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  1. Article ; Online: Management of Patulous Eustachian Tube.

    Ikeda, Ryoukichi / Kikuchi, Toshiaki / Oshima, Hidetoshi / Kobayashi, Toshimitsu

    JMA journal

    2020  Volume 3, Issue 2, Page(s) 101–108

    Abstract: Patients with patulous Eustachian tubes (PET) suffer from annoying aural symptoms, such as voice or breath autophony, and aural fullness due to the ET's abnormal patency. It may lead to an enormous reduction in quality of life. Various treatment methods, ...

    Abstract Patients with patulous Eustachian tubes (PET) suffer from annoying aural symptoms, such as voice or breath autophony, and aural fullness due to the ET's abnormal patency. It may lead to an enormous reduction in quality of life. Various treatment methods, including conservative and surgical therapy, have been reported. In most cases, conservative treatment is sufficient to relieve patients of aural symptoms. However, some chronic and severe cases are resistant to traditional conservative therapy. Recently performed prospective and multicenter trials revealed the efficacy and safety of a silicone plug (Kobayashi plug) insertion for patients with severe PET. Patulous Eustachian tube handicap inventory-10 (PHI-10), tubal obstruction procedures, sitting computed tomography (CT), and ET function tests (tubo-tympano-aerodynamic graphy (TTAG) and sonotubometry) are useful for diagnosis as well as selecting candidates for surgery in severe cases.
    Language English
    Publishing date 2020-04-06
    Publishing country Japan
    Document type Journal Article ; Review
    ISSN 2433-3298
    ISSN (online) 2433-3298
    DOI 10.31662/jmaj.2020-0007
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  2. Article ; Online: Diagnosis of the Patulous Eustachian Tube.

    Ikeda, Ryoukichi / Kikuchi, Toshiaki / Oshima, Hidetoshi / Kobayashi, Toshimitsu

    Ear, nose, & throat journal

    2020  , Page(s) 145561320925938

    Abstract: Objectives: To review the diagnosis of patulous Eustachian tube (PET) based on the diagnostic criteria for the PET proposed by Japan Otological Society (JOS).: Methods: We reviewed typical aural symptoms of PET, Eustachian tube (ET) obstruction ... ...

    Abstract Objectives: To review the diagnosis of patulous Eustachian tube (PET) based on the diagnostic criteria for the PET proposed by Japan Otological Society (JOS).
    Methods: We reviewed typical aural symptoms of PET, Eustachian tube (ET) obstruction procedure to confirm diagnosis of PET, objective findings of a patent ET obtainable from observation of the movement of the tympanic membrane, and by ET function tests (tubo-tympano-aerodynamic graphy, sonotubometry). In addition, usefulness of other tests such as patulous Eustachian tube handicap inventory-10 (PHI-10), sonotubometry with postural change (Ohta method), and sitting computed tomography (CT) to diagnose PET is described.
    Results and conclusions: We have described the diagnosis of PET based on the diagnostic criteria for PET proposed by JOS; PHI-10, Ohta method, and sitting CT are also useful for the diagnosis of PET. Further investigation is needed for an accurate diagnosis and precise evaluation of the pathophysiology of this challenging disease.
    Language English
    Publishing date 2020-05-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 750153-5
    ISSN 1942-7522 ; 0145-5613
    ISSN (online) 1942-7522
    ISSN 0145-5613
    DOI 10.1177/0145561320925938
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  3. Article ; Online: Tympanic membrane findings and Eustachian tube function after transtympanic plugging for the chronic patulous Eustachian tube.

    Kusano, Yusuke / Ikeda, Ryoukichi / Kawamura, Yoshinobu / Oshima, Hidetoshi / Nomura, Yuri / Kikuchi, Toshiaki / Kawase, Tetsuaki / Katori, Yukio / Kobayashi, Toshimitsu

    Auris, nasus, larynx

    2023  Volume 50, Issue 6, Page(s) 859–865

    Abstract: Objective: To evaluate Eustachian tube (ET) function after Kobayashi plug surgery based on the tympanic membrane (TM) findings and active opening (AO) of the ET assessed with sonotubometry.: Subjects and methods: A retrospective survey of medical ... ...

