loss than in those with congenital hearing loss. Conclusions Preoperative surface-based morphometry could potentially predict CI outcomes and assist in patient selection and clinical decision making. However, further research with larger, more diverse samples is necessary to confirm these findings and determine their generalizability.

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Natural history of hearing and tumor growth in vestibular schwannoma in neurofibromatosis type 2-related schwannomatosis

Wakabayashi T., Tamura R., Karatsu K., Hosoya M., Nishiyama T., Inoue Y., Ogawa K., Kanzaki J., Toda M., Ozawa H., Oishi N.

European Archives of Oto-Rhino-Laryngology （European Archives of Oto-Rhino-Laryngology）  281 （ 8 ） 4175 - 4182 2024年

ISSN  09374477

　概要を見る

Objectives: To determine the natural history of hearing loss and tumor volume in patients with untreated neurofibromatosis type 2 (NF2)-related schwannomatosis. Moreover, we statistically examined the factors affecting hearing prognosis. Methods: This retrospective cohort study was conducted on 37 ears of 24 patients with NF2-related vestibular schwannomatosis followed up without treatment for more than 1 year. We obtained detailed chronological changes in the PTA and tumor volume in each case over time, and the rate of change per year was obtained. Multivariate analysis was also conducted to investigate factors associated with changes in hearing. Results: The average follow-up period was approximately 9 years, and hearing deteriorated at an average rate of approximately 4 dB/year. The rate of maintaining effective hearing decreased from 30 ears (81%) at the first visit to 19 ears (51%) at the final follow-up. The average rate of change in tumor growth for volume was approximately 686.0 mm3/year. This study revealed that most patients with NF2 experienced deterioration in hearing acuity and tumor growth during the natural course. A correlation was observed between an increase in tumor volume and hearing loss (r = 0.686; p < 0.001). Conclusions: Although the hearing preservation rate in NF2 cases is poor with the current treatment methods, many cases exist in which hearing acuity deteriorates, even during the natural course. Patients with an increased tumor volume during the follow-up period were more likely to experience hearing deterioration. Trial registration number 20140242 (date of registration: 27 October 2014).

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Development of cochlear spiral ligament fibrocytes of the common marmoset, a nonhuman model animal

Hosoya M., Iwabu K., Kitama T., Nishiyama T., Oishi N., Okano H., Ozawa H.

Scientific Reports （Scientific Reports）  13 （ 1 ） 11789 - 11789 2023年12月

　概要を見る

Spiral ligament fibrocytes generate potassium gradients, which hair cells require to convert mechanical sound waves into electrical palsy. Together with the stria vascularis, they regulate endolymph electrolyte homeostasis. Developing spiral ligament fibrocytes and generating endocochlear potential with an appropriate endolymph ion composition are essential for hearing. Understanding spiral ligament fibrocyte development is useful for studying age-related and genetic hearing loss, as well as for regenerative therapy and cochlear immunology. Despite interspecies differences, most studies of cochlear development have been conducted in rodent models due to the difficulty of using human fetal samples. This study investigated the cochlear development of spiral ligament fibrocytes in a small New World monkey species, the common marmoset (Callithrix jacchus). We examined the developmental expression of specific genes in spiral ligament fibrocytes, including those essential for the generation of endolymphatic potential. Our results showed that this animal model of spiral ligament fibrocyte development is similar to that of humans and is a suitable alternative for the analysis of human cochlear development. The time course established in this study will be useful for studying the primate-specific developmental biology of the inner ear, which may lead to novel treatment strategies for human hearing loss.

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A novel intraoperative continuous monitoring method combining dorsal cochlear nucleus action potentials monitoring with auditory nerve test system

Hosoya M., Nagaoka Y., Wakabayashi T., Shimanuki M.N., Nishiyama T., Ueno M., Ozawa H., Oishi N.

Journal of Otolaryngology - Head and Neck Surgery （Journal of Otolaryngology - Head and Neck Surgery）  52 （ 1 ） 67 - 67 2023年12月

ISSN  1916-0208

　概要を見る

Highly accurate real-time cochlear nerve monitoring to preserve cochlear nerve function is essential for simultaneous cochlear implantation and ipsilateral vestibular schwannoma resection. In the present study, we developed a novel real-time monitoring system that combines dorsal cochlear nucleus action potential monitoring with intracochlear stimulating electrodes (Auditory Nerve Test System, ANTS). We used this system for a case with vestibular schwannoma resection via the translabyrinthine approach. The monitoring system developed in this study detected highly reliable evoked potentials from the cochlear nerve every two seconds continuously during tumor resection. Near-total tumor resection was achieved, and cochlear implantation was performed successfully after confirming the preservation of cochlear nerve function in a case. The patient’s hearing was well compensated by cochlear implantation after surgery. Our novel method continuously achieved real-time monitoring of the cochlear nerve every two seconds during vestibular schwannoma resection. The usefulness of this monitoring system for simultaneous tumor resection and cochlear implantation was demonstrated in the present case. The system developed in this study is compatible with continuous facial nerve monitoring. This highly accurate and novel monitoring method will broaden the number of candidates for this type of surgery in the future.

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Effective cochlear implantation for idiopathic hypertrophic pachymeningitis with bilateral profound hearing loss: A case report

Idei K., Kitamura M., Shimanuki M.N., Hosoya M., Tsuzuki N., Hasebe N., Nishiyama T., Ozawa H., Oishi N.

Medicine (United States) （Medicine (United States)）  102 （ 47 ） e36124 2023年11月

ISSN  00257974

　概要を見る

Rationale: Hypertrophic pachymeningitis (HP) is a local or diffuse fibrous thickness of the dura mater of the brain or spinal cord, caused by infection or connective tissue disease. Headache is the most common clinical symptom, followed by various cranial nerve disorders such as visual impairment, diplopia, and hearing loss. HP can be classified into secondary and idiopathic. Here, we report a case of bilateral progressive profound sensorineural hearing loss diagnosed in a patient with idiopathic HP, where a cochlear implant was effectively used. Patient concerns: The patient was a 77-year-old woman. Hearing loss gradually progressed bilaterally, and magnetic resonance imaging showed a space-occupying lesion with a continuous contrast enhancement in the bilateral internal auditory canals, and diffused dural thickening from the middle to the posterior cranial fossa. Diagnoses: A trans-labyrinthine biopsy was conducted, and a definite diagnosis of idiopathic HP was made. Thickening of the dura mater in the bilateral internal auditory canals was thought to cause profound hearing loss. Interventions and outcomes: A cochlear implant was implemented 4 months after biopsy, and a favorable hearing response was obtained postoperatively. Lessons: This is the first report of a cochlear implant in a patient with idiopathic HP. Cochlear implantation was considered a good treatment for profound hearing loss due to idiopathic HP, which provides a reference for patients to receive timely and correct treatment.

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小児滲出性中耳炎に対する短期留置型鼓膜換気チューブの効果

利國 桂太郎, 西山 崇経, 羽生 昇, 富永 健裕, 石川 直明, 若林 毅, 中村 伸太郎, 北村 充, 大石 直樹, 小澤 宏之

日本耳鼻咽喉科頭頸部外科学会会報 （(一社)日本耳鼻咽喉科頭頸部外科学会）  126 （ 11 ） 1229 - 1234 2023年11月

ISSN  2436-5793

　概要を見る

難治化リスクを伴わない小児滲出性中耳炎の初回鼓膜チューブ挿入術において,ガイドラインでは短期留置型チューブを第一選択として推奨している.今回,短期留置型鼓膜チューブ(D型)を用いて鼓膜チューブ挿入術を行った15歳未満の小児69例122耳を対象とし,再発率,穿孔残存率,感染率について,留置期間や中耳貯留液の性状,血清学的指標との関連について検討した.平均留置期間は15.7ヵ月で,再発率は13.1%,穿孔率は6.0%,感染率は7.4%であった.再発の有無での2群間比較を行うと,再発なし群で有意に留置期間が長かった.また,血清学的指標と中耳貯留液の性状,再発率の間に明らかな傾向は認めなかった.(著者抄録)

A Case of Vestibular Schwannoma with Deafness Showing Remarkable Hearing Recovery Following Hearing-Preserving Surgery

Sakaki Y., Hosoya M., Nishiyama T., Wakabayashi T., Shimanuki M.N., Ozawa H., Oishi N.

Journal of International Advanced Otology （Journal of International Advanced Otology）  19 （ 5 ） 426 - 430 2023年09月

ISSN  13087649

　概要を見る

Surgery for vestibular schwannoma can be divided into hearing-preserving and nonhearing-preserving surgeries. Hearing-preserving surgery is usually not considered in patients with deafness due to vestibular schwannoma, because hearing is unlikely to improve, and surgery aims to maximize the tumor resection at the expense of hearing. We report an extremely rare case of a 46-year-old man with unilateral profound hearing loss due to a vestibular schwannoma with marked cystic degeneration in the left cistern, which significantly recovered to near-normal hearing levels after hearing-preserving surgery. Hearing loss gradually worsened, and preoperative pure-tone evaluation showed complete hearing loss in the left ear. However, the response to the distortion product otoacoustic emission was preserved, and hearing loss was considered to be retrocochlear. Tumor resection was performed using the retrolabyrinthine approach with continuous monitoring using dorsal cochlear nucleus action potential, auditory brainstem response, and facial nerve function muscle action potential. The cistern portion of the tumor was almost completely resected along with the wall. Postoperatively, the pure-tone threshold on the left side markedly improved. The present case clearly demonstrates the possibility of hearing recovery in patients with retrocochlear hearing loss. We should consider expanding the indications for hearing-preserving surgery.

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Imaging of Temporal Bone Mass Lesions: A Pictorial Review

Shimanuki M.N., Nishiyama T., Hosoya M., Wakabayashi T., Ozawa H., Oishi N.

Diagnostics （Diagnostics）  13 （ 16 ）  2023年08月

ISSN  2075-4418

　概要を見る

Tumoral lesions of the temporal bone include benign or malignant tumors and congenital or inflammatory lesions. Temporal bone lesions are difficult to approach. Therefore, making a preoperative diagnosis and considering whether the lesions require treatment are necessary; if they require treatment, then the type of treatment requires consideration. These tumors cannot be observed directly and must be diagnosed based on symptoms and imaging findings. However, the differentiation of temporal bone lesions is difficult because they are rare and large in variety. In this pictorial review, we divided temporal bone lesions by location such as along the facial nerve, along the internal jugular vein, around the endolymphatic sac, in the internal auditory canal/cerebellopontine angle, petrous apex, middle ear, and mastoid, focusing on the imaging findings of temporal bone lesions. Then, we created a diagnostic flowchart that suggested that the systematic separation of imaging findings is useful for differentiation. Although it is necessary to make comprehensive judgments based on the clinical symptoms, patient background, and imaging findings to diagnose temporal bone mass lesions, capturing imaging features can be a useful differentiation method.

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Transferability Based on Drug Structure Similarity in the Automatic Classification of Noncompliant Drug Use on Social Media: Natural Language Processing Approach.

Nishiyama T, Yada S, Wakamiya S, Hori S, Aramaki E

Journal of medical Internet research 25   e44870 2023年05月

ISSN  1439-4456

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Apoptosis of type I spiral ganglion neuron cells in Otof-mutant mice

Tsuzuki N., Namba K., Saegusa C., Mutai H., Nishiyama T., Oishi N., Matsunaga T., Fujioka M., Ozawa H.

