In our department, we treat basic diseases of the ear, nose, and throat, and as the last bastion of medical care for Kobe City, we receive referrals from many medical institutions. We also provide highly specialized care. In addition, our emergency and lifesaving center operates 24 hours a day, 365 days a year without rest, and we are fully prepared for follow-up after sudden illness and surgery. In other words, we can say that our department is a top class Otorhinolaryngology clinic in Japan, where the medical system for all diseases of Otorhinolaryngology is always ready. General tonsillectomy and endoscopic nasal surgery for sinusitis, as well as chronic otitis media and cholesteatoma otitis media are performed by doctor certified by academic societies as ear Otological Surgery Supervisor with advanced skills. I will get treatment. In particular, cochlear implant surgery for people with severe hearing loss was introduced early on. Looking at the NDB open data of the Ministry of Health, Labor and ministry of Health, Labor and Welfare notation in 2020, of the 1410 cases of cochlear implant surgery performed in Japan, 68 cases, about 5%, Especially in pediatric cases, 39 cases, or 12% of the 314 cases nationwide, are performed at our hospital. This is because the favorable surgical results are endorsed by patients and their families, and the treatment of pediatric deafness has been highly evaluated by Otorhinolaryngology in each region, with patient referrals from all over the country. This is probably a factor. The Comprehensive Ear and Hearing Center will be established in 2021, aiming to overcome hearing loss from both clinical and research perspectives.
Speech specialists and speech-language pathologists are in charge of treatment every Friday as a team for voice disorders that control "speech". In recent years, it has also been highly evaluated by patients who use speech as a profession, such as opera singers and members of opera companies.
In addition, regarding dizziness, which has many patients, for cases where the cause is difficult to understand or for intractable cases, we invite a society-Certified Physician from outside and request specialized medical treatment every other Monday.
For neoplastic lesions in the Otorhinolaryngology field, such as parotid and other salivary gland tumors, tongue and other oral cancers, pharyngeal, laryngeal, nasal sinus, and skull base tumors, we offer their treatment at Head and Neck Surgery. Please refer to Head and Neck Surgery for more information on this field.
Click here for Head and Neck Surgery websiteWe are able to maintain a safe and high level of care because of our abundant clinical experience, multidisciplinary team medical system, and constant efforts in education and training, including regular weekly department conferences and educational series of lectures. We always discuss all surgical cases well in advance to find the best treatment for each patient. For educational lectures, doctor affiliated with our department, we research and lecture at conferences on specific areas within Otorhinolaryngology to improve the level of our practice. In addition, the Department regularly presents the results of its extensive clinical experience and clinical research at national and international conferences, and many papers describing the results have been published in national and international medical journals (see the Announcements section for academic reports from the Department and Head and Neck Surgery).
Our department's policy is to provide safe and optimal treatment for our patients, based on our extensive experience and generous medical care system.
Medical record
2017-2020 number of surgeries
| Surgery name | 2017 | 2018 | 2019 | 2020 | |
|---|---|---|---|---|---|
| ear surgery | 254 | 302 | 320 | 235 | |
