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医学部 附属病院 耳鼻いんこう・頭頸部外科 |
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A Case of Eosinophilic Otitis Media Implanted with Bone-Anchored Hearing Aid 査読あり
Koga H., Ganaha A., Nakamura T., Goto T., Tono T.
Practica Oto-Rhino-Laryngologica 116 ( 3 ) 213 - 219 2023年
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Practica Oto-Rhino-Laryngologica
Eosinophilic otitis media (EOM) is characterized by the presence of highly viscous middle ear effusion containing eosinophils, and is usually associated with bronchial asthma. Intratympanic corticosteroid administration and/or systemic steroid administration are effective treatments. However, the middle ear effusion and progressive hearing loss are difficult to control, significantly affecting the patient’s quality of life. Therefore, appropriate care is important not only for controlling the middle ear effusion and otorrhea, but also for preventing the progression of hearing loss. A 46-year-old woman was referred to our hospital with suspected eosinophilic otitis media. She had a history of asthma and aspirin sensitivity. In addition, she had recurrent nasal polyps despite having undergone nasal polypectomy on two occasions. She was diagnosed as having bilateral EOM according to the diagnostic criteria. She was started on steroid treatment, but after showing initial response, the middle ear effusion recurred immediately after withdrawal of steroid treatment. Although the patient also had difficulty in communication because of bilateral hearing loss, she could not wear hearing aids because of the middle ear effusion. Hearing aids sometimes aggravate middle ear infection by blocking aeration, increasing the risk of sensorineural hearing loss. Therefore, we implanted a bone-anchored hearing aid (Baha®) in her right ear. Average hearing threshold of 500, 1000 and 2000 was 35 dB using Baha®. Although audiometry revealed deterioration of the bone-conduction threshold in the right ear at five years after the Baha® implantation, she still had sufficient bone conduction hearing using Baha® because of the preserved bone-conduction in the contralateral ear. The Baha® hearing system is a clinically effective and good hearing rehabilitative device for patients with EOM.
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Kajihara K, Ganaha A, Matsuda K, Nakamura T, Tono T
The journal of international advanced otology 18 ( 2 ) 183 - 187 2022年3月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of International Advanced Otology
Bony abnormalities, including sphenoid dysplasia and calvarial defects, are well recognized in patients with neurofibromatosis type 1. However, having multiple calvarial defects is rare. We present a case of a 35-year-old Japanese male patient who was referred to our hospital because of hearing loss. He was diagnosed with neurofibromatosis type 1 during early childhood. Otoscopic examination revealed a protrusion from the anterior wall of the external auditory canal that obstructed the external auditory canal. Computed tomography findings revealed multiple defects and an uneven skull surface. Large bony defects of the anterior wall of the external auditory canal were also identified bilaterally. Conductive hearing loss was caused by temporomandibular joint herniation that was obstructing the external auditory canal in both ears. An active middle ear implant was implanted in the right ear. A floating mass transducer was placed into the round window niche using a round window coupler. The active middle ear implant improved postoperative audiometric thresholds to approximately 35 dB across all frequencies. No complications occurred for up to 30 months after the operation. An active middle ear implant is a feasible and valuable option for patients with neurofibromatosis type 1 and conductive hearing loss due to multiple skull defects that result in temporomandibular joint herniation.
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Comparison of speech perception lists used to evaluate Japanese single syllable hearing.
Matsuda Y, Okuda T, Kamie A, Miyanaga N, Nakamura T, Shirane M, Shimoara S, Ganaha A, Tono T
Auris, nasus, larynx 49 ( 3 ) 383 - 388 2021年10月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Auris Nasus Larynx
Objective: In Japan, the 57S and 67S single syllable lists have been used to test speech perception in cochlear implant (CI) users. However, due to advances in implants and processors, these lists have become too simple for CI users. In 2019, the Japan Otological Society created a new list, referred to as the iCI2004. The objective of this study was to compare the performance of these lists. Methods: The Japanese single syllable speech perception tests, iCI2004, 57S, and 67S, were administered to 70 patients with CI users. The effects of single syllable characteristics on the test scores were examined. The type and number of single syllables used in each list were different. Therefore, we compared the scores for normal lists, shared single syllables, and non-shared single syllables. Results: The average test results were 52% for iCI2004, 64% for 57S, and 77% for 67S; 67S performed the best, followed by 57S and iCI2004. The test results were significantly different. In a comparison of shared single syllables, the average scores were 58% for iCI2004 and 63% for 57S (45 pieces). A comparison of iCI2004 and 67S (17 pieces) showed that the average scores were 63% for iCI2004 and 75% for 67S. A comparison of 57S and 67S (20 pieces) showed that the average score for 57S was 70% and the average scored for 67S was 77%. No significant differences were detected under all conditions. Based on these results, the type of single syllable adopted affected the result. Conclusion: The data gives no clear indication that the selection of the word table or presentation of sound pressure affects listening to sound for CI users in Japan. Based on the type and number of single syllables used, iCI2004 seems appropriate for evaluation of hearing in patients using CI.