Neuroscience Letters （Neuroscience Letters）  803   137178 - 137178 2023年04月

ISSN  03043940

　概要を見る

Otof, which encodes otoferlin, knockout mice are considered model mice for auditory neuropathy spectrum disorder, which is characterized by an absent auditory brainstem response (ABR) despite preserved distortion product otoacoustic emission (DPOAE). Although otoferlin-deficient mice lack neurotransmitter release at the inner hair cell (IHC) synapse, it remains unclear how the Otof mutation affects spiral ganglions. Thus, we used Otof-mutant mice carrying the Otoftm1a(KOMP)Wtsi allele (Otoftm1a) and analyzed spiral ganglion neurons (SGNs) in Otoftm1a/tm1a mice by immunolabeling type Ⅰ SGNs (SGN-Ⅰ) and type II SGNs (SGN-II). We also examined apoptotic cells in SGNs. Four-week-old Otoftm1a/tm1a mice had an absent ABR but normal DPOAEs. The number of SGNs was significantly lower in Otoftm1a/tm1a mice on postnatal day 7 (P7), P14, and P28 compared with that of wild-type mice. Moreover, significantly more apoptotic SGNs were observed in Otoftm1a/tm1a mice than in wild-type mice on P7, P14, and P28. SGN-IIs were not significantly reduced in Otoftm1a/tm1a mice on P7, P14, and P28. No apoptotic SGN-IIs were observed under our experimental conditions. In summary, Otoftm1a/tm1a mice showed a reduction in SGNs accompanied by apoptosis of SGN-Ⅰs even before the onset of hearing. We speculate that the reduction in SGNs with apoptosis is a secondary defect caused by a lack of otoferlin in IHCs. Appropriate glutamatergic synaptic inputs may be important for the survival of SGNs.

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Bell麻痺・Hunt症候群に対する経乳突顔面神経減荷術　手術による治療効果と聴力への影響

須田 悟史, 都築 伸佳, 大石 直樹, 西山 崇経, 細谷 誠, 若林 毅, 神崎 晶, 小澤 宏之

Otology Japan （(一社)日本耳科学会）  33 （ 1 ） 42 - 49 2023年02月

ISSN  0917-2025

　概要を見る

末梢性顔面神経麻痺に対する顔面神経減荷術は,その有効性について統一した見解は得られておらず,術後難聴の可能性も指摘されている.今回,当科で診療したBell麻痺・Hunt症候群のうち,ENoG値≦10%等の所見から重症例と診断され,治癒もしくは発症後6ヵ月以上経過観察可能であった48例(Bell麻痺:33例,Hunt症候群:15例)を対象として,経乳突顔面神経減荷術の治療成績および術後聴力閾値変化について検討した.治癒率について両疾患の手術群と保存加療群を比較し,Bell麻痺では有意差は見られなかったが[手術群(n=18):44.4%vs保存加療群(n=15):33.3%,p=0.52],Hunt症候群においては顔面神経減荷術の有効性が示唆された[手術群(n=9):66.7%vs保存加療群(n=6):0%,p=0.02].また術後は気導聴力で0.25,0.5,2,4,8kHz,骨導聴力では2,4kHzにおいて5～15dB程度の閾値上昇を来たす可能性が示された.本研究の限界として少数例の検討であることが挙げられ,今後の課題と考えている.(著者抄録)

Vestibular Schwannoma Surgery with Endoscope-Assisted Retrolabyrinthine Approach under Modified Reinforced Continuous Intraoperative Monitoring for Hearing Preservation: Experience of 33 Cases in a Single Center

Hosoya M., Nishiyama T., Wakabayashi T., Shimanuki M.N., Miyazaki H., Ozawa H., Oishi N.

Diagnostics （Diagnostics）  13 （ 2 ）  2023年01月

ISSN  2075-4418

　概要を見る

Surgery for vestibular schwannoma includes various techniques such as the middle cranial fossa, suboccipital, translabyrinthine, and retrolabyrinthine approaches. The retrolabyrinthine approach does not impair the labyrinth and allows postoperative hearing preservation. Previously, we reported an endoscope-assisted retrolabyrinthine approach under reinforced continuous intraoperative monitoring for preservation of hearing and facial nerve function. However, the hearing preservation rate was relatively low in patients with long-wave V latency in the auditory brainstem response or poor otoacoustic emission response under this approach. Thus, the hearing preservation rate in such patients remains to be improved. To overcome this limitation, we modified the previous approach. In 26 of the 33 consecutive cases (79%) over the last three years, preservation of hearing equivalent to that before surgery or improved hearing was achieved. Postoperative deafness was observed in only two of the 33 cases (6%). According to previous reports, the rate of hearing preservation using the retrolabyrinthine approach is approximately 30–50%. Therefore, we have achieved a higher hearing preservation rate than that previously reported using the endoscopy-assisted retrolabyrinthine approach under reinforced continuous intraoperative monitoring. These improvements in our department are considered to be helpful for hearing preservation.

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Intracochlear signal in FIESTA-C and hearings of patients with cerebellopontine angle schwannoma

Kitamura M., Oishi N., Nishiyama T., Hosoya M., Hasebe N., Tsuzuki N., Ogawa K.

Acta Oto-Laryngologica （Acta Oto-Laryngologica）  143 （ 1 ） 19 - 23 2023年

ISSN  00016489

　概要を見る

Background: Hearing loss in patients with cerebellopontine angle (CPA) schwannoma, is thought to be caused by the damage to the cochlea and the cochlear nerve. Aim: This study aimed to examine the relationships between the intracochlear signal in magnetic resonance imaging (MRI) and hearing in patients with CPA schwannoma. Material and method: In 79 patients with CPA schwannoma, we retrospectively examined the signal in the cochlea on the affected side was compared with that on the unaffected side to determine signal degradation in fast imaging reagents steady-state acquisition with cycle phases (FIESTA-C) MRI. For hearing evaluation, pure tone audiometry (PTA), speech audiometry, distortion product otoacoustic emissions (DPOAE), and auditory brainstem response (ABR) were used. For each parameter, we examined the differences between the groups with and without signal degradation. Results: In the hearing test results, the I-wave latency of ABR was significantly longer in the group with signal degradation in FIESTA-C (1.84 ± 0.35 msec vs. 2.04 ± 0.37 msec, p = 0.048). There was no statistically significant difference in other tests. Conclusion: The MRI signal changes in the cochlear were related to the I-wave latency of ABR and reflected cochlear function. Significance: We suggested the cochlear signal changes in CPA schwannoma patients related the hearing.

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Distribution of macrophages in the developing cochlea of the common marmoset, a primate model animal

Hosoya M., Kitama T., Shimanuki M.N., Nishiyama T., Oishi N., Okano H., Ozawa H.

Frontiers in Immunology （Frontiers in Immunology）  14   1229414 - 1229414 2023年

　概要を見る

Introduction: Macrophages are essential immune cells in the cochlea that contribute to inflammation, tissue repair, and homeostasis. They also play an important role in local cochlear immunity. The developmental immigration and maturation of macrophages in the cochlea have been investigated and are considered essential for normal hearing acquisition. Most of our current knowledge regarding cochlear development is based on rodent models because of the ethical challenges of using human fetal samples for research. However, inter-species differences between rodents and humans have been reported. In this study, we used a primate animal model to investigate the distributions of macrophages in the developing cochlea. The common marmoset (Callithrix jacchus), a small monkey species that inhabits the New World, was used as the model. Methods: We investigated the distribution of macrophages in the developing cochlea of the common marmoset by performing immunohistochemical analyses of cochlear tissue from common marmoset embryos at different development stages. Results: We revealed detailed distribution changes in the macrophages of a primate animal model cochlea. This observation indicates that most of the changes in the general distribution of macrophages were well preserved between rodents and this primate. The distribution changes observed in the common marmoset were also compatible with observations in the human fetus; although, observations in the human fetus are limited. Our observations in this study also revealed several differences between common marmosets and rodents. Conclusion: The time course of immunological development and maturations established in this study will aid in the study of the primate-specific developmental biology of the inner ear. These observations may eventually lead to new therapeutic strategies for hearing loss in humans. In addition, understanding the immunological steady-state of the cochlea may help in the study of age- and genetic-induced hearing loss and in the design of regenerative therapies.

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Bilateral Deafness Due to Relapsing Polychondritis with Semicircular Canal Calcification Treated With Cochlear Implantation: A Case Report

Arashi K., Nishiyama T., Hosoya M., Tsuzuki N., Wakabayashi T., Ozawa H., Oishi N.

Ear, Nose and Throat Journal （Ear, Nose and Throat Journal）     1455613231215173 - 1455613231215173 2023年

ISSN  01455613

　概要を見る

Relapsing polychondritis (RP) is a rare chronic inflammatory disease characterized by recurrent inflammation of cartilages throughout the body, with treatment-resistant dizziness and hearing loss in 40%-50% of patients with RP. Although rare, severe binaural hearing loss in RP is an indication for cochlear implantation (CI). Therefore, there are only a few reports on CI insertion in cases of RP. This report describes a 68-year-old woman who developed binaural hearing loss due to RP. She was treated with steroids and immunosuppressive drugs; however, her hearing did not improve significantly, and she relied on written communication for conversation. Subsequently, the patient underwent CI in the right ear. The patient showed improvement in speech perception; at 14 months postoperatively, she was able to speak with lipreading, and at 2 years postoperatively, she was able to speak without lipreading. Previous case reports on CI in patients with RP have shown varying degrees of postoperative hearing improvement. Our case demonstrates the effectiveness of CI in improving hearing and speech recognition in patients with RP having semicircular canal calcification. However, previous reports have shown that speech recognition declines 13 years after CI for RP. Therefore, continuous long-term follow-up is necessary.

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Development of the stria vascularis in the common marmoset, a primate model

Hosoya M., Kitama T., Iwabu K., Nishiyama T., Oishi N., Okano H., Ozawa H.

Scientific Reports （Scientific Reports）  12 （ 1 ） 19811 - 19811 2022年12月

　概要を見る

Stria vascularis is a structure that generates potassium gradients in the cochlea, which is vital for hair cells to convert mechanical sound waves into electrical pulses. The precise development of the stria vascularis and subsequent generation of endocochlear potential are thus essential for hearing. Understanding the development of the stria vascularis is valuable for studying hearing loss caused by aging or genetics and designing regenerative therapy. Although inter-species differences have been reported between rodents and humans, most of our current knowledge regarding cochlear development has been obtained from rodent models because of the difficulty in using human fetal samples in this field of research. Therefore, we investigated the development of the cochlear stria vascularis in the common marmoset (Callithrix jacchus), a small monkey species native to the New World. Our study confirms that stria vascularis development in the common marmoset is similar to that in humans and is suitable for furthering our understanding of human cochlear development. The time course established in this report will aid in studying the primate-specific developmental biology of the inner ear, which could eventually lead to new treatment strategies for hearing loss in humans.

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Comparison of Cartilage Conduction Hearing Aid, Bone Anchored Hearing Aid, and ADHEAR: Case Series of 6 Patients with Conductive and Mixed Hearing Loss

Kitama T., Nishiyama T., Iwabu K., Wakabayashi T., Shimanuki M.N., Hosoya M., Oishi N., Ozawa H.

Applied Sciences (Switzerland) （Applied Sciences (Switzerland)）  12 （ 23 ）  2022年12月

　概要を見る

Cartilage conduction hearing aids (CC-HA), bone anchored hearing aids (Baha), and ADHEAR are good choices to improve hearing in patients who cannot use air conduction hearing aids because of aural atresia or continuous otorrhea. As there are many overlaps in the characteristics of these devices, we conducted a comparative trial of CC-HA, Baha, and ADHEAR. We provided patients with the opportunity to select their devices. The data of 6 patients who underwent comparative trials in our department between October 2021 and August 2022 were retrospectively examined. The gains of Baha and CC-HA outweighed those of ADHEAR. Regarding the sound localization test, there was no significant tendency for any of the hearing devices. Regarding the Glasgow Benefit Inventory, there was no clear tendency among the three devices in the quality of life evaluation. The most satisfactory model was the one subjectively chosen by the patient, regardless of the gain and score of the sound source localization test. Therefore, we believe that it is necessary to provide an opportunity for comparative trials and a consultation with each patient in the process of selecting a device.

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Association between atherosclerosis, hearing recovery, and hearing in the healthy ear in idiopathic sudden sensorineural hearing loss: a retrospective chart analysis

Tsuzuki N., Wasano K., Oishi N., Hentona K., Shimanuki M., Nishiyama T., Hiraga Y., Ueno M., Suzuki N., Shinden S., Ogawa K., Ozawa H.