    Abstract Objective: To evaluate Eustachian tube (ET) function after Kobayashi plug surgery based on the tympanic membrane (TM) findings and active opening (AO) of the ET assessed with sonotubometry.
    Subjects and methods: A retrospective survey of medical records identified 74 ears of 66 patients with patulous ET (PET) received transtympanic insertion of the Kobayashi plug. Excluding the six ears (6 patients) with abnormal preoperative TM, sixty-eight ears of 60 patients were found to have normal TM preoperatively. Among these 68 ears, there were 51 ears in which sonotubometry was performed both before and after surgery to evaluate whether the AO of the ET was positive or not.
    Results: Out of the 68 ears with normal preoperative TM, 52 ears (76.5%) were judged successful (sum of complete relief and significant improvement). The postoperative TM was normal in 41 ears (60.3%), while 27 ears (39.7%) had abnormal TM findings postoperatively. The success rate was 75.6% (31/41) in ears with normal postoperative TM, while it was 77.8% (21/27) in ears with abnormal TM. Success in maintaining normal postoperative TM was found in 45.6% (31/68) of the total ears treated. Out of the 51 ears in which sonotubometry was performed both before and after surgery, AO was preoperatively positive in 88.2% of the ears (45/51), while it was positive in 64.7% (33/51) postoperatively. In thirty-four ears with normal TM postoperatively, AO was positive in 24 ears (70.6%), while it was positive in 9 out of 17 ears (52.9%) with abnormal postoperative TM. The success rate was 70.6% (36/51) for the 51 ears in which AO was assessed both pre- and postoperatively, and it was 66.7% (22/33) in ears with positive AO postoperatively, while it was 77.8% (14/18) in ears without AO postoperatively. The incidence of ears either having normal postoperative TM or positive AO postoperatively was 84.3% (43/51). Abnormal postoperative TM findings without effectiveness were found in 8.8% (6/68).
    Conclusion: The obstructive dysfunction of the ET is a calculated risk but did not occur in most ears after plugging with the Kobayashi plug. Therefore, routine insertion of the VT at the same time as the initial surgery is not recommended for PET cases that are adequately followed up.
    MeSH term(s) Humans ; Retrospective Studies ; Eustachian Tube ; Tympanic Membrane/surgery ; Ear Diseases/surgery
    Language English
    Publishing date 2023-03-29
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 604552-2
    ISSN 1879-1476 ; 0385-8146
    ISSN (online) 1879-1476
    ISSN 0385-8146
    DOI 10.1016/j.anl.2023.03.007
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  4. Article ; Online: Enlargement of Eustachian Tube Lumen in Patulous Eustachian Tube Patients Compared to that by Aging.

    Ikeda, Ryoukichi / Kusano, Yusuke / Kawamura, Yoshinobu / Oshima, Hidetoshi / Kikuchi, Toshiaki / Kawase, Tetsuaki / Katori, Yukio / Kobayashi, Toshimitsu

    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

    2022  Volume 43, Issue 4, Page(s) e446–e453

    Abstract: Objective: To evaluate the Eustachian tube (ET) dimensions in patulous ET (PET) patients compared with that by aging using sitting 3D computed tomography (CT).: Study design: Retrospective study.: Setting: Tertiary referral center.: Subjects and ...

