Search

Posterior expansion of the utricular endolymphatic space (ES) is a finding occasionally observed, and often occurs in bilateral ears. The clinical significance of posterior expansion of the utricular ES is not clear. To investigate the clinical significance of posterior expansion of the utricular ES detected on magnetic resonance imaging (MRI). Among 957 patients who underwent contrast-enhanced MRI to investigate the presence of endolymphatic hydrops (EH), clinical findings in cases with posterior expansion of the utricular ES were evaluated and the significance of their existence is considered. Posterior expansion of the utricular ES was detected in 30 ears from 20 cases (7 males, 13 females; mean age 48.7 years). The ears with posterior expansion had a significantly lower incidence of vestibular EH than those without, and this tendency was more prominent in cases in bilateral ears. Some cases with posterior expansion had vestibular symptoms and were diagnosed with Ménière's disease, although EH was not detected in their vestibules. Posterior expansion of the utricular ES was associated with Ménière's disease without vestibular EH. Posterior expansion of the utricular ES might not be associated with the formation of EH but may occur independently. [ABSTRACT FROM AUTHOR]

Listening difficulties (LiD) present difficulties in listening and paying attention to spoken information despite normal pure tone audiometry. Endolymphatic hydrops (EH) is a common inner ear condition associated with Ménière's disease but may also be present in the asymptomatic ear. Using magnetic resonance imaging, we investigated EH in patients with LiD and assessed whether the severity of EH was related to the results of auditory processing tests (APTs). 111 patients with no abnormalities on pure tone audiometry, but displaying difficulties in listening, underwent evaluation through APTs and questionnaires. Upon obtaining informed consent, the inner ears of 20 consenting patients were evaluated utilizing a 3-Tesla magnetic resonance imaging. A higher percentage of patients diagnosed with LiD by APTs had significant EH in the cochlea and vestibule than in previously reported control cases. The percentage of correct answers in the speech-in-noise test was significantly lower in patients with than in those without significant EH. In this study, significant EH of the cochlea was associated with poor listening to noise. The presence of EH affects the functioning of the auditory processing system, even in ears that test normally on standard audiometric tests. [ABSTRACT FROM AUTHOR]

In recent years, transcanal endoscopic ear surgery (TEES) is known as an innovative and minimally invasive surgery. To clarify the usefulness of TEES for the ossicular malformation, we performed a retrospective study. We examined cases of ossicular malformation performed using TEES at our hospital between April 2015 and April 2020. The hearing level results were countable for 16 cases. Post-operative hearing levels were significantly improved. Transient nausea, tongue paralysis, and taste disorders were observed; however, no other complications were observed. In 2015–2018, some of the cases required the assistance of a surgical microscope. In contrast, all the cases were performed by TEES after 2019 using a powered device to curve the canal. TEES requires considerable training, and the sensation of depth is difficult to acquire. However, this less invasive method is also helpful for ossicular malformation cases. [ABSTRACT FROM AUTHOR]

Otological diseases including Meniere's disease (MD) involve endolymphatic hydrops (EH), which can be visualized by magnetic resonance imaging (MRI) with gadolinium contrast agents, but the temporal changes of contrast in the inner ear have not been evaluated. We investigated the permeability of the blood–perilymph barrier (BPB) in ears with EH to evaluate the severity of the inner ear disturbances. The study included 32 ears from 16 patients with EH or related diseases who underwent MRI. The permeability of the BPB was assessed by the signal–intensity ratio (SIR) at four-time points: before and at 10 min, 4 h, and 24 h after administration of gadolinium for assessing EH. Cochlear EH was found in 25 of the 32 ears, and vestibular EH in 11. The rate of EH was significantly higher in symptomatic ears; however, the existence of EH was not related to SIR values. Nevertheless, SIR values in the basal turn were significantly higher 4 and 24 h after injection of gadolinium in patients aged ≥50 years. Higher SIR values observed in older patients with EH indicate severe disturbances of the BPB in the cochlea, which may account for intractable inner ear disturbances in older patients. [ABSTRACT FROM AUTHOR]

High signals in the inner ear of idiopathic sudden sensorineural hearing loss (ISSNHL) on magnetic resonance imaging (MRI) have been reported, but no quantitative evaluation has yet been done. To evaluate hearing outcomes and cochlear signal intensities on 3-T heavily T2-weighted three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (hT2W-3D-FLAIR) in patients with ISSNHL. Twenty-nine patients with ISSNHL were included. Patients underwent hT2W-3D-FLAIR with intravenous gadolinium injection and pure tone audiometry (PTA) at initial visits and 3 months later. Signal intensity ratios (SIRs) were measured in the basal or apical-middle turns of the affected cochlea. A statistical analysis of relationships between SIRs and the average hearing levels (HLs) at low (125, 250, and 500 Hz) and high (2, 4, and 8 kHz) tone frequencies was performed. Hearing improvements at high-tone frequencies in ears with HLs ≥60 dB were significantly worse in those with high SIRs at the basal turns on pre-contrast images. Similarly, hearing improvements at low-tone frequencies in ears with HLs ≥60 dB were significantly worse in those with high SIRs at the apical-middle turns on post-contrast images. High SIRs on hT2W-3D-FLAIR indicate cochlear disturbances with severe ISSNHL and could provide lesion-specific prognostic information. [ABSTRACT FROM AUTHOR]

High signal intensity in the endolymphatic duct (ED) is occasionally observed on magnetic resonance imaging (MRI) in ears that have otological disorders. The signal intensity (SI) in the ED on post-contrast MRI was investigated in subjects with various otological disorders, and the meaning of high SI in the ED was evaluated. 392 patients with otological disorders and 21 controls without otological symptoms underwent 3 T MRI. The SIs of the ED and the cerebellum were measured, the SI ratio (SIR) was calculated, and ears with SIR ≥4 were identified. A high SIR was identified in the ED of 3.7% of ears affected by definite Meniere's disease (dMD), 100% of ears affected by large vestibular aqueduct syndrome (LVAS), and 7.1% of ears with no otological symptoms. On the whole, a significant relationship was found between the existence of vestibular or cochlear EH and the SIR in the ED. The MRI finding of high SI in the ED may indicate the mechanism of inner ear disturbances in ears with otological disorders, especially in those with LVAS, and it may suggest an underlying disorder in some ears in which otological symptoms are not apparent. [ABSTRACT FROM AUTHOR]

Background: The presence of endolymphatic hydrops (EH) may cause hearing loss and affect the transmission of acoustic energy to the inner ear. Objectives: Acoustic energy absorbance on wideband acoustic immittance (WAI) was evaluated, focusing especially on EH in the vestibule. Material and methods: A total of 32 ears from 16 patients who underwent 3-T magnetic resonance imaging (MRI) to evaluate the presence of EH were examined, retrospectively. The degree of EH in the vestibule was classified into three grades (no, mild, and significant), and pure tone audiometry (PTA) and WAI were measured before and after a glycerol drip. Results: Ears with significant EH showed significantly higher hearing levels and air-bone gaps (ABG), and higher absorbance values on WAI at low frequencies (560–600 Hz) than ears with mild or no EH. Changes in absorbance values were observed in some ears without threshold change on PTA. Conclusions and Significance: This study showed significantly higher absorbance values of acoustic energy with significant vestibular EH at low frequencies. Considering ABGs observed in ears with significant EH, the presence of EH in the vestibule might cause an obstacle to the transmission of acoustic energy to the inner ear. [ABSTRACT FROM AUTHOR]

Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Endoscopic laryngo-pharyngeal surgery (ELPS), which is a transoral minimally invasive surgery using a gastrointestinal endoscope and a curved laryngopharyngeal retractor, is effective to treat primary lesions of superficial laryngopharyngeal cancers. To extend concepts of ELPS to invasive laryngopharyngeal cancers, we developed end-flexible-rigidscopic transoral surgery (E-TOS) from ELPS by changing a gastrointestinal endoscope to a flexible-tip rigid endoscope. Aims/Objectives: To retrospectively evaluate oncological outcomes and laryngopharyngeal functional preservation of E-TOS in patients with T1-selected T3 laryngopharyngeal cancers. Material and methods: In 47 patients T1-selected T3 pharyngeal and supraglottic cancers were resected by E-TOS using the flexible-tip rigid endoscope and curved instruments. Negative resection margin was histopathologically evaluated. The survival, preservation of larynx, and disease control rates were estimated using Kaplan-Meier method. Results: Curative resection was achieved in 94% of patients. No patient complained prolonged swallowing dysfunction or hoarseness after E-TOS. Postoperative bleeding, stenosis of the pharynx and esophageal entrance, and local recurrence was observed each in one patient. The 3-year overall survival, disease-specific survival, laryngeal preservation, local control, and locoregional control rates were, 86%, 93%, 100%, 98%, and 79%, respectively. Conclusion: E-TOS is an effective minimally invasive surgery for T1-selected T3 pharyngeal and supraglottic cancers with preserving laryngeal function. [ABSTRACT FROM AUTHOR]

Background: Diverticula in the internal auditory canal (IAC) have been reported in ears with otosclerosis. Objective: We evaluated hearing levels and vascular activity in ears with otosclerosis with and without IAC diverticula and clarify the significance of IAC diverticula. Materials and methods: Sixty-one ears from 54 patients who underwent stapes surgery for otosclerosis [fenestral (48 ears) and retrofenestral (13 ears) groups] were included in the present study. Preoperative hearing levels on pure tone audiometry (PTA) and intraoperative measurements of blood flow were compared between the groups. Results: A total of 24 of 61 ears (39.3%) showed IAC diverticula, significantly higher than the frequency in ears without otosclerosis (3.7%). No significant differences in air- and bone-conduction thresholds on PTA were evident between ears with and without IAC diverticula in each group. Ears without IAC diverticula tended to show higher blood flow in the area anterior to the oval window than ears with IAC diverticula, but the difference was not significant. Conclusions: The incidence of the IAC diverticula in otosclerosis was significantly higher than in cases without otosclerosis. The existence of IAC diverticula was not evidently related to the severity of the disease from the perspective of hearing level and vascular activity. [ABSTRACT FROM AUTHOR]

Background: Multifocal human papillomavirus (HPV) infection into the palatine and pharyngeal tonsils, which might be linked to a second primary tumor of HPV-positive oropharyngeal cancer (OPC), was investigated. Patients and methods: One hundred and five patients with various head and neck diseases including 14 patients with OPC were enrolled in this study. Swabs from the palatine and pharyngeal tonsils were collected in each individual, and auto-nested GP5+/GP6+ PCR for HPV DNA was performed. Results: HPV DNA was detected in the palatine tonsil or the pharyngeal tonsil in a small subset of upper respiratory tract cancer other than OPC (URTC) and non-cancer diseases. Furthermore, HPV DNA was detected in both the palatine and pharyngeal tonsils in the same individual in 2 of 48 (4%) URTC cases, and 1 of 43 (2%) non-cancer cases. On the other hand, p16-positive OPC cases demonstrated a higher HPV DNA detection rate (4 of 9, 44.4%) compared with other disease groups. Conclusion: HPV DNA detection in both the palatine and pharyngeal tonsils in the same individual, especially in HPV-OPC, suggested the ability of HPV to infect tonsillar tissues of Waldeyer’s ring multifocally. [ABSTRACT FROM AUTHOR]

Conclusion: The detection of human papillomavirus (HPV)-DNA in oral rinse with auto-nested GP5+/ GP6 + PCR is useful as a biomarker of oropharyngeal cancer. Background: This study aimed to determine the usefulness of oral rinse to detect HPV-DNA as a biomarker of HPV-positive oropharyngeal cancer (OPC). Patients and methods: One hundred and ten patients with various head and neck diseases, including 19 patients with OPC, were enrolled. Oral rinse and tonsillar swab were collected, and auto-nested GP5+/GP6 + PCR for HPV-DNA was performed. For oropharyngeal cancer, p16 immunostaining was also conducted. Results: The rate of HPV-DNA detection in both oral rinse and tonsillar swab was significantly higher in OPC compared with non-OPC upper respiratory tract cancer and non-cancer diseases. HPV-DNA was detected in oral rinse in nine out of 12 p16-positive OPC cases, while none of the p16-negative OPC cases demonstrated detectable HPV-DNA. All p16-positive cases were also positive for HPV-DNA in tumor tissue. Based on p16 immunostaining, the sensitivity and specificity of HPV-DNA detection in oral rinse were 75% and 100%, respectively. Among eight of nine evaluable OPC cases positive for HPV-DNA in oral rinse at diagnosis, HPV-DNA was undetectable in oral rinse in seven cases after treatment. [ABSTRACT FROM AUTHOR]

Conclusions:The present study yielded useful information concerning pre-lingually deaf adolescents and adults who try or manage to understand languages. PET-CT can provide insights into brain plasticity and elucidate which mode of communication is the most effective for education of such patients. Objectives:To study the cortical activity in pre-lingually deaf adolescent and adult cochlear implants (CI) users who have been trained in auditory-verbal/oral communication since childhood. Methods:Using positron emission tomography (PET) and 18F-fluorodeoxyglucose (FDG), brain activities in six pre-lingually and two post-lingually deaf CI users (mean age at CI surgery = , 20.3 years; three males, five females) were compared with those of 10 normal age-matched controls (mean age = 27.1 years). Regional cerebral blood flow changes were measured during an acoustic presentation of a story. Results:In compliant CI users, the number of hypermetabolic auditory-related areas was greater in those who had a CI in their 20s than in those who did so in their adolescence. In poor and non-compliant users, hypermetabolism was not seen in the auditory association area, but in the primary auditory areas (BA41) and the Broca’s area (BA45). In post-lingually deaf CI users, no increase in the number of hypermetabolic areas was found in auditory-related regions. [ABSTRACT FROM PUBLISHER]