| Tympanoplasty | 111 | 105 | 101 | 79 | |
| Tympanic tube insertion | 29 | 51 | 62 | 32 | |
| cochlear implant surgery | 52 | 70 | 58 | 68 | |
| stapes surgery | 6 | 5 | 8 | 5 | |
| facial nerve decompression | 4 | 1 | 7 | 1 | |
| congenital otostomy | 2 | 4 | 4 | 6 | |
| Ear Canoplasty | 0 | 3 | 3 | 1 | |
| myringoplasty | 2 | 4 | 3 | 1 | |
| mastoidectomy | 21 | 19 | 27 | 17 | |
| Exploratory tympanotomy | 3 | 6 | 5 | 1 | |
| middle ear surgery | 4 | 0 | 3 | 2 | |
| Endolymphatic sac release | 2 | 1 | 0 | 0 | |
| Acoustic neuromasectomy | 0 | 0 | 0 | 0 | |
| Other ear surgery | 18 | 33 | 39 | 22 | |
| nose surgery | 95 | 99 | 136 | 94 | |
| Endoscopic nose and sinus surgery | 66 | 72 | 104 | 49 | |
| nasal septum correction | 12 | 10 | 16 | 18 | |
| Nasal turbinate resection | 10 | 12 | 12 | 24 | |
| Optic canal release | 0 | 0 | 0 | 0 | |
| Lacrimal sac/nasolacrimal duct surgery | 0 | 0 | 0 | 0 | |
| Orbital blowout fracture surgery | 0 | 0 | 0 | 0 | |
| Jaw/Facial Fracture Reduction | 0 | 0 | 0 | 0 | |
| Other nasal surgery | 7 | 5 | 4 | 3 | |
| Oropharyngeal and laryngeal surgery | 283 | 316 | 313 | 212 | |
| Tonsillectomy (including palatine tonsils and adenoids) | 151 | 192 | 179 | 122 | |
| tonsillectomy | 136 | 167 | 155 | 107 | |
| adenoidectomy | 15 | 25 | 24 | 15 | |
| Tongue, oral cavity, pharyngeal tumorectomy | 88 | 86 | 98 | 74 | |
| Uvulopalatoplasty | 1 | 3 | 1 | 1 | |
| Tongue/oral benign tumor removal | 5 | 5 | 15 | 11 | |
| Tongue/oral malignant tumor removal | 49 | 42 | 37 | 26 | |
| Pharyngeal benign tumorectomy | 4 | 5 | 9 | 8 | |
| Pharyngeal malignant tumor resection | 29 | 31 | 36 | 28 | |
| Oropharyngeal malignant tumor resection | 16 | 13 | 14 | 12 | |
| Hypopharyngeal malignant tumor resection | 13 | 18 | 22 | 16 | |
| Other oropharyngeal surgery | 44 | 38 | 36 | 16 | |
| laryngeal microsurgery | 57 | 44 | 64 | 36 | |
| Swallowing function improvement, aspiration prevention, voice function improvement surgery | 7 | 11 | 10 | 10 | |
| laryngoplasty | 6 | 9 | 8 | 4 | |
| laryngectomy | 1 | 1 | 0 | 0 | |
| Other Swallowing/Voice Function Improvement Surgery | 0 | 1 | 2 | 6 | |
| head and neck surgery | 354 | 296 | 331 | 256 | |
| neck dissection | 74 | 71 | 67 | 46 | |
| Solitary neck dissection | 25 | 19 | 15 | 12 | |
| head and neck lumpectomy | 254 | 198 | 224 | 183 | |
| Submandibular benign tumor resection | 10 | 9 | 18 | 8 | |
| Submandibular malignant tumor resection | 1 | 3 | 2 | 1 | |
| Parotid gland benign tumor resection | 32 | 30 | 37 | 24 | |
| Parotid malignant tumor resection | 2 | 1 | 4 | 3 | |
| benign thyroid tumorectomy | 27 | 18 | 21 | 17 | |
| Basedow's disease surgery | 1 | 1 | 4 | 1 | |
| malignant thyroid tumorectomy | 33 | 25 | 34 | 25 | |
| Nasal/sinus benign tumor removal | 15 | 3 | 6 | 7 | |
| Nasal/sinus malignant tumor resection | 3 | 3 | 0 | 2 | |
| Laryngeal malignant tumorectomy | 13 | 10 | 10 | 2 | |
| lymph node biopsy | 89 | 78 | 66 | 71 | |
| Cervical cystectomy | 19 | 14 | 8 | 3 | |
| Submandibular Glandectomy | 0 | 0 | 0 | 1 | |
| Other head and neck lumpectomy | 9 | 3 | 14 | 18 | |
| Other head and neck surgery | 26 | 27 | 40 | 27 | |
| Esophageal foreign body extraction | 0 | 0 | 0 | 2 | |
| Tracheal foreign body extraction | 0 | 0 | 0 | 0 | |
| Foreign body extraction (outer ear, nasal cavity, pharynx) | 48 | 43 | 61 | 19 | |
| Tracheostomy | 93 | 68 | 63 | 69 | |
| total | 1191 | 1179 | 1175 | 882 | |
Departmental statistics
Main diseases/treatments
Pediatric cochlear implant rehabilitation
Based on the guidelines of the Japanese Otorhinolaryngology Society, we actively perform cochlear implant surgery and cochlear implant surgery using residual hearing. In particular, when it is deemed necessary from a therapeutic point of view, bilateral cochlear implant surgery is performed on the same day with good results.
