Fumihiko Ohta

Prediction of Sequelae following Facial Nerve Palsy

The severity of facial muscle synkinesis, contracture, spasm, crocodile tears and hearing impairment and/or tinnitus were observed carefully following facial nerve palsy and evaluated quantitatively by a scoring system. Using this system, a mathematical formula was obtained to predict sequelae from the severity of facial nerve palsy. The severity of palsy at 2 weeks and 2 months after its onset was an important sign for prediction of sequelae.

Hearing Aid Evaluation using Psychoacoustical Proximity between Japanese Monosyllables

To facilitate hearing aid selection, a new method was developed to assess the qualitative changes in speech perception with and without a hearing aid. This method utilizes maps of the Japanese monosyllables where the degrees of confusion are represented by distances between the monosyllables. On these maps, perceptual failures of the monosyllables can be simply analyzed by connecting confused stimuli and the corresponding wrong responses. The qualitative characteristics of monosyllable confusion for 53 patients with hearing impairment were comparatively analyzed with and without hearing aids. Results show that this method is useful for describing the qualitative effects of hearing aids on speech perception, and that it thus provides important information for hearing aid selection.

Reconstruction of the middle ear with tragal cartilage.

A surgical technique for reconstruction of a well-ventilated middle ear space using tragal cartilage has been developed. Our technique was designed so as to secure an atticoantrum cavity and a complement of posterior tympanic annulus with a cartilage. This technique can be utilized in a radical mastoidectomy cavity at an original surgery and at a revision.

Variable-speech-rate audiometry for hearing aid evaluation.

A new hearing aid evaluation method using variable-speech-rate audiometry (VSRA) was developed. VSRA was newly created based on the Japanese speech audiometry authorized by the Japan Audiological Society. The ordinary speech audiometry can not reveal a temporal factor in word discrimination ability of the hearing impaired. Since, with VSRA, we can compare several performance-intensity curves obtained from different speech-rate speech audiometries, the impact on the auditory system of each patient by the fast or slow speech rate could be easily determined. Taking the temporal factor of the auditory systems into consideration by using VSRA, hearing aid evaluation was performed for a master hearing aid with three types of signal processing and fitting for 36 hearing impaired subjects. Then hearing aid evaluation was performed using VSRA for a newly developed portable multi-function digital hearing aid with two types of signal processing and analog hearing aids which had been used by hearing-impaired patients. As a result, VSRA was useful for hearing aid evaluation, in particular, for cases when ordinary normal speech rate audiometry does not provide a significant difference in word discrimination scores. In addition, using VSRA revealed that amplitude compression is more effective for improvement of word discrimination than linear amplification.

Tympanostomy tubes for children with otitis media with effusion.

Tympanostomy tubes were inserted in 76 ears under general anesthesia in our clinic between the beginning of 1984 and the end of 1987. After 6 months and 9 months, hearing was tested in two groups of patients: those with tympanostomy tubes for 3 months or longer and those with tubes present for less than 3 months. Hearing improvement was greater in the former than in the latter group. Otorrhea was observed in 11 ears (14%) while the tympanostomy tubes were in place. Cultures of the discharge suggested that the middle ear is more frequently infected through the Eustachian tube than through the external acoustic meatus. OME recurred in 26% after tympanostomy tubes were inserted, but in none of the ears with tympanostomy tubes for 12 months or longer.

High Resolution Computed Tomography of Auditory Ossicles

Auditory ossicular sections were scanned at section thicknesses (mm)/section interspaces (mm) of 1.5/1.5 (61 patients), 1.0/1.0 (13 patients) or 1.5/1.0 (33 patients). At any type of section thickness/interspace, the malleal and incudal structures were observed with almost equal frequency. The region of the incudostapedial joint and each component part of the stapes were shown more frequently at a section interspace of 1.0 mm than at 1.5 mm. The visualization frequency of each auditory ossicular component on two or more serial sections was investigated. At a section thickness/section interspace of 1.5/1.5, the visualization rates were low except for large components such as the head of the malleus and the body of the incus, but at a slice interspace of 1.0 mm, they were high for most components of the auditory ossicles.

Treatment of sudden deafness with Abbokinase.

We studied the therapeutic effect of high-dose administration of a thrombolytic agent (Abbokinase®) in 33 patients with sudden deafness.The treated group received 120, 000IU of Abbokinase for 7 days and the results were compared with those in an untreated group.In terms of clinical efficacy, the treated group showed 9 higher rate of recovery from sudden deafness than the untreated group.Abbokinase was considered to effective in patients with sudden deafness.

Effect of Tarivid (Ofloxacin) on otorhinolaryngological infections.

In recent years, the number of adults with acute deterioration of chronic otorhinolaryngological infections has been increasing.Problems that we encounter in the treatment of chronic otorhinolaryngological infections include an increase of drug-resistant bacteria and unsatisfactory penetration of drugs into the tissues. The authors recently used Tarivide (ofloxacin), a new drug of the quinolone family, to treat 20 patients with acute deterioration of chronic otorhinolaryngological diseases (tonsillitis, nasosinusitis and tympanitis). The drug proved to be clinically effective in 95.0% and bacteriologically effective in 88.2% of the 20 patients. In 6 patients who were treated with this drug preoperatively, the blood and tissue concentrations of the drug were high.These results indicate that ofloxacin can be useful for the treatment of chronic infections in the field of otorhinolaryngology.

Clinical studies on Ceftriaxone in the treatment of acute tonsillitis and pharyngolaryngitis.

We performed clinical and bacteriological studies on Ceftriaxone, (Rocephin®) a broad spectrum antibacterial agent with a long half-life, in the treatment of adult infections of the upper respiratory tract (14 cases of tonsillitis and 20 cases of pharyngolaryngitis).The rate of clinical improvement was 92.8% for tonsillitis and 85.9% for pharyngolaryngitis. In terms of its bacteriological effect, rate of improvement for S. aureus and B. streptococcus was 87.5% and 81.8%, and 100% and 100% for tonsillitis and pharyngolaryngitis, respectively. The blood concentration of Ceftriaxone after a single injection was 169.2, 81.0, 45.1 and 16.8μg/ml at 1, 6, 12 and 24hr, respectively.These results suggest the effectiveness of Ceftriaxone in the treatment of infections of the upper respiratory tract.

Survey of 342 cases of facial palsy.

A statistical analysis was performed on 342 patients with facial nerve palsy treated at our clinic between May, 1970 and April, 1980. The incidence of Bells palsy was 71% (242 patients)and that of Hunts syndrome 16%. Little difference was detected in the initial palsy scores between Bells palsy and Hunts syndrome, but significant differences were after a period of two months. Final recovery was significantly better in those with Bells palsy. In addition, those receiving early treatment showed better final recovery. Better recovery was obtained in Bells palsy patients under 40 years of age than in those 40 years or more.