Conclusions: The presence of endolymphatic hydrops (EH) in the vestibule on magnetic resonance imaging (MRI) might be a high-risk factor for complications in cases that are candidates for stapes surgery. Objective: Pre-operative detection of EH could be valuable in cases that are candidates for stapes surgery to prevent unpredictable complications following surgery. Pre-operative MRI findings and postoperative findings following stapes surgery were compared to evaluate the efficacy of such MRI evaluation for the management of cases with otosclerosis. Subjects and methods: Sixteen cases who underwent pre-operative evaluation by 3T MRI performed 4 h after intravenous injection of gadolinium and stapes surgery for otosclerosis were recruited. Imaging data concerning the degree of EH in the vestibule and cochlea were compared with postoperative clinical findings for all cases. Results: Mild EH in the cochlea or the vestibule was observed in eight ears and one ear, respectively, whereas one ear showed significant EH both in the cochlea and the vestibule. The post-operative course was uneventful in 12 of 14 cases with no EH in the vestibule, and the other two cases had a short period of dizziness, but two cases with EH in the vestibule had a long period of dizziness. [ABSTRACT FROM AUTHOR]

Conclusion:All definite Meniere’s disease (MD) had endolymphatic hydrops (EH) at least in the cochlea or the vestibule. Symptoms of MD may appear after formation of EH. It is assumed that the probability of immediate progression to bilateral MD from unilateral MD is very low in patients without EH on the non-affected side. Objective:To evaluate the EH on both sides in patients with unilateral and bilateral MD, and to investigate factors with progression to bilateral MD including the degree of EH, hearing level, and the duration of MD. Patients and methods:The study included 29 patients with unilateral definite MD and 12 patients with bilateral definite MD. The endolymphatic space size was visualized by using 3-Tesla magnetic resonance imaging. Results:All patients with unilateral and bilateral MD had significant or mild EH at least in the cochlea or the vestibule on the affected side. On the non-affected side, EH was not observed at all in eight patients, but asymptomatic EH was observed in the cochlea in 14 patients and in the vestibule in 16 patients. There was no relationship between the EH on the non-affected side and the duration of MD. [ABSTRACT FROM PUBLISHER]

Objective --The formation and growth of nasal polyps requires remodeling of the extracellular matrix. Matrix metalloproteinases (MMPs) are a family of endopeptidases that can collectively degrade almost all extracellular matrix components. The aim of this study was to investigate the role of MMPs in nasal polyps. Material and Methods --The expression of MMP-2 and -9 was investigated in the nasal polyps of 20 patients undergoing endonasal sinus surgery and compared with that in control nasal mucosal samples obtained from 20 non-allergic hypertrophic rhinitis patients. Tissue samples were either homogenized for reverse transcriptase polymerase chain reaction analysis or frozen for immunohistochemistry. Results --MMP-2 mRNA expression was observed only in the nasal polyp samples and not in the control tissues. MMP-9 mRNA was not expressed in either type of tissue. Similarly, MMP-2 expression was observed in the nasal polyps of chronic sinusitis patients but not in the inferior turbinate mucosa of the control subjects. MMP-2 positivity was present in basal cells in the surface epithelium and in infiltrating cells in subepithelial tissues. MMP-9-positive cells were not observed in either nasal polyps or inferior turbinates. These results suggest that MMP-2 expression is characteristic of nasal polyps. Conclusion --MMP-2 may play a role in the remodeling of nasal polyps. [ABSTRACT FROM AUTHOR]

Conclusion: SPARC-expression is an indicator of the prognosis in terms of OS, independent of HPV-infection. HPV-negative patients with SPARC-Low show survival as favorable as HPV-positive patients, probably because of their higher salvage rate after relapse than SPARC-High patients.Objective: The objectives of the study were to clarify the correlation between the expression of secreted protein acidic and rich in cysteine (SPARC) and HPV-status, and to determine the prognostic value of SPARC-expression in oropharyngeal squamous cell carcinoma (OPSCC) patients.Methods: Fifty-three formalin-fixed and paraffin-embedded tissues were obtained from patients with OPSCC who underwent curative treatment. The SPARC protein was detected by immunohistochemistry. SPARC-expression level was divided into two categories, SPARC-High and SPARC-Low, according to the staining index.Results: Twenty-two out of the 53 OPSCC patients were HPV-positive. There was no significant correlation between the HPV-status and SPARC-expression level. Multivariate Cox proportional hazards regression analysis revealed that the HPV-status and SPARC-expression are independent prognostic indicators of favorable and unfavorable overall survival (OS) (p = 0.021 andp = 0.012), respectively. For disease-free survival, the HPV-status was the only predictive factor (p = 0.022). After stratification by the HPV-status, high SPARC-expression was a significant predictor of poor OS in HPV-negative OPSCC patients using Kaplan–Meier analysis and the log-rank test (p = 0.014). Ten out of 28 SPARC-Low patients relapsed, among which six patients (60%) were salvaged. However, 14 out of 25 SPARC-High patients relapsed, and only three patients (21.4%) were salvaged. [ABSTRACT FROM PUBLISHER]

Conclusion: This study revealed that endolymphatic hydrops (EH) reduced in some cases with Ménière's disease (MD) treated conservatively. It appears that the EH reduction was associated with improvement of the clinical symptoms. Objectives: The relationship between the degree of EH and clinical symptoms is not clear at present. The purpose of the present study was to investigate the time course of the relationship in patients with MD treated conservatively. Patients: Twelve patients with MD treated conservatively for more than 1 year in a university hospital. Methods: Twenty ears of 12 patients with MD treated conservatively were evaluated. The presence or absence of vertigo, tinnitus and ear fullness was confirmed when magnetic resonance imaging (MRI) was performed. Using a 3 T MRI scanner, three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MRI was performed 2 or 3 times 24 hours after intra-tympanic gadolinium injection or 4 hours after intravenous gadolinium injection. Results: In the three ears in which the symptoms alleviated, EH was reduced in two ears, but EH was reduced in only one of 17 ears in which the symptoms did not alleviate. The Fisher exact test revealed that EH reduction occurred more frequently in ears with alleviation of the symptoms ( p < 0.05). [ABSTRACT FROM AUTHOR]

Conclusions: Superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) is considered to be one of the treatments of choice for patients with adenoid cystic carcinoma (ACC) who prefer not to undergo radical surgery. Objective: To evaluate the efficacy of RADPLAT for patients with ACC of the head and neck. Patients and methods: Between 2001-2010, nine patients with untreated ACC were given superselective intra-arterial infusion of cisplatin (100-120 mg/m2/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity and radiotherapy (65-70 Gy). Results: Five patients had tumors arising in the base of the tongue, two in the maxillary sinus, and the remaining two in the nasopharynx. The median follow-up period was 9 years 7 months (9;7) (range = 4;6-12;5), and the 5-year local control (LC), overall survival (OS), and disease-free survival rates were 88.9%, 88.9%, and 55.6%, respectively. The 10-year OS rate was 57.1%, but all patients who remained alive for over 10 years are still alive with disease. Primary tumor recurrence was observed in five of the nine patients, with the median time to recurrence being 6 years (range = 4-9 years). Five of the nine patients had distant metastasis, and of these three patients also had primary recurrence. [ABSTRACT FROM AUTHOR]

