Effect of fixation place on airborne sound in cartilage conduction.

When a transducer is placed on aural cartilage, relatively loud sound becomes audible in a conduction form termed cartilage conduction (CC). Previous studies have revealed the acoustical differences between CC and conventional air or bone conduction. This study elucidates the working principle of CC through measurements of threshold shifts by water injection into the ear canal under various fixation place conditions. Seven volunteers with normal hearing participated. A lightweight transducer was fixed for three CC conductions (on the tragus, antitragus, and intertragal incisure), and two non-CC conditions (on the pre-tragus and mastoid). Thresholds were measured at 500, 1000, and 2000 Hz in the 0%-, 40%-, and 80%-water injection conditions. Results for the three CC conditions revealed unique features different from those for the non-CC conditions. For the CC conditions, the thresholds increased by the 40%-water injection at all frequencies. However, with additional water injection (80%-water injection), the thresholds decreased at 500 and 1000 Hz; in particular, dramatically at 500 Hz. The results suggest that a direct vibration of the aural cartilage is important to obtaining the significant contribution of airborne sound to hearing above 1000 Hz. Fixation place results in no significant difference in acoustic features among CC conditions.

Sound localisation ability using cartilage conduction hearing aids in bilateral aural atresia.

OBJECTIVE: Patients with bilateral aural atresia often exhibit poor sound localisation due to bone conduction (BC) features. However, most patients using cartilage conduction (CC) hearing aids reported improvement of sound localisation. DESIGN: CC hearing aids were fitted binaurally. Subsequently, sound localisation was evaluated in three conditions: unaided, aided with previously used hearing aids (air conduction or BC hearing aids), and aided with CC hearing aids. Ears were evaluated with eight loudspeakers positioned in a full-circle at 45-degree interval. Loudspeakers were classified into left and right by midline and front and back by horizontal line. The abilities to distinguish left from right and front from back were compared among three conditions. STUDY SAMPLE: Thirteen patients with bilateral aural atresia participated. RESULTS: The ability to distinguish sounds originating from left or right for participants aided with CC hearing aids was significantly better than that for other conditions (p < 0.05). For distinguishing sounds originating from front or back, unaided ears were significantly better than ears aided with CC hearing aids (p < 0.05). CONCLUSIONS: CC hearing aids provide the ability to distinguish left from right in patients with bilateral aural atresia.

Development of a Clinical Examination to Evaluate Gravity Perception during Static Head Roll Tilt.

Clinicians frequently encounter patients experiencing a floating sensation of unknown cause, referred to as floating dizziness. We developed a clinical examination to quantify gravity perception as a first step to test our hypothesis that a gravity perception disturbance causes floating dizziness. Our preliminary experiments revealed a linear relationship between head-tilt angle (HTA) and head-tilt perception (HTP) at a head roll tilt of <30°, with correlation coefficients of 0.991 and 0.999 between HTA and HTP in the whole body and head-tilt conditions, respectively. Using these observations, we established a method to evaluate the HTP gain (HTPG), which is the slope of a linear regression line produced by the relation of subjective visual vertical (SVV) with HTA during head tilt, as an index of gravity perception. We named this method head-tilt SVV (HT-SVV). When HTPG was>1, the subjects' HTP overestimated their HTA and vice versa. HT-SVV measurements of 329 healthy subjects gave an average and standard deviation (1.02±0.12) and reference value (0.80～1.25) for HTPG, a difference between left and right HTPG (4.7%±3.7%, <10.0%), and an absolute value for SVV in the upright head position (1.1°±0.8°, <2.5°). The next step is to make the HT-SVV system easier and faster to use as well as to collect more data from patients experiencing dizziness, including floating dizziness, to clarify the clinical significance of HT-SVV.

The effect of prostaglandin E1 on brainstem blood flow disturbance in an animal model of vertebrobasilar insufficiency.

