[Show abstract][Hide abstract] ABSTRACT: Background:
Otosclerosis is an abnormal bone growth in the otic capsule that can result in hearing loss. In this study, we compared postoperative hearing outcomes and vestibular symptoms between patients treated with laser-assisted stapedotomy versus stapedectomy.
The medical charts of 99 ears treated with stapes surgery were retrospectively reviewed.
A stapedotomy, partial stapedectomy, or total stapedectomy was conducted in 77, 16, and 56 ears, respectively. The ears treated with partial- and total stapedectomies were unified into one stapedectomy group. The postoperative changes in the air-bone gap after stapedotomies were significantly larger than those after stapedectomies at 1, 2, and 4 kHz. The postoperative changes in the air conduction threshold after stapedotomies were significantly larger than those after stapedectomies at 1, 2, 4, and 8 kHz. The postoperative changes in the bone conduction threshold at 0.5, 1, 2, and 4 kHz did not differ between the groups. The postoperative vertigo duration after stapedotomies was significantly shorter than that after stapedectomies.
Surgery-induced sensorineural hearing losses were similar for stapedotomies and stapedectomies. However, stapedotomies were more effective and atraumatic than stapedectomies because of the better postoperative hearing results at middle and high frequencies and the shorter postoperative vertigo.
[Show abstract][Hide abstract] ABSTRACT: Various surgical approaches for the treatment of laryngeal submucosal tumors have been reported. Endoscopic excision is indicated for small lesions, while external approaches are recommended for larger tumors. This report introduces a supra-thyroid alar cartilage approach (STACA), which has strong advantages for the preservation
of the laryngeal framework and voice recovery after surgery. Case series with chart review. Four patients with laryngeal submucosal tumors in the paraglottic space underwent complete tumor removal through STACA. Medical charts were reviewed to evaluate patient background, major complaints, tumor type, tumor size, the time period from operation to tracheostomy closure, tumor recurrence, and the difference between pre- and postoperative voice quality. Voice quality was assessed using the GRBAS score, maximum phonation time (MPT) and Voice Handicap Index-10 (VHI-10) 6 months after surgery. All patients were females between 43 and 67 years of age. Two patients had schwannoma, one laryngocele, and one lipoma. Mean tumor size was 3.4 cm. The main complaints were hoarseness in all patients, and dyspnea in one. The periods of time from surgery to oral intake and tracheostomy closure were 3.5 and 7 days, respectively. No patient developed recurrence during a minimum follow-up period of 2 years. The postoperative GRBAS scores, MPT and VHI-10 improved in all patients. STACA has advantages including minimal trauma, no deformity to the laryngeal framework, and good voice qualities after the resection of laryngeal submucosal tumors.
No preview · Article · Jun 2015 · Archives of Oto-Rhino-Laryngology
[Show abstract][Hide abstract] ABSTRACT: Abstract Laryngoscopy in cases of sulcus vocalis reveals bowed vocal folds, resulting in a spindle-shaped chink with glottal incompetence. The anatomic and functional problems and resulting incomplete glottal closure during phonation lead to the presenting symptoms of breathy hoarseness, decrease in maximum phonation time (MPT), and vocal fatigue. These symptoms, however, have been reported from the physician's viewpoint, not the patient's. Furthermore, no standardized guidelines for the treatment of sulcus vocalis have been established. Because the general attitude toward sulcus vocalis appears to have become 'It is only a vocal problem and does not significantly affect the patient's well-being,' knowledge of sulcus vocalis has decreased and knowledge about choices of therapy remain limited. We therefore conducted an epidemiological questionnaire survey on this pathological condition in voice clinics in seven hospitals in the Tokyo area to establish preliminary guidelines for the management of sulcus vocalis, in reference to the opinion of the patients. Here we report the summary of our preliminary study 'a survey for sulcus vocalis' and suggest guidelines for the management of such pathological conditions. Although these management guidelines may result in improvement in the symptoms of sulcus vocalis, patients and physicians should be aware that treatment of this condition is difficult and improvement is not guaranteed.
No preview · Article · Feb 2015 · Acta Oto-Laryngologica
[Show abstract][Hide abstract] ABSTRACT: We used new criteria to elucidate the demographics of acute low-tone sensorineural hearing loss (ALHL) and tested the Chinese medicine Wu-Ling-San as a treatment for ALHL.
We reviewed the medical records of patients with ALHL seen at the outpatient clinic of the Social Insurance Central General Hospital in Tokyo from April 2006 through August 2011. Patients were treated with an oral steroid, a diuretic, or Wu-Ling-San; alone or in combination.
We identified 130 definite and 48 probable ALHL cases. The mean age and male-to-female ratio in probable cases were significantly higher than those in definite cases (p < 0.05). The steroid-Wu-Ling-San combination was significantly more effective (100% recovery) than the diuretic alone (59%), Wu-Ling-San alone (62%), or the steroid-diuretic combination (60%, p < 0.05).
ALHL can develop in older patients more frequently than we expected. The steroid-Wu-Ling-San combination is a possible new treatment for ALHL.