Our department is one of the leading cochlear implant centers in Japan, with a generous medical care system consisting of experienced specialists and speech pathologists who specialize in cochlear implants.
The photo on the left is a 3D CT image of the right cochlear implant of a 1-year-old child (top), and a brain function image of an adult listening to words with the right cochlear implant (bottom: Tateya I, Naito Y, Hirano S, et al. Neuroreport, 2003).
Adult cochlear implant rehabilitation
The hearing of a cochlear implant is originally a mechanically synthesized sound because it directly stimulates nerves. It will be a new sound that is different from the sound you have memorized so far, the sound of the hearing aid. Adults, however, have verbal memories in their brains. When listening to words with a cochlear implant, many brain functions, such as motivation, attention, and guessing ability, are used to help you think and listen with your head. By listening to a lot of words while concentrating and guessing, you will be able to understand the words over time.
Rehabilitation after adult cochlear implant surgery involves adjustment of cochlear implant equipment and hearing practice called mapping. Equipment adjustment refers to adjusting the hearing of the cochlear implant to suit each individual with a speech-language pathologist using a dedicated computer. Hearing practice involves consciously listening to the sounds around you, listening to and understanding words, having a conversation, and listening to television and telephone with cochlear implants, at a hospital or at home at your own pace. I will continue.
For sinus mycosis, we use a hydrodebridder (high-pressure washer) for efficient treatment, and for trauma cases, we also perform rhinoplasty and nasal septum correction jointly with Plastic Surgery. Enlarged sinus surgery (bilateral frontal sinus monosinus surgery, cranial base surgery), which requires more advanced techniques, is also performed in collaboration with other departments.
The nasal sinuses and base of the skull are anatomically complex regions surrounded by important structures such as the brain, orbit, and internal carotid artery, but various types of tumors, including benign and malignant, occur in these regions. increase. The main treatment is surgical therapy, but surgery for malignant tumors and benign tumors occurring in the deep part of the face has traditionally been performed by an invasive approach using craniotomy or facial incision. However, in recent years, due to the development of equipment and technology, a minimally invasive endoscopic transnasal approach has been attempted even for malignant tumors.
At our hospital, we perform transnasal endoscopic nasal sinus malignant tumor surgery and endoscopic surgery for anterior skull base malignant tumors such as early nasal sinus cancer and olfactory neuroblastoma in the head and Head and Neck Surgery We perform anterior nasal skull base surgery (Fig.), a minimally invasive surgery that does not involve craniotomy or facial incision. In addition, for tumors that occur in the deep part of the face such as the pterygopalatine fossa and the infratemporal fossa, endoscopic transnasal surgery alone or in combination with a small facial incision does not create scars on the face or head. Or we perform surgery with minimal trauma.
In Head and Neck Surgery, doctor who are qualified as both Head and Neck Cancer Supervisor and rhinosurgery instructors play a central role in providing minimally invasive and reliable treatment using an endoscopic transnasal approach. I am working on endoscopic transnasal surgery aiming at resection.
On the other hand, for advanced nasal sinus cancer and advanced skull base malignant tumors, the combination of conventional external incision approach and endoscopic transnasal surgery reduces resection margins that tend to result in positive surgical margins. We are trying to improve the surgical results by ensuring that the When it invades the brain, we perform surgery jointly with Neurosurgery.
Overview of diseases, examinations, and treatment methods
Approximately 20% of patients who are suspected of having an otolaryngology-related disease later visit an otolaryngologist, and about 14% of them are neurologists. Benign paroxysmal positional vertigo (BPPV) with a cause is the most common. In our dizziness outpatient clinic, we are able to record and analyze eye movement in detail during head position/head position change nystagmus examination, which is important for definitive diagnosis because specific findings are seen in many diseases. In addition to the treatment of general dizziness diseases such as benign paroxysmal positional vertigo and Meniere's disease, we also provide specialized examinations and treatments for diseases requiring surgical operations such as perilymphatic fistula and semicircular canal cleft syndrome. We will also recommend diseases that require treatment in cooperation with the middle ear surgery team. Furthermore, in parallel with hearing rehabilitation in pediatric cochlear implant cases, we will carefully monitor the development of body balance ability by measuring the vestibulo-ocular reflex against manual rotation, which can be measured even in children.
clinical research
Notice regarding implementation of clinical research for patients undergoing Otorhinolaryngology examination
Currently, the Department of Otorhinolaryngology is conducting the following clinical research.
