Publications by authors named "Hiroshi Hidaka"

78 Publications

Identification of risk factors for mortality and delayed oral dietary intake in patients with open drainage due to deep neck infections: Nationwide study using a Japanese inpatient database.

Head Neck 2021 07 2;43(7):2002-2012. Epub 2021 Mar 2.

Department of Otolaryngology Head and Neck Surgery, Kansai Medical University, Hirakata, Japan.

Backgrounds: Data on risk factors for deep neck infection including descending necrotizing mediastinitis (DNM) have been limited. Using a nationwide database, the aim was identifying the factors related to patient death and delay in recovering oral intake.

Methods: Data of 4949 patients were extracted from a Japanese inpatient database between 2012 and 2017. The main outcome was survival at discharge. In a subgroup analysis of the 4949 patients with survival, the second outcome was delay in the interval between admission and full recovery of oral intake.

Results: Only a few factors (advanced-age, ventilation) were associated with both mortality and delayed oral dietary intake by logistic regression analyses. Conversely, several factors including DNM (adjusted-odds ratio [OR] 1.41) and repeated surgery (adjusted-OR 1.70) were significantly related only to delayed oral dietary intake.

Conclusions: Although DNM was not necessarily related to mortality, patients with DNM should receive careful attention to avoid delayed oral dietary intake.
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http://dx.doi.org/10.1002/hed.26660DOI Listing
July 2021

Delivery of Electrons by Proton-Hole Transfer in Ice at 10 K: Role of Surface OH Radicals.

J Phys Chem Lett 2021 Jan 5;12(1):704-710. Epub 2021 Jan 5.

Institute of Low Temperature Science, Hokkaido University, Sapporo 060-0819, Japan.

Although water ice has been widely accepted to carry a positive charge via the transfer of excess protons through a hydrogen-bonded system, ice was recently found to be a negative charge conductor upon simultaneous exposure to electrons and ultraviolet photons at temperatures below 50 K. In this work, the mechanism of electron delivery was confirmed experimentally by both measuring currents through ice and monitoring photodissociated OH radicals on ice by using a novel method. The surface OH radicals significantly decrease upon the appearance of negative current flow, indicating that the electrons are delivered by proton-hole (OH) transfer in ice triggered by OH production on the surface. The mechanism of proton-hole transfer was rationalized by density functional theory calculations.
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http://dx.doi.org/10.1021/acs.jpclett.0c03345DOI Listing
January 2021

CHO Radical Binding on Hexagonal Water Ice and Amorphous Solid Water.

J Phys Chem A 2021 Jan 28;125(1):387-393. Epub 2020 Dec 28.

Institute of Low Temperature Science, Hokkaido University, N19-W8, Kita-ku, Sapporo, Hokkaido 060-0819, Japan.

Binding energies of the CHO radical on hexagonal water ice () and amorphous solid water (ASW) were calculated using the ONIOM(QM:MM) method. A range of binding energies is found (0.10-0.50 eV), and the average binding energy is 0.32 eV. The CHO radical binding on the ASW surfaces is stronger than on the surfaces. The computed binding energies from the ONIOM(wB97X-D/def2-TZVP:AMBER) and wB97X-D/def2-TZVP methods agree quite well. Therefore, the ONIOM(QM:MM) method is expected to give accurate binding energies at a low computational cost. Binding energies from the ONIOM(wB97X-D/def2-TZVP:AMBER) and ONIOM(wB97X-D/def2-TZVP:AMOEBA09) methods differ noticeably, indicating that the choice of force field matters. According to the energy decomposition analysis, the electrostatic interactions and Pauli repulsions between the CHO radical and ice play a crucial role in the binding energy. This study gives quantitative insights into the CHO radical binding on interstellar ices.
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http://dx.doi.org/10.1021/acs.jpca.0c09111DOI Listing
January 2021

Systematic Review of Surgical Outcomes Following Repair of Patulous Eustachian Tube.

Otol Neurotol 2020 09;41(8):1012-1020

Sen-En Rifu Otologic Surgery Center.

Objective: To perform a systematic review and meta-analysis of surgical outcomes following repair of patulous Eustachian tube (PET).

Data Sources: Analysis of cases collected from studies published between January 1990 and December 2018 and identified using PubMed, Google Scholar, and Cochrane databases.

Study Selection: Articles addressing interventions to treat PET were selected.

Data Extraction: The database was searched using the keywords "patulous Eustachian tube treatment" and yielded 1,370 studies. Twenty studies were eligible for inclusion.

Data Synthesis: A total of 914 cases were evaluated for surgical approach, patient outcomes, and complications. The reported techniques were categorized by the procedure type, including ventilation tube insertion, mass loading of the tympanic membrane, ET injection, plug surgery, shim surgery, tuboplasty, and ET closure. Overall PET symptom improvement were reported for ventilation tube insertion (79 cases, mean: 58%, 95% CI: 47-69%), mass loading of the tympanic membrane (43 cases, mean: 50%, 95% CI: 32-69%), ET injection (139 cases, mean: 47%, 95% CI: 38-56%), plug surgery (386 cases, mean: 81%, 95% CI: 77-85%), shim surgery (122 cases, mean: 62%, 95% CI: 53-70%), tuboplasty (105 cases, mean: 41%, 95% CI: 31-51%), and ET closure (40 cases, mean: 66%, 95% CI: 49-80%). A low incidence of minor complications was reported.

Conclusions: This systematic review describes clinical outcome data following surgical management of PET. Plug surgery and shim surgery show relatively high effectiveness and safety. Further prospective studies that compare surgical approaches for PET are needed.
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http://dx.doi.org/10.1097/MAO.0000000000002753DOI Listing
September 2020

Location of the stapedius muscle with reference to the facial nerve in patients with unilateral congenital aural atresia: implication for active middle ear implants surgery.

