Hideo Shojaku

Background: Long-term efficacy of middle ear pressure therapy (MEPT) with the EFET01 device in patients in Japan with definitive Meniere's disease (MD) and delayed endolymphatic hydrops (DEH) was evaluated. Objective: To examine the effects of reducing vertigo attacks and improving hearing of MD and DEH patients by using MEPT with the EFET01 device for two years after treatment. Material and Methods: A retrospective study was conducted of 32 MD patients and 2 DEH patients treated by MEPT with the EFET01 device from December 2018 to April 2021. According to Japan Society for Equilibrium Research (JSER) guidelines, patients were investigated for the frequency of vertigo attacks and change in hearing levels during a period of 6 months before to 18-24 months after start of treatment. Results: The frequency of vertigo attacks significantly decreased in both MD and DEH patients, and hearing level has remained stable in the majority of our patients after treatment. Conclusion: Our study clarified that MEPT with the EFET01 device was effective in controlling vertigo symptoms of MD and DEH. It should be considered a safe option for patients failing medical treatment. Significance: The efficacy of MEPT with the EFET01 was shown over a 2-year follow-up period.

Delayed endolymphatic hydrops (DEH) is a rare disease, and the actual number of patients in Japan remains unknown. To investigate the number and prevalence of patients with DEH in Japan. In total, 781 departments of otolaryngology in Japan were selected for survey by stratified random sampling according to the total number of hospital beds. We sent questionnaires to the target departments and collected data regarding the number of patients with DEH who visited those departments in 2019. The overall response rate was 68.0% (531 departments). The estimate number of patients with DEH in Japan was 962, and the prevalence was calculated to be 0.8 per 100,000 population. Patients with DEH were extremely rare in Japan. This may be the first nationwide epidemiological study on the number and prevalence of patients with DEH in Japan or in the world.

Delayed endolymphatic hydrops (DEH) is an inner ear disease that causes recurrent vertigo in the ipsilateral ear or fluctuating hearing in the contralateral ear due to endolymphatic hydrops seconda... 背景：迟发性内淋巴水肿 (DEH) 是一种内耳疾病, 导致由内淋巴水肿引起的同侧耳复发性眩晕或继发于先例性耳聋的对侧耳听力波动。调查DEH的临床流行病学特征的大型多中心研究寥寥数几。目的：本研究旨在阐明日本DEH的特点。方法：通过由日本外周前庭疾病研究组进行的全国多中心调查来分析 662 例 DEH 患者的临床资料。结果：同侧DEH（IDEH）比例为 57.5%, 略高于对侧DEH(CDEH...

Middle ear pressure therapy (MEPT) is effective for intractable vertigo in patients with definite Meniere’s disease (MD) and treatment-refractory delayed endolymphatic hydrops (DEH). Four-month MEP... 背景：中耳压力疗法（MEPT）对患有确定梅尼埃病 (MD) 和难治性迟发性内淋巴积水 (DEH) 的患者的顽固性眩晕是有效的。EFET01VR是日本研发的MEPT装置, 自 2018 年 9 月以来由国民健康保险cover。使用 EFET01VR 进行四个月的MEPT, 已显示出疗效。然而, 治疗12 个月后的有效性和安全性尚不清楚, 而这才适用于确定 MEPT 装置治疗效果。目的： 检查使...

Background: Endoscopic modified medial maxillectomy (EMMM) is a surgical technique developed to approach maxillary sinus lesions, such as papilloma and postoperative maxillary cyst, while preserving the postoperative nasal morphology and nasal function. In this technique, a diamond burr is used to remove the bone, which may damage adjacent soft tissue. We developed EMMM using an ultrasonic bone aspirator (UBA) instead of a conventional diamond burr. The purpose of this study was to clarify the effectiveness of the UBA in EMMM in comparison to the conventional diamond burr technique in terms of operative time, intraoperative complications, postoperative symptoms, and recurrence. Methods: The medical records of all patients who underwent EMMM at Toyama University Hospital between June 2014 and December 2021 were reviewed. Patients who met the inclusion criteria were separated into Group 1, in which the UBA was used for EMMM, and Group 2, in which a drill with a diamond burr was used. Data on patient demographics, operation time, frequency of intraoperative complications and postoperative symptoms, and recurrence were statistically compared between the two groups. Results: There were no significant differences between the two groups in the patient demographic data, operative time, postoperative symptoms, or frequency of recurrence. The frequency of intraoperative damage to adjacent soft tissues was significantly lower in patients who underwent EMMM with the UBA in comparison to those who underwent EMMM with a conventional diamond burr. Conclusion: The application of the UBA to EMMM can improve surgical safety and facilitate surgical procedures.