In this research, we will use the data (information) obtained from the patient's daily clinical practice.
If you object to the use of your data for this research, you can stop using the information or providing it to other research institutions at any time. If you would like to know more about the research plan or content, if you have any objections to the use of your data in this research, or if you have any other questions, please contact us at the contact information below. .
| Graduate school title | Person in charge of our hospital | Explanatory text |
| Examination of the epidemiology, course, treatment results, and prognosis of rare laryngeal diseases | Shogo Shinohara | |
|---|---|---|
| Investigation of the influence of congenital hearing loss and elderly surgery on cochlear implant stimulation conditions | Norio Yamamoto | |
| Verification of usefulness of tympanic membrane perforation closure surgery using trafermin | Norio Yamamoto | |
| A social survey of children aged 0-6 who underwent a detailed examination or a secondary hearing test due to suspected hearing loss | Norio Yamamoto | |
| Research that contributes to the development of comprehensive hearing-related brain function tests for cochlear implant recipients | Norio Yamamoto | |
| Examination of the relationship between intraoperative EABR test and postoperative cochlear implant stimulation intensity in cases of inner ear/inner ear canal malformation | Yasushi Naito | |
| Research contributing to the development of speech rehabilitation for cochlear implant users | Norio Yamamoto | |
| A study of elderly people who wear cochlear implants for a long period of time | Mami Yasumoto | |
| A study of pediatric cochlear implant cases who underwent eardrum ventilation tube insertion before cochlear implant surgery | Hiroshi Yamazaki | |
| National epidemiological survey of vestibular neuritis | Hamaguchi Kiyomi | |
| Clinical course of vocal cord paralysis due to malignant tumor judged to be difficult to resect | Youta Tobe | |
| Handling of tympanic membrane ventilation tubes after cochlear implant surgery in children | Youta Tobe | |
| A case study of pharyngeal/cervical esophageal perforation triggered by trauma and foreign body aspiration | Tetsuhiko Michida | |
| Fact-finding survey of unilateral sensorineural hearing loss | Yasushi Naito | |
| Quantitative evaluation of cochlear implant wearing conditions and acoustic environment in children using log data | Yasushi Naito | |
| Study on improvement of quality of life by otologic treatment | Yasushi Naito | |
| Effects of voice therapy on essential voice tremor | Keiko Maekawa | |
| Research on factors affecting auditory behavioral development and language development in hearing-impaired children | Yasushi Naito | |
| Investigative research on intractable hearing impairment | Norio Yamamoto | |
| Research on improving the level of evidence for swallowing rehabilitation | Shinji Takebayashi | |
| Investigation of medical treatment contents at the first medical examination for dizziness and creation of a checklist at the first medical examination for dizziness | Hamaguchi Kiyomi | |
| Results of cochlear implant treatment for CHARGE syndrome | Yasushi Naito | |
| Clinical course of vocal cord paralysis due to malignant tumor judged to be difficult to resect | Yota Tobe |
news
Introduction of our department for doctor and those who aspire to become doctor
*This content is intended for doctor and is intended to deepen the understanding of this medical institution, and is not intended for publicity or advertising for the general public.
Nice to meet you, I am Yasushi Naito Naito from the Otorhinolaryngology Kobe City Medical Center General Hospital.
In April of this year, we established the "Comprehensive Ear and Hearing Center", which is the first in Japan to provide state-of-the-art medical care specializing in the ears. At our center, for infants and the elderly with severe hearing loss, we offer not only general treatment methods, but also the latest clinical research, and provide treatment that is close to each patient. I'm here.
This time, we would like to introduce the efforts of our center based on the current situation regarding pediatric hearing loss.
Yasushi Naito
Comprehensive Ear and Hearing Center Director
Otorhinolaryngology Counsilor
Current Status of Pediatric Hearing Loss
Hearing loss in children needs to be tackled in a multi-faceted manner, including not only ear treatment, but also brain and speech development, education, welfare, and employment support. For example, for severe congenital hearing loss, cochlear implants have become established as standard medical care, and equipment continues to advance. Rehabilitation for preschool children, subsequent school education, and support during school remain in the old framework, and have not caught up with the recent progress in hearing loss medical care, which has made it possible to acquire a much higher degree of hearing than before.
