Acute sensorineural hearing loss represents a spectrum of conditions characterized by sudden onset hearing loss. The "Clinical Practice Guidelines for the Diagnosis and Management of Acute Sensorineural Hearing Loss" were issued as the first clinical practice guidelines in Japan outlining the standard diagnosis and treatment. The purpose of this article is to strengthen the guidelines by adding the scientific evidence including a systematic review of the latest publications, and to widely introduce the current treatment options based on the scientific evidence. The clinical practice guidelines were completed by 1) retrospective data analysis (using nationwide survey data), 2) systematic literature review, and 3) selected clinical questions (CQs). Additional systematic review of each disease was performed to strengthen the scientific evidence of the diagnosis and treatment in the guidelines. Based on the nationwide survey results and the systematic literature review summary, the standard diagnosis flowchart and treatment options, including the CQs and recommendations, were determined. The guidelines present a summary of the standard approaches for the diagnosis and treatment of acute sensorineural hearing loss. We hope that these guidelines will be used in medical practice and that they will initiate further research.

Patients with unilateral hearing loss have difficulties perceiving speech in a noisy environment. Unilateral severe to profound hearing loss is most commonly caused by idiopathic sudden sensorineur... 背景：单侧听力损失患者在嘈杂的环境中难以感知言语。重度至极度单侧听力损失最常见的原因是特发性突发性感觉神经性听力损失(SSNHL)。目的：评估特发性单侧SSNHL患者在噪声中的言语感知, 并检查影响结果的因素。材料和方法： 回顾性纳入了93 名特发性单侧SSNHL患者。语音信号以恒定声压等级 呈现, 而噪声信号以 5dB (S0/Nhe) 为单位, 在 +5dB 到 -5dB 信噪比(SNR...

The present study aimed to clarify the incidence and clinical outcomes of nasopharyngeal carcinoma (NPC) in the Chubu region of Japan from 2006 to 2015, compared with previous reports. A retrospective analysis was conducted based on medical records from 40 hospitals located in the Chubu region in the central Japanese main island, with a population of around 22.66 million individuals. This study was designed in line with to two previous clinical studies into NPC conducted in the same area of Japan. We recruited NPC patients diagnosed in hospitals across this area over a 10-year period (2006–2015) using a questionnaire about sex, age, primary site, clinical symptoms, pathology, Union for International Cancer Control (UICC) staging, serological exam, treatment, and survival. A total of 620 NPC patients were identified. The age-standardized incidence of NPC from 2006 to 2015 was 0.27 per 100,000 individuals per year. There were no significant differences between this study and the previous two studies conducted in the same area of Japan. The five-year overall survival rate for all patients was 75.9%, while those for patients with stages I, II, III, and IVA were 97%, 91%, 79%, and 68%, respectively. The age-standardized annual incidence of NPC in the present study was 0.27 per 100,000 individuals per year, which was relatively low and stable. The five-year overall survival rate for all NPC patients was significantly improved in this decade compared with previous studies. The smoking rates in male and female NPC patients were 64.5% and 18.8%, respectively, thereby suggesting the involvement of smoking in the incidence of NPC.

Although anti-programmed death-1 (PD-1) antibody therapy improves the prognosis in patients with head and neck squamous cell carcinoma (HNSCC), some patients exhibit disease progression even after showing a good response to the treatment initially because of acquired resistance. Here, we aimed to reveal the dynamic changes in the tumor and tumor microenvironment (TME) in a 77-year-old man diagnosed with oral squamous cell carcinoma who developed acquired resistance after the administration of nivolumab using spatial transcriptomics. The results showed that, before immunotherapy, the activated pathways in the tumor area were mainly related to the cancer immune system, including antigen processing cross-presentation, interferon–gamma signaling, and the innate immune system. After immunotherapy, the activated pathways were mainly related to epigenetic modification, including RMTs methylate histone arginine and HDAC deacetylates histones. Before immunotherapy, the activated pathways in the TME were mainly related to the metabolism of proteins, including SRP-dependent co-translational protein targeting the membrane. After immunotherapy, the activated pathways in the TME were related to sensory perception and signal transduction. Our study revealed that epigenetic-modification-related pathways were mainly activated after establishing acquired resistance, suggesting that epigenetic modification in the tumor may prevent cancer immune system activation via the anti-PD-1 antibody.

Patients with unilateral hearing loss have difficulty localizing sound. Severe-to-profound unilateral hearing loss is most commonly caused by idiopathic sudden sensorineural hearing loss (SSNHL). To assess the sound localization ability of patients with idiopathic unilateral SSNHL and examine the factors affecting the results. We retrospectively enrolled 141 patients with idiopathic unilateral SSNHL. The assessment stimuli were speech-shaped noise from one of the nine loudspeakers in a 180° arc. Multiple regression analysis was used to examine the factors that affected sound localization ability. There was a strong correlation between the hearing level on the affected side post-treatment and the deviation score as the index of sound localization ability. The results of the multiple regression analysis suggested that sound localization may be partially affected by hearing level on the unaffected side and age. The results showed that sound localization ability decreased in idiopathic SSNHL patients with severe-to-profound hearing loss post-treatment. This study provides important data for future interventions for unilateral hearing loss, including cochlear implants.

Thyroglossal duct cysts (TGDC) are the most common type of congenital neck masses, which generally present in young adults. We present a rare case of a giant TGDC in a 77-year-old patient who required atypical perioperative management. The patient presented with a large soft mass on his anterior neck. Computed tomography showed a lobulated cystic mass measuring 18 × 16 cm, extending from the tongue base to the inferior level of the clavicle. Because difficult intubation was expected, the cyst was punctured and most of the fluid was drained prior to surgery. The swelling of the tongue base was remarkably reduced, and intubation was performed safely. The cyst was extracted using the Sistrunk procedure and tracheotomy was performed. Histopathological examination confirmed the diagnosis of TGDC. Preoperative volume reduction of the cyst and tracheotomy should be considered for oral intubation and postoperative airway management, respectively, in patients with large TGDC.