Yasue Uchida

Thirty-year trends in sudden deafness from four nationwide epidemiological surveys in Japan.

Conclusions. The estimated annual number of patients with sudden deafness treated in Japan has increased during the last 30 years, especially in the elderly population. Hypertension and diabetes mellitus could contribute to the etiology of this disorder. Objectives. To investigate the epidemiological trends of sudden deafness in Japan over the past 30 years by analyzing data from national surveys. Materials and methods. Nationwide epidemiological surveys on sudden deafness were conducted four times by the Research Committee of the Ministry of Health and Welfare in Japan. The first, second, third, and fourth surveys were performed in 1972, 1987, 1993, and 2001, respectively. Results. The estimated annual numbers of patients with sudden deafness treated in Japan were 4000 in 1972; 16 700 in 1987; 24 000 in 1993, and 35 000 in 2001.The average ages of patients at onset were 39.1, 45.4, 49.3, and 51.3 years, respectively. Thus, both the number of patients and the average age of patients with sudden deafness have increased during the past 30 years. Patients with sudden deafness in the fourth survey exhibited hypertension and diabetes mellitus more frequently than did patients in the first survey; this trend was particularly noticeable among elderly patients.

Is there a relevant effect of noise and smoking on hearing? A population-based aging study ¿Existe un efecto relevante del ruido y el tabaquismo en la audición? Un estudio de envejecimiento de base poblacional

The objectives of the present study were to evaluate both the respective and combined effects of occupational noise exposure and smoking on hearing, taking age into consideration. The evaluation was conducted using 1478 subjects without a history of ear disease out of a population-based sample of 2267 adults, aged 40–79 years. Pure-tone audiometry and a questionnaire were administered. A deleterious effect of noise exposure on hearing was significantly observed in both genders at many frequencies after adjustment for age, income, and education. The smoking habit alone significantly affected hearing deterioration at 4000 Hz in noise-unexposed males. The combined effect of noise and smoking was not interactive but additive. A dose-response effect of smoking on hearing loss was observed in middle-aged males without noise exposure. Smoking and noise exposure were associated with hearing loss respectively.This result is noteworthy for the preservation of good hearing especially at the beginning of aging.

Prevalence of Self-perceived Auditory Problems and their Relation to Audiometric Thresholds in a Middle-aged to Elderly Population

Objective --Hearing loss has been identified as one of the most frequent conditions affecting the elderly population. The purpose of this study was to provide estimates of the prevalence of self-perceived hearing problems in a middle-aged to elderly general population and to make a comparison among generations and between genders regarding the relationship between audiometric measurements and hearing problems. Material and Methods --The study was conducted using a population-based sample of 2150 adults, aged 40-79 years, who participated in the Longitudinal Study of Aging conducted by the National Institute for Longevity Sciences between 1997 and 2000. A questionnaire on hearing problems was administered and pure-tone audiometry was conducted. Results --A third of subjects in their 40s and half of the subjects aged > 60 years were aware of having difficulty hearing. The audiometric thresholds in both the better and worse ears were associated with self-perceived hearing difficulty in all age groups. Statistically significant age and gender differences were observed in each respondent group. The older group tended to underestimate their hearing difficulty in comparison with the younger group, and males tended to underestimate their hearing difficulty more than females. Conclusion --These results may contribute to the development of an intervention strategy for auditory rehabilitation for the middle-aged and elderly populations.

Association of interleukin‐1 gene polymorphisms with sudden sensorineural hearing loss and Ménière’s disease

Sudden sensorineural hearing loss (SSNHL) and Ménière’s disease are the most common inner ear diseases in which the causes are unknown. As recent magnetic resonance imaging has demonstrated disruption of the blood–labyrinth barrier in these inner ear diseases, inflammatory reaction associated with increased permeability of the blood vessels may be involved. The genotypes of interleukin 1A (IL1A) (−889C/T; rs1800587) and interleukin 1B (IL1B) (−511C/T; rs16944) were determined using an allele‐specific primer–polymerase chain reaction method in 72 patients with SSNHL, 68 patients with Ménière’s disease, and 2202 control subjects living almost in the same area as the patients. A significantly higher prevalence of the IL1A−889T allele was observed in SSNHL and Ménière’s disease compared with controls, although no significant difference in distribution of IL1B−511C/T genotypes was observed between the patients and controls. Adjusted odd ratios for SSNHL and Ménière’s disease risks in the −889TT genotypes were 25.89 (95% confidence interval (CI) 12.19–54.98) and 18.20 (95% CI 7.80–42.46), respectively, after age and gender were taken as moderator variables. Our results suggested that IL1A is closely associated with susceptibility of SSNHL and Ménière’s disease.

Molecular genetic epidemiology of age-related hearing impairment

Genetic epidemiology focuses on the genetic determinants in the etiology of disease among populations and seeks to elucidate the role of genetic factors and their interaction with environmental factors in disease occurrence. In recent years, genetic epidemiological research has become more focused on complex diseases, and human genome analysis technology has made remarkable advances. Age-related hearing impairment (ARHI) is a complex trait, which results from a multitude of confounding intrinsic and extrinsic factors. Although the number of genetic investigations of ARHI is increasing at a surprising rate, the etiology of ARHI is not firmly established. In this article, we review (1) the methodological strategies used to analyze genetic factors that contribute to human ARHI, (2) several representative investigations, and (3) specific genetic risk factors for human ARHI identified in previous work.

