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Papers - Oishi, Naoki

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Burow's solution-induced acute sensorineural hearing loss

Oishi Naoki, Inoue Yasuhiro, Saito Hideyuki, Ogawa Kaoru

Auris Nasus Larynx 37 ( 3 ) 369 - 372 2010.06

ISSN 0385-8146

This is the report of rare cases to show the potential ototoxicity of Burow's solution in clinical use. We encountered two cases of acute sensorineural hearing loss occurring after the administration of 8% Burow's solution (pH 2.93) into the tympanic cavities. Prior to treatment, both cases presented with tympanic membrane perforations in the posterior and inferior portions and a small amount of serous discharge. Fortunately, hearing loss recovered almost completely except for high tones within a few weeks. These two case reports demonstrate that the ototoxicity of Burow's solution should be considered when it is used to treat otitis media accompanied by tympanic membrane perforation. © 2009 Elsevier Ireland Ltd.

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Long-term prognosis of low-frequency hearing loss and predictive factors for the 10-year outcome

Oishi Naoki, Inoue Yasuhiro, Saito Hideyuki, Kanzaki Sho, Kanzaki Jin, Ogawa Kaoru

Otolaryngology - Head and Neck Surgery 142 ( 4 ) 565 - 569 2010.04

ISSN 0194-5998

Objectives: To determine the long-term prognosis of low-frequency hearing loss and predictive factors for the 10-year outcome of low-frequency hearing loss. Study Design: Case series with chart review. Setting: Tertiary referral center. Subjects and Methods: From 1979 to 1998, 466 consecutive patients with low-frequency hearing loss received initial treatment at the Hearing and Tinnitus Clinic of Keio University Hospital. Of the 49 eligible patients, pure-tone threshold data obtained over a period of 10 years after onset of low-frequency hearing loss were available for analysis. To determine the progression of hearing loss, we analyzed audiometric pattern changes. We also examined how the following factors affected 10-year prognosis: sex, age, side of hearing loss, accompanying dizziness, pre-therapeutic hearing thresholds at low frequencies, initial therapy results, and fluctuation of hearing during the first year after onset. Results: High- and pan-frequency hearing loss increased as time progressed. About half of the cases developed high- or pan-frequency hearing loss within 10 years of onset. Audiometric patterns measured at 10 years significantly correlated with those measured at one (r = 0.57), three (r = 0.73), and five years (r = 0.85). The 10-year prognosis significantly correlated with only two factors: initial therapy results (r = 0.49) and fluctuation of hearing during the first year (r = 0.43). Conclusions: About half of the cases in our study developed high- or pan-frequency hearing loss within 10 years of onset of low-frequency hearing loss. The initial therapy results and fluctuation of hearing during the first year may indicate the long-term prognosis of patients presenting with low-frequency hearing loss. © 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation.

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Effects of selective serotonin reuptake inhibitor on treating tinnitus in patients stratified for presence of depression or anxiety

Oishi Naoki, Kanzaki Sho, Shinden Seiichi, Saito Hideyuki, Inoue Yasuhiro, Ogawa Kaoru

Audiology and Neurotology 15 ( 3 ) 187 - 193 2010.03

ISSN 1420-3030

We evaluated the effects of a selective serotonin reuptake inhibitor, paroxetine, on treating tinnitus.Tinnitus patients stratified for the presence of depression and anxiety were studied retrospectively. Fifty-six patients were observed for more than 6 months. They were initially treated with paroxetine only at a dose of 10 mg/day for 2-4 weeks; thereafter, the dose was increased to 20 mg/day. Tinnitus distress was evaluated with the Tinnitus Handicap Inventory (THI) and with visual analog scales (VASs) for tinnitus loudness and annoyance. Depression and anxiety were measured with the Self-Rating Depression Scale (SDS) and the trait section of the State-Trait Anxiety Inventory (STAI). The patients were grouped according to their SDS and STAI scores, and each variable was compared at baseline and the 6-month follow-up. Changes among these variables were also examined to determine whether reduced tinnitus distress was related to the improvement of depression or anxiety. Patients with both depression and anxiety showed better results (decrease in THI, VASs, SDS and STAI scores) than patients with anxiety alone, or patients without depression and anxiety. In patients with depression and anxiety, changes in tinnitus variables and changes in depression and anxiety scores were strongly correlated. In other patients, however, changes in tinnitus variables and changes in depression and anxiety scores were not correlated. These results suggest that paroxetine is effective in treating distressed tinnitus patients with depression and anxiety by reducing their tinnitus severity as well as their depression and anxiety. Copyright © 2009 S. Karger AG, Basel.