Using an animal model of vertebrobasilar insufficiency (VBI), in which brainstem circulatory disturbance was induced in rats, we examined how prostaglandin E1 (PG-E1) affects brainstem blood flow (BBF) to clarify whether it is effective against VBI. Fifteen healthy male Wister rats that displayed positive responses to Preyer's reflex were used. Their BBF was continuously measured on the left side of the midline of the brainstem using laser Doppler flowmetry. A rat model of VBI, a pathological condition that presents with decreased BBF, was prepared by applying a vertebral artery clamp ipsilateral to the BBF measuring site and inducing hypotension of 60-70 mmHg by blood withdrawal. Saline as a control (n = 5), 5 ng/kg/min (n = 5) or 10 ng/kg/min (n = 5) PG-E1 at a dose was continuously administered to the rats using a motor-driven syringe pump. The effects of the drugs on the rats' BBF were evaluated. BBF, which was decreased by the unilateral vertebral artery clamping combined with blood withdrawal-induced hypotension, recovered in a dose-dependent manner after the administration of 5 or 10 ng/kg/min PG-E1, and complete recovery to the baseline level was achieved by 60 min treatment; however, no such effect was observed for intravenous saline. These results suggest that PG-E1 acts on local vessels and improves blood flow insufficiency in the brainstem in our animal model of VBI. PG-E1 might be useful as a cerebral vasodilator for VBI.

New treatment strategy for cupulolithiasis associated with benign paroxysmal positional vertigo of the lateral canal: the head-tilt hopping exercise.

This study was performed to determine whether a novel treatment was effective against cupulolithiasis associated with benign paroxysmal positional vertigo (BPPV) of the lateral semicircular canal, which is characterized by apogeotropic direction-changing nystagmus. We herein describe our head-tilt hopping (HtH) exercise, which is designed to release otoconial debris strongly adhered to the cupula. The subjects were trained to hop while tilting their heads laterally. They completed 3 to 5 exercise sessions per day over a 4-week period. Each session ended with a 20-hop trial. The HtH exercises were performed by 27 patients with intractable lateral canal BPPV who exhibited positional vertigo and persistent nystagmus beating toward the uppermost ear for more than 4 weeks, despite performing therapeutic head shaking in the horizontal plane maneuver. All the patients were subjected to the supine roll test before and immediately after the first trial as well as after 1 and 4 weeks of the program to evaluate the effect of the treatment on their apogeotropic nystagmus. Nystagmus of 9 (33.3 %) patients disappeared immediately after the first training session. After 1 and 4 weeks of the training, the number of patients that had experienced either of these improvements had increased to 15 (55.6 %) and 19 (70.4 %) subjects, respectively. These results suggest that HtH exercises aimed at releasing otoconial debris from the cupula are feasible as a new therapy for cupulolithiasis associated with intractable lateral canal BPPV. However, further studies for comparison with control are required to confirm these preliminary results.

Cartilage conduction hearing.

Sound information is known to travel to the cochlea via either air or bone conduction. However, a vibration signal, delivered to the aural cartilage via a transducer, can also produce a clearly audible sound. This type of conduction has been termed "cartilage conduction." The aural cartilage forms the outer ear and is distributed around the exterior half of the external auditory canal. In cartilage conduction, the cartilage and transducer play the roles of a diaphragm and voice coil of a loudspeaker, respectively. There is a large gap between the impedances of cartilage and skull bone, such that cartilage vibrations are not easily transmitted through bone. Thus, these methods of conduction are distinct. In this study, force was used to apply a transducer to aural cartilage, and it was found that the sound in the auditory canal was amplified, especially for frequencies below 2 kHz. This effect was most pronounced at an application force of 1 N, which is low enough to ensure comfort in the design of hearing aids. The possibility of using force adjustments to vary amplification may also have applications for cell phone design.

Gravity perception disturbance in patients with unilateral Meniere disease.

Objective: To investigate gravity perception disturbance (GPD) in patients with Meniere disease (MD), we classified GPD type based on the results of the head-tilt perception gain (HTPG) and the head-upright subjective visual vertical (HU-SVV) evaluated by the head-tilt SVV (HT-SVV) test in patients with unilateral MD. Methods: We conducted the HT-SVV test on 115 patients with unilateral MD and 115 healthy controls. Among the 115 patients, the period from the first vertigo episode to the examination (PFVE) was known for 91 patients. Results: The HT-SVV test classified 60.9% and 39.1% of patients with unilateral MD as GPD and non-GPD, respectively. GPD was classified according to HTPG/HU-SVV combinations as follows: Type A GPD (21.7%, normal HTPG/abnormal HU-SVV), Type B GPD (23.5%, abnormal HTPG/normal HU-SVV), and Type C GPD (15.7%, abnormal HTPG/abnormal HU-SVV). As the PFVE became longer, patients with non-GPD and Type A GPD decreased; however, those with Types B and C GPD increased. Conclusion: This study provides novel information on unilateral MD from the perspective of gravity perception by classifying GPD based on the results of the HT-SVV test. This study's findings suggest that overcompensation for vestibular dysfunction in patients with unilateral MD exhibited by large HTPG abnormalities may be strongly associated with persistent postural-perceptual dizziness. Level of Evidence: 3b.

