Hideharu Aoki

Foreign body in the maxillary sinus—possible plastic tube: a case report

We experienced the case of a patient who had a foreign body in the maxillary sinus. The patient complained of recurrent unilateral badly smelling rhinorrhea. The computed tomography and the magnetic resonance images revealed a foreign body in the maxillary sinus. The foreign body was removed via the Caldwell-Luc approach. The foreign body was a plastic tube, which was supposed to be designed for the drainage of the maxillary sinus. However, the patient did not remember having been subjected to a treatment using such kind of tube. After the surgical removal, the patient became free from the nasal symptoms.

The necessity of simple X-ray examination: a case report of button battery migration into the nasal cavity.

Background Since the discovery of button battery, it has been widely applied in various electric devices. However, the button battery has a potential risk as a foreign body in the nasopharyngeal field. Thus, there is a need for early diagnosis and removal of these batteries. Methods We experienced a case of foreign body in the nasal cavity. A battery was lost around a 2-year-old patient. He visited a local pediatric clinic. X-ray examination of the neck, chest. and abdomen showed no sign of a foreign body. He subsequently exhibited left cheek swelling and came to our clinic. Results X-ray examination of head revealed a metallic foreign body in the left nasal cavity. The foreign body was approached using an endoscope under general anesthesia. The nasal cavity was filled with necrotic tissue. We removed the foreign body using forceps. After surgery, perforation of nasal cavity was identified. Conclusions The button battery was a potential risk because it contained toxic substances, could release an electrical current, and exerted direct pressure on the surrounding tissues. Surgical removal of button battery is the treatment of first choice. As for late complications, saddle nose is reported. Our patient would receive nasoplastic surgery around the age of 18 years. In summary, our patient’s nose was not initially examined using x-ray study. It is very important to keep in mind the possibility of a nasal foreign body, not only for ear, nose, and throat doctors but also for pediatricians.

Relationship between Auditory Brainstem Response Waveform and Head Size

The relationship between the head size and the latency and amplitude of the auditory brainstem response (ABR) was investigated in 60 normal-hearing adults (30 males and 30 females). We found a strong positive correlation between the latency of ABR waves and the head size and a strong negative correlation surfaced between the ABR amplitude and head size. These results indicate that the head size is one of the most important factors influencing the waveform of the ABR.

Changes in the auditory brain-stem response in comatose patients.

The auditory brain-stem response (ABR) was correlated with age, cause of coma and prognosis in 157 comatose patients. It was found that changes in the ABR could not be attributed to the age or cause of coma. In the patients who recovered and the persistent vegetative state the one to five inter wave latency became shorter. In the patients who later died, the one to five inter wave latency was prolonged. The patients who showed no response or only wave one from the beginning of coma and those in whom the wave form increased with the latency all died. These findings suggest that the ABR may be important test for judging the prognosis in comatose patients.

Postoperative observations following tympanoplasty.

Postoperative observations were reported after tympanoplasty of 478 patients during last 5 years and 9 months. Changes in hearing level, incidence of re-perforation of the tympanic membrane, presence of ear drainage, and development of cholesteatoma were the main items investigated.Hearing level reached a certain level about one year after tympanoplasty and maintained that level afterwards. The incidence of permanent re-perforation was .5% and that of ear drainage was 2.5%. The development of cholesteatoma was observed 28 patients, 17.2% of all cholesteatoma cases (163 cases). The recurrence of cholesteatoma was usually diagnosed one to three years after tympanoplasty under operation microscope. Therefore, postoperative observation should be carried out for at least three years after surgery. In our clinic, however, more than 10% of the patients who received tympanoplasty did not return for examination three years after surgery. It is important to strive to increase the postoperative observation rate to 100% after tympanoplasty.

Changes of vestibular function after endolymphatic sac surgery.

In order to clarify the direct influence of endolymphatic sac surgery on vestibular function, changes of symptoms and positional nystagmus of 23 patients were analyzed before and after surgery.The incidence of dizziness was highest 7 to 10 days after surgery. During the same period, positional nystagmus was the most prominent. Two months after surgery, the incidence of dizziness had decreased significantly, and positional nystagmus had disappeared in most cases.This analysis revealed that the direct influence of endolymphatic sac surgery on vestibular function was greatest 7 to 10 days after surgery, and that it took about two months to disappear.

Tinnitus measurement and treatment - Part. 3 Follow up study on the long-term use of band-noise masker.

A follow up study was carried out of 12 patients using band-noise masker for 6 months to 3 years.Various auditory tests and measurements of tinnitus were performed before and after the long-term use of band-noise tinnitus masker: loudness balance, masking and pitch match tests.None of the 12 patients showed any remarkable changes in hearing at the 7 frequencies tested, from 125 to 8000Hz. Tinnitus frequency obtained by the pitch match method demonstrated no changes after long-term listening to band-noise. The contralateral loudness balance method indicated changes of tinnitus loudness; however, both the ipsilateral loudness balance method and the masking method showed no remarkable changes of tinnitus loudness after the long-term use of a tinnitus masker.We conclude that the long-term use of a band-noise masker has no effect on the pure tone threshold as long as close follow-up examinations are performed.