Middle ear pressure therapy (MEPT) is effective in treating intractable vertigo in patients with definite Meniere’s disease (MD) and delayed endolymphatic hydrops (DEH) refractory to conservative t... 背景：中耳加压疗法（MEPT）可有效治疗有确诊的梅尼埃病 (MD)的和迟发性内淋巴积水 (DEH)的顽固性眩晕患者, 他们依靠保守治疗难以治愈。一种新颖的无需经鼓室通气管的中耳压力装置, EFET01VR, 由日本开发, 经日本健康劳动福利部批准, 自 2018 年 9 月起在日本国民健康保险中使用。目的：检查使用 ETET01VR 进行中耳加压疗法的短期治疗效果, 并与之前的临床试验结果相...

In the external dacryocystorhinostomy (DCR), a sutured anastomosis technique performed between the nasal mucosal and lacrimal sac flaps reported by Dupuy-Dutemps and Bourguet was the gold standard ... 背景：Dupuy-Dutemps 和 Bourguet 报道了鼻粘膜和泪囊瓣之间的缝合吻合技术是外泪囊鼻腔吻合术 (DCR) 的金标准。该技术被认为是手术成功的原因。然而, 由于操作空间小, DCR (END-DCR)手术的鼻内皮瓣缝合技术尚未完全确立。目的：回顾性比较了使用 Sonopet 超声骨吸引器改进的皮瓣缝合吻合技术与使用金刚石钻孔器对于鼻泪管阻塞患者的效果。材料与方法：采用Son...

Amyloidosis is a disorder of protein folding in which various proteins automatically aggregate into a highly abnormal fibrillar conformation. Amyloidosis is classified into systemic and localized forms depending on whether the abnormal proteins deposited in several different organs or only a single organ. In localized amyloidosis of the head and neck regions, laryngeal amyloidosis is common; however, localized amyloidosis of the nose is extremely rare. We herein report a case of localized amyloidosis of the nose and review the relevant literature on localized sinonasal amyloidosis. A 41-year-old man presented with a history of severe nasal obstruction, which had persisted for two decades. Nasal endoscopy and imaging studies showed extensive thickening of the bilateral nasal mucosa and diffuse submucosal deposition of calcification. After histopathological and systemic examinations, he was diagnosed with localized amyloidosis of the nasal mucosa. Septoplasty and bilateral inferior turbinoplasty, which consisted of mucosal resection using an ultrasonic bone curette, was performed and his symptoms markedly improved. Localized sinonasal amyloidosis has a good prognosis and surgical resection should be selected as a first-line treatment; however, clinicians should recognize the high probability of recurrence.

A 12-month follow-up study showed that middle ear pressure treatment with a transtympanic membrane massage (TMM) device had a similar effect to a Meniett device.The effects of pressure treatment wi... 背景：一项为期 12 个月的随访研究表明, 使用经鼓膜按摩 (TMM) 装置进行中耳压力治疗的效果与 Meniett 装置相似。目的：回顾性比较对于治疗梅尼埃病 (MD) 和延迟内淋巴管水肿(DEH)患者, 使用 TMM 装置进行压力治疗的效果与使用 Meniet 装置的效果。这些患者至少 有24 个月的随访。材料和方法：二十七患者接受了 TMM 装置治疗, 14 名患者接受了 Meniet...

The retrospective study showed that the effect of the middle ear pressure treatment by the tramstympanic membrane massage (TMM) device was similar to that of the Meniett device. The new TMM device named EFET device was prospectively evaluated in patients with Meniere’s disease (MD) and delayed endolymphatic hydrops (DEH) and we compared the effects to the Meniett device. 23 ears of 19 patients were treated with an EFET device, and 17 ears of 15 patients were treated with the Meniett device. All patients suffering from intractable MD and DEH were treated for 4 months. The insertion of a transtympanic ventilation tube was necessary for the Meniett device, but not the EFET device. In patients treated by the EFET and Meniett devices, the frequency of vertigo significantly improved after treatment. The distribution of vertigo outcomes at 4 months after treatment did not differ between patients treated with the both devices. Middle ear pressure treatment by the EFET device is effective and provides minimally invasive options for intractable MD and DEH like the Meniett device.