Late-onset and congenital hearing loss detected using AABR due to congenital cytomegalovirus infection that improved with valganciclovir.

Congenital cytomegalovirus (cCMV) infection is the most common congenital viral infection and is the leading non-genetic cause of sensorineural hearing loss and an important cause of neurodevelopmental disabilities. Auto auditory brainstem response (AABR) is a simple hearing test and used for the purpose of neonatal hearing screening, but can use it for early detection hard of hearing within the study age of the model. We experienced two case of asymptomatic CMV infection in which congenital and late-onset hearing loss were diagnosed early with AABR, and hearing loss improved with valganciclovir.

Association between home-based exercise using a pedometer and clinical prognosis after endovascular treatment in patients with peripheral artery disease.

BACKGROUND: Exercise therapy following endovascular treatment (EVT) is important for patients with peripheral artery disease (PAD); however, continuous exercise therapy is difficult to be performed in clinical practice. This study aimed to investigate the association between the implementation of home-based exercise using pedometers after EVT and 1-year clinical outcomes. METHODS: This multicenter observational prospective cohort registry included patients with PAD complaining of intermittent claudication who underwent EVT for aortoiliac and/or femoropopliteal artery lesions between January 2016 and March 2019. Patients were instructed to perform home-based exercises using a specific pedometer after EVT. The study population was divided into good and poor recording groups according to the frequency of the pedometer measurements. The good recording group was defined as those who completed ≥50 % of the prescribed daily pedometer recording during the follow-up period. The poor recording group was defined as those with an inability to use a pedometer and/or who completed <50 % of the prescribed daily pedometer recordings. The primary outcome was 1-year major adverse events (MAE), defined as a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, target vessel revascularization, and major amputation of the target limb. RESULTS: The mean age was 74.4 years; 78 % were male. A total of 623 lesions were analyzed (58.7 % aortoiliac, 41.3 % femoropopliteal). At 1 year, a lower cumulative incidence of MAE was observed in the good recording group compared to that in the poor recording group [10/233 (4.3 %) vs. 35/267 (13.7 %) patients, respectively; p < 0.001]. Multivariate Cox regression analysis showed that patients in the good recording group had a lower hazard ratio for 1-year MAE (0.33; 95 % confidence interval, 0.16-0.68; p = 0.004) than that in the poor recording group. CONCLUSIONS: Good self-recording of pedometer measurements was associated with favorable prognosis in patients with PAD following EVT.

Orthostatic hemodynamics in the vertebral artery and blood pressure in patients with orthostatic dizziness/vertigo.

OBJECTIVES: Orthostatic dizziness/vertigo (ODV) is a common symptom and is believed to occur due to the cerebral hypoperfusion caused by orthostatic hypotension (OH). However, the detailed mechanism underlying ODV onset is poorly understood. The vertebral artery (VA) mainly supplies blood to the central vestibular system; therefore, the orthostatic decrease of VA blood flow could possibly lead to ODV. This study investigated the orthostatic blood pressure and VA hemodynamics in ODV patients to elucidate the hemodynamic mechanism underlying ODV onset. Furthermore, the influence of orthostatic hypotension (OH) on VA hemodynamics was examined because OH is probably the most common cause of ODV. METHODS: This study included 181 patients with ODV and 73 control patients without ODV. All subjects underwent an active standing test to measure the extracranial Doppler (ECD) sonography spectrum of the VA and blood pressure (BP). VA blood flow velocity and BP were simultaneously measured for each patient in the supine static position and then in the upright standing positions following 3 min of standing. We investigated the orthostatic change in the average of flow velocity in bilateral VAs (VAFV) and BP for ODV patients compared with the control patients. RESULT: VAFV in ODV patients was significantly reduced when standing up compared with the control patients. In the ODV patients, there was no difference in orthostatic decrease in VAFV between patients those with OH and without OH. However, the VAFV in the standing position was significantly lower in patients with OH than without OH. In cases with OH, the ODV patients exhibited a greater decrease in VAFV compared with the control patients, but this was not statistically significant. In the absence of OH, a significantly greater orthostatic decrease in VAFV was observed in ODV patients compared with the controls. CONCLUSION: Our findings suggest that the orthostatic decrease of VA blood flow is deeply involved in the hemodynamic mechanism underlying ODV onset and is possibly associated with OH and other etiologies.