Acta Otolaryngol 2020 Jun 18;140(6):445-449. Epub 2020 Feb 18.

Sen-En Rifu Otologic Surgery Center, Miyagi, Japan.

Detailed investigations of the stapedial muscle (SM) in congenital aural atresia (CAA) patients have yet to be adequately conducted. To assess image variations in the mastoid segment of the facial nerve (FN) and SM in CAA. A total of nine patients comprising of 9 ears with unilateral CAA were studied. The courses of the FN and SM were evaluated from the basic point to 1 mm intervals between the mastoid portion of FN, and measured from the mean X and Y values in each group. The atresia side of FN among the Y values showed significant differences compared to the contralateral side. In terms of the SM, there were no significant differences in both the X and Y values. The stapedial muscle of the CAA patients was located medially to the FN. Conversely, the distance from the PSC to the FN revealed no significant differences with regard to the X and Y values for each group. The current observations revealed that the SM is located more posterior to the FN in CAA patients, and this is mainly attributed to the laterally and anteriorly displaced FN.
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http://dx.doi.org/10.1080/00016489.2020.1725113DOI Listing
June 2020

Hearing Recovery After Ejection of Air in a Case of Traumatic Pneumolabyrinth: Mechanism and Management Options.

Otol Neurotol 2020 03;41(3):359-363

Department of Otolaryngology, Jichi-Medical University.

Objective: To describe a case of traumatic pneumolabyrinth and subsequent hearing recovery after ejection of air with transcanal endoscopic surgical exploration.

Patients: A 38-year-old man was struck by his child while cleaning his ear with an ear pick made of bamboo, which penetrated deep into the left ear canal. Severe vertigo with vomiting and left hearing impairment ensued. In addition, high-resolution computed tomography demonstrated an air density within the vestibule.

Interventions: Exploratory tympanotomy was performed endoscopically a day after the injury and air was ejected from the oval window surgically.

Main Outcome Measures: High-resolution computed tomography, audiologic testing.

Results: Several hours after surgery, the patient's subjective vestibular symptoms lessened and 7 days after surgery, the patient felt slight dizziness when moving his head and no apparent spontaneous nystagmus was observed with an infrared charge-coupled device camera and was discharged from the hospital. Two years later, there are no subjective vestibular symptoms at all and the pure-tone average of his left ear improved to 16.7 dB.

Conclusion: We presented a case of traumatic pneumolabyrinth and the subsequent hearing recovery after ejection of air following endoscopic exploratory tympanotomy. We propose that initial management for traumatic pneumolabyrinth should be ejection of the air bubble if it is located solely in the vestibule and sparing the cochlea.
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http://dx.doi.org/10.1097/MAO.0000000000002538DOI Listing
March 2020

Incidence of Functional Nasal Voice in Patients With Patulous Eustachian Tube.

Otol Neurotol 2018 12;39(10):e1034-e1038

Sen-En Rifu Otologic Surgery Center.

Objective: Some patients with a patulous Eustachian tube (PET) complain of a nasal voice. This feature is often dismissed without further investigation. As such, there are only a few reports on this important symptom and scant studies have been conducted on a sufficiently large number of cases with PET. Therefore, this study was undertaken to investigate the characteristics of patients having a nasal voice and to examine whether this symptom can be an indication of the severity of PET.

Study Design: Retrospective.

Setting: Tertiary referral center.

Subjects And Methods: A retrospective survey of medical records in Sen-En Rifu Hospital identified 85 patients (40 men and 45 women) with PET between 2013 and 2016. Diagnosis of definite PET was based on the Proposal on Diagnostic Criteria of PET announced by the Otological Society of Japan (2017). The questionnaire inquired about the presence of a nasal voice and it was distributed to each patient at the first visit to the clinic. If a patient marked "yes" for the presence of nasal voice, he/she was later asked on the telephone to exclude nasal voice ascribable to causes other than PET, such as nasal diseases. Correlation between nasal voice and patient characteristics (age, sex, affected side, and PET symptoms such as autophony of own voice, aural fullness, and autophony of breathing sounds), subjective severity of PET evaluated by patulous Eustachian tube handicap inventory-10 (PHI-10), and that with the objective severity of PET evaluated by tubo-tympano-aerodynamic-graphy (TTAG) and sonotubometry were investigated.

Results: Seventy-six patients (36 men and 40 women) with definite PET were evaluated in this study. Thirteen patients (17.1%) (five men and eight women) reported a nasal voice coinciding with the occurrence of PET symptoms such as voice autophony, aural fullness, and breathing autophony. Age, sex, affected side, PET symptoms (autophony of their own voice, aural fullness, and autophony of their breathing sounds), and objective findings (TTAG and sonotubometry) were not significantly different between the two groups. The average total score of the PHI-10 in the "PET associated Nasal Voice Group" was 35.8 ± 4.5, which was statistically higher than that of the "non PET associated Nasal Voice Group" 23.6 ± 10.7 (p = 0.002). Out of 76 patients, 44 were treated surgically (Kobayashi Plug). In the "PET associated Nasal Voice Group," 85% (11 out of 13) were subjected to surgical treatment, whereas 52% (33 out of 63) underwent surgical treatment in the "non PET associated Nasal Voice Group." The rate of surgical treatment was significantly higher in "PET associated Nasal Voice Group" (p = 0.047).

Conclusion: Nasal voice due to PET symptoms was observed in 17.1% of PET patients. It was generally found in patients with severe subjective symptoms. Nasal voice can be an indication of subjective severity. However, this study failed to show objective evidence of wider Eustachian tube in such cases. Patients with a nasal voice tended to seek vigorous treatment including surgery.
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http://dx.doi.org/10.1097/MAO.0000000000001981DOI Listing
December 2018

Vibrant Soundbridge implantation via a retrofacial approach in a patient with congenital aural atresia.

