To describe the establishment and initial findings of Japan's first comprehensive nationwide registry covering cochlear implants (CIs), active middle ear implants (AMEIs), and bone conduction implants (BCIs), launched in 2023. The registry aims to improve national data collection, support evidence-based policymaking, and track trends in surgical practice and patient demographics. A web-based electronic data capture (EDC) system was implemented to replace the previous paper-based reporting system. Between January 2023 and December 2024, data were voluntarily submitted by participating facilities across Japan. Collected data included patient demographics, implant types, hearing thresholds, etiologies, and manufacturer information. Registry completeness was assessed by comparison with Japan's National Database of Health Insurance Claims (NDB). A total of 1880 patients were registered, and 1809 patients with surgical information entered from 104 facilities were selected for analysis, comprising 1723 CI cases and 86 AMEI or BCI cases (11 VSB, 22 BB, 53 Baha). Among 605 pediatric CI recipients, early-age implantation was increasingly observed, with 58 patients (10 %) aged under 1 year and 183 (30 %) aged 1 year. Among adult CI recipients, 271 patients were aged 75 years or older, including 40 patients aged 85 years or older. Additionally, simultaneous bilateral CI surgery was performed in 265 patients, of whom 175 were children, reflecting the expanding indications. Patients with better ear thresholds <90 dB HL accounted for 33 % of adults and 29 % of children. Congenital hearing loss predominated in children, while acquired causes were more common in adults. Among cases with a known etiology, hereditary deafness was the most common (24.5 %), although 39.6 % of etiologies were unknown. CI data completeness reached 73 % compared with NDB, indicating strong nationwide participation and a high level of data reliability. This is the first comprehensive report from the national registry in Japan that includes not only CIs but also AMEIs and BCIs. The registry demonstrated reliable data capture and highlighted important trends in patient demographics and surgical practices. Continued data collection will enhance clinical decision-making and support policy development, ultimately improving care for auditory implant recipients.

血管内リンパ腫は腫瘍細胞が血管内腔で増殖し腫瘍塞栓による多臓器不全を来す予後不良な疾患で, 腫瘤形成を伴わないため早期診断は困難である. 症例は77歳女性で主訴は頭痛, CT で篩骨洞陰影を認め急性副鼻腔炎として抗生剤点滴するも軽快せず, 高熱や急速な全身状態悪化を認めた. 内視鏡下篩骨洞開放術を行ったが, 鼻内に腫瘍性病変は認めず, 鼻腔粘膜生検により血管内リンパ腫と診断された. いったんは化学療法に反応したが, 初診より1年9カ月後に死亡した. 原因不明の発熱や進行性の全身状態悪化を認めた場合, 血管内リンパ腫を疑う必要がある. 鼻腔粘膜は血管に富み手術侵襲も少ないため, 本疾患の生検部位として有用であることが示唆された.

In cholesteatoma, the prognosis of tympanoplasty has been well discussed in terms of hearing outcomes and residual or recurrent lesions. Postoperative dizziness and vertigo are major complications of tympanoplasty; however, few reports are available. We investigated each condition of cholesteatoma postoperative vestibular risk using the STAM system and staging published by EAONO/JOS, as well as findings on bony destruction. From April 2010 to March 2021, 156 patients (166 ears) with cholesteatoma who underwent primary microscopic tympanoplasty at our hospital were registered. Subjective vestibular symptoms were recorded the day after surgery. Postoperative vestibular symptoms were observed in 13.9% of subjects. All of them were stage II and had both attic and mastoid lesions. Attic (p < .05) and mastoid (p < .01) lesions were risk factors. Multivariate analysis showed that significant differences were found in past histories of vestibular symptoms (p < .05) and exposure of the dura mater (p < .01). In the exposed dura group, the length of the prominence of the lateral semicircular canal to the middle cranial fossa dura was significantly shorter than that of the non-exposed group (p < .01). Narrow working space and downward operation may increase vestibular risk.