Scientific Reports （Scientific Reports）  12 （ 1 ） 21571 - 21571 2022年12月

　概要を見る

Atherosclerosis is reported to be a risk factor for the severity of idiopathic sudden sensorineural hearing loss (ISSNHL). We evaluated the hypothesis that atherosclerosis affects the hearing thresholds of both the affected and healthy sides of ISSNHL patients. We conducted multivariate analyses on retrospectively collected data of patients with ISSNHL (N = 762) to evaluate the relationship between known factors linked to atherosclerosis and hearing thresholds on affected and healthy sides and whether these factors are prognostic for hearing recovery. Older ages, vertigo or dizziness, diabetes mellitus, and congestive heart failure were significantly related to higher hearing thresholds on the affected side. Older ages, male, and vascular disease were significantly related to higher hearing thresholds on the healthy side. Vertigo or dizziness, severe hearing loss and hearing loss at high frequencies on the affected side, higher hearing thresholds on the healthy side, regular anticoagulant medication, and delayed steroid treatment were significantly related to lack of recovery. Since several atherosclerosis-related factors are associated with higher hearing thresholds on both affected and healthy sides in ISSNHL and higher hearing thresholds on the healthy side predict poorer prognosis, diagnosis, and predicting prognosis of ISSNHL may benefit from rigorous evaluation of patients’ cardiovascular comorbidities and hearing levels on both the healthy and affected sides.

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症例をどうみるか　内頸動静脈の露出を伴う先天性真珠腫症例に対する耳後部切開併用内視鏡下摘出術

西山 崇経, 大石 直樹, 若林 毅, 北間 翼, 細谷 誠, 小澤 宏之

JOHNS （(株)東京医学社）  38 （ 10 ） 1403 - 1406 2022年10月

ISSN  0910-6820

　概要を見る

症例は8歳男児で、5ヵ月ほど前より右耳漏が出現し、近医で耳処置を行った際に真珠腫上皮を認め、側頭骨CTで内頸動脈と頸静脈球の露出を伴う先天性真珠腫が疑われたため当科紹介受診となった。経過と画像所見より、内頸動脈と高位頸静脈球の露出を伴う前鼓室の先天性真珠腫の診断となった。内視鏡下経外耳道アプローチにて手術を行うこととし、術中所見では真珠腫の上方は耳管鼓室口下端、下方は前鼓室下端まで進展していた。真珠腫上皮を母膜の連続性を保ちながら剥離して適宜減量した。前下方の真珠腫上皮を摘出するために、骨性鼓膜輪前下方と外耳道入口部を必要に応じて削開し視野と操作野を作成した。最終的に内頸動脈壁が2ヶ所露出しており、母膜の連続性を保ちながら慎重に吸引管を用いて剥離・摘出した。術後はめまい、味覚障害、顔面神経麻痺を認めず、経過良好で術後2日目に退院となった。

外傷性アブミ骨陥入に対してアブミ骨摘出術後にアパセラムCを用いた伝音再建を行った1例

笠原 健, 西山 崇経, 中山 梨絵, 小澤 宏之

Otology Japan （(一社)日本耳科学会）  32 （ 3 ） 320 - 327 2022年09月

ISSN  0917-2025

　概要を見る

中耳外傷により耳小骨まで損傷が及ぶ例は多くなく、特にアブミ骨底板が卵円窓に陥入したという報告は外傷性耳小骨損傷の7.7%～19.0%と比較的少ない。今回、左耳かきによりアブミ骨が卵円窓へ陥入し外リンパ瘻を伴った症例を経験した。術前に55dBの混合性難聴を認め、激しいめまい症状を認めた。来院当日に手術加療を行い、術中はアブミ骨が卵円窓へ深く陥入し整復困難であったため摘出し、アパセラム耳小骨Cにて伝音再建を行った。術後めまいは速やかに改善し、聴力も徐々に改善した。アブミ骨の卵円窓への陥入が軽度な症例は、アブミ骨の整復のみで治療が可能という報告があるが、本症例のようにアブミ骨が深く卵円窓へ陥入している症例に関しては、アブミ骨摘出を伴う伝音再建術が必要となる。アブミ骨摘出を要する症例では術後聴力改善が得られない症例も少なくなく、術前から聴力予後が悪い可能性についての説明が重要であると考えられた。(著者抄録)

Intratemporal Facial Nerve Schwannomas: A Review of 45 Cases in A Single Center

Kitama T., Hosoya M., Noguchi M., Nishiyama T., Wakabayashi T., Shimanuki M.N., Yazawa M., Inoue Y., Kanzaki J., Ogawa K., Oishi N.

Diagnostics （Diagnostics）  12 （ 8 ）  2022年08月

ISSN  2075-4418

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There are no established indications for facial nerve schwannoma treatment, including surgery, radiation and follow-up observation, and it is difficult to determine treatment policy uniformly. The treatment policy was examined from each treatment course. Data of patients with facial nerve schwannomas at our hospital from 1987 to 2018 were retrospectively examined. Their age, sex, clinical symptoms, tumor localization, treatment policies and outcomes were reviewed. In total, 22 patients underwent surgery and 1 patient underwent radiotherapy; 22 patients were followed up without treatment. After total resection, there were no tumor recurrences, and most patients had grade 3 or 4 postoperative facial paralysis. After subtotal resection, tumor regrowth was observed in four patients and reoperation was required in two patients. Facial nerve function was maintained in four patients and was decreased in two patients. During follow-up, six patients showed tumor growth. Only one patient had worsening facial nerve paralysis; four patients underwent facial nerve decompression owing to facial nerve paralysis during follow-up. If the tumor compresses the brain or it is prone to growth, surgery may be indicated, and when the preoperative facial nerve function is grade ≤ 3, consideration should be given to preserving facial nerve function and subtotal resection should be indicated. If the preoperative facial nerve function is grade ≥ 3, total resection with nerve grafting is an option to prevent regrowth. If there is no brain compression or tumor growth, the follow-up is a good indication, and decompression should be considered in facial nerve paralysis cases.

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A novel auricular prosthesis which incorporates a cartilage conduction hearing aid based on 3D data processing technique: a preclinical evaluation

Nishiyama T., Hayashi S., Oishi N.

European Archives of Oto-Rhino-Laryngology （European Archives of Oto-Rhino-Laryngology）  279 （ 7 ） 3741 - 3744 2022年07月

ISSN  09374477

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Purpose: To achieve the challenging goal of simultaneously improving aesthetics and auditory function in the treatment of microtia, we developed an auricular prosthesis incorporating a cartilage conduction hearing aid (APiCHA), which covers a cartilage conduction hearing aid (CC-HA). We evaluated the acoustic characteristics generated by the method of combining these two components using an artificial mastoid and investigated the possibility of clinical translation. Methods: The first step in creating an APiCHA is to take molds of both the affected and normal auricles and invert the 3D data of the normal auricle to create data for the auricular prostheses. Grooves were then made inside the prosthetic data to fit the affected ear and a CC-HA, and the APiCHA was made of silicone. The acoustic characteristics were measured using an artificial mastoid, and the results were compared between CC-HA alone and with APiCHA. Results: Compared with CC-HA alone, the gain was approximately 2 dB lower at high frequencies from 1 k Hz and higher, and approximately 2 dB higher at approximately 900 Hz when CC-HA was used with APiCHA. For the other frequencies, the acoustic characteristics were almost the same. Conclusion: The changes in acoustic characteristics caused by the combined use of APiCHA and CC-HA were minimal and did not pose a clinical problem. The combined use of APiCHA and CC-HA can be considered as a non-invasive and clinically applicable treatment option to achieve both aesthetic and auditory improvements for microtia.

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Understanding the Molecular Mechanism of Vestibular Schwannoma for Hearing Preservation Surgery: Otologists’ Perspective from Bedside to Bench

Hosoya M., Wakabayashi T., Wasano K., Nishiyama T., Tsuzuki N., Oishi N.

Diagnostics （Diagnostics）  12 （ 5 ）  2022年05月

ISSN  2075-4418

　概要を見る

Vestibular schwannoma is a clinically benign schwannoma that arises from the vestibulocochlear nerve that causes sensorineural hearing loss. This tumor is clinically and oncologically regarded as a benign tumor as it does not metastasize or invade surrounding tissues. Despite being a benign tumor, its management is difficult and controversial due to the potential serious complications, such as irreversible sensorineural hearing loss, of current interventions. Therefore, preventing hearing loss due to the natural course of the disease and complications of surgery is a challenging issue for an otologist. Improvements have been reported recently in the treatment of vestibular schwannomas. These include advances in intraoperative monitoring systems for vestibular schwannoma surgery where the risk of hearing loss as a complication is decreased. Precise genomic analysis of the tumor would be helpful in determining the characteristics of the tumor for each patient, leading to a better hearing prognosis. These procedures are expected to help improve the treatment of vestibular schwannomas. This review summarizes recent advances in vestibular schwannoma management and treatment, especially in hearing preservation. In addition, recent advances in the understanding of the molecular mechanisms underlying vestibular schwannomas and how these advances can be applied in clinical practice are outlined and discussed, respectively. Moreover, the future directions from the bedside to the bench side are presented from the perspective of otologists.

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術後咽頭皮膚瘻に対するパウチ法を用いた管理の有用性

松居 祐樹, 西山 崇経, 今西 順久, 重冨 征爾, 佐藤 陽一郎, 猪狩 雄一, 五島 可奈子, 笠原 健, 小澤 宏之

日本耳鼻咽喉科頭頸部外科学会会報 （(一社)日本耳鼻咽喉科頭頸部外科学会）  125 （ 3 ） 271 - 278 2022年03月

ISSN  2436-5793

　概要を見る

縫合不全に伴う唾液漏出は頭頸部術後合併症の一つであり,救済処置として咽頭皮膚瘻を形成し二期的閉鎖を目指すことが多く,創部が安定し閉鎖術が行えるまでの期間は瘻孔からの唾液管理を要する.瘻孔に軟膏ガーゼを充填し,さらに上からガーゼで圧迫し,気管孔にカフ付きカニューレを留置する方法(以後,「従来法」)が一般的だが,度重なるガーゼと貼付テープの交換による疼痛や皮膚障害,カニューレ刺激による喀痰量増加,咳嗽誘発など患者負担が大きい.近年,患者負担軽減のためにさまざまな方法が報告されているが,咽頭皮膚瘻特有の構造的および性状的な問題点を解決できない例もあり,最適なパッキング方法とは言い難い.今回われわれは採尿バッグやストマパウチと粘土状皮膚保護剤を組み合わせた方法(以後,「パウチ法」)による管理を行った.パウチ法は粘土状皮膚保護剤による土手の成形と,パウチの面板の切り取り面積の調整により,瘻孔径を問わずさまざまな症例に柔軟に対応することができる汎用性の高い方法と考えられた.また,全例で交換頻度は3～4日毎,皮膚障害は軽度まで,カニューレは不要だった.パウチ法は従来法の欠点を補い,患者負担を軽減することができる方法だった.パウチ法の運用は,パウチ内に貯留する唾液管理は患者自身で対応可能であり,使用資材の取り扱いはストマ専従ナースとの協力が重要だった.(著者抄録)

Factors Influencing the Purchase Rate of Cartilage Conduction Hearing Aids

Nishimura T., Hosoi H., Sugiuchi T., Matsumoto N., Nishiyama T., Kenichi T., Sugimoto S., Yazama H., Sato T., Komori M.

