Decrease in number of mast cells in resected nasal polyps as an indicator for postoperative recurrence of chronic rhinosinusitis.

BACKGROUND: In the clinical setting, chronic rhinosinusitis with nasal polyps (CRSwNP) is usually divided into eosinophilic-CRS (ECRS) and non-ECRS (NECRS) in Japan. Patients with the former are believed to be at risk for postoperative recurrence of CRS. However, some patients have been missed according to these phenotypic classifications due to the low number of infiltrating eosinophils in polyp tissues. OBJECTIVE: In the present study, we attempted to identify cellular or molecular candidate markers to predict nasal polyp recurrence. METHODS: Nasal polyps were collected from 32 patients with CRSwNP who had undergone an endoscopic sinus surgery. These patients were divided into ECRS and NECRS groups in accordance with the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) scoring system and the number of eosinophils in polyp tissues. Unclassifiable patients were referred to as the unknown group. RESULTS: Eosinophil infiltration in resected nasal polyps was most evident in the ECRS group. However, the number of mast cells and tryptase-positive cells in nasal polyps were significantly lower in ECRS and unknown groups compared with the NECRS group. A significant positive correlation was detected between the JESREC score and number of eosinophils. The numbers of mast cells and tryptase-positive cells were negatively correlated with the JESREC score in all included samples. Significant positive correlations were detected between the number of transforming growth factor ß1-positive cells and the number of mast cells, tryptase-positive cells, and chymase-positive cells mast cells. CONCLUSIONS AND CLINICAL RELEVANCE: These findings indicated that the enumeration of mast cells in resected polyps may be another approach to predict postoperative polyp recurrence in CRSwNP patients.

Clinical Study of Extrapulmonary Head and Neck Tuberculosis: A Single-Institute 10-year Experience

Introduction Although the incidence of tuberculosis (TB) in Japan has been decreasing yearly, Japan remains ranked as an intermediate-burden country for TB. Objective This study aims to investigate the current situation of head and neck extrapulmonary TB (EPTB) diagnosed in our department. Methods We retrospectively reviewed the clinical records of 47 patients diagnosed with EPTB in the head and neck in our department between January 2005 and December 2014. The extracted data included sex and age distribution, development site, chief complaint, presence or absence of concomitant active pulmonary TB (PTB) or history of TB, tuberculin skin test (TST) results, interferon-gamma release assay (IGRA) results, and duration from the first visit to the final diagnosis of EPTB. Results The subjects consisted of 20 men and 27 women, and age ranged from 6 to 84 years. The most common site was the cervical lymph nodes (30 patients), with the supraclavicular nodes being the most commonly affected (60%). Histopathological examination was performed on 28 patients. TST was positive in 9 out of 9 patients and the IGRA was positive in 18 out of 19 patients. We observed concomitant PTB in 15 out of the 47 patients. Mean duration from the first visit to the final diagnosis of EPTB was 56 days. Conclusion The clinical symptoms of TB, especially those in the head and neck region, are varied. Otolaryngologists should be especially aware of the extrapulmonary manifestations of TB to ensure early diagnosis and treatment from the public health viewpoint.

Clinical Study of Extrapulmonary Head and Neck Tuberculosis: A Single-Institute 10-year Experience.

Introduction Although the incidence of tuberculosis (TB) in Japan has been decreasing yearly, Japan remains ranked as an intermediate-burden country for TB. Objective This study aims to investigate the current situation of head and neck extrapulmonary TB (EPTB) diagnosed in our department. Methods We retrospectively reviewed the clinical records of 47 patients diagnosed with EPTB in the head and neck in our department between January 2005 and December 2014. The extracted data included sex and age distribution, development site, chief complaint, presence or absence of concomitant active pulmonary TB (PTB) or history of TB, tuberculin skin test (TST) results, interferon-gamma release assay (IGRA) results, and duration from the first visit to the final diagnosis of EPTB. Results The subjects consisted of 20 men and 27 women, and age ranged from 6 to 84 years. The most common site was the cervical lymph nodes (30 patients), with the supraclavicular nodes being the most commonly affected (60%). Histopathological examination was performed on 28 patients. TST was positive in 9 out of 9 patients and the IGRA was positive in 18 out of 19 patients. We observed concomitant PTB in 15 out of the 47 patients. Mean duration from the first visit to the final diagnosis of EPTB was 56 days. Conclusion The clinical symptoms of TB, especially those in the head and neck region, are varied. Otolaryngologists should be especially aware of the extrapulmonary manifestations of TB to ensure early diagnosis and treatment from the public health viewpoint.

