Faculty Profiles - Seiichiro Makihara

Papers - Seiichiro Makihara

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Orbital complications of infected mucocele in the paranasal sinuses. Reviewed International journal

Seiichiro Makihara, Shin Kariya, Mitsuhiro Okano, Tomoyuki Naito, Munechika Tsumura, Kazunori Nishizaki

Auris, nasus, larynx 47 ( 6 ) 990 - 995 2020.12

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

OBJECTIVE: Infected mucocele of the paranasal sinuses can induce orbital infection, including orbital subperiosteal abscess, which may lead to life-threatening intracranial complications. Effective diagnosis is important, and treatment should be aggressive. This paper presents our experiences in endoscopic surgical management of orbital complications secondary to infected paranasal sinus mucoceles. METHODS: From our retrospective review of the medical charts for 82 patients with 92 sides diagnosed with paranasal sinus mucoceles, we present 7 sides in 7 adult patients with orbital complications secondary to infected mucoceles. The collected data include the suggested etiology, side of sinus involvement, localization of abscess in the orbit, orbital wall bone defects caused by mucocele compression, ophthalmic symptoms, duration between symptom onset and initial visit, operation date, type of surgery performed, and follow-up. RESULTS: The mucocele was located in the ethmoid-frontal region in 9.8% of the sides (9/92), in the frontal sinus in 7.6% (7/92), in the ethmoidal sinus in 9.8% (9/92), in the maxillary sinus in 67.4% (62/92), in the maxillary-ethmoidal sinus in 3.3% (3/92), and in the sphenoid sinus in 2.2% (2/92). The patients with ethmoid-frontal mucoceles had a significantly higher incidence of orbital complications (6/9) as compared with the other sub-types of mucoceles (frontal, 0/7; ethmoidal, 0/9; maxillary, 1/62; maxillary-ethmoidal, 0/3; sphenoid, 0/2). Chandler's classification showed Type I in one, Type II in three, and Type III in three. Sinus involvement was observed at the ethmoid-frontal sinuses in six cases and the maxillary sinus in one case. All seven cases had a partial defect of the orbital wall bone (lamina papyracea, or inferior orbital wall bone) by mucocele compression, and the patients underwent endoscopic marsupialization. For the cases with subperiosteal abscess, the lamina papyracea was also removed partially for draining the abscess. In all cases, symptoms were resolved without any recurrence of the mucocele. CONCLUSIONS: Infected ethmoid-frontal mucoceles with a defect of the lamina papyracea tend to induce orbital infection, so prompt surgery for the infected mucoceles should be considered early even with Types I and II, before visual acuity is impaired, because surgery is the only curative treatment for the mucoceles.