Journal of the American Academy of Audiology （Journal of the American Academy of Audiology）  33 （ 1 ） 14 - 22 2022年01月

ISSN  10500545

　概要を見る

Background: Innovated hearing aids (HAs), termed cartilage conduction hearing aids (CC-HAs), show good performance in patients with closed ears and continuous otorrhea. However, factors other than the ear condition that influence the purchase rate of CC-HAs remain unclear. Purpose: To identify the factors that influence the purchase rate of CC-HAs. Research Design: A correlational study. Study Sample: A total of 249 patients were enrolled. Data Collection and Analysis: The patients' demographics, clinical characteristics, outcomes, and CC-HA transducer types were compared. The data were analyzed for six groups classified based on the ear condition. Results: In the unilateral closed-ear group, the purchase cases were significantly younger than the nonpurchase cases (p < 0.05). Regarding the outcomes in the bilateral closed-ear group, the purchase cases showed significantly better-aided thresholds at 0.25 and 0.5 kHz than the nonpurchase cases. No significant differences in the functional gains and speech recognition scores were found between purchase and nonpurchase cases in all six groups. Regarding the transducer type, the continued-use rate of the simple transducer type was significantly lower in the bilateral chronic continuous otorrhea, bilateral open, and unilateral open groups. Conclusion: In the closed ears, no remarkable negative factors were found. Transducer type had a significant influence on the continued-use rate in the nonclosed ears including the ears with chronic continuous otorrhea, although the purchase rate of CC-HAs in the bilateral chronic continuous otorrhea group was comparable to the closed ears.

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A rare case of external ear canal stenosis caused by COVID-19-related arterial thrombosis

Hosoya M., Minami A., Nishiyama T., Tsuzuki N., Wakabayashi T., Oishi N.

Ear, Nose and Throat Journal （Ear, Nose and Throat Journal）  103 （ 1_suppl ） 1455613221097198 - 1455613221097198 2022年

ISSN  01455613

　概要を見る

Thrombosis is a characteristic symptom of coronavirus disease 2019 (COVID-19). Here, we present a case of external ear stenosis caused by arterial thrombosis after COVID-19 infection. To the best of our knowledge, this is the first report of external ear stenosis related to COVID-19. A 62-year-old man presented with left hearing loss. The patient had a history of hospitalization for COVID-19 treatment 11 months prior to visiting our hospital. He had been experiencing ear fullness and tinnitus after COVID-19 treatment. Physical examination revealed severe left external ear canal stenosis with a subcutaneous mass. Surgical removal of the subcutaneous mass was performed. Histopathological analysis revealed that a subcutaneous thrombosis caused the external ear canal stenosis. This case describes an unusual case of external ear canal stenosis after COVID-19. Clinical and pathological findings indicate that COVID-19 affected the external ear canal. In addition, histopathological results confirmed the formation of arterial thrombosis in the temporal bone region after COVID-19 treatment. This case shows the broad range of body sites that can be involved with thrombotic events with COVID including the subcutaneous tissue around the outer ear. This observation would be helpful in investigating or explaining the various otological symptoms of COVID-19.

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Cricotracheostomy in a patient with severe kyphosis: A case report

Kasahara K., Nishiyama T., Shigetomi S., Ikari Y., Matsui Y., Ozawa H.

Ear, Nose and Throat Journal （Ear, Nose and Throat Journal）  103 （ 11 ） 1455613221077596 - 1455613221077596 2022年

ISSN  01455613

　概要を見る

Cricotracheostomy is a useful surgical procedure for opening the airway in cases where conventional tracheotomy is difficult. This is a safe and easy technique involving removal of the anterior portion of the cricoid cartilage. Herein, we report the case of a patient with difficulty in neck extension due to severe kyphosis, who underwent cricotracheostomy. A 65-year-old woman developed dyspnea and was transported to our hospital. SpO2 was 60% (room air) and endotracheal intubation was performed. She was managed on ventilator. However, weaning off the ventilator was difficult, and endotracheal intubation was prolonged. Subsequently, the patient was referred to us for a tracheostomy. The patient was unable to maintain the supine position due to severe kyphosis, and computed tomography revealed that the brachiocephalic artery was running just below the thyroid gland. Therefore, conventional tracheostomy was difficult to perform, and we performed cricotracheostomy instead. After the cricotracheostomy, there were no tracheal problems, such as tracheal stenosis and stomal hemorrhage. Cricotracheostomy can be performed in cases where multiple anatomical difficulties may be faced in the tracheostomy site, as in this case. Furthermore, cricotracheostomy is beneficial for long-term airway management because it causes fewer complications compared to conventional tracheotomy.

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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 - 25 2021年12月

ISSN  1916-0208

　概要を見る

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.]

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Severe sudden sensorineural hearing loss related to risk of stroke and atherosclerosis

Tsuzuki N., Wasano K., Oishi N., Hentona K., Shimanuki M., Nishiyama T., Hiraga Y., Shinden S., Ogawa K.

Scientific Reports （Scientific Reports）  11 （ 1 ） 20204 - 20204 2021年12月

　概要を見る

The cause of idiopathic sudden sensorineural hearing loss (idiopathic SSNHL)—diagnosed after excluding other causes of hearing loss, such as SSNHL associated with vestibular schwannoma (VS)—is unknown. The presumed pathogenesis of idiopathic SSNHL includes circulatory disorders (e.g., cochlear infarction). We tested the hypothesis that patients with SSNHL who are at high stroke risk will have a lower rate of VS compared to those with low stroke risk. The rationale is that the primary cause of SSNHL in patients with high stroke risk might be a circulatory disturbance. We conducted a retrospective study in six hospitals. Our sampling of SSNHL patients included those diagnosed with idiopathic SSNHL and VS-associated SSNHL. SSNHL patients who had a head MRI were stratified by severity of hearing loss and evaluated for differences in the detection rate of VS between the high-scoring CHADS2 (CHADS2-H-), an index of stroke risk, and low-scoring CHADS2 (CHADS2-L-) groups. We identified 916 patients who met the inclusion criteria. For severe hearing loss, the CHADS2-H group had a significantly lower rate of VS than the CHADS2-L group (OR 0 [95% CI 0.00–0.612]; P = 0.007). These results indirectly support the hypothesis that a primary cause of severe idiopathic SSNHL in those at high risk of stroke might be a circulatory disorder.

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The Frequency Characteristic of Silicone Domes in Receiver in the Canal Hearing Aids

Ueno M., Shinden S., Suzuki D., Suzuki N., Nishiyama T., Oishi N., Ogawa K.

Journal of the American Academy of Audiology （Journal of the American Academy of Audiology）  32 （ 9 ） 556 - 561 2021年10月

ISSN  10500545

　概要を見る

Background There are several types of silicone domes in receiver in the canal hearing aids (RICs), which have different occlusion levels. However, the frequency characteristics of each type of silicone dome are unclear. Purpose This study aimed to determine the frequency characteristics of three types of silicone domes (open domes, double-type power domes, and tulip domes) in RICs. Research Design This is an interventional study. Study Sample In total, 11 participants with a normal sense of hearing were prospectively enrolled. Intervention Participants were fitted with hearing aids, which were adjusted to similar settings, and only the silicone domes were changed. The acoustic gain of hearing aids was adjusted to 20 dB in the range of 250 Hz to 4 kHz using the 2-cc coupler. Data Collection and Analysis We measured the real-ear aided gain (REAG) for each type of silicone dome. In each frequency, we statistically compared the REAG of each type of dome. Acoustic gain using the Open Fit coupler of each type of dome was also measured. Results The REAG was obtained with no leakage with open domes only at 2 kHz, and with tulip domes and double-type power domes in the range of 1 to 2 kHz. Double-type power domes obtained significantly higher REAG than tulip domes at 250 and 500 Hz. Under the Open Fit coupler, all types obtained higher acoustic gain than the REAG. Conclusion This study provides the analysis of the frequency characteristics of silicone domes in RICs. The highest degree of occlusion was observed in double-type power domes, followed by tulip domes, and the lowest was observed in open domes.

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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年08月

ISSN  1341321X

　概要を見る

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.

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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年06月

ISSN  09374477

　概要を見る

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.

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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 - 110628 2021年03月

ISSN  01655876

　概要を見る

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.

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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年03月

ISSN  0030-6622

　概要を見る

外耳道癌の確立した治療法はないが、切除可能例では手術が優先される。当院ではT1〜T3症例に手術、T4症例に化学放射線療法(CCRT)を選択してきた。側頭骨外側切除術は伝音難聴が必発のため聴覚機能が犠牲になるとされてきたが、術後補聴による聴覚の再獲得に取り組んでいる。当科での短期成績の検討を行った。2012年1月〜2018年6月に初回治療を行った外耳道癌21例22耳を対象とした。改訂Pittsburgh分類にてT1が4耳、T2が9耳、T3が6耳、T4が3耳だった。17耳に手術、5耳にCCRTか重粒子線治療を施行した。側頭骨外側切除術を施行したT3例6耳中3耳で断端陽性となったが、T1・T2例ではすべて陰性だった。2年生存率はT1が100%、T2が88.9%、T3が83.3%、T4が100%だった。聴器合併症は側頭骨外側切除術例では伝音難聴のみだったが、放射線治療例では骨導低下、外耳道狭窄、難治性耳漏などを認めた。術後に軟骨伝導補聴器を試聴した5例中4例で常時装用となった。術前CTで腫瘍が鼓膜をわずかに越えるのみ、造影MRIで外耳道前方の軟部組織の境界が明瞭な症例では切除断端は陰性であり、側頭骨外側切除術の良い適応であった。そのほかのT3・T4症例ではCCRTが第一選択と考えられた。放射線の難治性合併症を考慮すると、側頭骨外側切除術後に補聴を行う治療では聴覚を有効活用できた。(著者抄録)

Deficiency of large tumor suppressor kinase 1 causes congenital hearing loss associated with cochlear abnormalities in mice

Nishiyama T., Fujioka M., Saegusa C., Oishi N., Harada T., Hosoya M., Saya H., Ogawa K.

Biochemical and Biophysical Research Communications （Biochemical and Biophysical Research Communications）  534   921 - 926 2021年01月

ISSN  0006291X

　概要を見る

Mammalian auditory hair cells are not spontaneously replaced. Their number and coordinated polarization are fairly well-maintained and both these factors might be essential for the cochlear amplifier. Cell cycle regulation has critical roles in regulating appropriate cell size and cell number. However, little is known about the physiological roles of the Hippo pathway, which is one of the most important signaling cascades that regulates cell growth, differentiation, and regenerative capacity in the cochlear sensory epithelium. Herein, we investigated the in vivo role of the large tumor suppressor 1 (LATS1), an essential kinase in the Hippo/yes-associated protein pathway, in the cochlea using the LATS1 knockout mice. LATS1 was expressed in hair cells and supporting cells. It was strongly expressed on the surface of the cuticular plate of the organ of Corti. We found that LATS1 knockout caused congenital hearing loss due to the irregular orientation and slightly reduced number of hair cells, whereas the number of supporting cells remained unchanged. On the surface of the hair cells, the kinocilium and stereocilia were dispersed during and after morphogenesis. However, the expression of the receptor-independent polarity regulators, such as Par3 or Gαi, was not affected. We concluded that LATS1 has an indispensable role in the maturation of mammalian auditory hair cells, but not in the development of the supporting cells, and thus, has a role in the hearing acquisition.

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Management of tinnitus in patients with vestibular schwannoma who underwent surgical resection

Kitamura M., Oishi N., Suzuki N., Kojima T., Nishiyama T., Noguchi M., Hosoya M., Ogawa K.

European Archives of Oto-Rhino-Laryngology （European Archives of Oto-Rhino-Laryngology）  278 （ 11 ） 4243 - 4249 2021年

ISSN  09374477

　概要を見る

Purpose: To evaluate tinnitus and its management in patients with vestibular schwannoma (VS) who underwent surgery, we investigate the effect of surgical approach or residual hearing on tinnitus severity and the effects of intervention for tinnitus including educational counseling, sound therapy using hearing aids (HAs), and medication (selective serotonin reuptake inhibitors, and SSRIs). Methods: Seventy-one subjects of VS patients who underwent surgery were included. Their tinnitus severity was evaluated using the Japanese version of the Tinnitus Handicap Inventory (THI). The relationships between postoperative THI scores and surgery types or residual hearing levels were examined. We also examined longitudinal changes in THI scores and the efficacy of the intervention. Results: Surgery approach, hearing preservation or hearing loss surgery, and residual hearing levels were not significantly related to the postoperative tinnitus severity. In 71 cases, 45 cases did not require any management for tinnitus. On the contrary, 26 patients had at least one episode of tinnitus distress (THI score was greater than or equal to 18). Educational counseling alone was found to be effective in 17 cases out of the 26 cases, and the remaining 9 cases required more intervention than educational counseling alone. We selected sound therapy with HA for 7 cases and administration of SSRI for 2 cases, which was found to be highly effective in 8 cases. Conclusion: Based on the present study, we consider that appropriate management may be possible for tinnitus in the majority of VS patients who underwent surgery.