    Abstract Objective: To evaluate the Eustachian tube (ET) dimensions in patulous ET (PET) patients compared with that by aging using sitting 3D computed tomography (CT).
    Study design: Retrospective study.
    Setting: Tertiary referral center.
    Subjects and methods: A retrospective survey of medical records in Sen-En Rifu Hospital identified 105 ears of 76 PET patients and 65 ears of 34 patients without ET dysfunction findings (non-PET). Subjects in both PET and non-PET groups were then divided into two age groups. Groups A and C defined as non-PET and PET subjects respectively, who were under the age of 60 years, while Groups B and D defined of non-PET and PET subjects respectively, who were 60 years and above. 3D CT (Accuitomo; Morita, Kyoto, Japan) was performed on all subjects in the sitting position. The ET lumen from the ET pharyngeal orifice to 15 mm was analyzed.
    Results: No significant difference in the ET lumen near the pharyngeal orifice was found between Group A and C; however, there was a significant difference in the ET at points lateral to the pharyngeal orifice. The ET lumen was significantly larger at the site close to the pharyngeal orifice in Group B as compared to that of Group A. For the two groups of PET classified according to the size of the pharyngeal orifice and area close to the isthmus, age was only significantly different between two groups of pharyngeal orifice. On the contrary, sonotumometry and Ohta method were significantly different between the two groups of the area close to the isthmus.
    Conclusion: The lumen of the ET is enlarged in both PET and aging. However, the responsible site was found to be different. While the enlargement of the ET lumen in 60 years and above subjects without PET mainly occurred near the pharyngeal orifice of the ET, it was near the isthmus in under 60 years PET patients. Further study of possible clinical implications of these findings as well as treatment strategy are required.
    MeSH term(s) Aging ; Ear Diseases/diagnostic imaging ; Eustachian Tube/diagnostic imaging ; Humans ; Middle Aged ; Otitis Media ; Retrospective Studies
    Language English
    Publishing date 2022-01-25
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2036790-9
    ISSN 1537-4505 ; 1531-7129
    ISSN (online) 1537-4505
    ISSN 1531-7129
    DOI 10.1097/MAO.0000000000003482
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  5. Article ; Online: Outcome of the 'waiting until spontaneous extrusion' strategy for long-term tympanostomy tube placement in children with cleft palate.

    Nomura, Yuri / Oshima, Hidetoshi / Nomura, Kazuhiro / Kakuta, Risako / Ikeda, Ryoukichi / Hirano, Ai Kawamoto / Ota, Jun / Kawase, Tetsuaki / Katori, Yukio

    Acta oto-laryngologica

    2022  Volume 142, Issue 3-4, Page(s) 248–253

    Abstract: Background: Otitis media with effusion (OME) in children with cleft palate (CP) is known to be refractory to treatment and most of these patients undergo surgery for ventilation tube (VT) placement.: Objectives: To identify the outcomes of children ... ...

    Abstract Background: Otitis media with effusion (OME) in children with cleft palate (CP) is known to be refractory to treatment and most of these patients undergo surgery for ventilation tube (VT) placement.
    Objectives: To identify the outcomes of children with CP using long-term VT with a 'waiting until spontaneous extrusion' strategy.
    Material and methods: We retrospectively reviewed the medical records of all children with CP who visited our department from December 2016 to November 2017 and who received long-term VT placement in our department. Risk factors related to residual perforation and recurrence of OME were analyzed.
    Results: A total of 106 children were included in this study. Our statistical analysis of 94 ears followed for more than three months after VT loss revealed that longer VT placement was associated with residual perforation, and shorter VT placement was associated with OME recurrence. Although a longer duration of VT placement was associated with an increased rate, extremely long-term VT placement was not associated with residual perforation, as expected. Half of the VTs were spontaneously extruded at 40 months after insertion.
    Conclusions and significance: Long-term VT insertion using a waiting until spontaneous extrusion strategy is a potential option for children with CP.
    MeSH term(s) Child ; Cleft Palate/complications ; Cleft Palate/surgery ; Humans ; Middle Ear Ventilation ; Otitis Media with Effusion/complications ; Retrospective Studies ; Risk Factors
    Language English
    Publishing date 2022-04-22
    Publishing country England
    Document type Journal Article
    ISSN 1651-2251
    ISSN (online) 1651-2251
    DOI 10.1080/00016489.2022.2041210
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  6. Article ; Online: Patulous Eustachian Tube Patients With Respiratory Fluctuation of Tympanic Membrane in Both Sitting and Supine Positions: A Sign of Severity of Disease?

    Kusano, Yusuke / Kawamura, Yoshinobu / Ikeda, Ryoukichi / Oshima, Hidetoshi / Kikuchi, Toshiaki / Kawase, Tetsuaki / Katori, Yukio / Kobayashi, Toshimitsu

    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

    2021  Volume 42, Issue 8, Page(s) e1058–e1061

    Abstract: Objective: The aim is to report four cases of patulous Eustachian tube (PET) patients with respiratory fluctuation of the tympanic membrane (TM) even in the supine position, and to examine the frequency and characteristics of such patients.: Patients!# ...