Auris Nasus Larynx 2019 Apr 7;46(2):204-209. Epub 2018 Sep 7.

Sen-En Rifu Otologic Surgery Center, Miyagi-gun, Miyagi, Japan.

Objective: A method of Vibrant Soundbridge (VSB) placement to the round window (RW) via the retrofacial approach with preoperative evaluation of the relationship between the facial nerve (FN) and RW by 3D-CT reconstruction was proposed for the treatment of congenital aural atresia (CAA) patient.

Methods: A fenestration to the mesotympanum was made mastoid portion of the FN. During the approach, part of the stapedial muscle was encountered and removed. The RW niche was identified, and the floating mass transducer was placed from an inferior approach into the RW niche.

Results: There were no intra-operative or post-operative surgical complications.

Conclusion: The VSB placement to the RW via the retrofacial approach with partial removal of the stapedial muscle can be feasible alternative in CAA cases associated with an anteriorly and laterally positioned aberrant FN. Preoperative assessment using 3D CT may facilitate in assessing the feasibility of the approach and implantation of VSB.
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http://dx.doi.org/10.1016/j.anl.2018.08.012DOI Listing
April 2019

Anatomy of the posterior and middle ethmoidal arteries via computed tomography.

SAGE Open Med 2018 27;6:2050312118772473. Epub 2018 Apr 27.

Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.

Objective: The aim of this study is to investigate the anatomy of the posterior and middle ethmoidal arteries from the viewpoint of an endoscopic sinus surgeon.

Methods: Based on 100 computed tomography images, the anatomical position of the posterior ethmoidal artery in relation to the posterior ethmoid cells was classified into five types. The presence of the posterior and middle ethmoidal arteries, their distance from the skull base, and their length exposed in the ethmoid cells were measured. The association of patients' age and sex, presence of the middle ethmoidal artery, and anatomical type of the posterior ethmoidal artery with the posterior ethmoidal artery distance from the ethmoid roof was analyzed.

Results: The posterior ethmoidal artery's position, relative to the ethmoid cell walls, was most often near the first wall, anterior to the optic canal (92.5%). The posterior ethmoidal artery's distance from the skull base ranged from 0 to 6.4 mm (mean: 1.2 mm). Older age, longer length of the posterior ethmoidal artery exposed in the ethmoid cells, and absence of the middle ethmoidal artery were positively associated with a longer posterior ethmoidal artery distance from the skull base.

Conclusion: Attention should be paid to the posterior and middle ethmoidal arteries.
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http://dx.doi.org/10.1177/2050312118772473DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946601PMC
April 2018

Poor oral intake causes enteral nutrition dependency after concomitant chemoradiotherapy for pharyngeal cancers.

Eur Arch Otorhinolaryngol 2018 Jun 2;275(6):1607-1611. Epub 2018 Apr 2.

Department of Otolaryngology-Head and Neck Surgery, Tohoku Graduate School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan.

Purpose: To identify precipitating factors responsible for enteral nutrition (EN) dependency after concomitant chemoradiotherapy (CCRT) of head and neck cancers and to examine their statistical correlations.

Methods: Factors related to feeding condition, nutritional status, disease, and treatment of 26 oropharyngeal and hypopharyngeal cancer patients who received definitive CCRT were retrospectively investigated by examining their medical records. The days of no oral intake (NOI) during hospitalization and the months using enteral nutrition after CCRT were counted as representing the feeding condition, and the changes in body weight (BW) were examined as reflecting nutritional status. The factors related to EN dependency after CCRT were analyzed.

Results: Long duration of total NOI (≥ 30 days) and maximum NOI ≥ 14 days were significant predictors of EN dependency. Decreased BW (≥ 7.5 kg) was the next predictor identified, but it was not significant. Multivariate analysis showed that the total duration of NOI was more correlated with EN dependency than changes in BW.

Conclusions: A long duration of NOI was more strongly related to EN dependency than nutritional factors.
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http://dx.doi.org/10.1007/s00405-018-4963-yDOI Listing
June 2018

Endoscopic Modified Medial Maxillectomy for Fungal Ball of the Hypoplastic Maxillary Sinus With Bony Hypertrophy.

J Craniofac Surg 2018 May;29(3):e304-e307

Department of Otolaryngology, Tohoku Rosai Hospital.

Sinus fungal ball is defined as noninvasive chronic rhino-sinusitis with a clump of mold in the paranasal sinuses, typically affecting the maxillary sinus. Fairly good outcomes of endoscopic surgery have been reported where the ball is removed through the antrostomy. However, the affected sinus tends to have a smaller cavity and thicker bony walls. As such, it is often challenging to maintain a window size that is sufficient to control possible recurrence. The endoscopic modified medial maxillectomy procedure was applied to a 61-year old and a 70-year old female patient with maxillary sinus fungal ball. Using this method, we created a much larger inferior meatal antrostomy without difficulty. The window provided us with an endoscopic view of the whole sinus and complete eradication of the lesion. Endoscopic modified medial maxillectomy is useful as a surgical procedure for maxillary sinus fungal ball and should be considered for better outcomes.
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http://dx.doi.org/10.1097/SCS.0000000000004379DOI Listing
May 2018

Liquid-like behavior of UV-irradiated interstellar ice analog at low temperatures.

Sci Adv 2017 09 29;3(9):eaao2538. Epub 2017 Sep 29.

Institute of Low Temperature Science, Hokkaido University, Sapporo, Hokkaido 060-0819, Japan.