DOI： 10.1016/j.anl.2020.05.012

都市部と郊外における昆虫アレルゲン感作の実態と、昆虫単独感作例の臨床免疫学的特徴 Reviewed

岡愛子, 小山田匠吾, 岡晋一朗, 古舘佐起子, 高橋優宏, 岩崎聡, 赤松摩紀, 野口佳裕, 假谷伸, 金井健吾, 牧原靖一郎, 西崎和則, 岡野光博

耳鼻咽喉科免疫アレルギー 38 ( 3 ) 57 - 63 2020.12

Language：Japanese Publisher：日本耳鼻咽喉科免疫アレルギー学会

【背景】わが国における昆虫アレルゲン感作の実態や,その特徴については未明な点が多い。【対象と方法】鼻症状を主訴に国際医療福祉大学三田病院(東京都)あるいは国際医療福祉大学病院(栃木県)を受診し,特異的IgE検査を施行した524症例(東京都316例,栃木県208例)を対象とした。2病院における昆虫(蛾,ユスリカ,ゴキブリ)感作率と,昆虫感作例,特に昆虫単独感作例の臨床免疫学的特徴を検討した。【結果】蛾,ユスリカ,ゴキブリの感作率は東京で30.7%,10.0%,10.6%,栃木で26.4%,10.6%,12.5%であり,東京と栃木で有意差を認めなかった。昆虫感作例の中,95.1%が蛾への感作を示した。昆虫非感作例と比較して昆虫感作例は,有意差をもって男性に多く血清総IgE値が高かった。昆虫単独感作例は他抗原との重複感作例と比較し,高齢者に有意に多く認めた。また有意な差を認めなかったものの,重複感作例と比較し昆虫単独感作例で通年性の症状を多く認めた。【まとめ】アレルギー性鼻炎の昆虫抗原として蛾の重要性が確認された。昆虫抗原への感作率は都市部と郊外で差を認めなかった。昆虫単独感作例は高齢男性が多い,総IgE値が高い,通年性症状という特徴を示した。特に高齢者では血管運動性鼻炎や老人性鼻漏の患者層と重なっており,総IgE値が高い症例では昆虫抗原を含めたIgE検査を行う必要が示唆された。(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2020&ichushi_jid=J01987&link_issn=&doc_id=20201228330001&doc_link_id=%2Fch6menek%2F2020%2F003803%2F001%2F0057-0063%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fch6menek%2F2020%2F003803%2F001%2F0057-0063%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

脳神経外科、耳鼻咽喉科が連携した下垂体、傍鞍部腫瘍に対する経鼻的内視鏡手術の取組み

井本良二, 平下浩司, 多々納幹貴, 川井伸彦, 柚木正敏, 吉野公博, 牧原靖一郎, 内藤智之, 津村宗近

香川労災病院雑誌 ( 26 ) 1 - 7 2020.12

Language：Japanese Publisher：香川労災病院

症例1は54歳男性で、数ヵ月前からの視力低下を自覚して近医眼科を受診、両耳側半盲を指摘され、精査加療目的に当科紹介受診となった。非機能性下垂体腺腫と術前診断し、経鼻的内視鏡手術における下垂体腺腫摘出術の方針とした。術後軽度の頭痛は認めたものの両側の視力および視野は改善を認め、尿崩症等の内分泌異常、髄液漏等もなく第15病日に退院となった。病理結果は下垂体腺腫であった。症例2は68歳男性で、1年前から嗅覚障害を自覚しており、近医耳鼻科を受診、嗅覚低下・嗅裂ポリープを認め当院耳鼻咽喉科に紹介受診となった。鼻腔内所見における嗅裂ポリープの生検にて嗅神経芽細胞腫と診断された。鼻腔経由での血管処理が困難と考え、左上眼瞼皮膚切開を併用し、前篩骨動脈、後篩骨動脈の凝固切断、経鼻内視鏡下に鼻副鼻腔腫瘍、頭蓋底骨、硬膜両嗅球、両嗅索を一塊切除した。術後経過は良好で第12病日に退院となった。

重症睡眠時無呼吸症候群を伴った成人ソトス症候群の1例 Reviewed

浦口健介, 牧原靖一郎, 内藤智之, 松本淳也, 津村宗近, 假谷伸

耳鼻咽喉科・頭頸部外科 92 ( 12 ) 1031 - 1036 2020.11

Language：Japanese Publisher：(株)医学書院

28歳男。出生時から顔貌異常があり、過成長を認めた。10代の頃にソトス症候群と臨床診断されていたが、全身状態が落ち着いていたため定期通院はしていなかった。今回、日中の眠気・頭痛があり、睡眠時無呼吸症候群の精査目的で当科を受診した。諸検査の結果から、下顎低形成による硬組織の異常から口腔・咽頭腔の狭小化をきたし、閉塞性睡眠時無呼吸症候群になっていると考えた。持続陽圧呼吸(CPAP)療法を行い、治療効果判定のためCPAP装着下にポリソムノグラフィ検査を行ったところ、AHI、AIとも改善していることが確認された。日中の眠気・頭痛も改善し、現在CPAPを継続しながらフォロー中である。