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Otosclerosis update (2) - Treatment and prevention

Ogawa Kaoru, Inoue Yasuhiro, Saito Hideyuki, Kanzaki Sho, Okamoto Yasuhide, Mizutari Kunio, Suzuki Takashi, Oishi Naoki, Watada Yukiko, Watabe Takahisa, Fujioka Masato

Practica Oto-Rhino-Laryngologica 103 ( 2 ) 103 - 112 2010.02

ISSN 0032-6313

Skull-base meningioma extending to the parapharyngeal space

Inagaki Yozo, Oishi Naoki, Fujimine Takekatu, Fujii Ryouichi, Saito Hideyuki, Ogawa Kaoru

Practica Oto-Rhino-Laryngologica 103 ( 1 ) 53 - 57 2010.01

ISSN 0032-6313

kull-base and parapharyngeal tumors require intricate treatments due to its anatomic complexity, variations in histological type, and the site often involves the presence of critical blood vessels and nerves. Diagnostic imaging and fine-needle aspiration cytology are thus essential. We report a case of skull-base meningioma extending to the parapharyngeal space in which we made a definitive diagnosis by biopsy (as grade I) and took a wait-and-see approach. A 52-year-old woman had complained of a headache since June 2006 and was seen in the neurology department at our hospital in July. A tumor from around the left jugular foramen to parapharyngeal space was revealed by magnetic resonance imaging (MRI) and she was referred for consultation to the neurosurgical department and our department. It was difficult to establish the diagnosis from the clinical manifestation and diagnostic images due to the tumor's complicated anatomy, therefore it was confirmed by biopsy instead of cytology. It can be said that biopsy is useful to determine therapeutic measures for the skull-base meningioma because it is less invasive and can verify a histological type compared with the complete removal of the tumor.

Acute-onset unilateral psychogenic hearing loss in adults

Oishi Naoki, Kanzaki Sho, Kataoka Chinatsu, Tazoe Mami, Takei Yasuhiko, Nagai Keiichi, Kohno Naoyuki, Ogawa Kaoru

ORL 71 ( 5 ) 279 - 283 2009.11

ISSN 0301-1569

We encountered 6 rare cases of acute-onset unilateral psychogenic hearing loss in adults. All were women in their 20s and 30s. Three cases had severe hearing impairment characterized by hearing loss at every frequency; 2 cases had profound hearing impairment, and 1 case had low-frequency hearing impairment. Of the 6 cases, 3 had a history of hearing loss, and 1 had a history of psychogenic visual disturbance. All 6 cases were initially diagnosed as having idiopathic sudden sensorineural hearing loss; all subsequently received steroid therapy. Three cases were not diagnosed as being psychogenic in origin until otoacoustic emissions and auditory brain responses were performed. Although the presence of distinctive clinical features (age, gender, and past history) is important for suspecting psychogenic hearing loss, objective audiological tests such as otoacoustic emissions are essential for diagnosing some cases. Compared to the existing reports of similar cases, our cases had a poorer prognosis (only 2 cases were cured). Copyright © 2009 S. Karger AG, Basel.

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Otosclerosis update (1) - Pathophysiology and diagnosis

Ogawa Kaoru, Inoue Yasuhiro, Saito Hideyuki, Kanzaki Sho, Okamoto Yasuhide, Mizutari Kunio, Suzuki Takashi, Oishi Naoki

Practica Oto-Rhino-Laryngologica 102 ( 3 ) 169 - 175 2009

ISSN 0032-6313

GFAP aggregates in the cochlear nerve increase the noise vulnerability of sensory cells in the organ of Corti in the murine model of Alexander disease

Masuda Masatsugu, Tanaka Kenji F., Kanzaki Sho, Wakabayashi Kenichiro, Oishi Naoki, Suzuki Takafumi, Ikenaka Kazuhiro, Ogawa Kaoru

Neuroscience Research 62 ( 1 ) 15 - 24 2008.09

ISSN 0168-0102

Outer hair cell (OHC) loss in the auditory sensory epithelium is a primary cause of noise-induced sensory-neural hearing loss (SNHL). To clarify the participation of glial cells in SNHL, we used an Alexander disease (AxD) mouse model. These transgenic mice harbor the AxD causal mutant of the human glial fibrillary acidic protein (GFAP) under the control of the mouse GFAP promoter. It is thought that GFAP aggregates compromise the function of astrocytes. In the auditory pathway, the formation of GFAP aggregates was observed only in GFAP-positive cells of the cochlear nerve. The presence of GFAP aggregates did not change auditory function at the threshold level. To assess the change in vulnerability to auditory excitotoxicity, both transgenic and control mice were treated with intense noise exposure. Auditory threshold shifts were assessed by auditory brainstem responses (ABR) at 1 and 4 weeks after noise exposure, and OHC damage was analyzed by quantitative histology at 4 weeks after exposure. Transgenic mice showed more severe ABR deficits and OHC damage, suggesting that cochlear nerve glial cells with GFAP aggregates play a role in noise susceptibility. Thus, we should focus more on the roles of cochlear nerve glial cells in SNHL. © 2008 Elsevier Ireland Ltd and the Japan Neuroscience Society.

