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Biomedical subjects

Takayuki Shinohara

Publications and source records attributed to Takayuki Shinohara.

2 recordsLinked to original sources

Neurotrophic factor intervention restores auditory function in deafened animals.

A primary cause of deafness is damage of receptor cells in the inner ear. Clinically, it has been demonstrated that effective functionality can be provided by electrical stimulation of the auditory nerve, thus bypassing damaged receptor cells. However, subsequent to sensory cell loss there is a secondary degeneration of the afferent nerve fibers, resulting in reduced effectiveness of such cochlear prostheses. The effects of neurotrophic factors were tested in a guinea pig cochlear prosthesis model. After chemical deafening to mimic the clinical situation, the neurotrophic factors brain-derived neurotrophic factor and an analogue of ciliary neurotrophic factor were infused directly into the cochlea of the inner ear for 26 days by using an osmotic pump system. An electrode introduced into the cochlea was used to elicit auditory responses just as in patients implanted with cochlear prostheses. Intervention with brain-derived neurotrophic factor and the ciliary neurotrophic factor analogue not only increased the survival of auditory spiral ganglion neurons, but significantly enhanced the functional responsiveness of the auditory system as measured by using electrically evoked auditory brainstem responses. This demonstration that neurotrophin intervention enhances threshold sensitivity within the auditory system will have great clinical importance for the treatment of deaf patients with cochlear prostheses. The findings have direct implications for the enhancement of responsiveness in deafferented peripheral nerves.

Acoustic Stimulation↗

Ossicular reconstruction using hydroxyapatite prostheses with interposed cartilage.

PURPOSE: Despite the excellent biocompatibility of hydroxyapatite ossicular prostheses, extrusion of the prosthesis may be found during long-term follow-up, mainly due to the retraction of the eardrum. Although interposition of autologous cartilage between the eardrum and the prosthesis is empirically used to prevent extrusion, the clinical effect of this procedure has not been confirmed. The purpose of this study was to evaluate the effect of interposing a cartilage on the extrusion rate and hearing outcome. MATERIALS AND METHODS: Fifty-four ears in which cartilage was interposed with a hydroxyapatite prosthesis were compared with 53 ears without interposition. Three years after surgery, the otoscopic findings and hearing outcome were evaluated. RESULTS: The extrusion rate was 1.9% in the group with interposition and 13.2% in the group without interposition. The difference between the two groups was statistically different (chi(2) = 4.986; P =.03). There was no significant difference between the two groups in the postoperative air-bone gap. CONCLUSION: This procedure is an effective method for reducing the extrusion rate of hydroxyapatite prostheses without reducing the hearing gain resulting from ossiculoplasty.

Adolescent↗