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Cartilage Conduction Hearing Aid Fitting in Clinical Practice

Nishimura T., Hosoi H., Sugiuchi T., Matsumoto N., Nishiyama T., Kenichi T., Sugimoto S., Yazama H., Sato T., Komori M.

Journal of the American Academy of Audiology （Journal of the American Academy of Audiology）  32 （ 6 ） 386 - 392 2021年

ISSN  10500545

　概要を見る

Background ?Cartilage conduction hearing aids (CCHAs) were newly devised and spread fast in Japan since their launch in 2017. However, little knowledge is available for this new device. Purpose ?The aim of this study was to establish the knowledge of CCHAs and suggest their indication. Research Design ?Correlational study. Study Sample ?A total 256 patients were registered. Data Collection and Analysis ?The fitting of CCHAs was surveyed in nine institutions. The outcomes were assessed by audiometric tests. The patients were classified into seven groups, depending on the ear conditions. The clinical characteristics, assessment results, and purchase rates were compared among the groups. The assessment results of CCHAs were also compared with those of previously used hearing aids. Results ?Most patients who used CCHAs were classified into the bilateral closed (aural atresia or severe stenosis) ear (n = 65) or unilateral closed ear (n = 124) groups. The patients in these groups achieved good benefits that resulted in a high purchase rate. The bilateral continuous otorrhea group also supported a high purchase rate, although the benefits of CCHAs were not always excellent. In contrast, the purchase rate was poor in the patients who could use air conduction hearing aids (ACHAs) without absolute problems. As for using a CCHA as a contralateral routing of signals hearing aid, the benefits depended on the patients. Conclusions ?CCHAs are considered as a great option not only to the patients with closed ears but also to those who had difficulties in ACHAs usage.

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A Retrospective Analysis of 22 Cases with Carcinomas of the External Auditory Canal

Suzuki N., Oishi N., Ozawa H., Kanzaki S., Fujioka M., Nishiyama T., Noguchi M., Hosoya M., Sekimizu M., Saito S., Ogawa K.

Journal of Otolaryngology of Japan （Journal of Otolaryngology of Japan）  124 （ 3 ） 197 - 204 2021年

ISSN  00306622

　概要を見る

Carcinoma of the external auditory canal is a rare tumor, accounting for about 1% of all head and neck cancers. Although no treatment method has been established yet, surgical treatment is the primary treatment method in cases where resection is possible. At our institution, we adopt surgical treatment, mainly lateral temporal bone resection （LTBR）, for cases with T1―T3 disease, and chemoradiation therapy（CCRT）for cases with T4 disease, as the treatment of first choice. We have adopted cartilage conduction hearing aids（CC―HAs）in some cases following LTBR. We examined the short―term outcomes, at two years, in the patients treated at our department. This study was a retrospective case review of 22 ears with carcinoma of the external auditory canal in 21 patients who underwent initial treatment at our institution between January 2012 and June 2018. The observation period was 2 to 81 months（median 26 months）. The tumors were analyzed using the modified Pittsburgh tumor staging system. The tumor T stage was T1 in four ears, T2 in nine ears, T3 in six ears, and T4 in three ears. CCRT was performed in three ears with T4 disease and one ear with T2 disease, heavy ion radiotherapy was performed in one ear with T2 disease, and surgery（LTBR in 16 ears and partial external auditory meatus resection in one ear）was performed for all the other cases. The surgical margin after LTBR was positive in three out of six cases with T3 disease and negative in all of the cases with T1 and T2 disease. The positive surgical margin was mainly found in the medial wall of the tympanic cavity or cartilaginous portion of the external acoustic meatus. The overall 2―year survival rate was 87.4%; the rate was 100% in the T1 cases, 87.5% in the T2 cases, 75.0% in the T3 cases, and 100% in the T4 cases. Four out of five patients who tried CC―HAs continued to use them after the LTBR. The indication for LTBR should be carefully judged in cases with T3 disease. The appropriate indication for LTBR in cases with T3 disease are: 1）a small amount of soft tissue shadow beyond the tympanum in the preoperative CT, and/ or 2）a clear boundary between the tumor and the soft tissue around the external acoustic meatus in the preoperative enhanced MRI. In cases with T3 disease not fulfilling these criteria, CCRT should be selected as the treatment of first choice. However, considering the side effects after CCRT, including sensorineural hearing loss and persistent otorrhea in some cases, LTBR with postoperative CC―HAs is one of the optimal treatment options that would allow the remaining hearing ability to be utilized.

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Validation and multidimensional analysis of the japanese penn acoustic neuroma quality-of-life scale

Nishiyama T., Oishi N., Kojima T., Kasuya K., Noguchi M., Ishikawa T., Hosoya M., Ogawa K.

Laryngoscope （Laryngoscope）  130 （ 12 ） 2885 - 2890 2020年12月

ISSN  0023852X

　概要を見る

Objectives: In the management of vestibular schwannoma (VS), patient-perceived outcomes should be given as much attention as physician-reported objective outcomes. Concomitant symptoms can be annoying for sufferers, lowering quality of life (QoL). However, it is difficult to determine the degree to which these symptoms lower QoL using only objective measures. The Penn Acoustic Neuroma Quality of Life Scale (PANQOL) is a validated disease-specific questionnaire commonly used to assess QoL in VS patients. It was developed and published in English. In this study, we translated the PANQOL questionnaire into Japanese and validated its reliability and utility. We also evaluated patient factors that could influence PANQOL scores. Study Design: Cross-sectional study. Methods: Seventy-two VS patients monitored conservatively were included in this study. They were assessed using the Japanese versions of PANQOL (PANQOL-J) and questionnaires about specific symptoms related to VS. The PANQOL questionnaire was translated into Japanese according to the accepted standards. The reliability and utility of the PANQOL-J questionnaire, as well as the relationship with VS-specific symptoms, were statistically analyzed. Results: The mean total score was 78.7. Almost all of its domains had good internal consistency. Most PANQOL-J domains were related to those of the Short Form-36, with the exception of facial dysfunction domain. Scores of all PANQOL-J domains were comparable to scores of other questionnaires related to the VS-specific symptoms. Our analyses indicated tinnitus or facial palsy might affect the PANQOL-J total score. Conclusions: We confirmed the validity of the Japanese version of PANQOL questionnaire and its reliability and utility in the management of VS symptoms concerning facial function. Level of Evidence: 4 Laryngoscope, 2020.

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栄養指標と予後 口腔扁平上皮癌根治手術例における栄養・炎症・免疫複合指標の予後推定能の網羅的検討

松居 祐樹, 今西 順久, 重冨 征爾, 佐藤 陽一郎, 猪狩 雄一, 西山 崇経, 五島 可奈子, 笠原 健

日本癌治療学会学術集会抄録集 （(一社)日本癌治療学会）  58回   WS4 - 2 2020年10月

聴神経腫瘍術後「非有効聴力」残存耳に対する補聴器装用効果が得られた一例

長谷部 夏希, 大石 直樹, 西山 崇経, 北村 充, 都築 伸佳, 細谷 誠, 藤岡 正人, 神崎 晶, 宮崎 日出海, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  63 （ 5 ） 468 - 468 2020年09月

ISSN  0303-8106

高齢者の聴覚と暮らし方と健康に関する学術調査(第3報) 老人性難聴に関連する遺伝子多型の探索

野口 勝, 藤岡 正人, 忰田 かおり, 北村 充, 堀 明美, 薬師丸 令子, 西山 崇経, 石川 徹, 細谷 誠, 鈴木 成尚, 長谷部 夏希, 岡本 康秀, 大石 直樹, 神崎 晶, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  63 （ 5 ） 376 - 376 2020年09月

ISSN  0303-8106

高齢者の聴覚と暮らし方と健康に関する学術調査(第3報) 85-89歳の聴力分布

忰田 かおり, 藤岡 正人, 野口 勝, 堀 明美, 薬師丸 令子, 西山 崇経, 石川 徹, 鈴木 成尚, 細谷 誠, 北村 充, 長谷部 夏希, 岡本 康秀, 大石 直樹, 神崎 晶, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  63 （ 5 ） 375 - 375 2020年09月

ISSN  0303-8106

軟骨伝導補聴器市販化後調査 フィッティング症例の内訳と購入率

杉内 智子, 西村 忠己, 細井 裕司, 松本 希, 西山 崇経, 宮田 遼, 杉本 賢文, 矢間 敬章, 山内 大輔, 小森 正博

Audiology Japan （(一社)日本聴覚医学会）  63 （ 5 ） 396 - 396 2020年09月

ISSN  0303-8106

軟骨伝導補聴器市販化後調査 装用効果について

松本 希, 西村 忠己, 細井 裕司, 杉内 智子, 西山 崇経, 宮田 遼, 杉本 賢文, 矢間 敬章, 山内 大輔, 小森 正博

Audiology Japan （(一社)日本聴覚医学会）  63 （ 5 ） 397 - 397 2020年09月

ISSN  0303-8106

口腔扁平上皮癌における炎症・栄養・免疫複合指標の予後推定能の検討

松居 祐樹, 今西 順久, 五島 可奈子, 西山 崇経, 佐藤 陽一郎, 重冨 征爾, 栗林 徹, 舟越 和人

頭頸部癌 （(一社)日本頭頸部癌学会）  46 （ 2 ） 175 - 175 2020年07月

ISSN  1349-5747

外側側頭骨切除後の熱源としてDRESS症候群が疑われた一例

松居 祐樹, 西山 崇経, 五島 可奈子, 佐藤 陽一郎, 今西 順久

神奈川医学会雑誌 （神奈川県医師会）  47 （ 2 ） 209 - 210 2020年07月

ISSN  0285-0680

Low-dose rapamycin-induced autophagy in cochlear outer sulcus cells.

Saegusa C, Hosoya M, Nishiyama T, Saeki T, Fujimoto C, Okano H, Fujioka M, Ogawa K

Laryngoscope investigative otolaryngology 5 （ 3 ） 520 - 528 2020年06月

　概要を見る

Objectives: Autophagy is an intracellular housekeeping process that degrades cytoplasmic organelles, damaged molecules, and abnormal proteins or pathogens and is essential for normal hearing. Recent studies revealed the essential roles of autophagy in hearing and balance. The aim of this study was to evaluate the activation state of rapamycin-induced autophagy in cochlear outer sulcus cells (OSCs). Methods: We used autophagy reporter transgenic mice expressing the green fluorescent protein-microtubule-associated protein light chain 3 (GFP-LC3) fusion protein and counted GFP-LC3 puncta in cochlear OSCs to evaluate the activation state of autophagy after oral administration of rapamycin. Results: We observed basal level GFP-LC3 expression and an increase in the number of GFP-LC3 puncta in cochlear OSCs by oral administration of rapamycin. This increase was detected when the daily rapamycin intake was as low as 0.025 mg/kg, and it was dose dependent. The increased number of puncta was more at the basal turn than the apical turn. Conclusion: Oral intake of low-dose rapamycin activates autophagy in cochlear OSCs. Level of evidence: NA.

