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Department of Otolaryngology

Overview of Department

In addition to Professor Noboru Yamanaka and Associate Professor Muneki Hotomi, the present Department of Otolaryngology consists of two lecturers, three research associates, and seven research associates from within the University, three of whom are graduate students. With the motto “Research and treatment with a global outlook! From Kishu to the world,” we spend our days hard at work on medical care and research.

Research Overview

Our research focuses on tumor immunity, infections, allergies, and tonsillar focal diseases.
The fields of otolaryngology and head and neck cover sites with a high incidence of malignancies such as laryngeal cancer, hypopharyngeal cancer, thyroid cancer, and pituitary cancer, and these cancers often show early metastasis and have a relatively poor prognosis. In addition, the field of otolaryngology covers very common sites of infections such as otitis media, nasosinusitis, and adenoiditis and tonsillitis, and rapid recent growth in drug resistant bacteria has led to an increase in intractable and recurrent infections. Furthermore, recent years have seen a rise in allergic disorders such as the nasal allergies typified by hay fever, which might almost be termed the national disease, and in tonsillar focal diseases attributable to the tonsils. We aim to elucidate the disease pathology of these tumors, infections, and nasal allergies through an immunological and molecular approach, and develop clinical applications.

1. Studies of tumor immunity and metastasis in head and neck cancers and thyroid cancers

  1. Mechanism of epithelial-mesenchymal transition in metastasis and suppression of metastasis by its regulation
  2. Applications of comprehensive screening of cancer genes in assessments of risk of metastasis and tailor made treatments
  3. Elucidation of cancer stem cells and abscesses in early diagnosis and treatment
  4. Examination of metastatic risk factor of chromosome deletion in patients with head and neck cancers
  5. Applications to anti-angiogenic treatment of control of vascular endothelial growth factor (VEGF)
  6. Establishment of head and neck tumor banks and Studies of research application vascular endothelial growth factor (VEGF), and application to anti-angiogenic treatments

2. Virological, bacteriological, and immunological study of upper respiratory tract infections

  1. Examination of risk factors for intractable acute otitis media, acute sinusitis, and acute tonsillitis
  2. Surveillance of culprit microorganisms in upper respiratory tract infections (ATOMS, ARhiS, PhaTONS)
  3. Sado Study of incidence rates for otitis media and changes in nasopharyngeal bacterial flora in children before and after 7-valent pneumococcal conjugate vaccine (SADOMS and SADO study)
  4. Molecular immunity of pneumococcus and Haemophilus influenzae: genotype, capsule type, drug resistance type
  5. Studies of bacterial cellular invasion, phase variation, and biofilm production
  6. Examination of immune response to common proteins in bacterial strains (pneumococcus: PspA, Haemophilus influenzae: P6, Moraxella catarrhalis: UspA)
  7. Studies into development of a mucosal vaccine (transnasal and sublingual immunity) and prevention of bacterial infections by maternally-acquired immunity
  8. Comprehensive screening of the microbiome in the field of otolaryngology

3. Elucidation of lesions in tonsillar focal diseases

  1. Creation of human skin/SCID chimeric mice and animal model experiments for tonsillar focal diseases
  2. Examination of the role of heat shock proteins in the pathology of tonsillar focal diseases
  3. Development of a tonsillitis index for treatment selection in recurrent tonsillitis
  4. Accumulation of clinical outcomes on the effectiveness of tonsillectomy for pustulosis palmoplantaris and IgA nephropathy

4. Immunotherapy with hay fever causing peptides

  1. Structural analysis of hay fever allergans
  2. Site analysis of structure of IgE epitopes
  3. Application to treatment of selective deactivation of IgE epitopes

Collaborative studies with overseas institutions

To internationalize the above research, we are proactively engaged in collaborative studies with oversease universities and research institutions.

  1. Department of Microbiology, Alabama University School of Medicine (Professor David E. Briles, Professor Susan K. Hollingshead, Professor Moon N. Nahm)
    Major subjects include the role of pneumococcus antigens such as PspA, PspC, neuraminidase, pneumolysin, SASA, sortase, and PcpA as pathogenic factors (Professor David E. Briles, Susan K. Hollingshead) and studies of classification of pneumococcus serotypes (Professor Moon N. Nahm)
  2. National Institute of Health (NIH), United States (Dr. Steve Yan)
    Studies into the quinolone resistance mechanism and macrolide resistance mechanism of streptococcus
  3. Dhaka Shishu (Children) Hospital, Bangladesh (Professor Samir Saha)
    Studies of nasopharyngeal bacterial flora and drug resistant bacteria in Bangladeshi children
  4. Department of Pediatrics and Department of Medicine and Microbiology, State University of New York at Buffalo (Professor Howard Faden, Professor Timothy Murphy)
    Establishment of a scoring system for otitis media and research into pathogenicity and intracellular invasion of Haemophilus influenzae
  5. Department of Pediatrics, University of Zurich (Professor David Nadal)
    Research into EB virus infections and tumor immunity
  6. University of Turku, Finland (Professor Reidar Grenman)
    Reasearch into mechanisms for metastasis of head and neck tumours

Medical Care

We offer general otolaryngological and surgical head and neck medical care, but because of the nature of the hospital, most patients admitted are those with malignancies. We aim to improve the QOL of patients with malignancies by reconstructive surgery using microvascular anastomosis. In addition, as a university that aspires to the highest international standards, we are proactive in recommending cochlear implantation, temporal bone and paranasal cavity surgery using a navigation system, and endoscopic laser surgery. Postoperative rehabilitation is important in cochlear implantation, and surgeries have been rising year on year since the arrival of Professor Yamanaka, enabling profoundly deaf patients living in a completely silent world to gradually recover their hearing.

Collaboration between the University and related hospitals has resulted in an opportunity for case discussion via a “video training session” held on the second Monday of each month and a “Kishu Medical Training Class” held on the fourth Monday of each month. On each occasion, the University and related hospitals present interesting cases and a lively discussion of diagnosis and treatment options ensues.

Education

Finally, the staff in the department is engaged in the holistic, curriculum-based postgraduate education of students, interns, and physicians. This education is characterized by invitations to various part time teachers from outside the University with exceptional clinical or research backgrounds to participate in the postgraduate education of students, clinical interns, and physicians based on their abundant experience. Furthermore, we also provide education aimed at fostering a new image of the physician in future and we are ahead of other departments in terms of devoting part of clinical practice to nursing practice.