Current usage and effectiveness of influenza medications and factors regarding the time taken to alleviate fever based on postcard questionnaire survey.

Background: After the A/H1N1 influenza pandemic in 2009, two new drugs against the influenza virus, laninamivir and peramivir, were released in 2010 in Japan. We investigated the current usage and effectiveness of influenza medications and factors related to the time taken to alleviate fever. Methods: Patients diagnosed with influenza during the 2012-2013 season in Osaka Prefecture answered a postcard questionnaire that collected data regarding their demographic characteristics, flu vaccination status, symptoms, prescribed drugs, and drug-related adverse events. Results: The use of laninamivir consistently increased over the 3-year period and was prescribed at a similar rate as oseltamivir during the last year (39% and 45%, respectively). None of the neuraminidase inhibitors had a significant effect on the fever or other symptoms of influenza infection (P=.59 and P=.70, respectively). Vaccinated influenza patients experienced fever for a significantly longer duration than the nonvaccinated patients (P=.04). However, multivariate analysis showed that only influenza virus type, but not vaccination status, was related to the alleviation of fever within 2 days. Conclusions: There were no significant differences of effects on fever and symptoms among neuraminidase inhibitors. Virus type was only related to the alleviation of fever.

Disregard of cholesteatoma in congenital aural stenosis.

Congenital aural stenosis (CAS) is one type of congenital aural atresia (CAA) and is assumed to be a relatively mild type. Although CAS may be associated with cholesteatoma in the external ear canal, little attention has been paid to this association. We present two cases of CAS with middle ear infection due to destructive cholesteatoma. Both had been followed for microtia by a plastic surgeon. These patients had already exhibited cholesteatoma on CT examination, although it had been missed before the emergence of ear symptoms, otorrhea, and otalgia. We present our cases with successive changes in CT findings over time and discuss the problems of CAS with cholesteatoma.

Effects of cigarettes and alcohol consumption in benign paroxysmal positioning vertigo.

CONCLUSION: Smoking was associated with a lower incidence of benign paroxysmal positioning vertigo (BPPV). A larger study is required to establish the role of smoking in BPPV. OBJECTIVE: To evaluate the effect of cigarette and alcohol consumption on BPPV. PATIENTS AND METHODS: One hundred and fifty-six patients with BPPV and 155 age- and sex-matched normal subjects were compared according to their cigarette and alcohol consumption. Patients with BPPV who had had a recurrence of the disease and those who had not were also compared as to their cigarette and alcohol consumption. The question of whether the length of time until recovery was influenced by cigarette or alcohol consumption was also investigated. RESULTS: Control subjects smoked significantly more often than BPPV patients, and patients without recurrence more frequently than patients with recurrence. Alcohol consumption was also more common in control subjects than in BPPV patients, but there was no difference between patients with recurrence and without recurrence. There was a tendency for smoking patients to recover sooner than non-smoking patients. Alcohol consumption did not affect the length of time until recovery.

Positional and positioning nystagmus in healthy subjects under videonystagmoscopy.

OBJECTIVE: The eye-focused video camera as sensitive to infrared light is very useful for detecting nystagmus with open eyes in the dark. The existence of physiological nystagmus has been reported. We investigated how frequently physiological positional and positioning nystagmus is seen in healthy individuals under infrared video goggles. MATERIALS AND METHODS: Eighty-nine healthy individuals were examined in this study. Positional and positioning nystagmus was examined with infrared video goggles. RESULTS: Positional nystagmus could be detected in 65 of the 89 subjects under infrared video goggles. The majority of nystagmus was horizontal nystagmus, and vertical nystagmus was also seen in four subjects. Nystagmus was most frequently recognized in right or left shoulder down position. Positioning nystagmus was detected in 40 subjects. CONCLUSIONS: Positional and positioning nystagmus frequently exist in healthy subjects. This finding means that the existence of physiological nystagmus must be considered when diagnosing dizzy patients using this equipment.

Application of modified transmastoid approach methods to congenital atresia of the external ear canal with middle ear infection.

OBJECTIVE: To present our surgical technique for congenital atresia of the external ear canal with middle ear infection. METHODS: A modified transmastoid approach to congenital atresia of the external ear canal with middle ear infection was applied. Our method is to visualize the landmarks of the mastoid cavity such as the antrum, sinodural angle and digastric ridge by the canal-open method to avoid facial nerve injury and then prepare a relatively large external ear canal with reconstruction of the posterior wall of the external ear canal. RESULTS AND CONCLUSION: This method is suitable not only for treating congenital atresia of the external ear canal with middle ear infection, but also for avoiding facial nerve injury and postoperative complications such as re-stenosis of the new ear canal and postoperative middle ear infection.

Fibrous dysplasia of the temporal bone with cholesteatoma.

Fibrous dysplasia is an uncommon benign bone disorder of unknown origin. It rarely affects the temporal bone. We report a case of fibrous dysplasia of the temporal bone with cholesteatoma in the external auditory canal, the first complaint of which was left otorrhea. Fibrous dysplasia invaded the external ear canal, stenosis of which causes a cholesteatoma. Mastoidectomy, tympanoplasty, and meatoplasty were performed. We discuss the characteristics of this condition, its differential diagnosis and its treatment.