[Blood flow measurement and clinical usefulness of the temporal fascial scar tissue flap and the periosteal scar tissue flap in posterior canal wall reconstructed tympanoplasty for the mastoid cavity problem in the postoperative ear].

In the postoperative ear, following reconstructive tympanoplasty for a mastoid cavity problem, a very important key is to maintain a stable reconstructed posterior canal wall with the bone plate and cartilage in the posterior canal wall. The authors manage reconstruction of the posterior canal wall with the temporal fascial scar tissue flap (TFSF) and the temporal periosteal scar tissue flap (TPSF) to ensure obtaining a stable posterior canal wall and a tympanic membrane graft. Well-vascularized TFSF and TPSF enable us to acquire a solid reconstructed posterior canal wall because of the secure blood supplies to the flaps. In order to investigate the blood supplies of TFSF and TPSF, we employed laser Doppler blood flowmeters and measured blood flow in the flaps in 20 cases of posyoperative ears treated for a mastoid cavity problem. The blood supplies to both flaps were good, with the blood supply to the TFSF being statistically better than in the case of the TPSF. These findings suggested that the TFSF and TPSF were a reliable source of local well-vascularized tissue which were pliable and could facilitate the creation of a stable posterior canal wall. Furthermore it seems the good blood supply was linked to the prompt postoperative healing, the avoidance of postoperative infection, and good hearing improvement postoperatively.

Effect of edaravone on acute brainstem-cerebellar infarction with vertigo and sudden hearing loss.

We report 2 cases with acute brainstem and brainstem-cerebellar infarction showed improvement of their signs and symptoms after administration of edaravone. Case 1, a 74-year-old woman who experienced sudden vertigo, also had dysarthria and left hemiplegia. Magnetic resonance imaging (MRI) showed an abnormal region in the right ventrolateral medulla oblongata. The patient's vertigo and hemiplegia improved completely after treatment. Case 2, a 50-year-old man who experienced sudden vertigo and sensorineural hearing loss (SNHL), developed dysarthria after admission. MRI revealed acute infarction in the right cerebellar hemisphere. Magnetic resonance angiography revealed dissection of the basilar artery and occlusion of the right anterior inferior cerebellar artery. The patient's vertigo and hearing remarkably improved. We have described 2 patients whose early symptoms were vertigo and sudden SNHL, but who were later shown to have ischemic lesions of the central nervous system. Edaravone is neuroprotective drug with free radical-scavenging actions. Free radicals in the ear are responsible for ischemic damage. Edaravone, a free radical scavenger, may be useful in the treatment of vertigo and SNHL.

Lomerizine therapy for the treatment of benign paroxysmal vertigo of childhood transitioning into atypical basilar migraine: A case report.

We report a rare case of benign paroxysmal vertigo (BPV) of childhood transitioning into basilar migraine (BM) that was effectively treated with lomerizine. A 6-year-old male visited our hospital complaining of repeated attacks of vertigo for 3 months. The patient's vertigo attacks lasted for several hours and were accompanied by nausea, vomiting, intense fear and loss of consciousness. No nystagmus was observed during the vertigo attacks. Blood tests and imaging examinations revealed no abnormal findings. The results of electronystagmography and the caloric test were unremarkable. Pure-tone audiometry revealed profound right-side sensorineural hearing loss. Among the differential diagnoses, delayed endolymphatic hydrops, epilepsy and BM were considered. Delayed endolymphatic hydrops was considered unlikely since no nystagmus occurred during the vertigo attacks and there was no change in hearing; electroencephalography revealed no epileptic seizure waves. The attacks of vertigo were well-controlled with lomerizine. The patient was diagnosed with BM since the use of lomerizine, an agent for the treatment for migraine, was effective. Since it was reported that BPV is closely related to migraine and the onset of the vertigo attacks was accompanied by a loss of consciousness, we concluded that this patient had BM transitioning from BPV.

Sound lateralization test in adolescent blind individuals.

Blind individuals require to compensate for the lack of visual information by other sensory inputs. In particular, auditory inputs are crucial to such individuals. To investigate whether blind individuals localize sound in space better than sighted individuals, we tested the auditory ability of adolescent blind individuals using a sound lateralization method. The interaural time difference discrimination thresholds of blind individuals were statistically significantly shorter than those of blind individuals with residual vision and controls. These findings suggest that blind individuals have better auditory spatial ability than individuals with visual cues; therefore, some perceptual compensation occurred in the former.