A Rare Case of Elongated Styloid Process Fracture.

BACKGROUND An elongated styloid process occurs with Eagle syndrome and causes a variety of symptoms. Fracture of the elongated styloid process is a rare condition. With spontaneous fractures, appropriate treatment cannot be performed in many cases due to unexplained symptoms and indefinite complaints that are not thoroughly examined.

Successful treatment of eosinophilic otitis media associated with severe bronchial asthma with an anti-IL-5 monoclonal antibody, mepolizumab.

Eosinophilic otitis media (EOM), which is characterized by the accumulation of eosinophils in middle ear effusion and the middle ear mucosa, is a refractory type of otitis media that is often associated with asthma. Although an early diagnosis and appropriate treatment are necessary to prevent the progression of hearing loss in patients with EOM, there are currently no well-established treatments for this condition. We treated a 60-year-old male patient with asthma and EOM.

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).

Practicality analysis of the staging system proposed by the Japan Otological Society for acquired middle ear cholesteatoma: A multicenter study of 446 surgical cases in Japan.

Objective: The Objective of this study was to assess the practicality of the cholesteatoma staging system proposed by the Japan Otological Society (JOS) for acquired middle ear cholesteatoma (the 2010 JOS staging system).

Methods: Between 2009 and 2010, 446 ears with retraction pocket cholesteatoma underwent primary surgery at 6 institutions in Japan. The extent of cholesteatoma was surgically confirmed, and classified into three stages.

Novel endoscopic scoring system after sinus surgery.

Objective: To propose a simple post-operative endoscopic scoring system for use after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS), and to demonstrate the usefulness of this approach.

Methods: Subjects comprised 116 patients (84 men, 32 women; mean age, 54 years) with CRS who were analyzed endoscopically and radiologically after ESS between 2006 and 2012. The study was designed as a case series with planned data collection in the setting of university medical centers.

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.

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.

Clinical features and outcomes of four patients with invasive fungal sinusitis.

Objective: The frequency of invasive fungal sinusitis (IFS) has increased in recent years with the use of steroids, onset of diabetes mellitus, and the administration of antibacterial agents. We report on the clinical features and outcomes of four patients with IFS involving the cavernous sinus and orbit. Prognostic factors facilitating an early diagnosis are described, and the usefulness of combination therapy involving systemic administration of antifungal agents and surgical intervention is discussed.

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.

Endoscopic endonasal management of medial orbital blowout fractures.

This study demonstrated that endoscopic endonasal sinus surgery is a successful technique for reducing medial orbital blowout fractures and does not cause complications. Twenty-three patients with isolated medial blowout fractures that did not involve the inferior wall underwent reduction surgery using the endoscopic endonasal approach. Surgery was indicated if the patient experienced persistent diplopia, ocular motility limitation, or enophthalmos.

Endoscopic endonasal transseptal approach for localized sphenoid sinus diseases.

Objective: Surgery for localized sphenoid sinus disease can be performed in different ways. Direct (transnasal) and indirect (transethmoidal) approaches are now prevalent in endoscopic endonasal sinus surgery (ESS) because they are safe and effective. However, the identification or treatment of a sinus is occasionally difficult due to the anatomical variation, postoperative changes, or other reasons.

Valacyclovir for the treatment of Bell's palsy.

Despite recent evidence suggesting that Bell's palsy is associated with reactivation of alfa-herpes viruses, the disease has been treated empirically, and the use of valacyclovir has not been definitively established. In 2007, two prospective, randomised, placebo-controlled trials evaluating valacyclovir were reported in patients with Bell's palsy. One demonstrated that valacyclovir/prednisolone therapy was statistically more effective than placebo/prednisolone therapy in improving the recovery of patients with Bell's palsy, excluding zoster sine herpete.

Submucous inferior turbinotomy cooperating with combined antrostomies for endonasal eradication of severe and intractable sinusitis.

Objective: This paper aims to prove the usefulness of submucous inferior turbinotomy cooperating with the combined middle and the inferior antrostomies in endoscopic endonasal sinus surgery (ESS), enabling the eradication of severe maxillary sinusitis without extranasal approaches. The long-term surgical outcomes of 22 adult patients are presented together with details of this procedure.

Methods: Subjects comprised 22 adult patients with severe unilateral maxillary sinusitis, showing total opacification on computed tomography and failure of medical treatments preoperatively.

Endoscopic endonasal reduction surgery for diplopia caused by orbital roof fractures.

Background: Orbital roof fractures (ORF) frequently occur together with frontal bone fractures, and can cause diplopia as a sequela. However, ORF have never been treated using endoscopic endonasal reduction surgery.

Case: A 22-year-old woman was injured in a traffic accident and diagnosed with right ORF along with frontal bone fractures.

Reduction surgeries for delayed cases with isolated blowout fractures.

Objective: To show the effectiveness of endoscopic reduction surgeries for delayed cases with blowout fractures, and to determine the cause of persisting diplopia based on surgical findings.

Design: Retrospective study.

Setting: Between 1997 and 2006, 114 patients with isolated blowout fractures underwent surgery.

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.

Endoscopic endonasal reduction of blowout fractures of the orbital floor.

Objectives: The aim of this study was to document the usefulness of the endoscopic endonasal approach as a surgical treatment of isolated blowout fractures of the orbital floor.

Study Design: Retrospective study.

Setting: Between 1997 and 2003, using only an endonasal endoscopic surgical approach, we operated on 62 patients complaining of diplopia due to isolated blowout fractures of the orbital floor.

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.

Efficacy of mastoid cortex plasty for middle ear aeration in intact canal wall tympanoplasty for cholesteatoma.

Objective: To determine the effect of closing the bone defect of the mastoid cortex using bone pate after mastoidectomy (mastoid cortex plasty) during the first-stage operation for the restoration of the mastoid cavity aeration.

Study Design: This was a prospective study.

Setting: Tertiary medical center.

Mastoid cortex plasty using bone pate.

Objective: To describe the surgical technique of mastoid cortex plasty using bone pate and its clinical significance.

Study Design: Retrospective.

Setting: Tertiary medical center.