Site-specific analysis of B-cell non-Hodgkin's lymphomas of the head and neck: A retrospective 10-year observation.

CONCLUSION: B-cell non-Hodgkin's lymphoma (B-NHL) in the head and neck most commonly affected the oropharynx and the cervical lymph node in sexagenarian patients, with more than 70% of these cases being diffuse large B-cell lymphoma (DLBCL). Accordingly, B-NHL should be considered one of the most important differential diagnoses of head and neck malignancies. OBJECTIVES: It has previously been reported that the majority of head and neck malignant lymphomas are B-NHLs. This analysis aimed to assess the site-specific profiles of B-NHL of the head and neck. METHODS: The medical records of patients with B-NHL of the head and neck diagnosed between January 2004 and December 2013 were retrospectively reviewed. The clinical parameters of these patients, including age, sex, site distribution, and histopathologic sub-type, were analyzed. RESULTS: A total of 153 cases (95 males; 58 females) were included in this analysis (male-to-female ratio = 1.64:1). The patient age at the time of diagnosis ranged from 30-92 years (median = 68 years). The oropharynx was the most commonly affected site (40.5%), followed by the cervical lymph nodes (33.3%). The most common histopathologic sub-type was DLBCL (71.9%), followed by follicular lymphoma (11.1%), and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (9.2%).

Neural mechanisms of phonemic restoration for speech comprehension revealed by magnetoencephalography.

In daily communication, we can usually still hear the spoken words as if they had not been masked and can comprehend the speech when spoken words are masked by background noise. This phenomenon is known as phonemic restoration. Since little is known about the neural mechanisms underlying phonemic restoration for speech comprehension, we aimed to identify the neural mechanisms using magnetoencephalography (MEG). Twelve healthy male volunteers with normal hearing participated in the study. Participants were requested to carefully listen to and understand recorded spoken Japanese stories, which were either played forward (forward condition) or in reverse (reverse condition), with their eyes closed. Several syllables of spoken words were replaced by 300-ms white-noise stimuli with an inter-stimulus interval of 1.6-20.3s. We compared MEG responses to white-noise stimuli during the forward condition with those during the reverse condition using time-frequency analyses. Increased 3-5 Hz band power in the forward condition compared with the reverse condition was continuously observed in the left inferior frontal gyrus [Brodmann's areas (BAs) 45, 46, and 47] and decreased 18-22 Hz band powers caused by white-noise stimuli were seen in the left transverse temporal gyrus (BA 42) and superior temporal gyrus (BA 22). These results suggest that the left inferior frontal gyrus and left transverse and superior temporal gyri are involved in phonemic restoration for speech comprehension. Our findings may help clarify the neural mechanisms of phonemic restoration as well as develop innovative treatment methods for individuals suffering from impaired speech comprehension, particularly in noisy environments.

Blockage pattern of longitudinal flow in Meniere's disease.

CONCLUSION: In the present study, classification of the patterns of 3D CT images of the ductus reuniens (reuniting duct) (RD), saccular duct (SD), and endolymphatic sinus (ES) gave more precise information for assessing the pathological condition of Meniere's disease (MD) than our previous study. OBJECTIVE: This study attempted to provide more detailed information on MD by classifying the patterns of 3D CT images of the RD, SD, and ES in patients with MD. METHODS: We examined the ears of 62 patients with definitely diagnosed unilateral MD based on the criteria of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) using 3D CT. The 3D CT images of bony grooves of RD, SD, and ES (BRD, BSD, and BES) were classified into patterns according to aspects of their patency. RESULTS: BRD could be classified into six types by assessing their patency defined using the criteria in this study. In the ears on the affected side of patients with MD, the BRD, BSD, and BES lost continuity in 3D CT images along their bony routes and were significantly different from normal healthy ears (p < 0.01). There were no significant differences among each stage of MD in the distributions of BRD and BES except for BSD.