Biomedical subjects

Hideki Takegoshi

Publications and source records attributed to Hideki Takegoshi.

12 recordsLinked to original sources

PubMed2006

Evaluation of super-high-dose steroid therapy for sudden sensorineural hearing loss.

OBJECTIVE: To determine the efficacy of a high-dose steroid regimen for patients with sudden sensorineural hearing loss (SSNHL) and to evaluate the relationship between outcome and initial steroid dose. STUDY DESIGN AND SETTING: We conducted a retrospective study of 112 patients presenting to Saitama Medical Center. Patients received tapering courses of hydrocortisone (HC) with an initial dose of either 1200 mg or 600 mg. RESULTS: More than 87% of patients had recovery of hearing. When hearing stabilized, there were no significant differences between the 1200 mg and 600 mg groups in terms of hearing outcome (P>0.05). However, at completion of treatment, the 1200 mg group exhibited significantly superior complete recovery rate and improvement rate (P<0.05). CONCLUSION: Application of our treatment protocol of a tapered course of 1200 mg HC significantly and rapidly improves recovery outcomes in patients of SSNHL. EBM RATING: C-4.

Acute Disease↗

PubMed2006

[Clinical study on deep neck infection].

Deep neck infection (DNI) remains an emergent and life-threatening otolaryngologic disease. We examined 69 patients, 52 men and 17 women, with DNI, who were treated in our hospital between January 1995 and December 2004. The mean age of the patients with DNI was 50.0 years and the peak incidence was in the sixth decade. Twenty patients suffered from diabetes mellitus (DM). The primary DNI lesion was found in the tonsils in 34 cases, the oral cavity in 16 cases, and the pharynx in 12 cases, respectivelys. Among the 69 patients with DNI, the infection remained in the suprahyoid region in 31 cases, but it extended to the infrahyoid region in 33 cases and to the mediastinum in 5 cases. The titer of C-reacting protein (CRP) and the duration of admission were considered as parameters of the severity of DNI. CRP was significantly higher in elderly patients, in patients with DM, and in patients whose infection extended to the infrahyoid region and to the mediastinum, however, significant difference was not found between men and women, or among the types of primary DNI lesions. Moreover, the duration of admission was significantly longer in elderly patients, in patients with DM, and in patients with infrahyoid and mediastinal DNI, whereas no significant differences were found between men and women or among the types of primary lesions. Therefore, age, DM, and the extension of DNI are considered to be important factors which determining the severity of DNI.

Abscess↗

PubMed2005

Correlation between microtia and temporal bone malformation evaluated using grading systems.

OBJECTIVE: To evaluate the relationships between temporal bone abnormalities and the severity of microtia in Japanese patients using objective grading systems. DESIGN: Retrospective case series study conducted between 1992 and 2003. SETTING: Academic, tertiary care, referral medical center. PATIENTS: One hundred forty-two ears of 109 Japanese patients (85 male and 24 female patients; mean age, 12.8 years [range, 2-36 years]) with microtia. MAIN OUTCOME MEASURES: The severity of microtia was classified according to Marx classification. Developmental abnormalities of the temporal bone were evaluated by a computed tomographic (CT) scoring system modified after the system used by Jahrsdoerfer and colleagues, using high-resolution CT scans of the temporal bone. Correlations between the scores obtained from these 2 grading systems were evaluated using a nonparametric statistical method. RESULTS: Male preponderance and incidence of bilateral cases of approximately 30% were observed in our Japanese patients with microtia. There was no significant difference in the severity of microtia between unilateral and bilateral cases. The mean +/- SEM total points in the CT scoring system (full marks, 10) was 7.9 +/- 0.4 for grade I microtia, 6.6 +/- 0.6 for grade II, and 6.4 +/- 0.3 for grade III; the total points correlated inversely with the microtia grade. Development of the auricle correlated significantly with aeration in the middle ear spaces but not with ossicular development or formation of the oval/round windows. Proportion of acceptable surgical candidates according to the CT scoring system (>5 points) was 79% for grade I microtia, 52% for grade II microtia, and 65% for grade III microtia. CONCLUSION: The principle "the better developed the auricle, the better developed middle ear" was confirmed in Japanese patients with microtia; however, even with grade II/III microtia, more than half of the patients were considered suitable for atresia surgery.