経眼窩アプローチを併用し、内視鏡下に一塊切除した嗅神経芽細胞腫例 Reviewed

津村宗近, 牧原靖一郎, 大村和弘, 内藤智之, 松本淳也, 假谷伸, 岡野光博, 西崎和則

頭頸部外科 30 ( 1 ) 119 - 125 2020.6

Language：Japanese Publisher：(NPO)日本頭頸部外科学会

嗅神経芽細胞腫は、近年経鼻内視鏡下摘出術が導入されているが、腫瘍切除方法については、頭蓋底骨、硬膜、嗅球、嗅索と鼻腔内腫瘍を一塊切除するか、multi-layer resectionを施行するかに関して議論がある。本症例は70歳男性、硬膜浸潤を認めるKadsish分類Stage Cで眼窩内側壁に接する嗅神経芽細胞腫症例である。腫瘍近接のため経鼻的に篩骨動脈の確保が困難と考え、上眼瞼皮膚切開による内視鏡下経眼窩アプローチでの前、後篩骨動脈の凝固切断を施行し、経鼻内視鏡下に腫瘍を一塊切除施行した。副鼻腔内が腫瘍で充満しており、経鼻的に篩骨動脈へのアプローチが困難な場合に、有用であると考えられた。(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2020&ichushi_jid=J04210&link_issn=&doc_id=20200720160020&doc_link_id=10.5106%2Fjjshns.30.119&url=https%3A%2F%2Fdoi.org%2F10.5106%2Fjjshns.30.119&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Unilateral mucosal advancement flapによる鼻中隔穿孔閉鎖例 Reviewed

牧原靖一郎, 内藤智之, 津村宗近, 假谷伸, 岡野光博, 西崎和則

頭頸部外科 30 ( 1 ) 113 - 118 2020.6

Authorship：Lead author,　Corresponding author Language：Japanese Publisher：(NPO)日本頭頸部外科学会

本症例は18歳の男性で、鼻ほじりが原因と考えられる13mm大の鼻中隔穿孔を認め、Unilateral mucosal advancement flap techniqueを使用して穿孔閉鎖施行した。術後は穿孔が閉鎖し、自覚症状が消失した。Unilateral mucosal advancement flap techniqueは片側鼻腔で穿孔の下方と上方に二つのflapを作成し、そのflap同士を縫合することで穿孔を閉鎖する方法である。Flapは双茎で血流もよく、Interposition graftと組み合わせることで、1cmを超える中等度の大きさの鼻中隔穿孔の閉鎖に有効な方法と考えられた。(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2020&ichushi_jid=J04210&link_issn=&doc_id=20200720160019&doc_link_id=10.5106%2Fjjshns.30.113&url=https%3A%2F%2Fdoi.org%2F10.5106%2Fjjshns.30.113&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Role of Macrophage Migration Inhibitory Factor in NLRP3 Inflammasome Expression in Otitis Media. Reviewed International journal

Shin Kariya, Mitsuhiro Okano, Pengfei Zhao, Yukihide Maeda, Yuko Kataoka, Takaya Higaki, Seiichiro Makihara, Jun Nishihira, Tomoyasu Tachibana, Kazunori Nishizaki

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 41 ( 3 ) 364 - 370 2020.3

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

HYPOTHESIS: Macrophage migration inhibitory factor plays an important role in the expression of interleukin (IL)-1β and the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome in lipopolysaccharide-induced otitis media. BACKGROUND: NLRP3 inflammasome and macrophage migration inhibitory factor are critical molecules mediating inflammation. However, the interaction between the NLRP3 inflammasome and macrophage migration inhibitory factor has not been fully examined. METHODS: Wild-type mice and macrophage migration inhibitory factor gene-deficient (MIF) mice received a transtympanic injection of either lipopolysaccharide or phosphate-buffered saline. The mice were sacrificed 24 hours after the injection. Concentrations of IL-1β, NLRP3, ASC (apoptosis-associated speck-like protein containing a caspase recruitment domain and a pyrin domain), and caspase-1 in the middle ear effusions were measured by enzyme-linked immunosorbent assay. Temporal bones were processed for histologic examination and immunohistochemistry. RESULTS: In the immunohistochemical study using the wild-type mice, positive staining of macrophage migration inhibitory factor, NLRP3, ASC, and caspase-1 were observed in infiltrating inflammatory cells induced by lipopolysaccharide in the middle ear. The number of inflammatory cells caused by lipopolysaccharide administration decreased remarkably in the MIF mice as compared with the wild-type mice. The concentrations of IL-1β, NLRP3, ASC, and caspase-1 increased in the lipopolysaccharide-treated wild-type mice. The MIF mice with lipopolysaccharide had decreased levels of IL-1β, NLRP3, ASC, and caspase-1 as compared with the wild-type mice. CONCLUSION: Macrophage migration inhibitory factor has an important role in the production of IL-1β and the NLRP3 inflammasome. Controlling the inflammation by modulating macrophage migration inhibitory factor and the NLRP3 inflammasome may be a novel therapeutic strategy for otitis media.