    Abstract Objective: The aim is to report four cases of patulous Eustachian tube (PET) patients with respiratory fluctuation of the tympanic membrane (TM) even in the supine position, and to examine the frequency and characteristics of such patients.
    Patients: There were 195 ears (99 right ears and 96 left ears) from 146 cases (56 male and 90 female subjects aged 8-88, average 48.0 ± 18.9 yrs) diagnosed with definite PET by diagnostic criteria proposed by Japan Otologic Society (JOS) between January 2017 and December 2019 at Sen-En Rifu Hospital. Patients who presented with respiratory fluctuation of the TM in both the sitting and supine positions were examined.
    Main outcome measures: Clinical patient records, the severity of subjective symptoms (PET handicap inventory-10 [PHI-10]), objective ET function tests (tubo-tympano-aerodynamic graphy [TTAG] and sonotubometry), and sitting three-dimensional computed tomography (3-D CT) were analyzed.
    Results: Six ears (3.1%) of four cases (2.7%) exhibited respiratory fluctuation of the TM, even in the supine position. In these six ears (four cases), the PHI-10 score ranged from 16 to 36 with three ears exhibiting PHI-10 score equal to or exceeding 26 (in the category of severe handicap). Sitting CT indicated the findings of completely open ET in only two ears. All ears but one were managed by conservative treatment.
    Conclusion: Respiratory fluctuation of the TM in both the sitting and supine positions was observed in 2.7% of the definite PET patients. Surprisingly, such findings can be an indication of neither the subjective nor objective severity of the disease. Therefore, even for PET patients with such findings, surgery should not be immediately proposed, but rather, conservative management should be undertaken first.
    MeSH term(s) Ear Diseases/diagnostic imaging ; Eustachian Tube/diagnostic imaging ; Female ; Humans ; Male ; Nigeria ; Retrospective Studies ; Severity of Illness Index ; Sitting Position ; Tympanic Membrane/diagnostic imaging
    Language English
    Publishing date 2021-05-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2036790-9
    ISSN 1537-4505 ; 1531-7129
    ISSN (online) 1537-4505
    ISSN 1531-7129
    DOI 10.1097/MAO.0000000000003190
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  7. Article: Immunohistochemical localization of d-

    Kitaya, Shiori / Ikeda, Ryoukichi / Suzuki, Jun / Oshima, Hidetoshi / Nomura, Yuri / Kusano, Yusuke / Ohta, Nobuo / Kawase, Tetsuaki / Ise, Kazue / Murakami, Kazuhiro / Nakamura, Yasuhiro / Sasano, Hironobu / Katori, Yukio

    Laryngoscope investigative otolaryngology

    2022  Volume 7, Issue 4, Page(s) 1155–1163

    Abstract: Objective/hypothesis: Middle ear cholesteatoma is characterized by abnormal growth of the keratinizing squamous epithelium of the temporal bone. d-: Study design: Case-control studies.: Material and methods: Tissue samples were collected from 21 ... ...

    Abstract Objective/hypothesis: Middle ear cholesteatoma is characterized by abnormal growth of the keratinizing squamous epithelium of the temporal bone. d-
    Study design: Case-control studies.
    Material and methods: Tissue samples were collected from 21 patients comprising 21 ears with congenital middle ear cholesteatoma and 26 patients comprising 29 ears with acquired type. Their clinical and histopathological features were investigated. We divided the middle ear cholesteatoma samples into three layers: the perimatrix, matrix, and cystic contents. The patterns of immunoreactivity to d-
    Results: Two patterns of immunoreactivity to d-
    Conclusions: This study showed the expression levels of d-
    Level of evidence: 4.
    Language English
    Publishing date 2022-07-08
    Publishing country United States
    Document type Journal Article
    ISSN 2378-8038
    ISSN 2378-8038
    DOI 10.1002/lio2.856
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  8. Article ; Online: Pulsatile tinnitus caused by pneumocephalus after Janneta surgery.