Abnormalities, Multiple↗

PubMed2005

Sound-evoked neurogenic responses with short latency of vestibular origin.

OBJECTIVE: In ABR recording, a large negative deflection with a latency of 3 ms (N3) has been recorded in patients with peripheral profound deafness. It has been suggested that N3 might be of vestibular origin. So far, N3 has been recorded only in patients with peripheral profound deafness. If we can record N3 potentials in subjects with preserved hearing, recording N3 potentials might be a new clinical test of the vestibular system. To record neurogenic potentials (N3) of vestibular origin in healthy volunteers and patients with vestibular disorders. METHODS: Twelve healthy volunteers (10 men and two women, aged 23-37 years) and 12 patients with vestibular disorders (6 men and 6 women, aged 29-71 years) were enrolled in this study. To record responses, surface electrodes were placed on the ipsilateral mastoid and the vertex. An electrode on the nasion served as the ground. Recording was performed using an auditory evoked potential recording system with a mini-mixer and a stereo-amplifier. Signals at the vertex to the ispilateral mastoid were amplified and bandpass filtered (100-3000 Hz). One thousand-hertz short tone bursts (1 kHz STB; rise/fall time=0.5 ms, plateau time=1 ms) were presented to either ear through a headphone with or without white noise (WN) ipsilateral to the stimulated ear. The stimulation rate was 10 Hz, and the analysis time was 10 ms. The responses to 500 stimuli were averaged twice. RESULTS: When 1 kHz STB (95 dBnHL, equivalent to 130 dBSPL) were presented with 100 dBSPL WN (ipsilateral to the stimulated ear), a negative peak with 3-4 ms latency (N3) was observed in 23 of the 24 ears (95.8%) with reproducibility in healthy subjects. Without WN, N3 was observed in 17 of the 24 ears (70.8%). The threshold of N3 was 90.2 dBnHL on the average. The presence of N3 in the patients was in agreement with the presence of the VEMP, which were also recorded. CONCLUSIONS: Using techniques of WN exposure ipsilateral to the stimulated ear, we recorded N3 in healthy subjects and in vestibular disorder patients with preserved hearing. This negative peak is likely to be of vestibular origin. SIGNIFICANCE: N3 may be measured from subjects who cannot contract neck muscles due to their ages, mental states, or consciousness disorders. In other words, N3 may be measured from subjects from whom VEMP cannot be recorded. In combination with VEMP, N3 may be useful for the detection of lesion sites.

Acoustic Stimulation↗

PubMed2005

Facial canal anatomy in patients with mandibulofacial dysostosis: comparison with respect to the severities of microtia and middle ear deformity.

OBJECTIVE: To study the difference in the facial canal anatomy in terms of the severity of microtia and deformity of the middle ear in patients with mandibulofacial dysostosis using high-resolution computed tomography. STUDY DESIGN: Retrospective analyses. SETTING: The study was carried out at the Department of Otorhinolaryngology, University of Tokyo, Tokyo, Japan. PATIENTS: Thirty-six ears of 18 patients with mandibulofacial dysostosis were examined by high-resolution computed tomography. These ears were graded based on the Marx classification and Jahrsdoerfer scoring systems. MAIN OUTCOME MEASURES: The high-resolution computed tomography findings and age distribution of each group were compared with those of other groups by multiple comparison using Tukey's honestly significant difference test. RESULTS: The course of the facial nerve was not significantly different in terms of the severity of microtia and deformity of the middle ear. The bony cochlea in the patients with mandibulofacial dysostosis was displaced by a mean value of 2 mm more anteriorly and a mean value of 0.7 mm shallower than that in the cases with normal auricles. CONCLUSION: The facial nerve of patients with mandibulofacial dysostosis is displaced more anterolaterally than that of the cases with normal auricles; however, the auricle anomaly is not severe.

Adolescent↗

PubMed2005

[Effect of the external nasal dilator breathe right and nasal cycle influence].