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刺激音の症例別最適化による聴神経腫瘍手術時の聴覚モニタリング改善の試み

細谷 誠, 大石 直樹, 野口 勝, 西山 崇経, 鈴木 成尚, 長谷部 夏希, 北村 充, 藤岡 正人, 神崎 晶, 小川 郁

日本耳科学会総会・学術講演会抄録集 （(一社)日本耳科学会）  29回   449 - 449 2019年10月

小児症例における軟骨伝導補聴器試聴者の臨床的検討

西山 崇経, 大石 直樹, 神崎 晶, 藤岡 正人, 鈴木 成尚, 野口 勝, 細谷 誠, 北村 充, 長谷部 夏希, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  62 （ 5 ） 395 - 395 2019年10月

ISSN  0303-8106

高齢者の聴覚と暮らし方と健康に関する学術調査(第2報) 老人性難聴のリスクファクターの探索

忰田 かおり, 藤岡 正人, 北村 充, 堀 明美, 薬師丸 令子, 野口 勝, 粕谷 健人, 西山 崇経, 石川 徹, 細谷 誠, 鈴木 成尚, 長谷部 夏希, 岡本 康秀, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  62 （ 5 ） 568 - 568 2019年10月

ISSN  0303-8106

高齢者の聴覚と暮らし方と健康に関する学術調査(第2報) GWASによる老人性難聴関連遺伝子多型の探索

野口 勝, 藤岡 正人, 忰田 かおり, 北村 充, 堀 明美, 薬師丸 令子, 粕谷 健人, 西山 崇経, 石川 徹, 細谷 誠, 鈴木 成尚, 長谷部 夏希, 岡本 康秀, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  62 （ 5 ） 435 - 435 2019年10月

ISSN  0303-8106

自宅連日検査によるPendred症候群の臨床像の探索と解析

山野邉 義晴, 藤岡 正人, 忰田 かおり, 細谷 誠, 長谷部 夏希, 鈴木 成尚, 西山 崇経, 野口 勝, 勝沼 紗矢香, 鈴木 法臣, 南 修司郎, 神崎 晶, 大石 直樹, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  62 （ 5 ） 418 - 418 2019年10月

ISSN  0303-8106

聴神経腫瘍の臨床 聴力温存率向上を目指した取り組み

大石 直樹, 細谷 誠, 鈴木 成尚, 北村 充, 長谷部 夏希, 野口 勝, 西山 崇経, 藤岡 正人, 神崎 晶, 宮崎 日出海, 小川 郁

日本耳科学会総会・学術講演会抄録集 （(一社)日本耳科学会）  29回   448 - 448 2019年10月

神経線維腫症2型を呈する日本人症例におけるNF2遺伝子変異と臨床像の関係

野口 勝, 藤岡 正人, 大石 直樹, 奈良 清光, 務台 英樹, 長谷部 夏希, 松崎 佐栄子, 西山 崇経, 鈴木 成尚, 細谷 誠, 神崎 晶, 松永 達雄, 小川 郁

日本耳科学会総会・学術講演会抄録集 （(一社)日本耳科学会）  29回   445 - 445 2019年10月

新しいHeads up Surgery外視鏡耳科手術の長所と短所は何か? 顕微鏡と比較、脳外科医の評価と比較

神崎 晶, 西山 崇経, 細谷 誠, 野口 勝, 鈴木 成尚, 大石 直樹, 藤岡 正人, 小川 郁

日本耳科学会総会・学術講演会抄録集 （(一社)日本耳科学会）  29回   239 - 239 2019年10月

当科におけるアパタイト人工耳小骨を用いた内視鏡下アブミ骨手術症例の検討

細谷 誠, 藤岡 正人, 鈴木 成尚, 西山 崇経, 野口 勝, 長谷部 夏希, 北村 充, 神崎 晶, 大石 直樹, 小川 郁

日本耳科学会総会・学術講演会抄録集 （(一社)日本耳科学会）  29回   461 - 461 2019年10月

当科での経外耳道的内視鏡下耳科手術(TEES)により施行した鼓室形成術1型(inlay法)症例の検討

北村 充, 藤岡 正人, 神崎 晶, 細谷 誠, 長谷部 夏希, 西山 崇経, 野口 勝, 鈴木 成尚, 大石 直樹, 小川 郁

日本耳科学会総会・学術講演会抄録集 （(一社)日本耳科学会）  29回   387 - 387 2019年10月

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.

Makoto Hosoya, Naoki Oishi, Takanori Nishiyama, Masaru Noguchi, Kento Kasuya, Noriomi Suzuki, Hidemi Miyazaki, Kaoru Ogawa

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 44 （ 5 ） 875 - 880 2019年09月

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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年09月

ISSN  0917-2025

　概要を見る

MRIの普及に伴い、より小・中型の聴神経腫瘍が診断される機会が増えてきている。「早期発見」によって、聴神経腫瘍における疾患予後である「腫瘍の大きさが制御され、より良好な機能が温存される」症例の増加が期待される。疾患の自然経過を踏まえたうえで、「早期治療」をすべき症例を選別することが重要である。当科では、聴力温存・経側頭骨手術である後迷路法に近年取り組み、精度の高い術中持続神経モニタリングを併用し約4年間で施行した聴神経腫瘍手術は68例であり、その6割で後迷路法を施行した。後向きの検討から、術前ABR/DPOAEの結果により、より高い確率で聴力温存を果たし得る症例を選別できることが判明した。現在当科では、将来に聴力を喪失するあるいは腫瘍が増大する可能性が高いと判断される症例に対し、小腫瘍あるいは聴力が比較的良好な段階で聴力温存手術を施行する治療プロトコールを採用し、聴力温存率の向上に取り組んでいる。(著者抄録)

聴覚過敏症状の自覚的表現についての検討

西山 崇経, 新田 清一, 鈴木 大介, 坂本 耕二, 齋藤 真, 野口 勝, 大石 直樹, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  62 （ 3 ） 235 - 239 2019年06月

ISSN  0303-8106

　概要を見る

聴覚過敏は、日常的な音に対して過敏性や不快感を示す状態で、外界からの音によらない耳鳴や、自分の声のみが強く聞こえる自声強聴とは異なった病態を表すと考えられている。しかし、過敏症状には「響く」、「大きく(強く)聞こえる」など多彩な表現が存在するにもかかわらず、各表現を分類して意義を検討している報告はない。そこで、過敏症状を訴えた168名を対象に、過敏症状の自覚的表現と疾患との関連や、これらの表現の臨床的意義について検討した。疾患の内訳は、約3分の2が急性感音難聴で、次いで加齢性難聴であり、聴力検査上異常を認めない症例も1割程度含まれていた。「響く」が最も多く、「響く」か否かを問診することは過敏症状のスクリーニングに役立ち、「割れる」や「二重に聞こえる」は感音難聴の存在を疑い、「大きく(強く)聞こえる」は極めて軽微な内耳障害や、聴覚中枢を含めた病態の関与を考える必要がある表現と考えられた。(著者抄録)

遺伝性難聴Pendred症候群/DFNB4の難聴・めまいに対する新規療法の医師主導治験

藤岡 正人, 細谷 誠, 西山 崇経, 野口 勝, 鈴木 成尚, 矢部 はる奈, 吉浜 圭祐, 松永 達雄, 宇佐美 真一, 小川 郁

小児耳鼻咽喉科 （日本小児耳鼻咽喉科学会）  40 （ 2 ） 123 - 123 2019年05月

ISSN  0919-5858

3 hands surgeryでの経外耳道的内視鏡下耳科手術(TEES)

藤岡 正人, 小澤 宏之, 野口 勝, 西山 崇経, 細谷 誠, 鈴木 成尚, 神崎 晶, 大石 直樹, 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）  122 （ 4 ） 617 - 617 2019年04月

ISSN  0030-6622

小児滲出性中耳炎における血液学的炎症指標を用いた予後関連因子の検討

西山 崇経, 大石 直樹, 利國 桂太郎, 羽生 昇, 神崎 晶, 藤岡 正人, 野口 勝, 鈴木 成尚, 細谷 誠, 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）  122 （ 4 ） 607 - 607 2019年04月

ISSN  0030-6622

側頭骨内顔面神経鞘腫42例の臨床像

大石 直樹, 野口 勝, 井上 泰宏, 神崎 晶, 藤岡 正人, 西山 崇経, 鈴木 成尚, 細谷 誠, 平賀 良彦, 原田 竜彦, 神崎 仁, 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）  122 （ 4 ） 640 - 640 2019年04月

ISSN  0030-6622

当院における外耳道癌症例の検討

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, 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）  122 （ 4 ） 596 - 596 2019年04月

ISSN  0030-6622

自宅連日検査によるペンドレッド症候群の聴力変化の記録とその解析検討

山野邉 義晴, 藤岡 正人, 西山 崇経, 野口 勝, 鈴木 成尚, 細谷 誠, 矢部 はる奈, 吉浜 圭祐, 勝沼 紗矢香, 鈴木 法臣, 野口 佳裕, 川島 慶之, 藤川 太郎, 神崎 晶, 大石 直樹, 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）  122 （ 4 ） 622 - 622 2019年04月

ISSN  0030-6622

当院の神経線維腫症2型症例におけるNF2遺伝子の分子遺伝学的検討

野口 勝, 藤岡 正人, 大石 直樹, 吉浜 圭祐, 松永 達雄, 務台 英樹, 奈良 清光, 西山 崇経, 鈴木 成尚, 細谷 誠, 松崎 佐栄子, 神崎 晶, 小川 郁

日本耳鼻咽喉科学会会報 （(一社)日本耳鼻咽喉科学会）  122 （ 4 ） 705 - 705 2019年04月

査読有り,  ISSN  0030-6622

当院における難聴遺伝外来の現況とこころみ

細谷 誠, 藤岡 正人, 野口 勝, 吉浜 圭祐, 西山 崇経, 鈴木 成尚, 大石 直樹, 神崎 晶, 松永 達雄, 小川 郁

日本耳鼻咽喉科学会会報 （(一社)日本耳鼻咽喉科学会）  122 （ 4 ） 622 - 622 2019年04月

ISSN  0030-6622

【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年01月

ISSN  0910-6820

Severity of Tinnitus Distress Negatively Impacts Quality of Life in Patients With Vestibular Schwannoma and Mimics Primary Tinnitus.

Kojima T, Oishi N, Nishiyama T, Ogawa K

Frontiers in neurology 10   389 - 389 2019年

　概要を見る

Objective: Quality of life (QoL) and subjective symptoms are predominantly used to evaluate treatment outcome of patients with vestibular schwannoma (VS). However, for patients undergoing conservative treatment-the most frequently used intervention-the association between QoL and subjective symptoms is unclear. Moreover, it is unknown whether VS-related tinnitus could be associated with the audiological and psychological status of the patient. Our overall aim is to provide objective evidence of this association to better guide treatment of VS. Methods: In a prospective study, we analyzed factors that influence VS-related tinnitus and QoL in 72 patients receiving conservative management of unilateral sporadic VS. This was done through questionnaires that assessed QoL, anxiety, depression, and audiological examinations. We used the SF-36 Short Form to assess QoL; the Tinnitus Handicap Inventory, Dizziness Handicap Inventory, Facial Clinimetric Evaluation Scale, Visual Analog Scale for hearing impairment to assess symptoms subjectively; and pure tone audiometry, the speech discrimination for hearing measurements. For psychological status, we used the Hospital Anxiety and Depression Scale. For analyses, we used Pearson correlation analysis and multiple regression between variables and QoL. Results: Correlation and regression analyses revealed that the severity of tinnitus distress had the largest negative impact on QoL in all domains of SF-36. The severity of tinnitus was significantly associated with subjective hearing impairment and the degree of depression and anxiety. Hearing thresholds had no statistical association with severity of tinnitus. Conclusions: To our knowledge, this is the first study to investigate VS-related tinnitus with respect to both patients' hearing status and psychological condition. Our results suggest that tinnitus distress strongly affects VS patients' QoL and that its characteristics are similar to primary tinnitus. An intervention for VS-related tinnitus, therefore, should assess to what extent tinnitus bothers patients, and it should reduce any unpleasant emotions that may exacerbate symptoms. This approach should improve their QoL.