Conclusions: Our data indicate that SSSR and SSSR + FGLM-NH2 protect sensory hair cells against neomycin-induced death in the vestibular epithelium. In addition, the results show that SSSR and FGLM-NH2 can be used as protective molecules against aminoglycoside ototoxicity. Objectives: This study investigated the role of the peptides SSSR and SSSR + FGLM-NH2 in mammalian vestibular hair cell death induced by aminoglycoside. Methods: Cultured utricles from mature CBA/N mice were used in this study. The cultured utricles were assigned to five groups (control group, neomycin group, neomycin + SSSR group, neomycin + FGLM-NH2 group, and neomycin + SSSR + FGLM-NH2 group). Aat 24 h after exposure to neomycin, the hair cells were labeled immunohistochemically, and the rate of survival of vestibular hair cells was evaluated using a fluorescence microscope. Results: The rate of survival of vestibular hair cells was significantly higher in the neomycin + SSSR and neomycin + SSSR + FGLM-NH2 groups than in the neomycin group. The results suggest that SSSR could protect hair cells against aminoglycoside ototoxicity. [ABSTRACT FROM AUTHOR]

Conclusion: Additional treatment with clarithromycin (CAM) reduced persistent middle ear inflammation after acute otitis media (AOM) caused by Haemophilus influenzae in children. CAM is a treatment option for persistent inflammation following AOM and to prevent continuing otitis media with effusion. Objective: We conducted a clinical study to evaluate a new method of treatment for persistent inflammation after AOM in children. Methods: H. influenzae-infected children with AOM were treated acutely with antimicrobial agents, after which those still demonstrating effusion of the middle ear cavity received additional treatment with carbocysteine (S-CMC) alone or S-CMC combined with clarithromycin (CAM) for 1 week. The two regimens were compared in terms of clinical effects. Results: After the initial acute treatment, many patients still showed abnormal otoscopic findings. At the completion of additional treatment, there were no significant differences between the two treatment groups. However, 1 week after completion of additional treatment, the prevalence of a diminished light reflex was significantly lower in the CAM + S-CMC group than in the S-CMC group ( p = 0.017). The prevalence of redness of the tympanic membrane also tended to be lower in the combined treatment group than in those receiving a single drug ( p = 0.097). [ABSTRACT FROM AUTHOR]

Conclusion: The antero-posterior (AP) body tracking test (BTT) showed that the dominant foot could affect the tilt angle of the sway movement, delineated by primary component analysis. Differences associated with the dominant foot could represent the difference in space perception of each person. Objectives: To examine whether the dominant foot could affect the postural control mechanism using the BTT. Methods: Ninety-seven healthy participants enrolled in the study were classified into right-foot and left-foot dominance groups, and their performances were compared. For the BTT, each participant stood on a stabilometer and caught the movement of a visual target moving vertically (anterior-posterior) or horizontally by the center of pressure movement, displayed on a 14-inch screen monitor at 100 cm in front of the subject. The mean displacement angle of the obtained stabilogram was evaluated by principal component analysis. Results: The AP BTT in the right-foot dominance group showed a clockwise tilt with a mean displacement angle of 3.022 ± 3.761°, whereas the group with left-foot dominance had a modest counter-clockwise tilt with a mean displacement angle of -0.694 ± 4.497°. This difference was found to be significant by the independent t test ( p < 0.0001). In the lateral BTT, the mean displacement angles were not significant. [ABSTRACT FROM AUTHOR]

Conclusion: An epidemiological survey of hospitals and private clinics in Japan regarding idiopathic sudden sensorineural hearing loss (SSNHL) revealed that the incidence of SSNHL was 60.9 per 100 000 population. There were more females than males in the younger generation. Objective: The incidence of SSNHL varies largely by country. Because the Japanese criteria for diagnosing SSNHL have changed in accordance with those widely used in other parts of the world, a clinicoepidemiological study was undertaken using the new criteria. Methods: Ehime, Aichi, and Iwate Prefectures were selected from the western, central, and northeastern regions of Japan, respectively. The subjects for this study were patients who suffered SSNHL between April 1, 2012 and March 31, 2013. Questionnaires were mailed to all hospitals and private clinics in which ENT doctors were working. Initial and final audiograms were requested for 10% of the patients. Results: In all, 78 of 90 hospitals (87%) and 303 of 407 private clinics (74%) responded. It was reported that 1663 patients visited hospitals and 3090 patients visited only private clinics. It was estimated that 6205 SSNHL patients visited hospitals or private clinics in 1 year from a population of 10 145 000. Also, 23% of patients suffered acute low-tone SNHL (female to male ratio; 3:1 in definite cases). [ABSTRACT FROM AUTHOR]

Conclusions: Eosinophil cationic protein (ECP) concentrations in middle ear effusion (MEE) in patients with eosinophilic otitis media (EOM) were significantly decreased at 3 months after the administration of omalizumab from the baseline level ( p < 0.05). This study provides new evidence that omalizumab reduces eosinophilic inflammation in the middle ear and that the reduction of ECP may not be caused by suppression of interleukin (IL)-5 production in the middle ear mucosa. Objective: EOM is an intractable otitis media characterized by a highly viscous effusion containing eosinophils. We recently reported that anti-IgE therapy using omalizumab was efficacious in the treatment of EOM. To clarify the underlying mechanism, we determined changes in biomarkers in MEE related to eosinophilic inflammation after therapy. Methods: Nine patients with EOM received the anti-IgE agent omalizumab for 3 months. Among them, five patients continued anti-IgE therapy for longer than 1 year. Eight EOM patients without administration of omalizumab were also included in the study as controls. The concentrations of eosinophilic inflammatory markers such as ECP, IgE, IL-4, and IL-5 in MEE were measured before and after the administration of omalizumab. Results: After 3 months of omalizumab therapy, the ECP concentration in MEE was significantly reduced from the baseline level ( p < 0.05), while no significant change of ECP in the serum was observed. The concentrations of IL-4 and IL-5 in MEE showed no significant change before and after the therapy in EOM patients treated with omalizumab. [ABSTRACT FROM AUTHOR]

Conclusion: The results indicate that oral administration of azithromycin (AZM) is equivalent to intravenous administration of cefazolin (CEZ) for preventing surgical site infection (SSI) in patients undergoing tonsillectomy, and should be used as cost-effective antimicrobial prophylaxis. Objective: Staphylococcus aureus, Streptococcus spp., and pharyngeal anaerobes have been described as major pathogens causing SSI in transpharyngeal operations such as tonsillectomy. The purpose of this study was to explore whether administration of AZM, an oral antimicrobial agent, might be equivalent to intravenous administration of a first-generation cefem antimicrobial agent for preventing SSI in patients undergoing tonsillectomy. Methods: Patients undergoing tonsillectomy were divided into an AZM-treated group and a CEZ-treated group, for intergroup comparison of responses. AZM was administered once orally, 2 days before the operation, whereas patients in the CEZ-treated group received CEZ intravenously 30 min before the operation, 4 h postoperatively, and then twice daily for 3 consecutive days beginning the day after the operation. Results: There were no significant intergroup differences in mean duration of hospitalization after the operation, incidence of postoperative hemorrhage, postoperative analgesic effect, or hematologic/blood biochemical findings. The incidence of postoperative fever was significantly lower in the AZM-treated group. Diarrhea occurred as an adverse drug reaction in the AZM-treated group, but no clinically significant adverse reactions were noted. [ABSTRACT FROM AUTHOR]