DOI： 10.1097/MAO.0000000000002537

ポリグリコール酸フェルト(デュラウェーブ)を用いて頭蓋底硬膜再建した2症例 Reviewed

浦口健介, 小桜謙一, 牧原靖一郎, 福田真紀, 土井彰, 太田剛史

日本耳鼻咽喉科学会会報 123 ( 3 ) 257 - 263 2020.3

Language：Japanese Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会

内視鏡経鼻頭蓋底手術は広く行われるようになったが、手術侵襲の程度によっては時に硬膜再建が必要になることがある。今回、硬膜補綴材であるポリグリコール酸(PGA)フェルトを使用し硬膜再建を行った2症例を報告する。症例1は78歳男性。嗅神経芽細胞腫(Kadish分類Stage B)の腫瘍切除後に硬膜欠損に対してPGAフェルト・鼻中隔粘膜弁を用いて硬膜再建した。症例2は68歳女性。外反性乳頭腫に合併した扁平上皮癌であり、術中に篩板からの髄液漏を認めPGAフェルト・有茎粘膜弁を用いて硬膜再建した。術後に感染や髄液漏はなく、PGAフェルトを用いることで簡便かつ短時間で低侵襲に硬膜再建を行うことができた。(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2020&ichushi_jid=J01099&link_issn=&doc_id=20200409390011&doc_link_id=%2Fdz0jibik%2F2020%2F012303%2F011%2F0257-0263%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz0jibik%2F2020%2F012303%2F011%2F0257-0263%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Corrigendum to “Effect of prostaglandin D2 on VEGF release by nasal polyp fibroblasts” (Allergology International (2016) 65(4) (414–419), (S1323893016300259), (10.1016/j.alit.2016.03.003)) International journal

Kengo Kanai, Mitsuhiro Okano, Tazuko Fujiwara, Shin Kariya, Takenori Haruna, Ryotaro Omichi, Sei ichiro Makihara, Yuji Hirata, Kazunori Nishizaki

Allergology International 69 ( 1 ) 163 - 163 2020.1

Language：English Publishing type：Research paper (scientific journal)

The authors regret that the following two corrections are needed. The authors would like to apologize for any inconvenience caused. 1. The current text for the Authors' Contributions: “MO and KN designed the study and wrote the manuscript. TF, SK, KK, SM and YH contributed to data collection. TH and RO performed the statistical analysis and interpretation of the results”. The correct text should be “KK, MO and KN designed the study and wrote the manuscript. TF, SK, KK, SM and YH contributed to data collection. TH and RO performed the statistical analysis and interpretation of the results”. The underlined initial has been added. 2. The affiliation number of the last author “Kazunori Nishizaki” was mentioned incorrectly as “b”. The correct affiliation should be “a”.

DOI： 10.1016/j.alit.2019.11.001

Long-term treatment with clarithromycin and carbocisteine improves lung function in chronic cough patients with chronic rhinosinusitis Reviewed International journal

Shin Kariya, Mitsuhiro Okano, Takaya Higaki, Seiichiro Makihara, Tomoyasu Tachibana, Kazunori Nishizaki