Hearing-impaired children go to kindergarten facilities or ordinary kindergartens for infants, ordinary schools for elementary schools, elementary schools with "hearing and language classes" and hearing-impaired classes, or hearing special support schools, and then go on to junior high school or high school. At each stage, there are a variety of options, and the teachers, speech pathologists, and other specialists in charge change one after another.
In addition, there is a lack of scientific evidence to guide decisions on whether to use only verbal communication for hearing-impaired children or to use visual methods such as sign language. is frequently seen.
Furthermore, as children with hearing loss grow older, there is no place for mutual connections between hearing-impaired children, and there are many cases in which hearing-impaired children become isolated.
Therefore, in the treatment of pediatric hearing loss, we believe that it is important not only to provide treatment, but also to provide an environment where patients and their families can approach treatment with peace of mind.
Purpose of opening the Comprehensive Ear and Hearing Center
In light of the current situation of pediatric hearing loss, our hospital has established a new "Comprehensive Ear and Hearing Center" in the Department of Otorhinolaryngology.
This center conducts research on brain functions that form the basis of language development and develops rehabilitation programs so that each child can select the optimal mode of communication. We also want to provide a place for hearing-impaired children and their families to connect and support each other.
On the other hand, Japan has become a super-aging society, and age-related hearing loss has become an unavoidable problem for almost everyone.
Hearing loss in the elderly is considered to be the greatest preventable risk of dementia. No scientific evidence has yet been provided.
The Comprehensive Ear and Hearing Center provides proactive interventions such as hearing aids, counseling, and cochlear implant surgery for hearing loss in the elderly. We aim to provide a rationale for
Treatment options tailored to each individual patient
Some of our efforts go beyond the framework of medical insurance.
When a patient is introduced to our center, we first perform hearing, language development, cognitive function tests, detailed diagnostic imaging, etc. within the scope of general insurance medical treatment, and explain the results. After that, we will confirm whether you will be the subject of some clinical research on hearing loss conducted by our department and whether you will consent to such research, and if the conditions are met, we will ask you to cooperate and participate in the clinical research. will be
Please understand in advance that there are many patients who are not subject to clinical research and are examined in detail as part of regular insurance medical treatment. In addition, the findings obtained from clinical research include matters that have not yet been confirmed by large-scale clinical trials or follow-up tests at many facilities, so we will only explain our findings as a reference at this time.
message to teachers
Through such research, our center aims to create new examinations and treatments for the future and contribute to the advancement of medicine.
At present, our center mainly treats infants and the elderly with severe hearing loss (those who cannot hear sounds, or those who can hear sounds but cannot understand them). In fact, there are many cases where we do not know if patients will continue to see us at our center unless they undergo a detailed examination at our department. We would appreciate it if you could widely introduce us to the Otorhinolaryngology" Comprehensive Ear and Hearing Center Outpatient: Naito" through the Regional Medical Cooperation Center.
We will start various initiatives so that people will say, "Kobe City where people with Comprehensive Ear and Hearing Center loss can live with peace of mind and vitality, from children to the elderly." Thank you for your patient referral.
How to refer to our hospital
In order to shorten the waiting time for patients who are referred by doctors at local medical institutions, we ask that patients make reservations by fax for examinations and tests. When making an introduction, please make an introduction reservation according to the flow chart below.
In addition, in the case of referrals from affiliated registered medical facilities, it is also possible to use the Internet referral reservation system.
Our department was introduced in a video produced Japanese Society of Otorhinolaryngology-Head andNeck Surgery.
Other news
Hearing test subsidy for newborns begins
Announcement of the hearing test subsidy
Hearing loss in newborns is difficult to detect at home and can delay language development if left untreated.
Therefore, Kobe City will start an initiative to subsidize the cost of hearing tests for newborns from October 1st.
It is important to detect hearing loss early and receive appropriate treatment.
