Junichi Yoda

The benefit of cochlear implantation in the Japanese elderly

The purpose of this study was to evaluate the benefit of cochlear implant for Japanese elderly people with profound hearing loss. A questionnaire was administered to the five Japanese elderly people over 65 years old with the Nucleus 22 channel device and their family. The questionnaire was designed to gain insight into the patients daily use and to evaluate the quality of life. Elderly patients who were implanted with the Nucleus device showed good ability to identify environmental sound and revealed no significant deterioration compared to younger patients. Implanted patients showed some difficulties in understanding speech in the noisy environment and conversation among several persons. Nevertheless, 80% of patients over 65 and their family reported communication benefits in the family and in social activities. In addition, 80% of the patients reported that they felt the better or improved quality of life after the implantation. All patients considered the implant was good for their life and would recommend a cochlear implant to a deaf friend. It is notable that 60% of patients and their family report that the recipients have become more cheerful. This study showed the cochlear implant contributes to the better quality of life in the Japanese elderly.

Mucoepidermoid Carcinoma in the Nasopharynx.

We report a case of mucoepidermoid carcinoma in the nasopharynx. A woman, aged 59, who suffered from chronic otitis media with effusion was referred to our department due to a mass lesion on the Rosenmullers fossa. The mass lesion was pathologically diagnosed as a mucoepidermoid carcinoma. CT and MRI scans showed a well bordered round shadow which was limited to the orifice of the left eustachian tube, without invasion of the skull base.As the patient did not agree to surgical treatment, we selected radiotherapy using a gamma knife for treatment of the nasopharyngeal tumor. The tumor responded well to gamma knife treatment and disappeared with 30Gy irradiation (Edge dose). The patient has shown no recurrence of the tumor for a year and 6 months after treatment. Gamma knife radiotherapy may be one potential treatment strategy for intractable lesions of the head and neck such as mucoepidermoid carcinoma in the nasopharynx.

Treatment of Tinnitus with LipoPGE1.

Severe tinnitus in 32 patients wtih senile deafness was treated with Lipoprostaglandin E1 10μg i. v. once a week. The tinnitus score was significantly decreased from 10 to 3.9±2.4. Slight to marked improvement was recorded in 90.6% of the patients. Early treatment, within 4 weeks of the onset of tinnitus, was more effective than later treatment. There were 4 patterns of improvement. No severe side effect was observed.The results of this study suggest that Lipoprostaglandin E1 is very useful in the treatment of tinnitus.