[Clinical analysis of metabolic syndrome in vertiginous diseases].

To explore the relationship between metabolic syndrome and vertigo, we measured waist circumference, plasma glucose, triglycerides and blood pressure in 333 subjects aged 20-79 years with vertigo. We found overall metabolic syndrome prevalence defined by Japanese diagnostic criteria to be 13.2%, similar to that in other national surveys by the Japanese Ministry of Health, Labour and Welfare. The 6-fold higher prevalence in men over women exceeded that of other reports, however. The highest frequency was in vertebrobasilar insufficiency (VBI) disorders, suggesting that conditions such as VBI in men with vertigo could involve metabolic syndrome as a risk factor for vertigo incidence.

Posturographic Findings in Patients With Psychological Dizziness.

BACKGROUND: The diagnosis and treatment of patients with psychogenic vertigo (PSY) is difficult because of the lack of reliable objective findings for this condition. We examined the characteristics of foam posturography in patients with peripheral vestibular disorders (PVD) and those with PSY. In particular, we focused on the objective findings of foam posturography in PSY. METHODS: Between January 2010 and December 2011, 2-legged stance tasks were conducted in patients with vertigo/dizziness under 4 conditions: eyes opened with/without foam rubber and eyes closed with/without foam rubber. In terms of the velocity of movement of the center of pressure, we examined Romberg ratios, that is, the ratios of changes in visual conditions under the fixed foam rubber conditions, and foam rubber ratios, that is, the ratios of changes in foam rubber conditions under fixed visual conditions. These ratios were compared among 3 groups: healthy controls (CONT) (n=195), PVD (n=178), and PSY (n=32). RESULTS: Romberg ratios using foam rubber in the PVD group were significantly higher than those in the CONT group. Those in the PSY group were significantly lower. Likewise, the foam rubber ratios in the PVD group were significantly higher than those in the CONT group when the eyes were closed. Those in the PSY group were significantly lower. CONCLUSION: Judging from scores in Romberg ratios using foam rubber and foam rubber ratios when eyes were closed, foam posturography might have the potential to differentiate PSY from PVD.

The Impact of the COVID-19 Pandemic on Follow-Ups for Vertigo/Dizziness Outpatients.

OBJECTIVES: In the present report, we aimed to investigate the impact of the coronavirus disease (COVID-19) pandemic on vertigo/dizziness outpatient cancellations in Japan. METHODS: We examined 265 vertigo/dizziness outpatients at the ear, nose, and throat department of the Nara Medical University between March 01, 2020, and May 31, 2020, during the COVID-19 pandemic in Japan. We also focused on 478 vertigo/dizziness outpatients between March 01, 2019, and May 31, 2019, before the COVID-19 pandemic, to compare the number of cancellations between these 2 periods. The reasons for cancellation and noncancellation were investigated using telephone multiple-choice questionnaires (telMCQs), particularly for patients with benign paroxysmal positional vertigo (BPPV) and Meniere's disease (MD). RESULTS: There were many cancellations for medical examinations during the 2020 study period. The total number of vertigo/dizziness outpatients decreased by 44.6% in the 2020 period compared to the same period in 2019. The percent reduction in clinic attendance from 2019 to 2020 (ie, [2019-2020]/2019) for patients with BPPV was higher than that for patients with MD. Compared to the other vertigo-associated conditions, patients with MD exhibited a lower percent reduction in clinic attendance. According to the results of the telMCQs, 75.0% of BPPV cases and 88.2% of MD cases cancelled their appointment and gave up visiting hospitals due to fear of COVID-19 infection, even if they had moderate to severe symptoms. On the contrary, 25.0% and 80.0% patients with BPPV and MD, respectively, did not cancel their appointment; they should not have visited the hospital but stayed at home because they had slight symptoms. CONCLUSIONS: These findings suggest that advanced forms should be prepared for medical care, such as remote medicine. These forms should not only be for the disease itself but also for the mental distress caused by persistent symptoms.

Effects of Vestibular Rehabilitation on Physical Activity and Subjective Dizziness in Patients With Chronic Peripheral Vestibular Disorders: A Six-Month Randomized Trial.