Interstellar ice is believed to be a cradle of complex organic compounds, commonly found within icy comets and interstellar clouds, in association with ultraviolet (UV) irradiation and subsequent warming. We found that UV-irradiated amorphous ices composed of HO, CHOH, and NH and of pure HO behave like liquids over the temperature ranges of 65 to 150 kelvin and 50 to 140 kelvin, respectively. This low-viscosity liquid-like ice may enhance the formation of organic compounds including prebiotic molecules and the accretion of icy dust to form icy planetesimals under certain interstellar conditions.
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http://dx.doi.org/10.1126/sciadv.aao2538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5621975PMC
September 2017

The efficacy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) for patulous Eustachian tube patient.

Acta Otolaryngol 2018 Jan 7;138(1):6-9. Epub 2017 Sep 7.

a Department of Otolaryngology - Head and Neck Surgery , Tohoku University Graduate School of Medicine , Sendai , Japan.

Objective: To assess the efficacy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) for patulous Eustachian tube (PET) patients.

Methods: A prospective survey of medical records identified 36 patients and 47 ears with PET, and 15 patients and 15 ears as control. The ETDQ-7, patulous Eustachian tube handicap inventory-10 (PHI-10) and Likert scale were evaluated. PET patients were divided into two groups based on severity of symptoms using the PHI score.

Results: The Cronbach α value of the PET group was 0.765. The average total score of the ETDQ-7 in the control group was 7.6 ± 1.1 and 22.5 ± 10.0 in the PET group (p < .01). No correlation was found between ETDQ-7 and Likert scale (r = 0.248, p = .09). The average total score of the ETDQ-7 in the mild or moderate PET group was 19.9 ± 9.0 and 25.3 ± 11.1 in the severe PET group and this was not statistically different (p = .08).

Conclusion: The highest ETDQ-7 score was also observed in PET patients and in ET dysfunction patients. These findings necessitate careful discrimination between ET dysfunction and PET in balloon dilation Eustachian tuboplasty (BET) based on ETDQ-7.
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http://dx.doi.org/10.1080/00016489.2017.1366053DOI Listing
January 2018

Reply to commentary to: factors influencing endoscopic dacryocystorhinostomy outcome.

Eur Arch Otorhinolaryngol 2017 12 21;274(12):4263. Epub 2017 Aug 21.

Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

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http://dx.doi.org/10.1007/s00405-017-4710-9DOI Listing
December 2017

Risk factors for delayed oral dietary intake in patients with deep neck infections including descending necrotizing mediastinitis.

Eur Arch Otorhinolaryngol 2017 Nov 20;274(11):3951-3958. Epub 2017 Aug 20.

Department of Otolaryngology Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8575, Japan.

Although clinical outcomes of descending necrotizing mediastinitis (DNM) and/or deep neck infection (DNI) have been extensively reported, no study has addressed delay in recovering oral ingestion after surgical interventions other than sporadic case reports. We herein compared clinical features of DNM and DNI cases over the same period, and clarified precipitating factors of delay in recovering oral ingestion by logistic regression analysis. We reviewed records of patients with DNI and DNM at our institution from August 2005 to July 2015. We extracted data on patient age, sex, complication with diabetes mellitus, gas gangrene, extension of infections, operative procedure, tracheotomy, bacterial results, and duration of empirical antibiotic therapy. Patients were categorized into three groups according to vertical spread of infection: 60 DNI patients without extension below the hyoid bone (group-A), 48 DNI patients with extension below the hyoid bone without DNM (group-B), and 10 DNM patients (group-C). Age, diabetes mellitus, and gas gangrene were significantly different among the groups. Concerning surgical intervention, tracheotomy was significantly less frequently performed in group-A (25%) than the other groups (74%) (p < 0.001). Logistic regression analyses revealed that extension of infections below the hyoid bone and tracheotomy were significantly associated with delayed oral dietary intake [odds ratios (95% confidence intervals) 2.96 (1.06-8.28) and 10.69 (3.59-31.88), respectively]. Along with DNM patients, patients who undergo tracheotomy for infections that extend below the hyoid bone should receive postoperative care with careful attention to avoid delay in recovering oral ingestion.
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http://dx.doi.org/10.1007/s00405-017-4716-3DOI Listing
November 2017

Clinical and bacteriological differences of deep neck infection in pediatric and adult patients: Review of 123 cases.

Int J Pediatr Otorhinolaryngol 2017 Aug 5;99:95-99. Epub 2017 Jun 5.

Department of Otolaryngology - Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

Objectives: Deep neck infections (DNIs) can lead to life-threatening disease. However, the detailed pathophysiology remains unclear due to its rarity and only a few reports have directly compared DNIs in children and adults. This study aimed to reveal the clinical differences between DNIs in children and adults.

Methods: We retrospectively reviewed 123 patients who suffered from DNIs at Tohoku University Hospital from August 2005 to July 2015. We extracted data on patient sex, age, antecedent illness, extension of infections, operative procedures, and bacteriology results. The patients were categorized into pediatric (≤18 years) and adult (>18 years) groups. Fisher's exact test was performed to determine significant differences between the two groups.

Results: Fifteen children (6 males and 9 females) and 108 adults (71 males and 37 females) were identified. The most common antecedent illness in pediatric patients was lymphadenitis, which was the least common in adult patients (73% vs 7%, p < 0.0001). The incidence of DNIs extending below the hyoid bone was significantly lower in pediatric patients than in adult patients (20% vs 53%, p < 0.05). Regarding bacterial culture analysis, Staphylococcus species was the most common pathogen in children (60%), whereas only 9% of adults were positive for Staphylococcus (p < 0.001). Streptococcus species were significantly less common in children than in adults (27% vs 56%, p = 0.05). Anaerobes were also significantly less common in children than in adults (13% vs 45%, p < 0.01). Concerning surgical intervention, 53% of pediatric patients underwent external incision compared with 70% of adults. Specifically, tracheostomy was significantly less frequently performed in children than in adults (7% vs 54%, p < 0.01).

