| Project/Area Number |
17K11312
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Otorhinolaryngology
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| Research Institution | Asahikawa Medical College |
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Principal Investigator |
Kishibe Kan 旭川医科大学, 医学部, 講師 (80447101)
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| Project Period (FY) |
2017-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2019: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2017: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
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| Keywords | ANCA関連血管炎性中耳炎 / ANCA関連血管炎 / 難治性中耳炎 / 多発血管炎性肉芽腫症 / 耳鼻咽喉科 |
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| Outline of Final Research Achievements |
Diagnostic criteria for otitis media with ANCA-associated vasculitis (OMAAV) were proposed in 2013 and new diagnostic criteria were proposed in 2015. We investigated how the practice of OMAAV has changed during this period and compared it to the 2013 survey. In the 2019 survey, facial nerve palsy decreased in percentage of lesions, temporal bone shadows decreased in imaging studies, hearing loss, tinnitus, ear discharge, and ear pain decreased in ear symptoms at initial visit; and hearing loss at first visit increased below 40 dB. All of these changes in diagnostic criteria were thought to have led to the diagnosis of earlier, milder cases. In addition, a short disease duration, mild inflammation, use of immunosuppressive drugs, and efforts to prevent relapse seemed necessary to improve the auditory prognosis. Furthermore, it was found that even with mild hearing loss, the combination of immunosuppressive drugs improved hearing prognosis.
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| Academic Significance and Societal Importance of the Research Achievements |
OMAAV診断基準2015は、より早期の軽症例を診断できるようになっていた。このことから、現行の診断基準2015はOMAAVの診断に有用であると考えられた。また、聴力予後をよりよくするためには、短い病悩期間、炎症が軽度、免疫抑制剤の使用、再燃防止に努めることが必要であることが判明した。短い病脳期間と炎症が軽度なことは、より早期の症例が診断可能となった診断基準2015により診断することで可能となる。また、OMAAVでは軽症例であっても免疫抑制剤を併用することで、より聴力予後が改善できる。このことから、OMAAVの治療には免疫抑制剤の併用がより推奨されることが判明した。
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