Introduction: The present study aimed to determine whether supervised vestibular rehabilitation therapy (VRT) by physical therapists (PTs) affects subjective dizziness in patients with chronic vestibular disorders, and whether supervised VRT-induced changes in subjective dizziness are related to the changes in physical activity levels in daily life. Methods: Patients (n = 47) with chronic peripheral vestibular disorders were randomly divided into the VRT group (n = 25) and control group (n = 22). Patients in the VRT group received weekly supervised visits from PTs for a period of 6 months. Every other month, both groups were advised by neuro-otologists to increase the amount of activity in their daily life. All patients wore an accelerometer device, which recorded their physical activity for seven successive days before the end of the intervention. Patients also completed the dizziness and unsteadiness questionnaires before and after the intervention. Results: Subjective dizziness decreased significantly regardless of whether supervised VRT was administered; however, dizziness evoked by social activity and head and body movements improved more significantly in the VRT group than in the control group. In the VRT group, there was a significant negative correlation between the increase in sedentary behavior and improvement in subjective dizziness, and a significant positive correlation between the increase in light physical activity and improvement in subjective dizziness at the second month of intervention. The VRT group showed a significantly higher rate of increase in light physical activity than the control group, after 6 months of intervention. Conclusion: Supervised VRT could be highly effective in treating subjective dizziness in patients with chronic peripheral vestibular disorders. We believe frequent (weekly) and medium-term (6 months) PT-guided interventions may be highly effective in enhancing physical activity in daily life, and may subsequently improve subjective dizziness in these patients. Trial registration: This clinical study was registered with University hospital Medical Information Network (identification number: 000028832). https://www.umin.ac.jp/.

Changes in the Results of the Subjective Visual Vertical Test After Endolymphatic Sac Drainage for Intractable Meniere's Disease.

OBJECTIVE: To investigate otolithic function before and after endolymphatic sac drainage (ELSD) for Meniere's disease (MD) by using the subjective visual vertical test (SVV) in the upright and tilted positions. METHODS: Eighteen patients with definite unilateral MD diagnosed in accordance with the American Academy of Otolaryngology Head and Neck Surgery criteria in 1995 and Barany Society criteria in 2015 were included. SVV in the upright position and the head-tilt position was performed preoperatively and on postoperative days 1, 5, 8, 28, and 112. Changes in the results of SVV in the upright position (UP-SVV) and head-tilt perception gain (HTPG) after surgery were measured. RESULTS: The average UP-SVV values significantly changed from 0.05° by the affected side before surgery to 2.5° by the unaffected side on the fifth postoperative day, followed by recovery to the normal range by the eighth postoperative day. The HTPG values for the unaffected side showed the maximum increase on postoperative day 5 during the present study period, although the values in the affected side did not alter significantly. CONCLUSION: ELSD for MD is a surgical treatment that involves less risk of otolith function damage and abnormalities in gravitational cognition. SVV in the head-tilt position could be one of the neuro-otologic examinations used to easily understand the vestibular compensatory process.

A study of 24 cases of salivary gland carcinoma with distant metastasis.

Salivary gland carcinoma is a relatively rare disease of the head and neck. Although it frequently presents with distant metastases, few reports have been published on this subject. The present study investigated the prognosis of patients with distant metastases from salivary gland cancer. A total of 24 cases of salivary gland carcinoma with distant metastasis who were initially treated at the Department of Otolaryngology-Head and Neck Surgery of Nara Medical University during a 16-year period from August 2004 to July 2020 were included. The histopathological types included salivary duct carcinoma (8 cases), adenoid cystic carcinoma (6 cases), myoepithelial carcinoma (3 cases), Squamous cell carcinoma (2 cases), adenocarcinoma (2 cases), acinic cell carcinoma (2 cases) and mucoepidermoid carcinoma (1 case). A total of 18 patients had stage IV carcinoma, which represented the majority. Of all patients, ~80% developed distant metastases within 2 years of initial diagnosis. Survival rates after the appearance of distant metastases were 43.5% at 5 years and 14.5% at 10 years. The results of the current study revealed that no factors significantly influenced long-term prognosis after the development of distant metastases. In future, it may be necessary to re-examine these results in a larger sample size and standardise treatment methods as a result.

Novel Magnetic Resonance Imaging-Based Method for Accurate Diagnosis of Meniere's Disease.

