Hiroyuki Takezawa

Elevation of bone conduction threshold in children with middle ear effusion

A retrospective study of children having otitis media with effusion revealed fluctuations in bone conduction thresholds as well as in air conduction thresholds. Previous investigations in this area presented both low- and high-tone bone conduction hearing loss which were reversible. We conducted a detailed study including complete otologic, audiologic and tympanometric evaluation of 27 (41 ears) children who had fluctuating bone conduction hearing loss. From these audiologic examinations, 3 types of bone conduction hearing loss could be classified: high-tone, low-tone and flat-type bone conduction hearing loss. We observed the shift of bone conduction thresholds in children after removal of middle-ear fluids by the appropriate medical management.

Clinical Study of Laryngeal Cancer.

One hundred and nine cases of laryngeal cancer were treated between 1987 and 1997 in the Department of Otorhinolalyngology at Obihiro Kousei Hospital. The average age of the patients was 65.4 years old, and the male to female ratio was 21:1. Based on histopathological diagnosis, 108 cases were reported as squamous cell carcinoma and one case was reported as spindle cell carcinoma. There were 15 cases of supraglottic carcinoma, 91 cases of glottic carcinoma and 3 cases of subglottic carcinoma. There were 33 cases in stage I, 35 cases in stage II, 22 cases in stage III and 19 cases in stage IV. The five-year survival rates of the patients for stages I to IV were 100%, 90%, 66% and 65% respectively.

Nasal Allergy in Tokachi; A Clinical Study.

1993年4月1日より, 1995年7月31日までの間に帯広厚生病院耳鼻咽侯科を受診し, 鼻アレルギーと診断された患者でRISTおよびPASTを施行しえた患者336例を対象として, 十勝地方の鼻アレルギー患者, 特に花粉症においての臨床的検討を加えた。北海道地方ではイネ科花粉症が重要であるといわれているが, 十勝地方ではシラカンバの樹木花粉症が最も重要であり, カモガヤ, チモシーのイネ科花粉症同様ヨモギ花粉症も重要であることがわかった。これは十勝地方の気候, 植性によるものであり, 日常診療において役立てるべきであると思われた。

Infants with otitis media with effusion, with and without acute otitis media.

Acute otitis media (AOM) is one of the most common infectious disease in childhood. The purpose of this study was to clarify the association between AOM and otitis media with effusion (OME). A nine-year retrospective study was conducted of 131 children with OME (219 ears).The patients were classified into four groups according to the clinical course of hearing impairment.The incidence of AOM in OME patients was 65.6% on the average, and a history of AOM was a significant risk factor for the development of chronic OME.The diagnosis of AOM is difficult in young infants. Our results suggest that AOM in early infancy is a strong predictor of recurrent middle ear problems later in childhood.In order to prevent this, AOM in young infants must be treated as effectively as possible. This therapy includes proper antimicrobial treatment, myringotomy, drainage of the middle ear and careful follow up.

Pediatric otolaryngological diseases found on screening tests in Hokkaido rural district.

Otolaryngological examinations were carried out on 1017 children (1-13, mean 4.9 years old) in 5 rural towns in Hokkaido. In addition to the usual ENT examinations, tympanometric examination and cytological study of nasal secretions were performed in all children.The incidence of abnormal nasal findings and nasal eosinophilia increased, whereas that of abnormal ear findings and abnormal tympanograms decreased with age. There was no correlation between the occurence of nasal eosinophilia and abnormal tympanograms. A history of allergy, included asthma, also showed no correlation with the incidence of abnormal ear findings. The incidence of upper respiratory tract infection was lower in the older children.These findings suggest that allergy is not related to otological abnormalities, including otitis media with effusion.