The external nasal dilator Breathe Right is a nonprescription disposable mechanical device worn over the bridge of the nose that supports the outer walls of the nasal vestibule to increase cross-sectional nasal valve area and enhance air flow through the nose. When worn, the device applies a gentle outward pull to the outside walls of the nasal vestibule that helps prevent collapse of the lateral walls of the nasal vestibule. The device appears similar to an adhesive bandage with two polyester springs attached lengthwise to the nonadhesive side of the backing material. The form of the external nose varies significantly between racial groups and some comment is possible about the form of the nasal valve, i.e., Caucasian noses are leptorrhine, Negroid noses platyrrhine, and Oriental noses intermediate. A question exists about whether Breathe Right is as effective in Japanese as in Caucasians against nasal obstruction. We measured the effect by acoustic rhinometry in 35 healthy subjects. We measured 2 cross-sectional areas-the I-notch and C-notch-and 3 nasal volumes-V(0-1), from 0 to 1 cm corresponding to the I-notch, V(1-3), from 1 to 3cm corresponding to the C notch, and V (3-6), from 3 to 6cm. We studied the influence of the nasal cycle on the effect of Breathe Right in the nasal cavity. We evaluated subjects in a stable sitting position before applying Breathe Right, after using 5 minutes, and in a free interval of 25 minutes following. The experiment was repeated 10 times. We found that Breathe Right increases the nasal volume especially in V(1-3) and the cross-sectional area especially in the C-notch. Interestingly, the change in the C-notch decreased gradually with time. One possible mechanism may be the change in compliance between the skin under the Breathe Right and the nasal mucous membrane. The nasal cycle did not significantly influence the effect of Breathe Right.

Adult↗

PubMed2004

[A statistical analysis of epistaxis between outpatients and inpatients].

Although we found several statistical studies on epistaxis, we found no reports discussing clinical differences in nasal bleeding between outpatients and inpatients. We therefore examined 103 inpatients (1998-2001) and 337 outpatients (2001) with epistaxis for gender, age, season, bleeding points, and blood pressure. We then compared these parameters statistically in both groups using Mann-Whitney's U test. The incidence of epistaxis in inpatients was statistically higher in winter than in any other season, and most had uncontrolled borderline hypertension. We concluded that borderline hypertension worsens in winter and that patients with borderline hypertension should be medicated to prevent severe epistaxis.

Adolescent↗

PubMed2003

Aplasia of zygomatic arch and dislocation of temporomandibular joint capsule in Treacher-Collins syndrome: three-dimensional reconstruction of computed tomographic scans.

Seven patients with Treacher-Collins syndrome were studied. All of patients were children or teenagers. Helical CT scanner (Toshiba) was used to reconstruct zygomatic arch and temporomandibular joint capsule on lateral aspect of temporal bone in five patients of microtia and atresia of both ears and two patients of narrow ear canals of both ears without microtia.Three-dimensional reconstructions of computed tomography on lateral aspect of temporal bone demonstrated various congenital abnormality including aplasia of zygomatic arch in seven patients and dislocation of temporomandibular joint capsule in seven patients.

Adolescent↗

PubMed2003

Effect of white noise on vestibular evoked myogenic potentials.

OBJECTIVES: To clarify if p13-n23 of vestibular evoked myogenic potentials (VEMPs) is independent of cochlear afferents. METHODS: Twenty normal volunteers and 10 patients with hemifacial palsy enrolled into this study. VEMP and auditory brainstem responses (ABRs) were recorded with or without white noise (WN, 75 dBnHL or 95 dBnHL) ipsilaterally or contralaterally to the stimulated ear. Short tone bursts (STBs) of 0.5 kHz (95 dBnHL, rise/fall time=1 ms, plateau time=2 ms) were presented though headphones. For recording VEMPs surface electromyographic activity was recorded in the supine subjects form symmetrical sites over the upper half of each SCM with a reference electrode over the upper sternum. RESULTS: The amplitude of p13-n23 significantly decreased during exposure of the contralateral ear as well as the ipsilateral ear to 95 dBnHL WN in normal volunteers (41% reduction by the ipsilateral exposure and 38% reduction by the contralateral exposure). Exposure to 75 dBnHL WN caused only minimal reduction of the amplitudes of p13-n23 (5% reduction) although it caused remarkable reduction of the amplitudes of V-SN(10) (ABRs) (23% reduction). However, 95 dBnHL WN exposure showed no effect on the amplitudes of p13-n23 in the ipsilateral side to hemifacial palsy. CONCLUSION: Overall the data are in favor of the hypothesis that cochlear afferents could affect the amplitude of p13-n23 only through the stapedial reflex, although our data might not be strict proof of an absence of influence of cochlear afferents' activity.