Background: Pathologically, Meniere's disease symptoms are considered to be associated with endolymphatic hydrops. Examinations revealing endolymphatic hydrops can be useful for accurate Meniere's disease diagnosis. We previously reported a quantitative method for evaluating endolymphatic hydrops, i.e., by measuring the volume of the endolymphatic space using three-dimensional magnetic resonance imaging (MRI) of the inner ear. This study aimed to confirm the usefulness of our methods for diagnosing Meniere's disease. Here, we extracted new explanatory factors for diagnosing Meniere's disease by comparing the volume of the endolymphatic space between healthy volunteers and patients with Meniere's disease. Additionally, we validated our method by comparing its diagnostic accuracy with that of the conventional method. Methods and Findings: This is a prospective diagnostic accuracy study performed at vertigo/dizziness centre of our university hospital, a tertiary hospital. Eighty-six patients with definite unilateral Meniere's disease and 47 healthy volunteers (25 and 33 males, and 22 and 53 females in the control and patient groups, respectively) were enrolled. All participants underwent 3-Tesla MRI 4 h after intravenous injection of gadolinium to reveal the endolymphatic space. The volume of the endolymphatic space was measured and a model for Meniere's disease diagnosis was constructed and compared with models using conventional criteria to confirm the effectiveness of the methods used. The area under the receiver operating characteristic curve of the method proposed in this study was excellent (0.924), and significantly higher than that derived using the conventional criteria (0.877). The four indices, sensitivity, specificity, positive predictive value, and negative predictive value, were given at the threshold; all of these indices achieved higher scores for the 3D model compared to the 2D model. Cross-validation of the models revealed that the improvement was due to the incorporation of the semi-circular canals. Conclusions: Our method showed high diagnostic accuracy for Meniere's disease. Additionally, we revealed the importance of observing the semi-circular canals for Meniere's disease diagnosis. The proposed method can contribute toward providing effective symptomatic relief in Meniere's disease.

Word Categorization of Vowel Durational Changes in Speech-Modulated Bone-Conducted Ultrasound.

Ultrasound can deliver speech information when it is amplitude-modulated with speech and presented via bone conduction. This speech-modulated bone-conducted ultrasound (SM-BCU) can also transmit prosodic information. However, there is insufficient research on the recognition of vowel duration in SM-BCU. The aim of this study was to investigate the categorization of vowel durational changes in SM-BCU using a behavioral test. Eight Japanese-speaking participants with normal hearing participated in a forced-choice behavioral task to discriminate between "hato" (pigeon) and "haato" (heart). Speech signal stimuli were presented in seven duration grades from 220 ms to 340 ms. The threshold at which 50% of responses were "haato" was calculated and compared for air-conducted audible sound (ACAS) and SM-BCU. The boundary width was also evaluated. Although the SM-BCU threshold (mean: 274.6 ms) was significantly longer than the ACAS threshold (mean: 269.6 ms), there were no differences in boundary width. These results suggest that SM-BCU can deliver prosodic information about vowel duration with a similar difference limen to that of ACAS in normal hearing.

Anaplastic thyroid cancer with long-term survival with lenvatinib therapy and preservation of laryngeal function after one-stage reconstruction: A case report.

Laryngotracheal reconstruction is performed to treat locally advanced thyroid carcinoma invading the larynx and/or trachea. The reconstructive technique varies. The present report describes the case of a 71-year-old female patient who underwent surgery for thyroid carcinoma involving the larynx. Reconstructive surgical techniques were employed to maintain laryngeal structure and function. An anterolateral thigh flap with free rib cartilage grafts was used to compensate for laryngeal defects. Although a temporary tracheal stoma was constructed, it closed spontaneously after decannulation. Therefore, one-stage laryngeal reconstruction was accomplished. Post-operative histopathological examination revealed focal anaplastic changes in the lesion, which mainly consisted of papillary components. Post-operative positron emission tomography/computed tomography indicated early recurrence in the left side of the neck. Therefore, lenvatinib was started as adjuvant therapy. Complete response was observed with lenvatinib therapy. The patient was alive and had good laryngeal function 26 months after the operation. One-stage laryngeal reconstruction can reduce burden and improve quality of life in patients with thyroid carcinoma involving the larynx. Lenvatinib may be useful for treating early recurrence of anaplastic thyroid carcinoma after reconstructive surgery with a free flap.