Biomedical subjects

Yasuyuki Hinohira

Publications and source records attributed to Yasuyuki Hinohira.

5 recordsLinked to original sources

PubMed2006

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. PATIENTS AND METHODS: Between January 1998 and March 2004, 29 patients (29 ears) with tympanosclerosis involving the ossicular chain underwent tympanoplasty at our hospital. Patients with myringosclerosis only, or with an associated cholesteatoma, were excluded from this study. The clinical and operational records and pre- and postoperative pure tone audiograms were reviewed retrospectively. RESULTS: Intact canal wall tympanoplasty was applied to all 29 patients. A non-staged operation was performed on 21 patients, and a staged operation was performed on the remaining 8 patients. In 25 patients (86.2%), the sclerotic lesion of the ossicles was located in the epitympanum. In the remaining four, the sclerotic lamella coated only the ossicular chain. On average, the preoperative air conduction hearing level of 57.9 dB was significantly improved to 46.3 dB after tympanoplasty. The success rate of middle ear surgery was 65.5% (19 of 29 patients), according to the criteria of the Otological Society of Japan. In 16 patients (55.2%), the mobility of the stapes was preserved (group A), while in the remaining 13 patients (44.8%), the stapes was fixed (group B). The mean preoperative bone conduction of 25.5 dB in group A was significantly better than that of 37.2 dB in group B. The hearing result significantly improved in group A but not in group B. The success rates were 75% (12 of 16 patients) in group A and 53.8% (7 of 13 patients) in group B.

Adolescent↗

PubMed2005

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. STUDY DESIGN: Retrospective study. SETTING: Bone pate scutum plasty was performed in 69 ears during first-stage operations. We attempted to reconstruct a smooth attic bony wall. At the time of the second-stage operations, the results of the scutum plasty were examined. RESULTS: The incidence of retraction pocket was statistically reduced from 20.2% to 5.8%. CONCLUSION: Although the reconstructed scutum showed atrophy to some extent, bone pate scutum plasty is effective in preventing postoperative retraction pocket if a smoothly shaped attic wall can be reconstructed.

Adolescent↗

PubMed2005

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. In order to perform the endonasal reduction surgery, supplemental septoplasty and/or submucous conchotomy were done. Immediately following the reduction and the fixation, eye traction tests were performed to confirm the ocular motility improvement. Tampon gauzes or balloon catheters were used for the temporal fixation to support the orbital floor. RESULTS: Postoperatively, diplopia completely disappeared in 55 of the 62 patients (88.7%) that were followed over 6 months. CONCLUSION: The high success rate with regard to diplopia indicates that the endoscopic endonasal approach may be an alternative to extranasal methods. EBM RATING: B-3.

Adolescent↗

PubMed2002

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. METHODS: Bone pate collected while drilling the mastoid cortex was mixed with fibrin glue to make a pate plate. The mastoid cortex defect was closed with a pate plate cut to the desired shape and size. PATIENTS AND MAIN OUTCOME MEASURES: Mastoid cortex plasty was included in the first-stage operation in 49 patients who underwent staged tympanoplasty. The second-stage operation was an inspection to see whether the mastoid cortex was reconstructed and the ingrowth of fibrous soft tissue was prevented. RESULTS: In 35 patients, the mastoid cortex was reconstructed completely, and soft tissue ingrowth into the mastoid cavity was blocked completely. In the remaining 14 patients, a defect of varying size occurred at the site of drainage-tube insertion. This defect was small enough to prevent soft tissue ingrowth into the mastoid cavity. CONCLUSION: Mastoid cortex plasty is a simple and rapid procedure for preventing postoperative deformity of the mastoid process and is valuable for restoring mastoid cavity function.

Adolescent↗

PubMed2002

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. PATIENTS: Thirty-five patients with cholesteatoma invading the mastoid cavity. INTERVENTION: Seventeen patients received mastoid cortex plasty with scutum plasty and insertion of a Silastic sheet after removal of the cholesteatoma using a combined approach during the first-stage operation. The 18 control patients received only scutum plasty with the insertion of a Silastic sheet without mastoid cortex plasty during the first-stage operation. MAIN OUTCOME MEASURES: The restoration of the middle ear aeration was assessed with high-resolution computed tomography before both the first-stage operation and the second-stage operation. RESULTS: The range of middle ear aeration ameliorated significantly whether or not mastoid cortex plasty was performed. Scutum plasty with the insertion of a Silastic sheet without mastoid cortex plasty was significantly effective only for the amelioration of the epitympanum aeration. Mastoid cortex plasty with scutum plasty with the insertion of a Silastic sheet was significantly effective for the amelioration of the epitympanum and also the mastoid cavity aeration. In both groups, before the first-stage operation, approximately 70% of the patients had good mesotympanum aeration, and the mesotympanum aeration ameliorated further after the first-stage operation, although this amelioration was not significant. CONCLUSIONS: Mastoid cortex plasty is statistically effective for the amelioration of mastoid cavity aeration after the first-stage operation.

Adolescent↗