AMERICAN JOURNAL OF OTOLARYNGOLOGY 41 ( 1 ) 102315 - 102315 2020.1

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO-ELSEVIER INC

Purpose: Chronic cough is a common complaint. Because the pathophysiology of chronic cough is complicated, the management of chronic cough is challenging. To the best of our knowledge, no previous study has examined the effect of macrolide antibiotics in chronic cough patients with chronic rhinosinusitis. The purpose of this study is to determine the changes in lung function for chronic cough patients with chronic rhinosinusitis who are treated by clarithromycin and carbocisteine.Materials and methods: Thirty-two chronic cough patients with chronic rhinosinusitis were recruited. Patients using inhaled corticosteroids and/or a bronchodilator, asthmatic patients, and patients with abnormal findings on auscultation and/or chest X-ray examination were excluded from this study. The patients received low-dose clarithromycin treatment for 3 months. Both before and after the treatment, a computed tomography (CT) scan of the paranasal sinuses, lung function test, peripheral blood test, and sino-nasal outcome test (SNOT-20) were applied.Results: Both the lung function and Lund-MacKay CT scores were improved by the long-duration therapy with macrolide antibiotics. The change in obstructive pulmonary function and the improvement of the CT score in each subject were significantly correlated. SNOT scores also improved after the treatment.Conclusions: The macrolide antibiotics treatment has beneficial effects on lung function in non-asthmatic chronic cough patients with normal chest X-ray findings. The improvement of chronic rhinosinusitis may have some role in the lung condition. Upper respiratory tract examination and treatment may be useful for the management of chronic cough.

DOI： 10.1016/j.amjoto.2019.102315

False vocal cord perforation with abscess treated by negative pressure wound therapy. Reviewed International journal

Seiichiro Makihara, Shin Kariya, Tomoyuki Naito, Kensuke Uraguchi, Junya Matsumoto, Yohei Noda, Mitsuhiro Okano, Kazunori Nishizaki

SAGE open medical case reports 8 2050313X20915415 2020

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE PUBLICATIONS INC

Perforation of the larynx is very rare but may result in severe airway complications that include pneumothorax, pneumonia, mediastinitis, and retropharyngeal abscess. If conservative treatment fails, aggressive treatments including reconstructive surgery with pedicle flap are considered. Negative pressure wound therapy has been used for large skin defects, necrotizing fasciitis, pharyngocutaneous fistula, stoma dehiscence, osteoradionecrosis of the mandible, chyle fistula, flap failure, and lymphangioma in the field of head and neck surgery. We report a case of false vocal cord perforation with abscess successfully treated by negative pressure wound therapy after abscess treatment. The result suggests that negative pressure wound therapy can be an alternative or adjunctive approach for larynx perforation when the perforation is difficult to close after conservative therapy.

DOI： 10.1177/2050313X20915415

Methotrexate-associated lymphoproliferative disorder with multiple pulmonary nodules and bilateral cervical lymphadenopathy. Reviewed International journal

Seiichiro Makihara, Shin Kariya, Mai Noujima-Harada, Nobuya Ohara, Tomoyuki Naito, Junya Matsumoto, Yohei Noda, Mitsuhiro Okano, Tadashi Yoshino, Kazunori Nishizaki

Auris, nasus, larynx 46 ( 6 ) 927 - 933 2019.12

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

As has been well recognized, methotrexate (MTX) leads to a state of immunosuppression and can provide a basis for the development of lymphoproliferative disorders (LPDs). MTX-associated LPDs can affect nodal sites as well as extranodal sites, though the manifestation of an LPD in the form of multiple pulmonary nodules is rare. Here, we report two cases of MTX-associated LPD with multiple bilateral pulmonary nodules, which was a finding suggestive of lung cancer, and bilateral cervical lymphadenopathy. After withdrawal of MTX, the multiple bilateral pulmonary nodules and bilateral cervical lymphadenopathy disappeared without chemotherapy in both cases. From these results, patients with pulmonary nodules and cervical lymphadenopathy should be examined for head and neck malignant tumors. Also, physicians should carefully check the administration of MTX. In patients with an MTX-associated LPD, we need to make an early diagnosis and consider discontinuing the administration of MTX as soon as possible.