    Ikeda, Ryoukichi / Kikuchi, Toshiaki / Sato, Shunsuke / Oshima, Hidetoshi / Kawamura, Yoshinobu / Kusano, Yusuke / Kawase, Tetsuaki / Katori, Yukio / Kobayashi, Toshimitsu

    Auris, nasus, larynx

    2020  Volume 48, Issue 4, Page(s) 793–796

    Abstract: Pulsatile tinnitus of nonvascular origin is rare. We herein present a case of pulsatile tinnitus complicated with Jannetta surgery due to a communication created between the drilled mastoid cells and epidural space. She was successfully cured by ... ...

    Abstract Pulsatile tinnitus of nonvascular origin is rare. We herein present a case of pulsatile tinnitus complicated with Jannetta surgery due to a communication created between the drilled mastoid cells and epidural space. She was successfully cured by otological surgery where the mastoid tip was packed with bone cement. A 68-year-old woman was referred to the previous hospital with complaints of right autophony, aural fullness, hyperacusis to her footsteps, and pulsatile tinnitus for the past three years. She had received Jannetta surgery for right hemifacial spasm seven years before. The computed tomography (CT) of the right temporal bone showed bony dehiscence between the mastoid cells and posterior cranial fossa. She underwent otological surgery to obliterate the tip of the mastoid cavity with artificial bone cement (BIOPEX
    MeSH term(s) Aged ; Female ; Humans ; Mastoid/diagnostic imaging ; Mastoid/pathology ; Mastoid/surgery ; Mastoidectomy ; Microvascular Decompression Surgery/adverse effects ; Pneumocephalus/complications ; Pneumocephalus/diagnostic imaging ; Postoperative Complications ; Tinnitus/etiology ; Tomography, X-Ray Computed
    Language English
    Publishing date 2020-06-22
    Publishing country Netherlands
    Document type Case Reports ; Journal Article
    ZDB-ID 604552-2
    ISSN 1879-1476 ; 0385-8146
    ISSN (online) 1879-1476
    ISSN 0385-8146
    DOI 10.1016/j.anl.2020.05.024
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  9. Article ; Online: Objective assessment of autophony during phonation in the diagnosis of patulous Eustachian tube patients.

    Ikeda, Ryoukichi / Hamanishi, Shinji / Kikuchi, Toshiaki / Oshima, Hidetoshi / Kawamura, Yoshinobu / Kusano, Yusuke / Kawase, Tetsuaki / Katori, Yukio / Wada, Hiroshi / Kobayashi, Toshimitsu

    Auris, nasus, larynx

    2020  Volume 48, Issue 4, Page(s) 738–744

    Abstract: Objective: A system enabling the objective assessment of the transmission of voice sounds to the external auditory canal (EAC) during phonation has recently been revised. Our aim was to evaluate the effectiveness of this new system in the diagnosis of ... ...

