Tetsuya Shitara

Sudden deafness accompanied by asymptomatic mumps

In this study we investigated asymptomatic mumps as a possible cause of sudden deafness. We studied 131 sudden deafness patients by measuring their serum mumps antibody values. Positive IgM antibody results, which strongly suggest recent mumps infection, were revealed in 9 of the 130 patients tested (6.9%). Asymptomatic mumps infections are apparently closely related to sudden deafness. Further studies will provide more definite diagnoses of mumps deafness and might be applicable to the treatment of such hearing loss.

Estimated Annual Number of Patients Treated for Sensorineural Hearing Loss in Japan Results of a Nationwide Epidemiological Survey in 1987

We mailed questionnaires to 98 university hospitals and 939 hospitals with 200 beds or more throughout Japan asking for information on patients treated for sensorineural hearing loss between January 1 and December 31, 1987. The number of patients treated for sensorineural hearing loss in 1987 in Japan was estimated 13,900-19,600, ii) idiopathic bilateral progressive sensorineural hearing loss 13,900-19,600, ii) idiopathic bilateral progressive sensorineural hearing loss in 800-2,000, iii) perilymphatic fistula in 200-310, iv) mumps deafness in 200-400, and v) unilateral profound deafness in 2,000-3,000. Sex ratio (men over women) was 0.9 in sudden deafness and mumps deafness, 1.1 in idiopathic bilateral progressive sensorineural hearing loss and 1.5 in perilymphatic fistula. Patients were distributed with a definite peak from 50 to 59 years old in sudden deafness, from 30 to 39 years old in perilymphatic fistula, and two apparent peaks in teenagers and those aged 60-69 years in idiopathic bilateral progressive sensorineural hearing loss.

Chemosurgery with Trichloroacetic Acid for Allergic Rhinitis

The use of 80 w/v% solution of trichloroacetic acid (TCA) for the treatment of allergic rhinitis was reported. The solution was applied to the inferior turbinates only once bilaterally. The result of the treatment in 77 nonselected cases of perennial allergic rhinitis for over 3 years showed that an improvement was obtained in 72% for nasal obstruction, 60% for sneezing, and 50% for watery nasal discharge. The result of provocation tests after treatment showed an improvement in 77% of the cases, and the histamine concentration in the nasal wash decreased. These results were discussed with reference to the result of our previous histological studies. We concluded that our method of treatment using TCA was simple and effective for allergic rhinitis without any serious side effects.

Comparative Study on Sudden Deafness by Two Nationwide Epidemiological Surveys in Japan

Nationwide epidemiological surveys of sudden deafness were conducted in 1972 and 1987 by the Research Committee of the Japanese Ministry of Health and Welfare. Sex ratio (men over women) of definite cases of sudden deafness was 1.19 in 1972 and 0.96 in 1987. The number of patients with sudden deafness was more common between 30 and 49 years of age in 1972, whereas it was more common between 50 and 59 years of age in 1987. When the incidence of sudden deafness in the overall population was calculated, this disorder was found to be more frequent in people between 50 and 59 years of age both in 1972 and 1987. However, the incidence of sudden deafness per population was more increased in people from 50 to 75 years of age in 1987 than in 1972.

Evaluation of Activated Eosinophil Infiltration for the Assessment of the Effect of Chemosurgical Treatment for Allergic Rhinitis Using Trichloroacetic Acid

An immunohistochemical study was made on the degree of activated eosinophil (EG2) infiltration in the inferior turbinate of 20 cases of perennial allergic rhinitis who underwent septal reconstruction and bilateral inferior turbinectomy approximately 5 months after the unilateral application of trichloroacetic acid (TCA). The distribution of EG2 was also evaluated in nasal smears obtained from the same subjects, and a comparison was made between TCA-applied and nonapplied sides. It was found that the number of EG2 was significantly decreased in the TCA-applied side. It was assumed that TCA application successfully suppressed reagin-dependent allergic reaction in the tissues.

Transient Deafness with Iopamidol Following Angiography

A case of transient, severe sensorineural hearing loss with iopamidol following angiography is reported. The 26-year-old woman had previously been diagnosed with Arnold-Chiari malformation, and underwent vertebral angiography by a retrograde transfemoral catheterization. Immediately following the second injection of iopamidol she did not react on the nurses call. An ABR revealed no response in either ear even when the click intensity was 105 dB. The patient was immediately treated with steroid and OHP. Fortunately, 24 h after the angiography she was able to communicate at a normal conversation level. Transient severe sensorineural hearing loss is thought to result from bilateral anoxia of the cochlea due to hypoplasia of the basilo-vertebral artery systems. Cochlea anoxia lasts 10-20 min after which the hearing loss is recovered.

Evaluation of mucociliary function in patients with allergic rhinitis treated with trichloroacetic acid : Mucociliary transit time (Saccharin time) measurements

By means of the saccharin time measurement, the mucociliary function of the nasal mucosa of the inferior turbinate was evaluated in clinical cases with allergic rhinitis after the therapeutic application of trichloroacetic acid solution. It was found that the saccharin time (ST) tended to be prolonged within 1 year after the treatment, whereas it gradually became shortened to reach the level of normal control after 3 years. The result would indicate that the mucociliary function recovered correspondingly with regeneration of the ciliary epithelium.

Idiopathic Bilateral Sensorineural Hearing Loss: Its Clinical Study in Cases with Rapidly Progressed Deafness

In a series of 127 patients with idiopathic bilateral sensorineural hearing loss (IBSH) at the Hearing Clinic in the Department of Otolaryngology, Kitasato University Hospital, 20 cases showed rapid progression of hearing impairment. These patients had been treated with the same therapeutic regimen used in sudden deafness (SD). Improvement of hearing loss after treatment was generally less effective in the cases with rapidly progressed IBSH than in the cases with SD. However, hearing improvement was achieved in some cases with rapidly progressed IBSH when the treatment had started in the early stages after the onset of rapidly progressive hearing loss.

Hearing Recovery and its Process from the Time of Onset in Sudden Deafness

A total of 547 patients with idiopathic sudden hearing loss were divided into eight groups according to the days (1-8 days) of their initial visit after onset, and initial hearing thresholds, hearing recovery and its process were investigated. There were no significant differences in initial hearing thresholds and hearing recovery among the eight groups. However, a difference was noticeable in the distribution of the thresholds at the initial visit and that on the 7th day between groups 1, 2 and 7. Many cases showed rapid recovery in groups 1, 2 and 7. We speculate that the treatment influenced the hearing recovery process in patients who showed relatively rapid recovery.

Effectiveness of Fibronectin in Myringoplasty Using Temporal Fascia

A study of myringoplasty with temporal fascia homograft employing fibronectin was conducted in 14 ears in which the same myringoplasty procedure without fibronectin (1-5 times) had failed to afford closure of tympanic membrane perforation. Closure was obtained in eight ears. These results suggest that fibronectin is effective in myringoplasty using treated temporal fascia homograft.