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 - Clinical Medicine (Core Departments) - Surgery for Sensory and Motor Systems
Otolaryngology-Head and Neck Surgery
Otolaryngology - Head and Neck Surgery treats all disorders in the head and neck field. Therefore we treat the largest number of diseases in the clinical departments. Among diverse diseases, disorders of sensory organs (auditory, vestibular, olfactory, and gustatory) are characteristic of our specialty. The most important problem to overcome is the deafness due to the cochlear hair cell damages. We are mainly working on this project using the methods of regenerative medicine. At the same time, we are working on the project for the regeneration of several organs such as mastoid mucosa, vocal fold, trachea, and recurrent laryngeal nerve, for functional recovery after the deficit by surgery. Clinical application for the novel inner ear treatment using inner ear drug delivery system and for the regeneration of the ear drum and atrophied vocal folds has been started. Another project is to elucidate the central mechanisms of human auditory system using functional brain imaging (MEG, fMRI, and PET).

  Juichi Ito, M.D., Ph.D.
Professor
Research and Education
■Regeneration of inner ear
Once damaged, inner ear sensory cells never regenerate and their function do not recover. The purpose of our study is to overcome this difficulty and realize functional regeneration of inner ear. The 43rd Erwin von Bälz prize was awarded to this work.
We have been addressing this difficulty using following approaches.
1. Stem cell transplantation
We transplant the multipotent stem cells, such as ES cells, iPS cells, bone marrow stromal cells, adipose stem cells etc., into inner ear. Some of grafted cells survived and differentiated into inner ear cells, and partial functional recovery was observed. Our cell transplantation technique is widely highly respected in the field of inner ear research.
2. Mechanisms of hearing impairment and the development of the new treatment
Several genes that play important roles in the development and function of inner ear has been identified. We investigate the mechanisms of hearing impairment using the knockout mice and model animals to develop the therapeutic application. By manipulating related genes, we successfully induced proliferation of supporting cells that do not usually happen in the inner ear of adult mammals. We also investigate the therapeutic potentials of growth factors and low molecular weight agents for the treatment of hearing.
3. Therapeutic application by inner ear drug delivery system (DDS)
Using the drug delivery system, we locally apply the trophic factors and therapeutic drugs into the inner ear. This method enables application of drugs without systemic side effects. We have developed the inner ear DDS and conducted the clinical trial using the local application of insulin-like growth factor 1 (IGF-1). The next phase clinical trial is in preparation.
■Regeneration of middle ear, trachea, and larynx
We study the way of regeneration of several other organs in the head and neck using the in situ tissue engineering techniques. Transplantation of scaffolds with stem cells enabled the regeneration of larynx, trachea, recurrent laryngeal nerve, and middle ear mucosa.


Otolaryngology-Head and Neck Surgery
Professor Juichi Ito
Senior
 Lecturer


Shigeru Hirano,
Takayuki Nakagawa
Assistant
 Professor


Ichiro Tateya,
Akiko Taura,
Harukazu Hiraumi,
Tatsunori Sakamoto,
Norio Yamamoto,
Morimasa Kitamura,
Shin-ichiro Kitajiri
TEL +81-75-751-3346
FAX +81-75-751-7225
e-mail inqent.kuhp.kyoto-u.ac.jp
URL http://www.kuhp.kyoto-u.ac.jp/~ent/
Neurally induced ES and iPS cells for transplantation into inner ear
Proliferation of supporting cells were successfully induced by gene manipulation
Surface image of Cochlear outer hair cells
Regeneration of an ear drum using bFGF spongel
Regeneration of the vocal fold using acellular extracellular matrix
Members of inner ear regeneration research
Members of regeneration research of middle ear, traceha and larynx
Recent Publications
1. Hirano S, Tateya I, Kishimoto Y, Kanemaru S, Ito J. Clinical trial of regeneration of aged vocal folds with growth factor therapy. Laryngoscope. 2012 ;122:327-331.
2. Hamaguchi K, Yamamoto N, Nakagawa T, Furuyashiki T, Narumiya S, Ito J. Role of PGE-type receptor 4 in auditory function and noise-induced hearing loss in mice. Neuropharmacology. 2012 Mar;62(4):1841-7.
3. Inaoka T, Shintaku H, Nakagawa T, Kawano S, Ogita H, Sakamoto T, Hamanishi S, Wada H, Ito J. Piezoelectric materials mimic the function of the cochlear sensory epithelium. Proc Natl Acad Sci U S A. 2011 Nov 8;108(45):18390-5.
4. Kanemaru S, Umeda H, Kitani Y, Nakamura T, Hirano S, Ito J. Regenerative treatment for tympanic membrane perforation. Otol Neurotol. 2011 ;32(8):1218-1223.
5. Yoshida A, Kitajiri S, Nakagawa T, Hashido K, Inaoka T, Ito J. Adipose tissue-derived stromal cells protect hair cells from aminoglycoside. Laryngoscope. 2011 Jun;121(6):1281-6
6. Yamamoto N, Chang W, Kelley MW. Rbpj regulates development of prosensory cells in the mammalian inner ear. Dev Biol. 2011 May 15;353(2):367-79.