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Nakamura T, Ganaha A, Tono T, Yamada Y, Okuda T, Shimoara S, Matsuda Y
Auris, nasus, larynx 49 ( 6 ) 1072 - 1077 2021年5月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Auris Nasus Larynx
There are few reports of the treatment for severe hearing loss due to otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV) achieved by cochlear implantation (CI). Here, we have reported the case of a patient with severe bilateral sensorineural hearing loss with low-frequency residual hearing by OMAAV. CI was performed in her right ear based on the results of contrast-enhanced magnetic resonance imaging (CE-MRI) and promontory stimulation test (PST). The residual hearing in her right ear was preserved after CI and utilized for combined electric acoustic stimulation (EAS). The combined EAS was used for 3 years until the residual hearing became stabilized. However, the usable hearing in low frequency worsened gradually, and the fitting strategy of cochlear implant was changed from combined EAS to CI alone 4 years after CI. Even when the speech discrimination score with CI no longer exceeds 50 %, the patient continued using CI because of its advantages in maintaining the quality of life of the patient. The combined EAS was found to be a feasible option even in an OMAAV patient with residual hearing. CE-MRI and PST may thus be helpful in deciding the side of CI surgery in a patient with OMAAV.
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Tsuruda T, Yoshikawa N, Kai M, Yamaguchi M, Toida R, Kodama T, Kajihara K, Kawabata T, Nakamura T, Sakata K, Hatakeyama K, Gi T, Asada Y, Tono T, Kitamura K, Ikeda R
Internal medicine (Tokyo, Japan) 60 ( 3 ) 423 - 429 2021年2月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Internal Medicine
We herein report the cytokine expression at different stages for three patients who developed cardiac complications after immune checkpoint inhibitor (ICI) therapy. Case 1 with biopsy-proven myocarditis showed increased levels of interleukin (IL)-8, monocyte chemotactic and activating factor, and granulocyte macrophage colony-stimulating factor (GM-CSF) when he developed Takotsubo cardiomyopathy. Case 2 with subclinical myocarditis showed predominant activation of IL-8 during the progressive clinical course. Case 3 with cytokine-releasing syndrome showed substantial activations of IL-6, IL-8, GM-CSF, and interferon-γ. Our data suggest the development of unique cytokine activation in individual patients with cardiac complications after ICI therapy.
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VSB implantation in a NF1 patient with multiple bony defects in the temporal bones and the skull. 国際会議
Akira Ganaha, Keiji Matsuda, Kei Kajihara, Takeshi Goto, Takeshi Nakamura, Noriaki Miyanaga, Tetsuya Tono
12th Asia Pacific Symposium on Cochlear Implants and Related Sciences
開催年月日： 2019年11月27日 - 2019年11月30日
記述言語：英語 会議種別：ポスター発表
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Benefit of hearing preservation during cochlear implantation in patients with OMAAV. 国際会議
Nakamura Takeshi, Tetsuya Tono, Shouken Shimoara, Yuusuke Matsuda, Takahiro Nakashima
12th Asia Pacific Symposium on Cochlear Implants and Related Sciences
開催年月日： 2019年11月27日 - 2019年11月30日
記述言語：日本語 会議種別：ポスター発表
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めまい主訴の側頭葉てんかん・巨赤芽球性貧血症例．
湯地俊子，清水謙祐，中村 雄，鳥原康治，東野哲也
第78回日本めまい平衡医学会総会・学術講演会
開催年月日： 2019年10月23日 - 2019年10月25日
記述言語：日本語 会議種別：ポスター発表
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アブミ骨手術における顔面神経の解剖学的要因の影響．
中島崇博，梶原 啓，中村 雄，後藤隆史，我那覇章，松田圭二，東野哲也
第29回日本耳科学会総会・学術講演会
開催年月日： 2019年10月10日 - 2019年10月12日
記述言語：日本語 会議種別：口頭発表（一般）
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新生児聴覚スクリーニングにより早期診断に至った先天性伝音難聴に対して手術治療を行った3例の検討．
中村 雄，池ノ上あゆみ，我那覇章，中島崇博，後藤隆史，山田悠祐，猿渡英美，東野哲也
第29回日本耳科学会総会・学術講演会
開催年月日： 2019年10月10日 - 2019年10月12日
記述言語：日本語 会議種別：口頭発表（一般）
科研費（文科省・学振・厚労省）獲得実績 【 表示 ／ 非表示 】
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音源定位をサポートするハプティックデバイスの開発/一側聲の包括的治療を目指して
研究課題/領域番号：22K16914 2022年04月 - 2024年03月
独立行政法人日本学術振興会 科学研究費補助金 若手研究
担当区分：研究代表者