Conclusion: In patients with poorly controlled diabetes mellitus (DM), hearing disturbance was associated with renal dysfunction and diabetic neuropathy, represented by decreases in median nerve compound action potential amplitude. Methods: The evaluation was conducted using 43 subjects who were hospitalized for the purpose of DM education. The mean age was 58.1 years (range 21-82 years). The mean HbA1c was 9.5%. The mean DM duration was 11.0 years. Renal function, retina condition, and nerve conduction were evaluated in relation to DM complications (nephropathy, retinopathy, and neuropathy). Nerve conduction studies were used to obtain detailed information on the condition of the peripheral nerves. After otological inspection, pure-tone audiometry, auditory steady-state response (ASSR), and distortion-product otoacoustic emissions (DPOAEs) were measured. Stepwise multiple linear regression was used to analyze the results in the better ear and worse ear. Results: Decreases in median nerve compound action potential amplitude were associated with deterioration in pure-tone audiometry and ASSR. Diabetic neuropathy, creatinine clearance, diabetic nephropathy, and retinopathy were related to hearing in ASSR and/or DPOAEs. [ABSTRACT FROM AUTHOR]

Conclusion: Using magnetic resonance imaging (MRI), endolymphatic hydrops could be visualized on both sides after intratympanic (IT) injection of gadolinium contrast agents (Gd) in one symptomatic ear and subsequent intravenous (IV) Gd injection. The MRI revealed a difference of intracochlear Gd distribution between the IT injection side and the contralateral IV side. Objectives: Although the IT method allows greater enhancement of the perilymph, many patients feel reluctance in receiving the IT injection in asymptomatic ears. We attempted to evaluate endolymphatic space size on both sides without the IT injection in asymptomatic ears. Methods: In 10 patients with Meniere's disease, MRI was performed 24 h after the IT Gd injection in one symptomatic ear and 4 h after the IV Gd injection. The signal intensity of Gd in the basal and apical turns of the cochlea was evaluated. Results: The signal intensity in the scala tympani of the basal turn of the cochlea was 1.70 ± 0.60 on the IT + IV side and 0.42 ± 0.10 on the contralateral (IV) side. Gd was distributed uniformly in the scala tympani in the cochlea on the IV side, whereas it was strongly localized in the basal turn on the IT + IV side. [ABSTRACT FROM AUTHOR]

Conclusion: Our study showed that patients with atypical Meniere's disease had endolymphatic hydrops (EH) in both the cochlea and the vestibule. Using an imaging method, we provide evidence that atypical Meniere's disease is a true variant of classic Meniere's disease. Objectives: The aim of present study was to investigate images of the endolymphatic space in patients with atypical Meniere's disease (cochlear and vestibular Meniere's disease). Methods: Sixty-four patients divided into two groups were enrolled in this study. The first group included 36 patients who had fluctuating hearing loss without vertigo, as candidates for cochlear Meniere's disease (CMD). The second group included 28 patients who had recurrent vertigo without hearing loss, as candidates for vestibular Meniere's disease (VMD). The patients underwent 3 T magnetic resonance imaging (MRI) after injection of gadolinium enhancement medium intratympanically or intravenously. We evaluated EH using MRI. Results: Of 56 ears (36 patients) with CMD, 38 showed EH in the cochlea and 44 showed EH in the vestibule. Of 56 ears (28 patients) with VMD, 29 showed EH in the cochlea and 47 showed EH in the vestibule. The VMD group had a significant vestibular predominance in EH distribution whereas the CMD group showed no significant regional predominance of EH. [ABSTRACT FROM AUTHOR]

Conclusion: We conclude that intra-arterially injected cisplatin passed via lymph flow into sentinel nodes (SNs) as the platinum concentration in the SNs was higher than that in the non-sentinel nodes (NSNs). It is possible that preoperative intra-arterial chemotherapy targeting primary cancer also has a therapeutic effect on subclinical metastatic SNs. Objectives: Intra-arterial chemoradiotherapy has been reported to be effective against not only primary tumors but also nodal metastases. We considered the hypothesis that intra-arterially injected cisplatin passed via lymph flow into regional nodes. This study aimed to investigate intra-arterially injected cisplatin distribution to regional nodes by comparing platinum concentrations in SNs and NSNs. Methods: Five patients with T1-2 N0 tongue cancer were treated with preoperative intra-arterial chemotherapy (cisplatin, 100 mg/m2) targeting primary cancer. Partial glossectomy together with SN biopsy and elective neck dissection were performed 2 weeks after intra-arterial chemotherapy. Platinum concentrations in the lymph nodes were measured using a Zeeman atomic absorption spectrometer. Results: Thirteen SNs were harvested together with eight NSNs from the areas adjacent to the SNs. Platinum concentrations were then measured, revealing a significant difference in platinum concentration between the SNs and the NSNs (mean ± SD, 0.682 ± 0.246 µg/g vs 0.506 ± 0.274 µg/g; p = 0.049). [ABSTRACT FROM AUTHOR]

Conclusion. Contrast enhancement of the inner ear by three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) taken 4 h after intravenous gadolinium (Gd) injection was better than when taken at 10 min. Using heavily T2-weighted 3D-FLAIR MRI, visualization of endolymphatic hydrops (EH) was possible in the vestibule and the cochlea after a standard intravenous dose of Gd. Objectives. To define a suitable time point for imaging Gd uptake in the inner ear acquired with heavily T2-weighted 3D-FLAIR MRI after standard intravenous Gd administration. Methods: Using a 3 Tesla MRI unit, heavily T2-weighted 3D-FLAIR MRI images were taken twice at approximately 10 min (conventional timing) and 4 h after intravenous gadodiamide (0.1 mmol/kg) injection in 10 patients with inner ear diseases including Ménière's disease. Results: The 4 h delay increased Gd enhancement of the 3D-FLAIR MRI images of the perilymphatic space in both symptomatic and asymptomatic ears. The increase in Gd enhancement was greater in symptomatic than in asymptomatic ears. Using this heavily T2-weighted 3D-FLAIR technique, EH was observed in both the cochlea and vestibule in images taken 4 h after the intravenous Gd injection. [ABSTRACT FROM AUTHOR]