Acoustic Stimulation↗

PubMed2003

Difference in facial canal anatomy in terms of severity of microtia and deformity of middle ear in patients with microtia.

OBJECTIVE: To study the difference in the facial canal anatomy in terms of the severity of microtia and deformity of the middle ear in patients with microtia using high-resolution computed tomography (HRCT). STUDY DESIGN: Forty-six ears with microtia were examined by HRCT. These ears were graded based on two systems of classification and scoring, respectively. The HRCT findings of each group were compared with those of other groups by multiple comparison using the Tukey honestly significant difference test. METHODS: Forty-six ears with microtia (unilateral microtia, n = 12; bilateral microtia, n = 34) were examined by HRCT. These ears were graded based on two systems of classification and scoring, respectively. The HRCT findings and age distribution of each group were compared with those of other groups by multiple comparison using the Tukey honestly significant difference test. RESULTS: The mastoid portion of the facial nerve was 3 mm more anteriorly displaced in patients with grades II and III microtia than in those with grade I microtia (P <.01). From the scoring system that was used, the course of the facial nerve was not significantly different between patients with a score of 5 points or less and those with a score of 6 points or more. CONCLUSION: The mastoid portion of the facial nerve in patients with grades II and III microtia would be more anteriorly displaced because of hypoplasia of the second genu.

Child↗

PubMed2002

Galvanic-evoked myogenic responses in patients with an absence of click-evoked vestibulo-collic reflexes.

OBJECTIVES: To show that galvanic-evoked responses on the sternocleidomastoid muscle (SCM) are useful for differentiating labyrinthine lesions from retro-labyrinthine lesions in patients with an absence of click-evoked vestibulo-collic reflexes. METHODS: We studied the average responses in the unrectified electromyographic (EMG) activities of the SCM to galvanic stimulation (3mA, 1ms). The cathodal electrode was on the mastoid, and the anodal electrode was on the forehead. Twenty-two healthy subjects and 28 patients with vestibular disorders were studied. All of the 28 patients showed the unilateral absence of vestibulo-collic reflexes evoked by 95dBnHL clicks on the affected side. RESULTS: In healthy subjects mastoid-forehead galvanic stimulation produced a positive-negative biphasic EMG response at short latency on the SCM ipsilateral to the cathodal electrode. All patients with labyrinthine lesions showed biphasic EMG responses even in the affected side. In contrast, almost all patients with retro-labyrinthine lesions (16/18) showed no response or a decreased response on the affected side. CONCLUSIONS: These results suggest that galvanic-evoked myogenic responses on the SCM may be useful in the differential diagnosis of labyrinthine lesions from retro-labyrinthine lesions in patients with an absence of vestibulo-collic reflexes evoked by clicks.

Acoustic Stimulation↗

PubMed2002

Facial canal anatomy in patients with microtia: evaluation of the temporal bones with thin-section CT.

PURPOSE: To ascertain the location of the facial nerve in patients with microtia by using thin-section computed tomography (CT). MATERIALS AND METHODS: Thin-section CT was performed in 66 ears of patients with microtia (unilateral, n = 12; bilateral, n = 34) and mandibulofacial dysostosis (MFD, n = 20). Findings were compared with those in 22 ears with normal auricles (control group) by using the Dunnett two-sided t test. RESULTS: The facial nerve at the mastoid portion in patients with MFD was 2 mm more lateral and 3 mm more anterior than that in control subjects (P <.01). The same portion in patients with microtia was 3 mm more anterior than that in the control subjects (P <.01). The distance between the facial nerve and the most lateral point of the temporal bone in patients with MFD was 10 mm shorter and that in patients with bilateral microtia was 3 mm shorter than that in the control subjects (P <.01). CONCLUSION: The facial nerve in patients with microtia was not more lateral from the Bill bar (vertical crest) than that in control subjects. The facial nerve in patients with MFD was different from that in patients with microtia who had no other head anomalies.

Case-Control Studies↗