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The value of electroneurography in acute peripheral facial nerve palsy

Minami Shujiro, Shinden Seiichi, Yamashita Taku, Wasano Koichiro, Oishi Naoki

Practica Oto-Rhino-Laryngologica 101 ( 6 ) 435 - 439 2008

ISSN 0032-6313

Objective: To evaluate the use of electroneurography (ENoG) as a prognostic indicator in acute peripheral facial paralysis in a general hospital. Design: Retrospective study. Participants: The patients had been treated for a sudden onset unilateral facial paralysis during an 18 month period (2005. 7-2006.12). Main outcome measures: ENoG was performed 7 to 14 days after the onset facial palsy. The recovery of facial nerve function was documented by Yanagihara's grading system. All patients were followed monthly until recovery or up to 6 months after onset. Results: One-hundred ten patients with acute peripheral facial paralysis, including Bell's palsy (86%), Ramsay-Hunt Syndrome (6%), trauma (6%), and others (2%) underwent ENoG test. Patients were divided into 5 classes according to the ENoG value; [40%-] 41%, [20-40%] 24%, [10-20%] 9%, [0-10%] 11%, [0%] 15%. The recovery rate in each group was; [40%-] 98%, [20-40%] 96%, [10-20%] 90%, [0-10%] 58%, [0%] 24%. The patients whose ENoG values were greater than 10 % showed a 96 % chance of recovery (sensitivity 0. 88, specificity 0. 86). Patients with a greater ENoG value recovered significantly faster. Conclusion: ENoG provides accurate information predicting the prognosis and recovery rate of patients with facial palsy.

A clinical study of Bell's palsy and factors influencing its prognosis

Oishi Naoki, Shinden Seiichi, Yamashita Taku, Minami Shujiro, Ogura Mariko

Journal of Otolaryngology of Japan 110 ( 8 ) 592 - 598 2007.08

ISSN 0030-6622

We encountered 185 patients with Bell's palsy at our hospital between January 2003 and December 2005. Of these patients, 60% visited our department within 3 days of the onset, and 90% within 7 days of the onset ; the interval from onset to hospital visit showed no relation with the severity of the paralysis, Complete recovery was obtained in 85.0% of the patients with steroid or steroid + antiviral treatment. Preservation of the stapedius reflex was a statistically significant predictor of good prognosis, with a high positive predictive value (95.5%). Several factors influencing the prognosis were examined with a Cox's proportional hazards model. The factors considered were the sex of the patients, left / right localization, age, postauricular pain, eye symptoms, taste disorder, underlying diabetes, the Yanagihara facial grading system score, and use of antiviral drugs. The analysis revealed only the Yanagihara score and antiviral drug use as statistically important, with hazard ratios of 1.101 and 1.586, respectively. Although this study had several limitations, steroid + antiviral treatment could yield a better prognosis as compared to steroid treatment alone.

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Cerebral infarction presenting as sudden sensorineural hearing loss and vertigo - A case report

Oishi Naoki, Takei Satoshi

Oto-Rhino-Laryngology Tokyo 48 ( 5 ) 26 - 31 2005.10

ISSN 0386-9687

A 54-year-old man transferred to our emergency department due to sudden vertigo and left-side hearing impairment lasting several hours was found in clinical examination and audiovestibular tests to have profound sensorineural hearing loss and spontaneous right horizontal rotatory nystagmus. He had no other neurological deficits and was given intravenous steroids. On day 4, he reported mild numbness in the right hand. MRI showed infarctions in the left pons (basilar artery region) and in the left middle cerebellar penduncle (AICA region). These were followed by a right Babinski reflex, gait ataxia, and delayed left-sided facial palsy with newly left horizontal rotatory nystagmus. Antiplatelet agents and anticoagulation therapy were begun. He recovered completely except for the profound hearing loss.

Use of methylrosanilinium chloride for a post-operative MRSA-infected wound

Oishi Naoki, Takei Yasuhiko, Kiyota Sekiko, Yabe Haruna

Practica Oto-Rhino-Laryngologica 97 ( 11 ) 1021 - 1025 2004

ISSN 0032-6313

A 52-year-old male patient consulted our hospital with complaints of long lasting pain in the throat and swelling in the neck. Physical, pathological and X-ray examinations led to a diagnosis of carcinoma in the base of the tongue, which had already extended deeply into the tongue and epiglottis (oropharyngeal carcinoma, T4N2cM0). After chemoradiotherapy which did not successfully reduce the tumor, surgical removal of both the tongue and larynx, and reconstruction of the base of the oral cavity with a PM-MC flap were performed. Unfortunately, the operation was accompanied by a subcutaneous infection which occurred as a result of a surgical complication of a pharyngeal fistula. The germ culture examination revealed that the wound was infected with MRSA. Since povidone-iodine and general use of antibiotics were not effective in suppressing the inflammation, possibility arose for serious and critical complications such as MRSA pneumonia or rupture of a major neck artery. However, immediately after we started using methylrosanilinium chloride for the MRSA-infected wound, the inflammation began to disappear quickly without any serious side effect to surrounding tissue. We concluded that methylrosanilinium chloride was effective in the treatment of MRSA-infected wounds.

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