Conclusions: The blood--labyrinth barrier is impaired in association with the hydrops grade in Méénièère's disease. Objectives: To investigate the relationship between endolymphatic hydrops and the clinical characteristics of patients with Méénièère's disease revealed by 3 T magnetic resonance imaging (MRI). Methods: A double dose of gadoteridol (Gd; 0.2 mmol/kg) was injected intravenously in 12 patients with Méénièère's disease. We performed three-dimensional fluid attenuated inversion recovery MRI and three-dimensional real inversion recovery MRI 4 h later using a 3 T MRI unit. Ten patients had unilateral and two had bilateral Méénièère's disease. Results: Fourteen ears with Méénièère's disease showed intense Gd contrast on MRI compared with that in the 10 asymptomatic contralateral ears of patients with unilateral Méénièère's disease (1.12 ±± 0.36 vs 0.82 ±± 0.15). The hydrops grade was correlated significantly with the contrast effect. The 14 ears with Méénièère's disease had endolymphatic hydrops. Of the 10 contralateral ears of patients with unilateral Méénièère's disease, 2 had endolymphatic hydrops in the cochlea and 6 had endolymphatic hydrops in the vestibule. [ABSTRACT FROM AUTHOR]

Conclusion: 3 Tesla (3T) magnetic resonance imaging (MRI) performed 4 h after intravenous gadolinium (Gd) injection provides sufficient anatomic resolution of the inner ear fluid spaces in sudden deafness. The signal intensity ratio (SIR) between the cochlea and cerebellum may be a good indicator of disruption of the blood–labyrinthine barrier. Objectives: We evaluated the inner ear 4 h after intravenous Gd injection to determine whether 3T MRI enables the acquisition of images of the affected inner ear in sudden deafness. Methods: Ten patients underwent 3T MRI scanning 4 h after intravenous Gd injection. Three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MRI was performed. Results: The SIR varied from 0.45 to 2.17 in 11 affected ears and from 0.43 to 1.48 in 9 unaffected ears. The difference of contrast (affected ear vs unaffected ear) could be detected in five of the nine patients with unilateral sudden deafness. The Gd distribution was recognized in the vestibule of 10 affected ears and in the cochlea of 5 affected ears, in which no significant hydrops was observed. In the remaining vestibules and cochleas of affected ears, the Gd enhancement was too faint to evaluate the endolymphatic hydrops. [ABSTRACT FROM AUTHOR]

Conclusion: Among patients with facial nerve paralysis, significant difference was observed on three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) between those with and without audio-vestibular disturbance. This MRI technique may contribute to elucidation of the pathology of Ramsay Hunt syndrome and Bell's palsy. Objective: To evaluate the 3D-FLAIR MRI findings in patients who have facial nerve paralysis with and without audio-vestibular disturbance. Methods: 3D-FLAIR MRI was performed with and without gadolinium enhancement in 15 patients (5 men and 10 women) with unilateral facial nerve paralysis: 3 patients with Ramsay Hunt syndrome, 3 patients having facial nerve paralysis with hearing loss or vertigo without vesicles, and 9 patients with Bell's palsy. Results: Five of the six patients with audio-vestibular disturbance showed high signals in the inner ear on precontrast 3D-FLAIR. In comparison, among nine patients with Bell's palsy, only one patient showed high signals in the inner ear on precontrast 3D-FLAIR ( p < 0.05). [ABSTRACT FROM AUTHOR]

Conclusion: Local application of hepatocyte growth factor using biodegradable gelatin hydrogels attenuates noise-induced hearing loss in guinea pigs. Objectives: To develop an inner ear drug delivery system using gelatin hydrogels that is capable of a sustained delivery of growth factors to the cochlea. We examined the efficacy of the local application of gelatin hydrogels containing hepatocyte growth factor (HGF) in protecting cochlear hair cells from noise-induced damage. Materials and methods: A piece of gelatin hydrogel previously immersed in either HGF or saline was placed on the round window membrane of a guinea pig 1 h after noise exposure (4 kHz octave band noise at 120 dB sound pressure level for 3 h). Auditory function was monitored using auditory brainstem responses (ABRs), and the loss of hair cells was evaluated quantitatively. Results: Local HGF treatment significantly reduced the noise exposure-caused ABR threshold shifts and the loss of outer hair cells in the basal portion of the cochleae. [ABSTRACT FROM AUTHOR]

Conclusions: Bilateral thyroarytenoid myectomy under microlaryngoscopy by the Muta method (TA myectomy) is a useful surgical treatment for adductor spasmodic dysphonia (ADSD), as a long-term-effect can be expected. Objective: Botulinum toxin (BT) injection is universally accepted as the first choice of treatment for ADSD. However, unfortunately it is not covered by National Health Insurance in Japan and therefore is not a common practice. So, various other therapeutic modalities have been reported. In the current study, we conducted bilateral TA myectomy on patients with ADSD and evaluated the results. Patients and methods: Seven patients with ADSD who visited our department between 1999 and 2005 are described. The details of BT injection and the surgical procedure were described to the patients. As all seven patients wanted to undergo this surgical therapy, they all underwent bilateral TA myectomy. Results: The constriction was eliminated immediately after surgery and the patients became capable of smooth phonation. Hoarseness was recognized, but it began to ease after 1-2 months and was corrected to B grade 1-0 of the GRBAS scale approximately 6 months after the surgery. Improvement in the condition was noted in all seven patients according to evaluations based on the mora method. All patients are currently in the B grade 0. [ABSTRACT FROM AUTHOR]

Conclusion. Total intravenous anesthesia (TIVA) without intubation has the advantages of both conventional general anesthesia and local anesthesia. It is useful in laryngeal framework surgery because intraoperative voice monitoring while the patient remains awake is required. Objective. In laryngeal framework surgery, it is desirable to monitor the voice during surgery. However, surgery is conducted under general anesthesia, although such a procedure renders the patient unable to phonate during surgery. We conducted TIVA without intubation, allowing patients to breathe spontaneously while undergoing operation, and succeeded in intraoperative voice monitoring with satisfactory postoperative voice production. Subjects and methods. The subjects were 21 patients who underwent surgery. For TIVA, propofol and pentazocine were used as a sedative and analgesic, respectively. A bispectral index (BIS) monitor was used to measure the depth of the anesthesia. Before the vocal folds were to be rotated, propofol administration was interrupted to arouse and instruct the patient to phonate. Guided by the phonation, the vocal folds were correctly positioned. Then propofol administration was resumed, and the wound was closed. Results. The BIS value during continued administration of propofol was around 60, but exceeded 90 in all patients within 233.6±64.5 s after cessation. They clearly remembered the conversation they had with us during surgery. [ABSTRACT FROM AUTHOR]

Conclusion: A concomitant treatment of intra-arterial chemotherapy and radiation therapy is a promising therapeutic option for oropharyngeal cancers. Objectives: Treatment for oropharyngeal cancer has been far from standardized because of its pathophysiologic complexity and its low incidence. In our department, T1 stage tumors with N0 or N1 status are primarily treated surgically, while T1 tumors with N2 or more advanced lymph node involvement are additionally treated with concomitant chemoradiotherapy (CRT). Treatment for T2, T3, and T4 tumors is based on CRT, but surgery is also performed if necessary. Patients and methods: The study included 73 patients with squamous cell carcinomas of the lateral oropharyngeal wall who received first-line therapy at our department between May 1993 and October 2003. Results: The 5-year disease-specific survival by disease stage was 100% for stage I, 90.9% for stage II, 88.2% for stage III, 69.8% for stage Iva, and 22.2% for stage IVb. The overall 5-year disease-specific survival was 71.8%, and the overall 5-year crude survival was 54.1%. [ABSTRACT FROM AUTHOR]

