Volume-rendered computed tomography images of the surgical field for endolymphatic sac surgery.

Purpose: Identification of the endolymphatic sac has failed occasionally. Postoperative complications have also rarely been reported. Given a safer and more reliable surgery, preoperative anatomical assessments are valuable, however, the vestibular aqueduct has seldom been seen with multi-planar reconstruction (MPR) computed tomography (CT) images yet.

Five-year postoperative outcomes of modified staged canal wall up tympanoplasty for primary acquired cholesteatoma.

Objective: For successful canal wall up tympanoplasty (CWUT) for the treatment of cholesteatoma, the restoration of stable middle ear aeration is also important; however, little is known about the dynamics of such aeration or the optimal surgical procedure. In this study, alternative additional surgical procedure was selected based on the grade of middle ear aeration during the second-stage operation.

Subjects And Methods: Patients included in this study underwent staged CWUT surgeries with mastoid cortex plasty (MCP) for well-aerated ears (grade 3) and bony mastoid obliteration (BMO) for poorly aerated ears (grade 2-0).

Osseous eustachian tube and peritubal cells in patients with unilateral cholesteatoma comparison between healthy and diseased sides using high-resolution cone-beam computed tomography.

Objectives: We investigated the factors that may possibly cause primary acquired cholesteatoma.

Setting: University-affiliated hospital.

Subjects And Methods: In 20 adult patients with unilateral cholesteatoma, the sizes of the osseous eustachian tubes (ETs) and the extent of peritubal and mastoid cell development in healthy and diseased ears were examined using high-resolution cone-beam computed tomography.

Yanagihara facial nerve grading system as a prognostic tool in Bell's palsy.

Objective: The aim of this study was to evaluate the accuracy of the Yanagihara facial nerve grading system in assessing the course of recovery and in determining the probability of a complete recovery of Bell's palsy within 1 week after onset.

Study Design: Retrospective study of patients at a single trial center.

Setting: Tertiary referral center.

Width of the normal facial canal measured by high-resolution cone-beam computed tomography.

Conclusions: In the facial canal, discrepancies between left and right side measurements at each point may be useful in the assessment and diagnosis of facial canal-related pathologies.

Objectives: This study was performed to obtain accurate and high-resolution images of the normal facial canal and measure its widths on cross-sections of the canal at anatomically and clinically important sites using high-resolution cone-beam computed tomography (CBCT).

Methods: CBCT volume data of bilateral temporal bones were obtained from 28 healthy adult volunteers.

Prognostic factors of Bell's palsy: prospective patient collected observational study.

The purpose of this study was to evaluate various parameters potentially influencing poor prognosis in Bell's palsy and to assess the predictive value for Bell's palsy. A single-center prospective patient collected observation and validation study was conducted. To evaluate the correlation between patient characteristics and poor prognosis, we performed univariate and multivariate analyzes of age, gender, side of palsy, diabetes mellitus, hypertension, and facial grading score 1 week after onset.

Position of TORP on the stapes footplate assessed with cone beam computed tomography.

Objective: To improve hearing outcomes of ossiculoplasty with a total ossicular replacement prosthesis (TORP) in ears lacking a footplate superstructure, 3-dimensional computed tomography (3D CT) images were reconstructed to verify the position of the TORP on the footplate and contact between the TORP and the stapes footplate.

Study Design: Retrospective study.

Setting: University-affiliated tertiary referral center.

A case of pneumolabyrinth induced by Eustachian tube air inflation.

Objectives: Here, we report a case of pneumolabyrinth induced by Eustachian tube air inflation (ETAI) with a catheter and present evidence that multiple air bubbles entered the perilymphatic space through a preexisting oval window fistula.

Setting: Tertiary referral center.

Patient: Sixty-six-year-old woman.

Re-implantation of the Rion E-type semi-implantable hearing aid: status of long-term use and hearing outcomes in eight patients.

Objectives: The Rion Ehime (E)-type implantable hearing aid (IHA) is the first middle ear implant. We implanted 39 IHAs into 39 patients, and found that the IHA functioned well for >15 years. So far, 28 IHAs have been removed because they stopped functioning.

Facial nerve decompression surgery in patients with temporal bone trauma: analysis of 66 cases.

Background: In the treatment of facial nerve paralysis after temporal bone trauma, it is important to appropriately determine whether nerve decompression surgery is indicated. The aim of this study was to examine the efficacy of facial nerve decompression surgery according to fracture location and the ideal time for surgery after trauma by analyzing the therapeutic outcome of traumatic facial nerve paralysis.

Methods: In total, 66 patients with facial nerve paralysis after temporal bone trauma who were treated at our institution between 1979 and 2009 were studied retrospectively.

Facial nerve decompression surgery using bFGF-impregnated biodegradable gelatin hydrogel in patients with Bell palsy.

Objective: Basic fibroblast growth factor (bFGF) promotes the regeneration of denervated nerves. The aim of this study was to evaluate the regeneration-facilitating effects of novel facial nerve decompression surgery using bFGF in a gelatin hydrogel in patients with severe Bell palsy.

Study Design: Prospective clinical study.

Lateral orifice of Prussak's space assessed with a high-resolution cone beam 3-dimensional computed tomography.

Objectives: To describe how to obtain high-resolution computed tomography (CT) images of the en face view of the lateral orifice of Prussak's space (Ps orifice) and tympanic ring and to investigate the shape and size of these structures in normal ears and in those with chronic otitis media and attic cholesteatoma.

Setting: University-affiliated referral center.