Conclusion: DNIs in children feature different characteristics from those in adults regarding severity, antecedent illness, bacteriology, and clinical management.
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http://dx.doi.org/10.1016/j.ijporl.2017.05.028DOI Listing
August 2017

POU4F3 mutation screening in Japanese hearing loss patients: Massively parallel DNA sequencing-based analysis identified novel variants associated with autosomal dominant hearing loss.

PLoS One 2017 17;12(5):e0177636. Epub 2017 May 17.

Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.

A variant in a transcription factor gene, POU4F3, is responsible for autosomal dominant nonsyndromic hereditary hearing loss, DFNA15. To date, 14 variants, including a whole deletion of POU4F3, have been reported to cause HL in various ethnic groups. In the present study, genetic screening for POU4F3 variants was carried out for a large series of Japanese hearing loss (HL) patients to clarify the prevalence and clinical characteristics of DFNA15 in the Japanese population. Massively parallel DNA sequencing of 68 target candidate genes was utilized in 2,549 unrelated Japanese HL patients (probands) to identify genomic variations responsible for HL. The detailed clinical features in patients with POU4F3 variants were collected from medical charts and analyzed. Novel 12 POU4F3 likely pathogenic variants (six missense variants, three frameshift variants, and three nonsense variants) were successfully identified in 15 probands (2.5%) among 602 families exhibiting autosomal dominant HL, whereas no variants were detected in the other 1,947 probands with autosomal recessive or inheritance pattern unknown HL. To obtain the audiovestibular configuration of the patients harboring POU4F3 variants, we collected audiograms and vestibular symptoms of the probands and their affected family members. Audiovestibular phenotypes in a total of 24 individuals from the 15 families possessing variants were characterized by progressive HL, with a large variation in the onset age and severity with or without vestibular symptoms observed. Pure-tone audiograms indicated the most prevalent configuration as mid-frequency HL type followed by high-frequency HL type, with asymmetry observed in approximately 20% of affected individuals. Analysis of the relationship between age and pure-tone average suggested that individuals with truncating variants showed earlier onset and slower progression of HL than did those with non-truncating variants. The present study showed that variants in POU4F3 were a common cause of autosomal dominant HL.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0177636PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5435223PMC
September 2017

Endoscopic surgical management of sinonasal inverted papilloma extending to frontal sinuses.

Otolaryngol Pol 2016 Nov;70(6):26-32

Department of Otolaryngology, Head and Neck Surgery, Chiba Graduate School University, Chiba, Japan.

Objective: Sinonasal inverted papilloma has been traditionally managed with external surgical approaches. Advances in imaging guidance systems, surgical instrumentation, and intraoperative multi-visualization have led to a gradual shift from external approaches to endoscopic surgery. However, for anatomical and technical reasons, endoscopic surgery of sinonasal inverted papilloma extending to the frontal sinuses is still challenging. Here, we present our experience in endoscopic surgical management of sinonasal inverted papilloma extending to one or both frontal sinuses.

Methods: We present 10 cases of sinonasal inverted papilloma extending to the frontal sinuses and successfully removed by endoscopic median drainage (Draf III procedure) under endoscopic guidance without any additional external approach.

Results: The whole cavity of the frontal sinuses was easily inspected at the end of the surgical procedure. No early or late complications were observed. No recurrence was identified after an average follow-up period of 39.5 months.

Conclusion: Use of an endoscopic median drainage approach to manage sinonasal inverted papilloma extending to one or both frontal sinuses is feasible and seems effective.
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http://dx.doi.org/10.5604/01.3001.0009.3801DOI Listing
November 2016

Novel application of a rigid curved larygno-pharyngoscope for examination and treatment of hypopharyngeal lesions.

Auris Nasus Larynx 2018 Apr 2;45(2):367-370. Epub 2017 May 2.

Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.

In endoscopic laryngo-pharyngeal surgery (ELPS), a rigid curved laryngo-pharyngoscope, which was invented by Dr. Sato et al., is necessary to obtain excellent surgical view of both hypopharynx and even the entrance of the esophagus. We have used this instrument for the examination and treatment of several diseases other than cancer located in the hypopharynx, such as difficult-to-find buried fish bones, retropharyngeal abscess, and congenital pyriform sinus fistula. In the result, we could acquire better view of hypopharynx and completed the intended procedure safely, especially for uncovering difficult-to-find fish bone buried in the mucosa. Even in the cases hardly to operate under this instrument, just use for detailed observation of the lesion was available. A rigid curved laryngo-pharyngoscope provides a wide and clear view of a challenging space, the hypopharynx. We recommend using this technique in cases such as difficult-to-find buried fish bones or retropharyngeal abscesses while avoiding a neck incision.
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http://dx.doi.org/10.1016/j.anl.2017.04.006DOI Listing
April 2018

Clinical practice guidelines for the diagnosis and management of otitis media with effusion (OME) in children in Japan, 2015.

Auris Nasus Larynx 2017 Oct 1;44(5):501-508. Epub 2017 May 1.

Department of Health Informatics, Kyoto University School of Public Health, Japan.

Objective: To (1) indicate the definition, the disease state, methods of diagnosis, and testing for otitis media with effusion (OME) in childhood (<12 years); and (2) recommend methods of treatment in accordance with the evidence-based consensus reached by the Subcommittee of Clinical Practice Guideline for Diagnosis and Management of OME in Children.

Methods: We produced Clinical Questions (CQs) concerning the treatment of OME and searched the literature published until April 2014 according to each theme including CQ, the definition, the disease state, the method of diagnosis, and examination. The recommendations are based on the results of the literature review and the expert opinion of the Subcommittee.