DOI： 10.1016/j.anl.2019.01.010

Attachment-oriented endoscopic surgical management for inverted papillomas in the nasal cavity and paranasal sinuses. Reviewed International journal

Seiichiro Makihara, Shin Kariya, Tomoyuki Naito, Kensuke Uraguchi, Junya Matsumoto, Yohei Noda, Mitsuhiro Okano, Kazunori Nishizaki

Auris, nasus, larynx 46 ( 5 ) 748 - 753 2019.10

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

OBJECTIVE: The treatment of all forms of sinonasal inverted papilloma (IP) is a complete, wide, local resection. The main surgical purpose is to remove all diseased mucosa and mucoperiosteum, together with a cuff of normal-looking mucosa at the attachment site, followed by drilling and/or coagulation. Our aim is to present our experiences in endoscopic surgical management of IP by using attachment-oriented excision. METHODS: We present 20 cases of sinonasal IP. The data collected includes the histopathological diagnosis, staging, extension of the tumor, tumor attachment site, approach to surgery, serum squamous cell carcinoma antigen (SCCA) level, and recurrences. RESULTS: All patients underwent endoscopic surgery. A Caldwell-Luc operation was required in addition to the endoscopic surgery in one case. There was one case of recurrence (5%). After the additional operation, there was no recurrence. The tumor attachment sites vary, and the case of recurrence had a wide attachment site at the primary surgery. No major intra- or post-operative complications were observed. CONCLUSION: The present study shows that attachment-oriented excision for IP is useful for complete resection of IP. Surgeons should choose the surgical approach according to the location of the tumor attachment site rather than the Krouse staging system.

DOI： 10.1016/j.anl.2019.02.007

非定型悪性外耳道炎の2例 Reviewed

牧原靖一郎, 假谷伸, 内藤智之, 松本淳也, 石原久司, 岡野光博, 西崎和則

耳鼻咽喉科・頭頸部外科 91 ( 7 ) 594 - 599 2019.6

Authorship：Lead author,　Corresponding author Language：Japanese Publisher：(株)医学書院

症例1は70歳男性で、右顔面神経麻痺と右耳痛を主訴とした。外耳道内に肉芽形成を認め、CTで右鼓室と乳突洞の軟部組織陰影、外耳道骨部から鼓室、乳突洞にかけての骨破壊像を認めた。細菌検査で右耳漏からアスペルギルスが検出された。顔面神経麻痺を伴った右悪性外耳道炎と診断し、シタフロキサシンの内服と高気圧酸素療法を行った。また、外耳道内にビホナゾールの塗布とブロー液による処置を行った。症例2は71歳男性で、両耳漏と両耳痛を主訴とした。外耳道内に肉芽形成を認め、CTで両側外耳道骨部から鼓室、乳突洞、両側下顎頭にかけて骨破壊像を認めた。細菌検査で耳漏からニューキノロン耐性緑膿菌を検出した。両側悪性外耳道炎と診断し、タゾバクタム/ピペラシリンの点滴と高気圧酸素療法を行った。2例とも経過は良好であったが、症例2は治療開始後25ヵ月に既往の悪性リンパ腫が再発し死亡した。

鼻副鼻腔血瘤腫の3例 Reviewed

牧原靖一郎, 内藤智之, 浦口健介, 松本淳也, 假谷伸, 岡野光博, 西崎和則

耳鼻咽喉科・頭頸部外科 91 ( 7 ) 588 - 593 2019.6

Authorship：Lead author,　Corresponding author Language：Japanese Publisher：(株)医学書院

症例1は40歳男性で、反復性の左鼻出血と鼻の痛みを主訴とした。CTで左上顎洞から一部の前篩骨洞にかけて内部不均一で造影効果の乏しい腫瘤性病変を認めた。上顎洞血瘤腫を疑い、endoscopic modified medial maxillectomy(EMMM)を施行した。症例2は80歳女性で、反復性の左鼻出血を主訴とした。CTで左上顎洞に充満する陰影を認め、脳血管造影で明らかな栄養血管や腫瘍濃染を認めなかった。上顎洞血瘤腫を疑い、EMMMを施行した。症例3は73歳男性で、頭痛を主訴とした。CTで左蝶形骨洞に充満する陰影を認め、脳血管造影で明らかな栄養血管や腫瘍濃染を認めなかった。蝶形骨洞血瘤腫を疑い、拡大蝶形骨洞手術を施行した。手術は正円孔、翼突管を同定し、広く蝶形骨洞前壁を開放した術野で行った。3例とも病理診断は血瘤腫で、症例1は術後約5年、症例2は術後約8ヵ月、症例3は術後2年5ヵ月の現在まで再発を認めていない。

Dangerous noodle: A case of swallowing syncope and a review of 122 cases from the literature. Reviewed

