Masutoshi Nishikawa

Nystagmus During Attack in Ménière's Disease

Nystagmus in Ménières disease before the vertiginous attack to its end was recorded using a newly devised long recording portable electronystagmograph. The nystagmus to the affected side was recorded before the patient complained of vertigo, while the non-affected side was recorded at the onset of the attack. And the nystagmus to the affected side was recorded in the middle and at the end of the attack.

Evaluation of the Pharmacia CAP System, A New Test for Allergic Diagnosis (Cedar Pollinosis)

For the diagnosis of allergic rhinitis we measured the specific IgE and the total serum IgE in the blood. Although we had measured them by the conventional Phadebas RAST and the Pharmacia IgE RIA before, we now adopted the new Pharmacia CAP System (CAP RAST FEIA and CAP IgE FEIA). To compare these methods, we measured the specific IgE to the cedar pollen and total serum IgE in the same blood of 224 hospital staff at the regular physical examination. As a result the new Pharmacia CAP System proved to be simpler, safer, faster, easier, more specific, and more sensitive than the Phadebas RAST and the Pharmacia IgE RIA. And also these methods correlated well with each other.

Delayed Response Following Cochlear Microphonics; Its Clinical Significance.

Transtympanic electrocochleography (ECoG) with 1000Hz tone-bursts and clicks was performed in 262 patients (262 ears) who visited the JA Yamaguchi Shuto General Hospital.The cochlear microphonics (CM), action potentials (AP) and summation potentials (SP) were analyzed.1) There were some patients with a delayed response following the tone-burst evoked CM, but others did not show such a delayed response.2) Delayed responses following a tone-burst evoked CM were frequently evoked in patients with a normal hearing level and in patients with high frequency sensorineural hearing loss.3) Patients with a delayed response following a tone-burst evoked CM appeared to have a better overall hearing level, lower click-evoked AP detection thresholds and a larger click-evoked AP amplitude than those without a delayed response.4) The tone-burst evoked CM detection thresholds were correlated with pure tone thresholds at a frequency of 1000Hz, and with the average pure tone hearing level within a frequency range of 500-4000Hz.

Correlation of Electrocochleographic Data and Hearing Loss.

Transtympanic electrocochleography (ECoG) with clicks and tone-bursts at a frequency of 1000 Hz was performed in 155 patients (160 ears) who visited JA Yamaguchi Shuto General Hospital. Action potentials (AP), negative summating potentials (—SP) and cochlear microphonics (CM) were examined.1) Click-evoked AP detection thresholds and tone-burst-evoked CM detection thresholds were cor-related with pure tone thresholds at frequencies of 1000 Hz and 4000 Hz, and with average pure tone hearing levels in the frequency range of 500-4000 Hz. Click-evoked AP detection thresholds correlated well with pure tone thresholds at a frequency of 4000 Hz (correlation coefficient: 0.800).2) Click-evoked AP detection thresholds in patients with high-frequency hearing loss were higher than those in patients with low-frequency hearing loss.Click-evoked AP amplitudes in patients with high-frequency hearing loss were lower than those in patients with low-freuency hearing loss. There were significant differences in click-evoked AP thresholds and AP amplitudes between patients with high-frequency and low-frequency hearing loss. Click-evoked AP thus appeared to be related to high-frequency hearing loss.3) There were significant differences in average pure tone hearing levels in the frequency range of 500-4000 Hz, pure tone thresholds at frequencies of 1000 and 4000 Hz, click-evoked AP detection thresholds and amplitudes, and tone-burst-evoked CM detection thresholds between patients with and without a delayed response following CM.Patients with a delayed response following CM thus appeared to have better hearing levels and better ECoG waveform responses than did those without a delayed response following CM.

Positive Summating Potential in Electrocochleograms.

Electrocochleograms (ECoG) obtained by the promontory recording technique using a needle electrode were recorded from 215 ears of patients affected by Menieres disease and other conditions in order to evaluate the clinical significance of summating potential (SP) polarity.The patients with positive SP waveforms tended to have better ECoG waveform responses than those without positive SP waveforms.The incidence of positive SP waveforms recorded from patients with Menieres disease was higher than that from patients with other conditions.

Intertest Reliability of Transtympanic Electrocochleography.

The intertest reliability of transtympanic electrocochleography (ECoG) was studied in 30 ears by measurements of the difference in amplitude and latency between the first and second tests. The interval between the initial test and the retest ranged from one week to 3.5 years.The summating potential (SP), action potential (AP), AP latency and -SP/AP ratio at high intensities (80 dBnHL) showed good test-retest correlations. The waveforms in the two tests had almost he same shapes.Therefore, the intertest reliability of ECoG is considered to be good.

Transtympanic Electrocochleography in Meniere's Disease.

Transtympanic electrocochleography was performed in 51 patients with Menieres disease. Both ears, (i. e., the ear affected by Menieres disease and the contralateral ear) were examined. The SP-AP ratio of the ear with Menieres disease (mean 0.40) was significantly higher than that of the contralateral ear (mean 0.27) (p<0.01). However, in six patients (14%) the SP-AP ratio of the contralateral ear was over 0.40. Therefore, the ear contralateral to the ear affected by Menieres disease should not be classified as normal.

Primary Ethmoid Mucocele; A Case Report.

Magnetic resonance imaging (MRI) was useful in diagnosing primary ethmoid mucocele, which appeared as a high signal intensity with a distinct border in T2-weighted images and a low signal intensity region in T1-weighted images. The mucocele was treated by intranasal ethmoidectomy.

A Dog Tick in the External Auditory Canal; A Case Report.

A 58-year-old female visited our clinic after her external auditory canal was bit by a dog tick. The dog tick which was bulging with sucked blood obstructed her external auditory canal and had the appearance of an ear polyp. It was crushed and extracted by an ear forceps.

Peritonsillar abscess; A statistical observation.

This paper describes a retrospective study of 36 cases of peritonsillar abscess treated from 1985 to 1989. There were 24 males and 12 females, aged 5 to 95 years old (median age, 40 years). Streptococci were the most common bacteria isolated. Sensitivity tests showed good response to ABPC and CEZ, but not to OFLX. The main therapies used were incision and drainage and administration of antibiotics. The hospital stays ranged from 3 to 24 days.