Results: Because children with Down's syndrome and cleft palate are susceptible to OME, we categorized OME into low-risk and high-risk groups (e.g., Down's syndrome and cleft palate), and recommended the appropriate treatment for each group.

Conclusion: In the clinical management of OME in children, Japanese Clinical Practice Guidelines recommend management not only of OME itself, such as effusion in the middle ear and pathological changes in the tympanic membrane, but also pathological abnormality in surrounding organs, such as infectious or inflammatory diseases.
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http://dx.doi.org/10.1016/j.anl.2017.03.018DOI Listing
October 2017

Factors influencing endoscopic dacryocystorhinostomy outcome.

Eur Arch Otorhinolaryngol 2017 Jul 20;274(7):2773-2777. Epub 2017 Mar 20.

Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

Endoscopic dacryocystorhinostomy (DCR) is a widely accepted treatment option for epiphora and dacryocystitis. To elucidate the cause of treatment failure after surgery, we analyzed patients' characteristics and perioperative background in association with poor outcome. We analyzed 165 patients with 213 sides who had endoscopic DCR. The influence of age, duration of symptoms, occlusion site and stent insertion were analyzed. Symptoms were completely cured in 85.0% (181/213) sides. Higher age (≥65 years) and proximal obstruction were associated with a poor prognosis while stent insertion and duration of symptoms were not. Higher age and proximal obstruction site were associated with a poor prognosis. Patients with a long history can be treated as per normal. The stent is not necessarily inserted in cases where the obstruction occurs distal to the lacrimal sac.
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http://dx.doi.org/10.1007/s00405-017-4541-8DOI Listing
July 2017

New Scoring System for Evaluating Patulous Eustachian Tube Patients.

Otol Neurotol 2017 06;38(5):708-713

*Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine †Sen-En Rifu Otologic Surgery Center, Sendai, Japan.

Objective: To assess the efficacy of patulous Eustachian tube handicap inventory (PHI) for patulous Eustachian tube (PET) patients.

Study Design: Prospective.

Setting: Tertiary referral center.

Subjects: A prospective survey of medical records in Sen-En Hospital identified 31 ears of 31 patients with definite PET who received insertion of the silicone plug as surgical treatment group, 29 ears of 29 patients treated with self-instillation of physiological saline solution as conservative treatment group, and 29 ears of 29 patients of sensorineural hearing loss without findings of PET treated between June 2015 and December 2015.

Method: Diagnosis of definite PET was based on the proposal on PET diagnosis criteria announced by the Otological Society of Japan. The evaluation scale of PHI was modified from the Japanese version of the tinnitus handicap inventory-12 (THI-12). The classification for grading of severity is defined as follows: 1) no handicap (0-8), 2) mild handicap (10-16), 3) moderate handicap (18-24), and 4) severe handicap (26-40), matching the severity grades of tinnitus handicap inventory-25 (THI-25). The outcome measurement was modified from the previous scoring system and is defined as 1) complete relief, 2) significant improvement, 3) slight improvement, 4) unchanged, and 5) worse, and is applied according to the classification for grading of severity. The PHI was conducted at the first visit to our center for all patients in the three groups. For cases requiring surgery for plug insertion, patulous Eustachian tube handicap inventory 10 (PHI 10) was also conducted postsurgery after the treatment (postsurgery).

Results: The findings from questions 1 to 7 and 9 to 11 were significantly different between the surgical (presurgery) and conservative treatment groups (p < 0.05). Taking these results, we analyzed 10 questions excluding questions 8 and 12 (PHI 10). The total score of PHI 10 averaged 19.5 ± 9.3 (n = 31) and 30.6 ± 8.6 (n = 29) in the surgical treatment (presurgery) and conservative treatment groups, respectively, with a significant difference (p < 0.05). Internal consistency reliability testing of the PHI 10 yielded a Cronbach α of 0.887 for all questions. In the surgical treatment (presurgery) and conservative treatment groups, there were 0 (0%) and 3 cases (12%) of no handicap, 3 (10%) and 13 cases (50%) of mild handicap, 6 (19%) and 4 cases (15%) of moderate handicap, and 22 (71%) and 6 cases (23%) of severe handicap, respectively. There was a significant correlation between the PHI 10 and Likert scale (r = 0.796, p < 0.01). In the surgical group, the presurgery and postsurgery PHI 10 scores (n = 25) were 29.6 ± 8.5 and 7.8 ± 11.3, respectively.

Conclusion: The PHI 10 is suitable for evaluating severity of PET if the patients have been diagnosed as definite PET. Furthermore, this scoring system could be suitable for surgical treatment assessment.
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http://dx.doi.org/10.1097/MAO.0000000000001370DOI Listing
June 2017

Solubility of soy lipophilic proteins: comparison with other soy protein fractions.

Biosci Biotechnol Biochem 2017 Apr 10;81(4):790-802. Epub 2017 Feb 10.

a Laboratory of Quality Analysis and Assessment, Division of Agronomy and Horticultural Science, Graduate School of Agriculture , Kyoto University , Kyoto , Japan.

Solubility of soy lipophilic proteins (LP) was studied as compared with that of other soy protein fractions. LP, β-conglycinin, glycinin, and soy protein isolate (N-SPI) were prepared under the condition to avoid heat denaturation. Solubility of LP was lower than that of other soy protein fractions under all the tested conditions varying in pH values and ionic strength. The solubility of LP was increased constantly by elevating temperature until 90 °C, whereas that of β-conglycinin and glycinin dropped at high temperature. Temperature-dependent change in solubility of N-SPI might reflect the balance among that of glycinin, β-conglycinin and LP. Based on the results of SDS-PAGE, determination of phospholipid content and Fourier Transform Infrared spectroscopy, we discussed the solubilization behavior of LP relating to its origin and composition.
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http://dx.doi.org/10.1080/09168451.2017.1282808DOI Listing
April 2017

Simulations and spectra of water in CO matrices.