Kensuke Uraguchi, Shin Kariya, Seiichiro Makihara, Aiko Oka, Hiroo Ueeda, Yohei Noda, Kazunori Nishizaki

Journal of arrhythmia 35 ( 1 ) 145 - 148 2019.2

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY

Swallowing syncope is a rare medical condition. Even though it has been known as a neurally mediated syncope, the definitive mechanism of this condition remains unclear. We show in this study an additional case of swallowing syncope and review the 122 reported cases from the literature. A 47-year-old Japanese man had been suffering from recurrent syncopal attacks, when he fainted immediately after swallowing. Holter electrocardiogram monitoring demonstrated a sinus pause (maximum R-R interval of 3.8 seconds) after he swallowed a noodle quickly. A permanent pacemaker was implanted because the frequency of syncope increased.

DOI： 10.1002/joa3.12130

Determining an Appropriate Time to Start Prophylactic Treatment with Intranasal Corticosteroids in Japanese Cedar Pollinosis Reviewed International journal

Takenori Haruna, Shin Kariya, Takaya Higaki, Sei-ichiro Makihara, Kengo Kanai, Yasutoshi Komatsubara, Aiko Oka, Kazunori Nishizaki, Mitsuhiro Okano

Medical Sciences 7 ( 1 ) 2019.1

Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG

: Prophylactic treatment with intranasal corticosteroids is effective for pollen-induced seasonal allergic rhinitis. However, the appropriate time to start this treatment remains unclear. We performed a double-blinded, randomized, placebo-controlled trial. Starting on February 1, 2014, patients with Japanese cedar pollinosis received either fluticasone furoate nasal spray (FFNS) for 8 weeks (Group A: n = 24), placebo nasal spray for 2 weeks followed by FFNS for 6 weeks (Group B: n = 23), or placebo for 4 weeks followed by FFNS for 4 weeks (Group C: n = 23). The primary endpoint was comparison of the total naso-ocular symptom score (TSS). Secondary endpoints including the increment cost effective ratio (ICER) were also determined. Continuous pollen dispersion began on the 24th of February. Therefore, Group A and Group B received 3-weeks and 1-week of prophylactic treatment, respectively, whereas Group C received post-onset treatment. During the peak pollen-dispersal period, significant differences in TSS were seen between the groups, particularly between Group A and C. The ICER of Group B vs. Group C was lower than that of Group A vs. Group C. These results suggest that long-term prophylactic treatment with FFNS is clinically the most potent treatment, whereas short-term prophylactic treatment is cost effective for pollen-induced allergic rhinitis.

DOI： 10.3390/medsci7010011

Utility of the axillary flap approach to the frontal recess in patients with chronic rhinosinusitis Reviewed

Seiichiro Makihara, Shin Kariya, Mitsuhiro Okano, Tomoyuki Naito, Kensuke Uraguchi, Junya Matsumoto, Kazunori Nishizaki

Otorinolaringologia 69 ( 3 ) 135 - 140 2019

Authorship：Lead author Publishing type：Research paper (scientific journal)

BACKGROUND: The frontal recess and sinus are the most likely areas for sinus surgery failure. A significant difference between races in the anatomical structure of paranasal sinuses has been reported. The axillary flap approach is one of the surgical techniques of endoscopic sinus surgery (ESS) that can improve access to the frontal recess. In this study, we examined the usefulness of the axillary flap approach to accessing the frontal recess and sinus by identifying the frontal ostium during ESS in Japanese patients. METHODS: We performed ESS with the axillary flap approach on 38 patients (59 sides). Demographic data, identification of the frontal ostium, surgical findings, preoperative and postoperative symptoms, incidence of revision surgery, and postoperative complications were collected. RESULTS: The frontal sinus ostium was identified in 96.6% (57 of 59) of the sides. All of the frontal sinus cells detected in a preoperative CT scan were identified during ESS with the axillary flap approach without using a 70-degree endoscope. The symptoms significantly improved after ESS. Three sides had middle meatal adhesions after ESS that required surgical repair under local anesthesia. There was no major postoperative complication such as cerebrospinal fluid leak, orbital injury, or hemorrhage requiring blood transfusion. No patient required revision ESS. CONCLUSIONS: The axillary flap technique is a safe and simple surgical procedure that provides excellent access to the frontal recess without using a 70-degree endoscope, even in Japanese patients. It allows clearance of cells in the recess with identification of the frontal ostium, leading to successful ESS.