Methods: Using the Accuitomo image reconstruction algorithm, the slope of the eardrum was turned to vertical on both coronal and axial images.

Long-term results with the Rion E-type semi-implantable hearing aid.

Objective: The Rion implantable hearing aid (IHA) Ehime (E)-type was developed for ears with middle ear diseases. This study focused on the current status of the patients, device problems, postoperative difficulties, and preventive measures against them.

Study Design: Case series with chart review.

Total mastoid obliteration in staged canal-up tympanoplasty for cholesteatoma facilitates tympanic aeration.

Objective: To assess middle ear aeration after total mastoid obliteration using bone pate and hydroxyapatite performed at the second stage of intact-canal-wall (ICW) tympanoplasty.

Study Design: Retrospective study.

Setting: Tertiary referral hospital.

Mouth movement disturbance as a sequela of bilateral Bell's palsy.

Objective: Bell's palsy rarely recurs or arises bilaterally. We describe unique oral motor sequelae that manifest with bilateral facial palsy.

Patients: Two rare patients with alternating bilateral Bell's palsy experienced compromised mouth movement, affecting eating, speaking, and air exchange, and reduced quality of life.

Improvements to staged canal wall up tympanoplasty for middle ear cholesteatoma.

Objective: To describe our improvements to staged canal wall up tympanoplasty with mastoidectomy (SCUT) for middle ear cholesteatoma, and to show more successful outcomes of the surgery compared with our data previously reported.

Study Design: Retrospective study in a tertiary referral hospital.

Setting: 78 ears of 76 patients with extensive cholesteatoma were operated on using the improved SCUT between July 1998 and December 2006.

Tympanosclerosis involving the ossicular chain: mobility of the stapes in association with hearing results.

Conclusion: The preoperative bone conduction level provides not only prognostic information but also information on the mobility of the stapes in tympanosclerosis. The surgical results depend upon the stapes mobility.

Objectives: We aimed to evaluate operative findings and hearing results of tympanosclerosis involving the ossicular chain, in order to understand the pathophysiology and to establish better surgical treatment of tympanosclerosis.

Digital volume tomography: radiologic examinations of the temporal bone.

Objective: We evaluated the clinical applicability and the value of digital volume tomography for visualization of the lateral skull base using temporal bone specimens.

Materials And Methods: Twelve temporal bone specimens were used to evaluate digital volume tomography on the lateral skull base. Aside from the initial examination of the temporal bones, radiologic control examinations were performed after insertion of titanium, gold, and platinum middle-ear implants and a cochlear implant.

Surgical treatment of retraction pocket with bone pate: scutum plasty for cholesteatoma.

Objectives: Postoperative attic retraction pocket is a critical issue and may be indicative of disease recurrence after canal-up tympanoplasty for middle ear cholesteatoma. Although scutum plasty is an acceptable procedure that can be used to prevent the pocket formation, how the scutum is reconstructed has remained controversial. The aim of this study was to clarify the value of scutum plasty using bone pate.

Role of T-lymphocyte subsets in facial nerve paralysis owing to the reactivation of herpes simplex virus type 1.

Conclusion: Although both T-cell subsets are essential for inhibiting HSV-1 reactivation in the GG, CD4 + T cells play a more important role in host defense against virus replication.

Objective: To elucidate the host immunological factors that participate in herpes simplex virus type 1 (HSV-1) reactivation in the geniculate ganglia (GG) and lead to facial paralysis, we developed a mouse model of facial paralysis that involved the reactivation of HSV-1 following general immune suppression.

Material And Methods: Eight weeks after recovery from primary facial paralysis caused by inoculating the auricle with HSV-1 the auricle was scratched and mice (n = 69) were given an i.

Bilateral spontaneous cerebrospinal fluid otorrhea.

We present a rare case of bilateral cerebrospinal fluid (CSF) otorrhea via multiple bony defects in the left tegmen and a single defect with the herniated brain tissue on the right side. Initially, the patient complained of left hearing loss and fullness and was diagnosed with serous otitis media. After myringotomy, the pulsating watery discharge suggested CSF otorrhea.

Efficacy of early treatment of Bell's palsy with oral acyclovir and prednisolone.

Objective: To investigate the therapeutic effects of acyclovir and prednisolone in relation to the timing of treatment in Bell's palsy.

Study Design: This was a retrospective study of 480 Bell's palsy patients who were treated with oral acyclovir and prednisolone (94 cases) or prednisolone alone (386 cases).

Patients: Patients met the after criteria: (1) severe or complete Bell's palsy with a score lower than 20 on the 40-point Yanagihara facial score and (2) treatment started within 7 days after onset.

Effect of single-drug treatment on idiopathic sudden sensorineural hearing loss.

Objectives: In order to evaluate the effect of a medical administration for the sudden deafness patients, single-drug treatment for idiopathic sudden sensorineural hearing loss (ISSHL) was assessed at multi-centers participating in the Acute Severe Hearing Loss Study Group sponsored by the Ministry of Health, Labor and Welfare of Japan.

Methods: The subjects consisted of ISSHL patients who were (1) 20 years of age or older, (2) diagnosed within 2 weeks after the onset of hearing loss, (3) showing a mean hearing level of 40-90 dB at five frequencies from 250 to 4000 Hz, (4) previously untreated, and (5) with normal for age in hearing of the opposite ear. The drugs used in this study were ATP, alprostadil, hydrocortisone and amidotrizoate, which were administered intravenously, and beraprost sodium and betamethasone, which were given orally.