Phys Chem Chem Phys 2017 Mar;19(10):7280-7287

Institute of Low Temperature Science, Hokkaido University, Sapporo 060-0819, Japan.

Models for the inclusion of water molecules in carbon monoxide matrices are developed using density functional theory applied to amorphous solid systems. The models cover a large range of systems for smaller or larger CO matrices with different water content, consisting of either individual HO molecules or small clusters linked by H-bonds. The vibrational spectra of the samples are predicted at the minimum of their potential energy surface. The spectra allow instances where the water molecules remain isolated or form aggregates to be discerned, and they also provide an indication of the strength of the H-bonding, when present. The calculations support recent experimental observations that linked IR bands at 3707 cm and 3617 cm to the presence of unbound water molecules in water-poor CO/HO mixed ices. Assignment of some observed bands to water dimers or trimers is suggested as well. The residual static pressure in fixed-volume simulation cells is also calculated.
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http://dx.doi.org/10.1039/c6cp08248cDOI Listing
March 2017

Effects of Visual Speech on Early Auditory Evoked Fields - From the Viewpoint of Individual Variance.

PLoS One 2017 31;12(1):e0170166. Epub 2017 Jan 31.

Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

The effects of visual speech (the moving image of the speaker's face uttering speech sound) on early auditory evoked fields (AEFs) were examined using a helmet-shaped magnetoencephalography system in 12 healthy volunteers (9 males, mean age 35.5 years). AEFs (N100m) in response to the monosyllabic sound /be/ were recorded and analyzed under three different visual stimulus conditions, the moving image of the same speaker's face uttering /be/ (congruent visual stimuli) or uttering /ge/ (incongruent visual stimuli), and visual noise (still image processed from speaker's face using a strong Gaussian filter: control condition). On average, latency of N100m was significantly shortened in the bilateral hemispheres for both congruent and incongruent auditory/visual (A/V) stimuli, compared to the control A/V condition. However, the degree of N100m shortening was not significantly different between the congruent and incongruent A/V conditions, despite the significant differences in psychophysical responses between these two A/V conditions. Moreover, analysis of the magnitudes of these visual effects on AEFs in individuals showed that the lip-reading effects on AEFs tended to be well correlated between the two different audio-visual conditions (congruent vs. incongruent visual stimuli) in the bilateral hemispheres but were not significantly correlated between right and left hemisphere. On the other hand, no significant correlation was observed between the magnitudes of visual speech effects and psychophysical responses. These results may indicate that the auditory-visual interaction observed on the N100m is a fundamental process which does not depend on the congruency of the visual information.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0170166PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5283660PMC
August 2017

Computed tomography findings of the bony portion of the Eustachian tube with or without patulous Eustachian tube patients.

Eur Arch Otorhinolaryngol 2017 Feb 12;274(2):781-786. Epub 2016 Nov 12.

Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Japan.

To investigate the bony segment of the Eustachian tube (ET) using sitting 3D-computed tomography (CT) scans in Patulous Eustachian tube (PET) patients. A retrospective survey of medical records in Sen-En Hospital identified 43 patients and 43 ears with PET and 30 patients and 30 ears with sensorineural hearing loss or vertigo patients as the control. Diagnosis of PET was based on the Proposal on PET Diagnosis Criteria announced by the Otological Society of Japan in 2012. Patients were examined by cone beam CT (Accuitomo; Morita, Kyoto, Japan) in the sitting position. The heights and widths at the tympanic orifice, the middle portion, and isthmus were measured. The lumen of the bony portion was divided into three shapes: peritubal cells (PTC) poor type, PTC good with prominence type, and PTC good without prominence type. In PET patients and the control group, the PTC poor type was identified in nine (21%) and seven ears (23%), PTC good with prominence type was identified in 14 (33%) and seven ears (23%), and PTC good without prominence type was identified in 19 (45%) and 16 ears (53%), respectively. There was no significant difference between the two groups. At the tympanic orifice portion, the average height of the ET lumen was 5.99 ± 1.29 and 6.04 ± 1.41 mm, and the average width of the ET lumen was 2.81 ± 0.82 and 2.78 ± 0.57 mm in the PET and control groups, respectively. The PTC good with prominence type had a significantly smaller width in the tympanic orifice portion than the other types in each group (p < 0.05). The width of the ET lumen in the tympanic orifice averaged 2.87 ± 0.38 and 3.10 ± 0.45 mm in the PTC poor type, 2.23 ± 0.70 and 2.22 ± 0.48 mm in the PTC good with prominence type, and 3.21 ± 0.87 and 2.90 ± 0.50 mm in the PTC good without prominence type in the PET and control groups, respectively. The shape of the bony portion of the ET in PET patients is almost identical to that of controls. Thus, the bony portion has no influence on the pathology of patulous Eustachian tube syndrome. The PTC good with prominence type has a significantly smaller tympanic orifice portion width than the other types. Preoperative evaluation of the bony portion of the ET could provide useful information for ET surgeons.
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http://dx.doi.org/10.1007/s00405-016-4383-9DOI Listing
February 2017

Predicting postoperative fever and bacterial colonization on packing material following endoscopic endonasal surgery.

Eur Arch Otorhinolaryngol 2017 Jan 1;274(1):167-173. Epub 2016 Jul 1.

Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.

