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Objectives:(1) Compare longitudinal changes of Varicella-zoster virus (VZV)-specific cell-mediated immunity (CMI) in Hunt syndrome with Bell’s palsy using IFN-γ enzyme-linked immunospot (ELISPOT). (2) Examine the role of VZV-specific CMI for VZV reactivation in the facial nerve in Hunt syndrome.Methods:This prospective study was conducted in our tertiary referral hospital between 2010 and 2013. Nineteen Hunt syndrome and 59 Bell’s palsy patients were enrolled. Mononuclear cells isolated from whole blood were incubated with VZV antigen in culture plates for 40 hours. Anti IFN-γ antibody was added and the ELISPOT system counted immunostained spots indicating VZV-specific CMI. The relationship between the spots and days from the onset of palsy were compared between Hunt syndrome and Bell’s palsy patients.Results:Immediately after the onset, the number of spots in the Hunt syndrome group was much lower than in the Bell’s palsy group, indicating low VZV-specific CMI. However, it increased rapidly and showed a ...

Objectives:(1) Estimate the degree of postoperative aeration in the middle ear after canal wall down tympanoplasty with soft-wall reconstruction (CWD tympanoplasty with SWR) for cholesteatoma. (2) Characterize the relationship between postoperative middle ear aeration and hearing outcome. (3) Propose an ideal state of middle ear aeration in order to obtain satisfactory hearing outcome after CWD tympanoplasty with SWR.Methods:This retrospective study was conducted in our tertiary referral hospital between 2001 and 2013. Seventy-eight ears with cholesteatoma treated surgically at our hospital by planned two-stage CWD tympanoplasty and SWR were included. Postoperative middle ear aeration was scored one year after second-stage surgery by computed tomography (CT). The patients were divided into 4 bins according to postoperative audiometric air-bone (A-B) gaps: 0-10, 11-20, 21-30, and >30 dB.Results:Postoperative middle ear aeration was significantly greater in the smaller A-B gap bins (0-10 and 11-20 dB) compa...

Objectives:1) Compare electroneuronography (ENoG) values in patients with facial palsy using two different methods, the midline method that records compound muscle action potentials (CMAPs) from the orbicularis oris muscle (the standard muscle for facial ENoG) and five electroneurogram recordings that records five CMAPs from five different facial muscles. 2) Reveal whether the ENoG value obtained with the midline method reflects entire facial nerve degeneration.Methods:Forty patients with facial palsy were enrolled. CMAPs were recorded using the midline method, in which the anode was placed on the mental protuberance and the cathode was placed on the philtrum. Additionally, five electroneurogram recordings were obtained by placing the anode on the skin of the parietal region and five cathodes on the skin over five facial muscles (frontalis, orbicularis oculi, nasalis, orbicularis oris, and depressor anguli oris muscles). ENoG values recorded using the two methods were compared.Results:The ENoG values of t...

Objectives:1) Compare Varicella-zoster virus (VZV)-specific cell-mediated immunity (CMI) in Hunt syndrome to Bell’s palsy using IFN enzyme-linked immunospot (ELISPOT). 2) Examine the role of VZV-specific CMI for VZV reactivation in the facial nerve in Hunt syndrome.Methods:This prospective study was conducted in our tertiary referral hospital between 2010 and 2012. Six Hunt syndrome and 28 Bell’s palsy patients were enrolled. Mononuclear cells were isolated from whole blood and incubated with VZV antigen in culture plates for 40 h. Anti IFN antibody was added and the ELISPOT system counted immunostained spots indicating VZV-specific CMI. Numbers of spots and the relationship between the spots and days from the onset of palsy were compared between Hunt syndrome and Bell’s palsy patients.Results:No difference in the number of spots was observed between Hunt syndrome and Bell’s palsy. However, Hunt syndrome showed a strong positive relationship between numbers of spots and days from the onset of palsy (r = 0...

Objective: 1) Discuss the effects of ventilation tube placement on postoperative mastoid growth in children with otitis media with effusion (OME). 2) Show an incidence of postoperative complication, for example, spontaneous extrusion, permanent tympanic membrane perforation.Method: In total, 177 tubes were inserted in 148 ears in 81 children with OME with a mean age of 5.5 years at our hospital from 2001 to 2009. Long-term tubes were used: The T-Tube (Goode) in 87 cases or the Type II tube (Paparella) in 90 cases.Results: The tubes fell out spontaneously in 46%: 61% in the T-Tube group and 32% in the Type II tube group. Postoperative permanent tympanic membrane perforation occurred in 10%. No relationship was observed between the incidence of tympanic membrane perforation and tube type or duration of tube insertion. Postoperative mastoid growth compared to preoperative condition estimated from X-rays was 42%, 55%, 59%, and 65% at 1, 2, 3, and 4 years after surgery, respectively. Retaining the tube in plac...