• Access to Document (DOI)

Intraoperative facial nerve monitoring revealed the origin of rapidly progressing schwannoma in the cerebellopontine angle: A case of large intermediate nerve schwannoma

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

Journal of International Advanced Otology （Journal of International Advanced Otology）  14 （ 3 ） 488 - 492 2018年12月

査読有り,  ISSN  13087649

　概要を見る

Schwannoma arising from the intermediate nerve is very rare, with only a few cases reported in the literature. Here, we report a rare case of a rapidly growing schwannoma that originated from the intermediate nerve in a 17-year-old woman. We performed tumor resection using the translabyrinthine approach with continuous intraoperative monitoring, in which the facial nerve root was used to evoke muscle action potential. The monitoring revealed the tumor origin and enabled complete surgical resection with the preservation of facial nerve motor function. The facial nerve root evoked muscle action potential-based continuous monitoring revealed the origin of the rare intermediate nerve schwannoma. Appropriate surgery using this monitoring system could spare facial nerve function even in this rare case and retain the patient’s quality of life.

• Access to Document (DOI)

【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年12月

ISSN  0917-2025

　概要を見る

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年10月

ISSN  0032-6313

Cadaverを用いた内視鏡下耳科手術(TEES)のトレーニング

藤岡 正人, 神崎 晶, 大石 直樹, 小澤 宏之, 西山 崇経, 野口 勝, 鈴木 成尚, 細谷 誠, 小川 郁

Otology Japan （(一社)日本耳科学会）  28 （ 4 ） 452 - 452 2018年09月

ISSN  0917-2025

コモンマーモセット蝸牛におけるミトコンドリアの観察

鈴木 成尚, 佐伯 翼, 藤岡 正人, 細谷 誠, 三枝 智香, 神崎 晶, 大石 直樹, 西山 崇経, 野口 勝, 小川 郁

Otology Japan （(一社)日本耳科学会）  28 （ 4 ） 429 - 429 2018年09月

ISSN  0917-2025

Tinnitus Sample Case History QuestionnairesとTHIを組み合わせた重症度別の耳鳴患者の臨床像

鈴木 成尚, 小島 敬史, 神崎 晶, 大石 直樹, 藤岡 正人, 西山 崇経, 野口 勝, 細谷 誠, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  61 （ 5 ） 328 - 328 2018年09月

ISSN  0303-8106

Mycobacterium abscessus subsp.abscessusによる中耳炎における手術時期についての考察

北村 友理, 西山 崇経, 神崎 晶, 大石 直樹, 藤岡 正人, 山田 浩之, 粕谷 健人, 石川 徹, 野口 勝, 細谷 誠, 戎野 ちひろ, 角田 真弓, 小川 郁

Otology Japan （(一社)日本耳科学会）  28 （ 4 ） 312 - 312 2018年09月

ISSN  0917-2025

Hippo経路構成因子のLats1キナーゼ欠損がマウス内耳に与える影響の解析

西山 崇経, 藤岡 正人, 大石 直樹, 細谷 誠, 神崎 晶, 鈴木 成尚, 野口 勝, 小川 郁

Otology Japan （(一社)日本耳科学会）  28 （ 4 ） 361 - 361 2018年09月

ISSN  0917-2025

当科における耳鳴認知行動療法グループ指導の導入

中野 瑛理佳, 神埼 晶, 片岡 ちなつ, 田副 真美, 粕谷 健人, 西山 崇経, 石川 徹, 野口 勝, 鈴木 成尚, 藤岡 正人, 大石 直樹, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  61 （ 5 ） 339 - 339 2018年09月

ISSN  0303-8106

高齢者の聴覚と暮らし方と健康に関する学術調査(第1報) 老人性難聴のリスクファクターの探索

忰田 かおり, 藤岡 正人, 堀 明美, 薬師丸 令子, 粕谷 健人, 野口 勝, 西山 崇経, 石川 徹, 細谷 誠, 鈴木 成尚, 大石 直樹, 神崎 晶, 今西 順久, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  61 （ 5 ） 302 - 302 2018年09月

ISSN  0303-8106

超高齢社会における聴覚医学の課題と使命 高齢者の聴覚と暮らし方と健康に関する学術調査(第1報) 老人性難聴関連遺伝子多型の探索

野口 勝, 藤岡 正人, 粕谷 健人, 西山 崇経, 石川 徹, 細谷 誠, 鈴木 成尚, 堀 明美, 忰田 かおり, 薬師丸 令子, 大石 直樹, 神崎 晶, 今西 順久, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  61 （ 5 ） 317 - 317 2018年09月

ISSN  0303-8106

聴神経腫瘍症例における難聴急性増悪時のステロイドの治療効果

野口 勝, 大石 直樹, 西山 崇経, 細谷 誠, 鈴木 成尚, 藤岡 正人, 神崎 晶, 小川 郁

Otology Japan （(一社)日本耳科学会）  28 （ 4 ） 388 - 388 2018年09月

ISSN  0917-2025

耳鳴に対する補聴器による音響療法の長期経過

大石 直樹, 稲垣 洋三, 野口 勝, 西山 崇経, 鈴木 成尚, 細谷 誠, 藤岡 正人, 神崎 晶, 新田 清一, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  61 （ 5 ） 338 - 338 2018年09月

ISSN  0303-8106

日本語版PANQOL質問紙を用いた聴神経腫瘍患者術後QOLの検討

西山 崇経, 大石 直樹, 野口 勝, 細谷 誠, 鈴木 成尚, 神崎 晶, 藤岡 正人, 小川 郁

Otology Japan （(一社)日本耳科学会）  28 （ 4 ） 387 - 387 2018年09月

ISSN  0917-2025

後迷路法による聴神経腫瘍手術における術後聴力予測因子の検討

細谷 誠, 大石 直樹, 粕谷 健人, 野口 勝, 西山 崇経, 石川 徹, 鈴木 成尚, 藤岡 正人, 神崎 晶, 宮崎 日出海, 小川 郁

Otology Japan （(一社)日本耳科学会）  28 （ 4 ） 386 - 386 2018年09月

ISSN  0917-2025

PANQOL日本語版を用いた聴神経腫瘍wait and scan患者のQOL評価

西山 崇経, 大石 直樹, 小島 敬史, 粕谷 健人, 神崎 晶, 藤岡 正人, 野口 勝, 石川 徹, 細谷 誠, 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）  121 （ 4 ） 585 - 585 2018年04月

ISSN  0030-6622

側頭骨炎症性腫瘤性病変に対する治療方針

粕谷 健人, 大石 直樹, 神崎 晶, 藤岡 正人, 西山 崇経, 野口 勝, 石川 徹, 細谷 誠, 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）  121 （ 4 ） 529 - 529 2018年04月

ISSN  0030-6622

当科での経外耳道的内視鏡下耳科手術(TEES)

藤岡 正人, 神崎 晶, 小澤 宏之, 大石 直樹, 粕谷 健人, 野口 勝, 西山 崇経, 石川 徹, 細谷 誠, 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）  121 （ 4 ） 570 - 570 2018年04月

ISSN  0030-6622

聴覚過敏を主訴とした感覚過敏症患者の臨床的特徴について(第2報)

神崎 晶, 粕谷 健人, 石川 徹, 西山 崇経, 野口 勝, 細谷 誠, 大石 直樹, 藤岡 正人, 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）  121 （ 4 ） 584 - 584 2018年04月

ISSN  0030-6622

聴神経腫瘍手術における顔面神経根誘発筋活動電位を用いた術中持続顔面神経モニタリングの有用性の検討

細谷 誠, 大石 直樹, 粕谷 健人, 野口 勝, 西山 崇経, 石川 徹, 藤岡 正人, 神崎 晶, 宮崎 日出海, 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）  121 （ 4 ） 585 - 585 2018年04月

ISSN  0030-6622

聴神経腫瘍に対する後迷路法 術中持続神経モニタリングを併用した手術手技の工夫

大石 直樹, 宮崎 日出海, 野口 勝, 西山 崇経, 細谷 誠, 粕谷 健人, 石川 徹, 藤岡 正人, 神崎 晶, 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）  121 （ 4 ） 586 - 586 2018年04月

ISSN  0030-6622

聴神経腫瘍wait and scan患者に対する手術適応の検討

野口 勝, 大石 直樹, 粕谷 健人, 西山 崇経, 細谷 誠, 石川 徹, 藤岡 正人, 神崎 晶, 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）  121 （ 4 ） 586 - 586 2018年04月

ISSN  0030-6622

外科的切除を選択した側頭骨炎症性偽腫瘍の1例

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

Otology Japan （(一社)日本耳科学会）  27 （ 4 ） 662 - 662 2017年10月

ISSN  0917-2025

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, 神崎 晶, 大石 直樹, 粕谷 健人, 野口 勝, 西山 崇経, 石川 徹, 細谷 誠, 小川 郁

Otology Japan （(一社)日本耳科学会）  27 （ 4 ） 276 - 276 2017年10月

ISSN  0917-2025

顔面神経鞘腫に対して全摘術を行った4症例とその適応の検討

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

Otology Japan （(一社)日本耳科学会）  27 （ 4 ） 471 - 471 2017年10月

ISSN  0917-2025

聴神経腫瘍に対する後迷路法 手術適応とアプローチの工夫

大石 直樹, 宮崎 日出海, 粕谷 健人, 野口 勝, 西山 崇経, 石川 徹, 細谷 誠, 藤岡 正人, 神崎 晶, 小川 郁

Otology Japan （(一社)日本耳科学会）  27 （ 4 ） 289 - 289 2017年10月

ISSN  0917-2025

残存聴力のない難治性中耳内耳疾患に対してSubtotal petrosectomyに準ずる手術加療を行なった9症例の検討

西山 崇経, 大石 直樹, 平賀 良彦, 粕谷 健人, 神崎 晶, 藤岡 正人, 石川 徹, 野口 勝, 細谷 誠, 小川 郁

Otology Japan （(一社)日本耳科学会）  27 （ 4 ） 469 - 469 2017年10月

ISSN  0917-2025

慢性めまいを呈した2例の外リンパ瘻症例

石川 徹, 神崎 晶, 大石 直樹, 藤岡 正人, 粕谷 健人, 西山 崇経, 野口 勝, 細谷 誠, 松田 帆, 池園 哲郎, 小川 郁

Otology Japan （(一社)日本耳科学会）  27 （ 4 ） 499 - 499 2017年10月

ISSN  0917-2025

修正Khalfa Hyperacusis Questionnaire日本語版の提案

石川 徹, 大石 直樹, 神崎 晶, 山田 浩之, 藤岡 正人, 粕谷 健人, 西山 崇経, 野口 勝, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  60 （ 5 ） 399 - 399 2017年09月

ISSN  0303-8106

当科における耳鳴認知行動療法グループ指導の導入(第一報)

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

Audiology Japan （(一社)日本聴覚医学会）  60 （ 5 ） 400 - 400 2017年09月

ISSN  0303-8106

補聴器治療を行った耳鳴患者におけるTinnitus Functional Indexによる治療効果評価

野口 勝, 大石 直樹, 鈴木 法臣, 神崎 晶, 藤岡 正人, 粕谷 健人, 西山 崇経, 石川 徹, 細谷 誠, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  60 （ 5 ） 405 - 405 2017年09月

ISSN  0303-8106

細胞周期調節経路の破綻に伴う内耳への影響 ∽Lats1キナーゼ欠損マウスの解析

西山 崇経, 藤岡 正人, 大石 直樹, 細谷 誠, 原田 竜彦, 神崎 晶, 粕谷 健人, 石川 徹, 野口 勝, 小川 郁

Audiology Japan （(一社)日本聴覚医学会）  60 （ 5 ） 283 - 283 2017年09月

ISSN  0303-8106

Hippo経路におけるLats1キナーゼ欠損による内耳機能・構造的影響の解析

西山 崇経, 藤岡 正人, 大石 直樹, 細谷 誠, 原田 竜彦, 鈴木 法臣, 松崎 佐栄子, 國仲 慎治, 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）  119 （ 4 ） 614 - 614 2016年04月

ISSN  0030-6622

急性感音難聴後の聴覚過敏症状に対し発症後早期から補聴器による聴覚リハビリテーションを行った2例

西山 崇経, 新田 清一, 鈴木 大介, 坂本 耕二, 石川 徹, 藤田 紘子, 上野 真史, 太田 真未, 小川 郁

AUDIOLOGY JAPAN （日本聴覚医学会）  58 （ 5 ） 455 - 456 2015年

ISSN  0303-8106

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A study on thyroid nodules without preoperative malignant features