Postoperative fever following endoscopic endonasal surgery is a rare occurrence of concern to surgeons. To elucidate preoperative and operative predictors of postoperative fever, we analyzed the characteristics of patients and their perioperative background in association with postoperative fever. A retrospective review of 371 patients who had undergone endoscopic endonasal surgery was conducted. Predictors, including intake of antibiotics, steroids, history of asthma, preoperative nasal bacterial culture, duration of operation, duration of packing and intraoperative intravenous antibiotics on the occurrence of postoperative fever, and bacterial colonization on the packing material, were analyzed retrospectively. Fever (≥38 °C) occurred in 63 (17 %) patients. Most incidences of fever occurred on postoperative day one. In majority of these cases, the fever subsided after removal of the packing material without further antibiotic administration. However, one patient who experienced persistent fever after the removal of packing material developed meningitis. History of asthma, prolonged operation time (≥108 min), and intravenous cefazolin administration instead of cefmetazole were associated with postoperative fever. Odds ratios (ORs) for each were 2.3, 4.6, and 2.0, respectively. Positive preoperative bacterial colonization was associated with postoperative bacterial colonization on the packing material (OR 2.3). Postoperative fever subsided in most patients after removal of the packing material. When this postoperative fever persists, its underlying cause should be examined.
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http://dx.doi.org/10.1007/s00405-016-4189-9DOI Listing
January 2017

First report of severe acute otitis media caused by Campylobacter rectus and review of the literature.

J Infect Chemother 2016 Dec 28;22(12):800-803. Epub 2016 Jun 28.

Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

Campylobacter rectus is a member of the human oral flora and is associated with periodontal disease. We report the first case of severe acute otitis media (AOM) due to C. rectus in a previous healthy 15-year-old boy, which was confirmed by 16S ribosomal RNA gene sequencing. C. rectus is a possible causative pathogen of AOM.
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http://dx.doi.org/10.1016/j.jiac.2016.06.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129946PMC
December 2016

Stepwise formation of H3O(+)(H2O)n in an ion drift tube: Empirical effective temperature of association/dissociation reaction equilibrium in an electric field.

J Chem Phys 2016 Jun;144(22):224306

Atomic Physics Laboratory, RIKEN, Wako, Saitama 351-0198, Japan.

We measured equilibrium constants for H3O(+)(H2O)n-1 + H2O↔H3O(+)(H2O)n (n = 4-9) reactions taking place in an ion drift tube with various applied electric fields at gas temperatures of 238-330 K. The zero-field reaction equilibrium constants were determined by extrapolation of those obtained at non-zero electric fields. From the zero-field reaction equilibrium constants, the standard enthalpy and entropy changes, ΔHn,n-1 (0) and ΔSn,n-1 (0), of stepwise association for n = 4-8 were derived and were in reasonable agreement with those measured in previous studies. We also examined the electric field dependence of the reaction equilibrium constants at non-zero electric fields for n = 4-8. An effective temperature for the reaction equilibrium constants at non-zero electric field was empirically obtained using a parameter describing the electric field dependence of the reaction equilibrium constants. Furthermore, the size dependence of the parameter was thought to reflect the evolution of the hydrogen-bond structure of H3O(+)(H2O)n with the cluster size. The reflection of structural information in the electric field dependence of the reaction equilibria is particularly noteworthy.
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http://dx.doi.org/10.1063/1.4953416DOI Listing
June 2016

Relationship Between Clinical Test Results and Morphologic Severity Demonstrated by Sitting 3-D CT in Patients With Patulous Eustachian Tube.

Otol Neurotol 2016 08;37(7):908-13

*Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan †Sen-En Rifu Otologic Surgery Center, Sendai, Japan.

Objective: To investigate the correlation of sitting 3-D computed tomography (CT) scans of the Eustachian tube (ET) with subjective and objective findings in patients with patulous Eustachian tube (PET).

Study Design: Retrospective.

Setting: Tertiary referral center.

Subjects: A retrospective survey of medical records in Sen-En Hospital identified 40 patients and 62 ears with PET between September 2014 and June 2015.

Method: Diagnosis of PET was based on the presence of three characteristic aural symptoms (autophony of voice or breathing sounds, and aural fullness), as well as verification of synchronous movement of the tympanic membrane in response to forced breathing under an endoscope. Any pressure changes in the external auditory canal (EAC) elicited by deep breathing and sniffing were detected by tubotympanoaerodynamography (TTAG). In addition, sonotubometry was performed where two parameters were used determined to evaluate ET function. Patients were examined by 3-D CT (Accuitomo; Morita, Kyoto, Japan) in the sitting position. The length of the closed ET lumen section was measured. Ears were divided into three groups as follows: completely open, closed-short (3 mm or less), and closed-long (longer than 3 mm).

Results: The median length of the closed section of the ET lumen was 1.85 ± 2.69 mm in positive findings of PET. The three groups were significantly different in both aural fullness (p = 0.023) and, similarly, the difference in tympanic membrane movement (p = 0.032) among these three groups was also significantly different (p = 0.032). However, for autophony of breathing sounds, there was no significant difference with regard to autophony of breathing sounds among these three groups (p = 0.324). Although TTAG findings were did not reveal any significantly difference among these three groups (p = 0.589), the difference was significant (p = 0.001) in degree of EAC pressure change in TTAG. The difference among the three groups was significant (p = 0.001) based on sonotubometry findings.

Conclusion: Under resting conditions, the lengths of the closed area of the ETs in PET groups are clearly shorter than in groups without PET based on sitting position CT scans in resting condition. Among the symptoms and clinical test findings including the ET function test results, the presence of tympanic membrane movement induced by respiration, the high degree of EAC pressure change in TTAG, as well as the positive results of sonotubometry are significantly correlated with the positive findings of sitting CT revealing the open ET.
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http://dx.doi.org/10.1097/MAO.0000000000001102DOI Listing
August 2016
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