Overview
| subject | Child whose parents live in the city and were born after October 1, 2019 |
|---|---|
| How to receive the subsidy ticket | Those who submitted a pregnancy notification after September will receive it together with the Maternal and Child Health Handbook. If you already have a maternal and child health handbook, you can pick it up at the city medical institution where you plan to give birth. If you plan to give birth outside the city, please check the website. |
message to everyone
The period from newborn to infancy is an important period for learning language. Hearing a variety of languages is important not only for the development of language, but also for the development of communication skills. I want all the babies who are born to receive the benefits of this system fairly.
Vice President Otorhinolaryngology Director
Yasushi Naito
Detailed information on the Newborn Hearing Test Subsidy Project
Kobe City HP "Neonatal Hearing Test Expense Subsidy Project"Contact information
神戸市総合コールセンター
TEL：078-333-3330
Comprehensive Ear and Hearing Center
Click here for Comprehensive Ear and Hearing Center websiteto everyone
It is important to detect hearing loss and hearing impairment in children early and provide appropriate support.
This time, with the aim of strengthening cooperation among medical care, health care, welfare, and education, and providing appropriate information and continuous support to hearing-impaired children and their families, we have launched a "hearing Support core function model project for children with disabilities” will start in January 2022.
The implementation body is "Kobe City", and the "Comprehensive Ear and Hearing Center" will perform the following operations as a business contractor.
1. Business overview
- The core function of supporting hearing-impaired children will be established in the "Comprehensive Ear and Hearing Center" of the Kobe City Medical Center General Hospital, and a specialized coordinator will be assigned.
- With the "Comprehensive Ear and Hearing Center" playing a central role, the following projects will be carried out in cooperation with medical, health, welfare, and educational institutions.
2. Business content
- Establish a council for supporting deaf children.
- We will strengthen cooperation among organizations involved in supporting hearing-impaired children.
- We will provide appropriate information including testing, hearing aids, cochlear implants, sign language, etc., in response to consultations from families regarding hearing impairment.
- We will support visiting nursery schools, kindergartens, etc. where hearing-impaired children attend.
- Targeting at supporters of hearing-impaired children, we will carry out training related to support.
3. Contact information
神戸市立医療センター中央市民病院 耳鼻咽喉科 総合聴覚センター
078-302-4516（直通）
Yasushi Naito, Advisor, Otorhinolaryngology Comprehensive Ear and Hearing Center
Hearing loss in children needs to be tackled in a multi-faceted manner, including not only ear treatment, but also brain and language development, education, welfare, and employment support. For example, for severe congenital hearing loss, cochlear implants have become established as standard medical care, and equipment continues to advance (Fig. 2). However, it has not kept pace with recent advances in hearing loss treatments that have made it possible to acquire much better hearing than was previously possible. Hearing-impaired children have multiple options at each stage, such as going to a kindergarten for children with hearing loss or a regular kindergarten for infancy, a regular school for elementary school, an elementary school with a hearing-impaired class or a hearing-special-needs school, and then going on to junior high school or high school. , Professionals such as speech pathologists and teachers in charge change one after another, so each time, families spend a lot of effort choosing facilities and explaining when to go on to higher education. In addition, there is little scientific evidence (Fig. 3) that serves as a guideline for the selection of whether children with hearing loss communicate only with verbal language or with visual methods such as sign language. Bewildering examples are frequent. Furthermore, as children with hearing loss grow older, there is no place for mutual connections between hearing-impaired children, and there are many cases in which hearing-impaired children become isolated.
At the newly opened "Comprehensive Ear and Hearing Center" (Fig. 4, Fig. 5) on the 1st floor of the South Building, research into brain function, which is the foundation of language development, and development of rehabilitation programs are being conducted so that each child can select the optimal mode of communication. At the same time, we would like to provide a place for hearing-impaired children and their families to connect and support each other.
On the other hand, Japan has become a super-aging society, and age-related hearing loss has become an unavoidable problem for almost everyone. Hearing loss in the elderly is considered to be the greatest preventable risk of dementia. No scientific evidence has yet been provided. The Comprehensive Ear and Hearing Center conducts proactive interventions such as appropriate hearing aids, counseling, and cochlear implant surgery for hearing loss in the elderly. We aim to provide a rationale for
I will do my best to make people say, "Kobe City where people with Comprehensive Ear and Hearing Center loss can live with peace of mind and vitality, from children to the elderly." increase.