Association of the C677T Polymorphism in the Methylenetetrahydrofolate Reductase Gene With Sudden Sensorineural Hearing Loss

To investigate the recently reported association of the C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene with sudden sensorineural hearing loss (SSNHL), we analyzed data from a community‐based Japanese population.

Endothelin-1 gene polymorphism and hearing impairment in elderly Japanese.

To investigate the association between the Lys198Asn (G/T) polymorphism (rs5370) in the endothelin‐1 gene (EDN1) and hearing impairment in middle‐aged and elderly Japanese.

Polymorphisms in Genes Involved in Inflammatory Pathways in Patients with Sudden Sensorineural Hearing Loss

Abstract: Although the etiology of idiopathic sudden sensorineural hearing loss (SSNHL) remains unclear, the pathologically increased permeability of blood vessels, elucidated by gadolinium-enhanced magnetic resonance imaging (MRI), suggests the involvement of inflammation. Because SSNHL is considered a multifactorial disease, possibly caused by interactions between genetic factors and environmental factors, the authors investigated the associations of polymorphisms of inflammatory mediator genes with susceptibility to SSNHL. The authors compared 72 patients affected by SSNHL and 2010 adults (1010 men and 1000 women; mean age 59.2 years; range 40–79) who participated in the National Institute for Longevity Sciences Longitudinal Study of Aging. Multiple logistic regression was used to obtain odds ratios (ORs) for SSNHL in subjects with polymorphisms in the genes IL-6 C − 572G, IL-4R G1902A, IL-10 A − 592C, TNFα C − 863A, TNFRSF1B G593A, VEGF C936T, VEGF C − 2578A, and VEGF G − 1154A, with adjustment for age, gender, and any history of hypertension, diabetes, or dyslipidemia. The per-allele OR for the risk of SSNHL in subjects bearing IL-6 C − 572G was 1.480 (95% confidence interval [CI], 1.037–2.111) in model 1 (no adjustment), 1.463 (CI, 1.022–2.094) in model 2 (adjusted for age and gender), and 1.460 (CI, 1.016–2.097) in model 3 (adjusted for age, gender, and a history of hypertension, diabetes, or dyslipidemia). Under the dominant model of inheritance, the ORs were 1.734 (CI, 1.080–2.783) in model 1, 1.690 (CI, 1.050–2.721) in model 2, and 1.669 (CI, 1.035–2.692) in model 3. The remaining seven polymorphisms failed to show any associations with the risk of SSNHL. These data need to be confirmed on larger series of patients. In conclusion, the IL-6 C − 572G polymorphism is associated with a risk of SSNHL. Because permeability of blood vessels in the inner ear is frequently increased in patients with SSNHL, inflammation of the inner ear might be involved.

The association between gene polymorphisms in uncoupling proteins and hearing impairment in Japanese elderly

Abstract Conclusion: This study illustrates that UCP2 Ala55Val polymorphisms exhibit a significant association with age-related hearing loss in the Japanese population. Objectives: Mitochondrial uncoupling proteins (UCPs) have been suggested to play a protective role against neuron oxidative damage and a thermal signaling role in neuron modulation in the inner ear. In the current study, we examined the relationship between gene polymorphisms in UCP1 and UCP2 and hearing impairment (HI) in Japanese elderly. Methods: A total of 1547 subjects aged 40–79 years and living in Aichi prefecture, Japan, were entered into this study. Subjects were followed up every 2 years, and the cumulative number of subjects for 3 sequential examinations in 6 years was 4942 persons. Detailed questionnaires, pure-tone audiometry measurements, and UCP1 A-3826G and UCP2 Ala55Val polymorphisms were examined. Using generalized estimating equations, associations between HI and gene polymorphisms in UCP1 and UCP2 with age, sex, history of occupational noise exposure, and body mass index were analyzed under dominant, recessive, and additive models. Results: UCP1 A-3826G polymorphism did not exhibit any significant association with HI. However, UCP2 Ala55Val polymorphism did exhibit a significant association with HI under all the dominant (p = 0.0167), recessive (p = 0.0411), and additive (p = 0.0061) models.

Bezold's abscess arising with recurrent cholesteatoma 20 years after the first surgery: with a review of the 18 cases published in Japan since 1960.

The classic Bezolds abscess was described as a deep neck abscess arising from an acute mastoiditis. With the pervasive use of antibiotics, the incidence of otitic suppurative complications including Bezolds abscess has dramatically decreased today. This decreased incidence has led to decreased familiarity and a subsequent increased delay in diagnosis. Otolaryngologists must recognize that intervening in benign processes such as cholesteatoma can lead to unforeseen serious complications. A case of Bezolds abscess arising in a 25-year-old man with recurrent cholesteatoma 20 years after his first surgery is presented. In this patient despite the prior canal wall down tympanoplasty, granulation tissue blocked the pathway from the mastoid to the external auditory meatus. A cholesteatoma formed in this obstructed space became secondarily infected and filled the mastoid cavity with pus. This recent clinical presentation of Bezolds abscess is described and the Japanese literature reviewed to renew familiarity with this rare complication.