Takanori Nishiyama, Koji Sakamoto, Fumihiro Ito, Seiichi Shinden, Kaoru Ogawa

Practica Otologica, Supplement （Society of Practical Otolaryngology）  141   102 - 103 2015年

ISSN  0912-1870

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A study on thyroid nodules without preoperative malignant features

Takanori Nishiyama, Koji Sakamoto, Fumihiro Ito, Seiichi Shinden, Kaoru Ogawa

Practica Oto-Rhino-Laryngologica （Society of Practical Otolaryngology）  107 （ 9 ） 729 - 734 2014年

ISSN  0032-6313

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一側性難聴耳の補聴器適合検査における遮音方法の検討 : 音場検査における遮音方法について

西山 崇経, 新田 清一, 鈴木 大介, 岡崎 宏, 坂本 耕二, 南 修司郎, 齋藤 真, 野口 勝, 中村 伸太郎, 太田 真未, 小川 郁

Audiology Japan （Japan Audiological Society）  56 （ 5 ） 437 - 438 2013年09月

ISSN  0303-8106

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人工内耳装用者の語音聴取と自覚的改善度・満足度の検討

岡崎 宏, 新田 清一, 鈴木 大介, 西山 崇経, 坂本 耕二, 齋藤 真, 野口 勝, 中村 伸太郎, 上野 恵, 太田 真未, 小川 郁

Audiology Japan （Japan Audiological Society）  56 （ 5 ） 543 - 544 2013年09月

ISSN  0303-8106

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一側性難聴耳の補聴器適合検査における遮音方法の検討〜裸耳と装用閾値の実例検証

南 修司郎, 鈴木 大介, 岡崎 宏, 西山 崇経, 齋藤 真, 野口 勝, 太田 真未, 小川 郁, 新田 清一

Audiology Japan （Japan Audiological Society）  56 （ 5 ） 439 - 440 2013年09月

ISSN  0303-8106

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突発性難聴の難聴残存症例における耳鳴と聴覚過敏の経時的変化

中村 伸太郎, 新田 清一, 西山 崇経, 鈴木 大介, 岡崎 宏, 坂本 耕二, 齋藤 真, 野口 勝, 上野 恵, 太田 真未, 小川 郁

Audiology Japan （Japan Audiological Society）  56 （ 5 ） 657 - 658 2013年09月

ISSN  0303-8106

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両耳/片耳装用の比較試聴の有用性に関する検討

鈴木 大介, 新田 清一, 岡崎 宏, 坂本 耕二, 甲能 武幸, 西山 崇経, 中村 伸太郎, 上野 恵, 小川 郁

言語聴覚研究 （(一社)日本言語聴覚士協会）  10 （ 3 ） 195 - 195 2013年09月

ISSN  1349-5828

サルベージ手術後に下顎骨壊死をきたした中咽頭癌の一例

中村 伸太郎, 坂本 耕二, 甲能 武幸, 西山 崇経, 新田 清一

頭頸部癌 （(一社)日本頭頸部癌学会）  39 （ 2 ） 229 - 229 2013年05月

ISSN  1349-5747

甲状腺癌リンパ節転移診断における穿刺物中サイログロブリン濃度測定に抗甲状腺抗体が及ぼす影響

坂本 耕二, 甲能 武幸, 西山 崇経, 中村 伸太郎, 新田 清一

頭頸部癌 （(一社)日本頭頸部癌学会）  39 （ 2 ） 157 - 157 2013年05月

ISSN  1349-5747

耳下腺腫瘍手術における大耳介神経温存の効果に関する検討

甲能 武幸, 坂本 耕二, 西山 崇経, 中村 伸太郎, 新田 清一

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）  116 （ 4 ） 416 - 416 2013年04月

ISSN  0030-6622

甲状腺癌リンパ節転移診断における穿刺組織中サイログロブリン濃度測定の有用性と限界

坂本 耕二, 中村 伸太郎, 西山 崇経, 甲能 武幸, 新田 清一

日本気管食道科学会会報 （The Japan Broncho-esophagological Society）  64 （ 2 ） 152 - 152 2013年

ISSN  0029-0645

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オープンフィッティングにおいて起こりうる問題とその対処法の検討 : 他機関における補聴器購入者の調整経験をもとに

上野 恵, 鈴木 大介, 岡崎 宏, 坂本 耕二, 甲能 武幸, 西山 崇経, 中村 伸太郎, 新田 清一

Audiology Japan （Japan Audiological Society）  55 （ 5 ） 519 - 520 2012年09月

ISSN  0303-8106

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一側性難聴患者に対する補聴器装用の試み

鈴木 大介, 新田 清一, 岡崎 宏, 坂本 耕二, 甲能 武幸, 西山 崇経, 中村 伸太郎, 上野 恵, 小川 郁

Audiology Japan （Japan Audiological Society）  55 （ 5 ） 543 - 544 2012年09月

ISSN  0303-8106

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一側性難聴に伴う耳鳴に対する補聴器による音響療法

新田 清一, 鈴木 大介, 岡崎 宏, 坂本 耕二, 甲能 武幸, 西山 崇経, 上野 恵, 小川 郁

Audiology Japan （Japan Audiological Society）  55 （ 5 ） 513 - 514 2012年09月

ISSN  0303-8106

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補聴器の初期調整時の装用時間と音に対する慣れの検討

岡崎 宏, 新田 清一, 鈴木 大介, 坂本 耕二, 甲能 武幸, 西山 崇経, 中村 伸太郎, 上野 恵, 小川 郁

Audiology Japan （Japan Audiological Society）  55 （ 5 ） 421 - 422 2012年09月

ISSN  0303-8106

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補聴器装用者の満足度に関わる要因の検討 : 簡便な質問紙を用いた検討

西山 崇経, 新田 清一, 鈴木 大介, 岡崎 宏, 坂本 耕二, 甲能 武幸, 中村 伸太郎, 上野 恵, 小川 郁

Audiology Japan （Japan Audiological Society）  55 （ 5 ） 527 - 528 2012年09月

ISSN  0303-8106

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正中法によるENoGを使った末梢性顔面神経麻痺の予後予測

西山 崇経, 新田 清一, 坂本 耕二, 山田 浩之, 甲能 武幸, 小川 郁

Otology Japan （(一社)日本耳科学会）  22 （ 4 ） 649 - 649 2012年09月

ISSN  0917-2025

軟素材外耳道再建型鼓室形成術における外耳道拡大術について

新田 清一, 坂本 耕二, 甲能 武幸, 西山 崇経, 中村 伸太郎, 小川 郁

Otology Japan （(一社)日本耳科学会）  22 （ 4 ） 537 - 537 2012年09月

ISSN  0917-2025

当院で施行した放射線療法症例のQOL調査

坂本 耕二, 新田 清一, 伊藤 文展, 甲能 武幸, 西山 崇経, 荒川 和清, 柴山 千秋

頭頸部癌 （(一社)日本頭頸部癌学会）  38 （ 2 ） 189 - 189 2012年05月

ISSN  1349-5747

頭頸部癌放射線療法に伴う有害事象の重症化に関わる栄養学的指標の検討

甲能 武幸, 坂本 耕二, 伊藤 文展, 西山 崇経, 新田 清一, 柴山 千秋, 荒川 和清

頭頸部癌 （(一社)日本頭頸部癌学会）  38 （ 2 ） 211 - 211 2012年05月

ISSN  1349-5747

当科における大唾液腺腫瘍手術症例の検討

伊藤 文展, 新田 清一, 坂本 耕二, 甲能 武幸, 西山 崇経

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）  115 （ 4 ） 502 - 502 2012年04月

ISSN  0030-6622

甲状腺癌リンパ節転移診断における穿刺物中サイログロブリン濃度測定の有用性

坂本 耕二, 新田 清一, 伊藤 文展, 甲能 武幸, 西山 崇経, 稲垣 洋三

日本気管食道科学会会報 （(NPO)日本気管食道科学会）  63 （ 2 ） s46 - s46 2012年04月

ISSN  0029-0645

甲状腺悪性腫瘍の頸部リンパ節転移に対するPET/CT検査の有用性について

甲能 武幸, 坂本 耕二, 伊藤 文展, 西山 崇経, 新田 清一

日本気管食道科学会会報 （(NPO)日本気管食道科学会）  63 （ 2 ） s47 - s47 2012年04月

ISSN  0029-0645

当科における補聴器装用患者の検討 軽度難聴患者を中心に

新田 清一, 鈴木 大介, 岡崎 宏, 坂本 耕二, 伊藤 文展, 甲能 武幸, 西山 崇経, 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）  115 （ 4 ） 493 - 493 2012年04月

ISSN  0030-6622

早期喉頭癌治療後の音声に関する検討

甲能 武幸, 齋藤 康一郎, 矢部 はるな, 新田 清一, 坂本 耕二, 伊藤 文展, 西山 崇経

音声言語医学 （日本音声言語医学会）  53 （ 1 ） 46 - 46 2012年01月

ISSN  0030-2813

補聴器装用患者の語音聴取に関する検討 補聴器装用の効果について

鈴木 大介, 新田 清一, 上野 恵, 岡崎 宏, 坂本 耕二, 伊藤 文展, 甲能 武幸, 西山 崇経

音声言語医学 （日本音声言語医学会）  53 （ 1 ） 68 - 69 2012年01月

ISSN  0030-2813

補聴器装用患者の語音聴取に関する検討 聴力レベル、聴力型との関係について

上野 恵, 鈴木 大介, 岡崎 宏, 坂本 耕二, 伊藤 文展, 甲能 武幸, 西山 崇経, 新田 清一

音声言語医学 （日本音声言語医学会）  53 （ 1 ） 68 - 68 2012年01月

ISSN  0030-2813

軟素材外耳道再建を行った鼓室形成術後の鼓膜陥凹と真珠腫再形成について

新田 清一, 坂本 耕二, 伊藤 文展, 甲能 武幸, 西山 崇経, 小川 郁

Otology Japan （(一社)日本耳科学会）  21 （ 4 ） 517 - 517 2011年10月

ISSN  0917-2025

オープンフィッティングにおける耳栓の特徴に関する検討

上野 恵, 鈴木 大介, 岡崎 宏, 坂本 耕二, 伊藤 文展, 甲能 武幸, 西山 崇経, 新田 清一

Audiology Japan （Japan Audiological Society）  54 （ 5 ） 473 - 474 2011年09月

ISSN  0303-8106

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乳幼児の聴力評価に関する検討 : BOA・CORとASSRの閾値差を中心に

岡崎 宏, 新田 清一, 鈴木 大介, 坂本 耕二, 伊藤 文展, 甲能 武幸, 西山 崇経, 上野 恵

Audiology Japan （Japan Audiological Society）  54 （ 5 ） 639 - 640 2011年09月

ISSN  0303-8106

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オープンフィッティングにおける耳栓の適応に関する検討

鈴木 大介, 新田 清一, 上野 恵, 岡崎 宏, 坂本 耕二, 伊藤 文展, 甲能 武幸, 西山 崇経

Audiology Japan （Japan Audiological Society）  54 （ 5 ） 475 - 476 2011年09月

ISSN  0303-8106

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難聴を主訴に受診した補聴器装用患者の耳鳴に関する検討

新田 清一, 鈴木 大介, 岡崎 宏, 坂本 耕二, 伊藤 文展, 甲能 武幸, 西山 崇経, 上野 恵, 小川 郁

Audiology Japan （Japan Audiological Society）  54 （ 5 ） 309 - 310 2011年09月

ISSN  0303-8106

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難聴患者の心理状態・生活障害に関する検討 : 聴力レベルとの関係について

西山 崇経, 新田 清一, 鈴木 大介, 岡崎 宏, 上野 恵, 坂本 耕二, 伊藤 文展, 甲能 武幸

Audiology Japan （Japan Audiological Society）  54 （ 5 ） 497 - 498 2011年09月

ISSN  0303-8106

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