Conclusion. This is the first report of nitric oxide (NO) production by cultured spiral ligament (SL) fibrocytes. The data suggest that dexamethasone (Dex) suppresses NO production by SL fibrocytes. Given that SL fibrocytes play a role in cochlear fluid and ion homeostasis, glucocorticoids may suppress cochlear malfunction caused by NO production in SL fibrocytes. Objective. To investigate NO production by cultured SL fibrocytes and regulation of NO production by Dex in mouse secondary cell cultures. Materials and methods. Cultured SL fibrocytes were stimulated with tumor necrosis factor-α (TNF-α), and NO production was visualized with membrane-permeable 4-amino-5-methylamino-2',7'-difluorofluorescein diacetate (DAF-FM diacetate). Inducible nitric oxide synthase (NOSII) messenger RNA (mRNA) was measured by reverse transcription-polymerase chain reaction (RT-PCR). Results. After TNF-α stimulation, the fluorescence intensity increased in a time-dependent manner. This increase in fluorescence intensity was suppressed by a nonspecific NOS inhibitor, NG-nitro L-arginine methyl ester (L-NAME), and Dex. After TNF-α stimulation, expression of NOSII mRNA was observed. Expression of NOSII mRNA was inhibited by Dex. [ABSTRACT FROM AUTHOR]

Most osteochondromas affect the long bones, but rarely originate in the spine. We report an extremely rare case of osteochondroma of the atlas causing obstructive sleep apnea syndrome (OSAS) in a 61-year-old female. The osteochondroma was removed completely using a transoral approach, and the symptoms of OSAS disappeared. A review of the literature regarding osteochondroma confirms the rarity of this lesion and the use of a transoral approach is discussed. [ABSTRACT FROM AUTHOR]

Conclusions. This regimen of concurrent chemoradiotherapy was safe and well tolerated. In terms of larynx preservation, the present regimen appears to be useful for patients with advanced resectable squamous cell carcinoma (SCC) of the larynx and hypopharynx. Objectives. To evaluate the efficacy and toxicity of concurrent chemoradiotherapy in patients with advanced resectable SCC of the larynx and hypopharynx, and to demonstrate the feasibility of larynx preservation. Patients and methods. Forty-six eligible patients were treated. The chemotherapy regimen consisted of a combination of four drugs: cisplatin (60 mg/m2, day 4), 5-fluorouracil (5-FU) (600 mg/m2 given continuously for 120 h, days 1–5), methotrexate (MTX) (30 mg/m2, day 1), and leucovorin (LV) (20 mg/m2, days 1–5). Two cycles of this regimen were given every 4 weeks during radiotherapy. Radiotherapy was delivered 5 days a week using a single daily fraction of 1.8–2.0 Gray, to a total dose of 66.6–70.2 Gray. Results. The 3-year disease-specific survival rates of patients with laryngeal or hypopharyngeal SCC were 81.3% and 78%, respectively. The 3-year disease-specific survival rates with larynx preservation of patients with laryngeal or hypopharyngeal SCC were 46.7% and 59%, respectively. The main toxicities were neutropenia, dermatitis, mucositis, and infection. [ABSTRACT FROM AUTHOR]

These results indicate that extensive, multiple cervical micrometastases occurred from an early stage in patients with T2N0 tongue cancer. The presence of micrometastases suggests the necessity of preventive neck dissection for Level I–IV nodes as a radical treatment. Cervical lymph node metastases occur with a relatively high frequency in patients with T2N0 squamous cell carcinoma of the tongue, and control of the metastases greatly influences the prognosis of patients. In this study, micrometastases in the cervical lymph nodes were investigated to clarify the necessity and required extent of preventive neck dissection. We investigated micrometastases in 24 subjects who had previously been diagnosed with T2N0 tongue cancer. We performed immunostaining with anti-cytokeratin antibody cocktail AE1/AE3 of sections of 401 paraffin-embedded lymph nodes obtained from these patients. Micrometastases were observed in 14 patients (58%) and were most abundant in Level II nodes ( n =11; 46%). Micrometastases were observed in the Level IV nodes of 3 patients (13%), and upstaging to pN2b occurred in 7 patients (29%). [ABSTRACT FROM AUTHOR]

Objective Electrically evoked otoacoustic emissions (EEOAEs) are sounds emitted in the ear canal when an alternating current is delivered to the cochlea. Salicylate, which causes reversible hearing loss, decreases both the electromotility of the outer hair cells (OHCs) and the EEOAE output. The frequency response of EEOAEs is known to depend on the location of the stimulating electrode. Using electrodes placed in the first or third turn of the cochlea, we measured EEOAEs before and after salicylate administration in order to clarify the frequency range of EEOAEs from which exact information can be acquired. Material and Methods A sinusoidal electrical signal (160 μA root-mean-square) at frequencies ranging from 500 Hz to 16 kHz was delivered to the first or third turn of the scala tympani of the guinea pig cochlea in order to determine EEOAEs. The EEOAE outputs were measured before and every 5 min after administration of salicylate (500 mg/kg) for 60 min. The threshold of the compound action potential (CAP) was measured before and 60 min after salicylate administration. Results CAP thresholds were reduced at frequencies ranging from 2 to 12 kHz after salicylate administration. The maximum EEOAE output recorded with the first-turn electrode was obtained at 12 kHz with a gentle slope of low cutoff, whereas the frequency response of the EEOAE recorded with the third-turn electrode demonstrated a steep dip at 2 kHz. Conclusion EEOAE reduction after salicylate administration was restricted to frequencies close to that of the characteristic frequency (CF) of the electrode position. This was probably related to the fact that the EEOAE is the sum of waves from the CF of the electrode position and the stimulus frequency. In terms of studying the electromotility of OHCs, useful information obtained from EEOAEs is restricted to the narrow frequency band close to the CF of the electrode location. [ABSTRACT FROM AUTHOR]

Objective To evaluate the 3D anatomy of the ET and its surrounding tissues in cases with or without patulous Eustachian tube (ET) using CT with the multiplanar reconstruction (MPR) technique. Material and Methods Twenty patients with a patulous ET and 25 without middle ear problems were investigated. After performing a temporal bone CT examination, MPR images of the ET were reconstructed and measurements were made. Results The ET lumen and its surrounding tissues were clearly identified. In the patulous ET group, the ET lumen was open throughout the cartilaginous portion and the volume of the low-density area was smaller in size than in the controls. In unilateral patulous ET patients, the anatomical features were found to be similar on both sides, in spite of the fact that the non-involved side did not show symptoms associated with a patulous ET. Conclusion For the first time, we were able to obtain clear reconstructed images of the patulous ET and its surrounding structure and to study its anatomical features. This method is useful for obtaining a better understanding of the ET and ET-related diseases such as patulous ET. [ABSTRACT FROM AUTHOR]