DOI： 10.23736/S0392-6621.19.02224-0

The Relationship Between the Width of the Frontal Recess and the Frontal Recess Cells in Japanese Patients. Reviewed International journal

Seiichiro Makihara, Shin Kariya, Mitsuhiro Okano, Tomoyuki Naito, Kensuke Uraguchi, Junya Matsumoto, Yohei Noda, Kazunori Nishizaki

Clinical medicine insights. Ear, nose and throat 12 1179550619884946 - 1179550619884946 2019

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: The agger nasi cell (ANC) is an easily identifiable landmark when approaching the frontal sinus. The success of endoscopic frontal sinus surgery may be influenced by the width of the frontal recess (FR). The aim of this study is to examine the relationship between the FR width and the ANC size in Japanese patients. In addition, the effect of various frontal recess cells (FRCs) on the development of frontal sinusitis has been examined. MATERIALS AND METHODS: Multiplanar computed tomography (CT) scans of the nasal cavities and paranasal sinuses in 95 patients (190 sides) before endoscopic sinus surgery were reviewed. The presence of FRCs, the thickness of the frontal beak (FB), the ANC size, and the anterior-to-posterior (A-P) length of the frontal isthmus (FI) and FR were evaluated in patients with and without frontal sinusitis. RESULTS: The prevalence of the ANC, frontal cell types 1, 2, 3, and 4, frontal bullar cell (FBC), suprabullar cell, supraorbital ethmoid cell, and interfrontal sinus septal cell was 85.3%, 11.6%, 0%, 7.9%, 0%, 25.3%, 45.8%, 16.8%, and 15.3%, respectively. The ANC volume showed a significant positive correlation with the A-P length of the FI and FR. The incidence of frontal sinusitis in the patients with FBCs was significantly higher than that without FBCs. CONCLUSION: A large ANC offers a greater potential to facilitating the approach to the frontal sinus because of the extensiveness of the FR in Japanese patients. The presence of FBCs may be related to a higher incidence of frontal sinusitis.

DOI： 10.1177/1179550619884946

Low Incidence of Allergic Fungal Rhinosinusitis in Japanese Patients. Reviewed International journal

Seiichiro Makihara, Shin Kariya, Tomoyuki Naito, Junya Matsumoto, Mitsuhiro Okano, Kazunori Nishizaki

Clinical medicine insights. Ear, nose and throat 12 1179550619870758 - 1179550619870758 2019

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Allergic fungal rhinosinusitis (AFRS) is a noninvasive fungal disease of the sinuses with a very high recurrence rate. A very small number of Japanese cases have been reported. MATERIAL AND METHODS: The subjects were 6 patients with AFRS out of 429 patients who underwent endoscopic sinus surgery at Kagawa Rosai Hospital between December 2011 and November 2017. We retrospectively examined the clinical features and outcomes of these 6 patients. RESULTS: The incidence of AFRS was 1.4% (6/429). Allergic fungal rhinosinusitis was unilateral in 5 cases and bilateral in 1. Computed tomography revealed hyperdense areas representing allergic mucin, but no patient exhibited bone erosion. Magnetic resonance imaging showed hypointense or no signal regions at the locations of allergic mucin. Postoperatively, 1 patient developed recurrence. Because the recurrent patient had no significant symptoms, he refused further surgery and received drug therapy. Preoperative eosinophil counts and total IgE levels were elevated in all patients; postoperatively, both remained high in the patient who developed recurrence. Postoperative treatments included steroid therapy and nasal irrigation. CONCLUSIONS: Allergic fungal rhinosinusitis is less prevalent in Japan than in Western nations. Peripheral blood eosinophil and serum IgE values may be used as the biomarkers. SIGNIFICANCE: Allergic fungal rhinosinusitis is prone to recurrence. Postoperative treatment including steroid therapy is important in the management of AFRS.

DOI： 10.1177/1179550619870758

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