    Abstract Objective: A system enabling the objective assessment of the transmission of voice sounds to the external auditory canal (EAC) during phonation has recently been revised. Our aim was to evaluate the effectiveness of this new system in the diagnosis of patulous Eustachian tube (PET) patients by comparing the results obtained using this method with those obtained from conventional objective tests to diagnose PET.
    Methods: A prospective survey of medical records was included with definite PET, possible PET, and sensorineural hearing loss as control. The measurement system consists of a personal computer, an AD/DA converter (NI 6361, National Instruments), a probe microphone system for recording voice sound (ER-10C, Etymotic Research) and two microphones for measuring noise sound in the EAC (ER-10B+, Etymotic Research). Pronouncing the "Ni" sound for 5 s were recorded with these three microphones. The ratio of the maximum sound pressure of voice sound and noise sound in EAC (EAC/Voice) was simultaneously calculated, and results were displayed on a personal computer for diagnosing.
    Results: Thirty-one patients of 42 ears with definite PET, 26 patients of 38 ears with possible PET, and 12 patients of 24 ears with sensorineural hearing loss as control were included. The EAC/Voice were 8.63 ± 5.43, 25.41 ± 32.63, and 25.87 ± 24.93 in the control, definite PET, and possible PET group respectively. The control group was significantly different from the definite PET (p < 0.05) and possible PET group (p < 0.05). ROC curve analysis confirmed 14.7 as the best diagnostic cut-off value of EAC/Voice (area under the curve=0.782, 95% CI 0.671-0.894). By adopting this cut-off point, 25 (56.8%) and 22 (61.1%) ears were determined as positive findings in the definite PET and possible PET group, respectively. There was no significant correlation between the positive findings judged by the current method and that of sonotubometry in the control (r = -0.63, p = 0.769), definite PET (r = 0.12, p = 0.451), and possible PET group (r = 0.12, p = 0.451).
    Conclusion: The current system is more useful in the objective assessment of autophony during phonation by calculating the ratio of voice sound and elicited noise sound transmitted in the EAC (EAC/Voice). This method seems promising because it is able to detect cases eluding conventionally used test methods such as sonotubometry performed without phonation, thereby increasing the accuracy of PET diagnoses.
    MeSH term(s) Adult ; Aged ; Case-Control Studies ; Ear Canal ; Ear Diseases/complications ; Ear Diseases/diagnosis ; Ear Diseases/physiopathology ; Eustachian Tube/pathology ; Female ; Hearing Disorders/etiology ; Hearing Loss, Sensorineural/physiopathology ; Hearing Tests ; Humans ; Male ; Middle Aged ; Phonation ; Prospective Studies ; ROC Curve ; Sound ; Voice/physiology ; Young Adult
    Language English
    Publishing date 2020-12-29
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 604552-2
    ISSN 1879-1476 ; 0385-8146
    ISSN (online) 1879-1476
    ISSN 0385-8146
    DOI 10.1016/j.anl.2020.12.001
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  10. Article ; Online: Metastasis of adenoid cystic carcinoma from a submandibular gland to the larynx.

    Ishikawa, Tomohiko / Tateda, Masaru / Oshima, Hidetoshi / Sawada, Akari / Oka, Naomi / Suzuki, Hiroyoshi / Hashimoto, Sho

    Auris, nasus, larynx

    2018  Volume 46, Issue 6, Page(s) 907–911

    Abstract: The present article discusses the first reported case of adenoid cystic carcinoma (ACC) metastasis from a submandibular gland to the larynx. Both treatments of distant metastasis of ACC and secondary laryngeal tumor are challenging. Despite its slow ... ...

    Abstract The present article discusses the first reported case of adenoid cystic carcinoma (ACC) metastasis from a submandibular gland to the larynx. Both treatments of distant metastasis of ACC and secondary laryngeal tumor are challenging. Despite its slow progression, ACC is associated with high rates of local recurrence, distant metastasis, and poor prognosis. Patients with secondary laryngeal cancer often have other concurrent metastatic lesions. Therefore, treatment selection should consider the biological behavior of the tumor and characteristics of the laryngeal lesion, along with the general condition and quality of life of the patient. The patient (55-year-old female) had a history of ACC of the right submandibular gland, removed surgically 9 years prior to the present consultation. Follow-up showed multiple pulmonary metastases. The patient complained of dysphonia lasting 3 months. Following the diagnosis of ACC metastasis to the larynx (supraglottic) and a neck lymph node via biopsy, we performed partial laryngectomy, left neck dissection, and tracheotomy. Histopathological examination showed an increase in the tumor grade over time. Two months after discharge, there was no obvious local recurrence or increase in lung metastasis.
    MeSH term(s) Carcinoma, Adenoid Cystic/secondary ; Carcinoma, Adenoid Cystic/surgery ; Female ; Humans ; Laryngeal Neoplasms/secondary ; Laryngeal Neoplasms/surgery ; Laryngectomy ; Lung Neoplasms/secondary ; Middle Aged ; Neck Dissection ; Submandibular Gland Neoplasms/pathology ; Tracheotomy
    Language English
    Publishing date 2018-11-23
    Publishing country Netherlands
    Document type Case Reports ; Journal Article
    ZDB-ID 604552-2
    ISSN 1879-1476 ; 0385-8146
    ISSN (online) 1879-1476
    ISSN 0385-8146
    DOI 10.1016/j.anl.2018.11.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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