Gaze fixation during optokinetic stimulation generates an after-nystagmus with a slow component towards the reverse direction of the optokinetic stimulation. The duration and maximum slow component velocity (SCV) of this "reverse OKAN" were observed by changing the duration, velocity and direction of the optokinetic stimulation in nine normal volunteers. The duration of reverse OKAN increased with increasing stimulation time but was unaffected by changes in the stimulation velocity. The maximum SCV of reverse OKAN decreased with an increase in the stimulation velocity but was not significantly affected by changes in the optokinetic stimulation time. There was no directional difference among the horizontal, upwards and downwards reverse OKANs. The reverse OKAN was thought to be generated by a mechanism different from the velocity storage mechanism which produced optokinetic nystagmus and the first phase of OKAN. Retinal slip during the optokinetic stimulation was considered to be an input to the mechanism which generated the reverse OKAN. We hypothesize that the mechanism causing the reverse OKAN may be a generator of the second phase of OKAN, which was also intimately connected with self-motion sensation during the optokinetic stimulation. [ABSTRACT FROM AUTHOR]

The effects of salicylate and acoustic overstimulation on the electromotility of the cochlear outer hair cells (OHCs) were assessed in vivo using electrically-evoked otoacoustic emissions (EEOAEs). Alternating currents to evoke the EEOAE were delivered by means of an extracochlear electrode on the round window, with which the compound action potentials (CAPs) were also monitored before and after the manipulations. The EEOAE outputs were a linear function of the injected currents between 52 and 267 μA rms. Administration of salicylate (500 mg kg) reduced the EEOAE outputs significantly at 5 and 8 kHz (p <0.005), while no change in EEOAEs was observed at any frequency after exposure to a 4 kHz pure tone at 100 dB SPL for 10 min or at 120 dB SPL for 30 min. These results indicate that administration of salicylate reduces the electromotility of the OHCs, and thus produces losses in neural sensitivity of the cochlea. In contrast, the electromotility of OHCs appears to be protected against short-term intense sound exposure. [ABSTRACT FROM AUTHOR]

AbstractBackgroundObjectiveMaterials and methodsResultsConclusionAlthough various medical remedies have been attempted to alleviate the symptoms of Meniere’s disease (MD), the risk–benefit ratios of these various treatments remain debatable.We investigated the efficacy of sound stimulation of 100 Hz for treating vestibular dysfunction in patients with Meniere’s disease (MD).Patients with definitive MD with intractable vestibular symptoms and endolymphatic hydrops (EH) in the inner ear were evaluated. The experimental group received sound stimulation of 75 dB at a frequency of 100 Hz for 5 min, and the control group received sound stimulation of 75 dB at a frequency of 250 Hz for 5 min. Cervical vestibular-evoked myogenic potentials (cVEMPs) were measured before and after each sound stimulation, and the results of the clinical tests were compared between the two patient groups.Significant increases in cVEMP amplitudes were observed after sound stimulation of 100 Hz in ears with vestibular endolymphatic hydrops, although no such improvement was observed in the control group.Sound stimulation of 75 dB at a frequency of 100 Hz leads to improvement in cVEMP amplitude in patients with definitive MD. Adequate sound stimulation might be a new method for treating vestibular dysfunction associated with MD. [ABSTRACT FROM AUTHOR]

We investigated the DNA ploidy pattern, cell cycle and the percentage of Ki-67 positive fractions in fresh surgical material from 17 benign and 33 malignant thyroid tumours using flow cytometry. DNA aneuploidy was not seen at all in benign tumours, but was seen in 3 out of 33 malignant tumours, suggesting that detection of DNA aneuploidy indicates malignancy, although the detection sensitivity was low. Regarding the cell cycle, there was no difference in the percentage of S-phase fractions (SPF) or G2 plus M phase fractions (G2M) between benign and malignant tumours. However, the percentage of Ki-67 positive fractions in malignant tumours (39.9±3.9%) was significantly higher than that in benign tumours (9.4±2.1%), indicating that malignant thyroid tumours contained a large population of G1 phase cells. When a cut-off value of 20% was used for Ki-67 positive fractions, sensitivity was 82%, specificity was 88% and accuracy was 84% for the diagnosis of malignant tumours. Although this study was carried out on surgically derived materials, it is possible that flow cytometric analysis of fine needle aspiration-derived materials may have a place in preoperative histopathological assessment of thyroid tumours. [ABSTRACT FROM AUTHOR]

The composition and size of muscle fibre types in the hyopharyngeus (HP), thyropharyngeus (TP), cricopharyngeus (CP) and cervical oesophageal muscle (CE) from 6 normal adult cats were investigated using parvalbumin (PA) immunohistochemistry. Fibre types I, IIA and IIB were identified in all muscles. HP and TP revealed predominance of type II fibres (74.8% and 75.2%, respectively), whilst CP and CE showed predominance of type I fibres (72.6% and 82.2%, respectively). The mean diameter of narrow fibres was greater in type II (23.9 μm) than in type I fibres (21.7 μm). The results seem to reflect the physiological features of each muscle, i.e. short rapid contractions of HP and TP, sustained contraction of CP and slow peristaltic movements of CE. [ABSTRACT FROM AUTHOR]

KGF (KGF), synthesized and secreted exclusively by stromal cells in epithelialized organs, specifically promotes proliferation of cells of epithelial origin, including keratinocytes. A related peptide, basic fibroblast growth factor (bFGF), has mitogenic properties for fibroblasts and endothelial cells. KGF expression is stimulated markedly in the skin during wound healing. To investigate the physiologic action of KGF in the healing of TM (TM) perforations, we examined KGF and KGF receptor (KGFR) mRNA transcript levels as well as those of bFGF and transforming growth factor-α (TGFα) in normal and wounded rat TM at varying intervals, using a semiquantitative reverse transcription-polymerase chain reaction (RT-PCR). We found KGF and TGFα mRNA expression to be induced rapidly, peaking 3 days after wounding and then declining. Expression of bFGF was induced gradually and remained increased until 7 days. In contrast, we found KGFR to be expressed in normal TM, remaining unchanged during TM repair. These results indicate that KGF and TGFα may mediate migration and proliferation of epithelial cells of the outer layer in the early stage of TM repair while bFGF may mediate the connective tissue reaction in the middle layer in a subsequent stage. [ABSTRACT FROM AUTHOR]

The distribution, number and nature of intrapharyngeal ganglia and their neurons in cats were examined by means of serial sections, histochemical and immunohistochemical methods. Six to eight large ganglia around the palatine tonsils and five to eight small ganglia in the laterodorsal wall of pharyngeal mucous membrane were observed. The intrapharyn geal ganglionic neuron (25-30 μm in diameter) totalled 600-800 and more than 80% of them were located around the palatine tonsils. The ganglionic neurons were acetylcholinesterase reaction positive. On immunohistochemistry, many choline acetyltransferase-immunoreactive and vasoactive intestinal polypeptide-immunoreactive neurons and a few tyrosine hydroxylase-immunoreactive nerve cells were found, but no calcitonin gene-related peptide-immunoreactive or substance P-immunoreactive neurons were recognized in the ganglion. The present findings indicate that intrapharyngeal ganglionic neurons are mainly parasympathetic and partially sympathetic in nature. [ABSTRACT FROM AUTHOR]