어지럼을 동반한 돌발성감각신경난청 환자에서 125 Hz 순음 역치는 예후적 가치가 있는가?

안용휘,심현준 대한평형의학회 2020 Research in Vestibular Science Vol.19 No.1

Objectives: To analyze 125-Hz pure-tone thresholds in dizzy patients with sudden sensorineural hearing loss (SSNHL) and to investigate the relationship between 125-Hz thresholds and the prognosis of SSNHL with vertigo. Methods: Hearing and vestibular function tests including 125-Hz pure-tone were performed in 132 patients with SSNHL and 65 subjects with normal hearing. Audiometric follow-up was performed at 6 months after initial visit. Intergroup and intragroup comparison of 125 Hz was made between SSNHL and control groups. Results: Twenty-four patients (18.2%) had normal thresholds at 125 Hz in SSNHL group, whereas all subjects showed normal at 125 Hz in control group. None with average hearing threshold at 250 and 500 Hz≥30 dB had normal threshold at 125 Hz. There was no significant relationship between 125-Hz threshold and results of vestibular function test. There was no correlation between 125-Hz threshold and hearing recovery in SSNHL group. Conclusions: There might be no need to assess 125-Hz pure-tone threshold in patients with SSNHL, because it is enough to evaluate thresholds of 250 and 500 Hz for low frequency.

어지럼증을 동반한 돌발성 감각신경성 난청의 예후에 대해 반고리관 마비와 양성돌발두위현훈 중 어느 것이 더 중요한가?

안용휘,심현준 대한평형의학회 2021 Research in Vestibular Science Vol.20 No.3

Objectives: This study was performed to determine characteristics and the prog-nostic values in idiopathic sudden sensorineural hearing loss (SSNHL) with comor-bid ipsilateral canal paresis (CP) and/or benign paroxysmal positional vertigo (BPPV). Methods: Of the 338 patients with a diagnosis of idiopathic SSNHL, 29 patients (8.6%) with CP and 24 patients (7.1%) with BPPV were recruited and compared to 23 patients with SSNHL and vertigo but without CP or BPPV. The patients were evaluated for their initial hearing threshold, type of canal involved, response to repositioning maneuvers, and hearing outcome for 6 months. Results: Patients with CP (+) BPPV (‒) showed lower pure-tone averages than those with CP (‒) BPPV (+) on initial and follow-up audiograms. The improve-ment in pure-tone averages was less in the CP (+) BPPV (‒) group than in the CP (‒) BPPV (+) group. The improvement in speech discrimination scores was less in the CP (+) BPPV (‒) group than in the CP (‒) BPPV (‒) group. BPPV most commonly involved the posterior canal (15 of 24, 62.5%), followed by the horizontal canal (13 of 24, 54.2%). Three of 24 patients (12.5%) had recurrences of BPPV. Conclusions: CP is a more serious sign for hearing recovery than BPPV, although both CP and BPPV are negative prognostic indicators of auditory function in SSNHL. Concurrent CP and/or BPPV in SSNHL suggest combined damage to the vestibule and may indicate severe and widespread labyrinthine damage, leading to a poor prognosis.

The Effects of Unilateral Tinnitus on Auditory Temporal Resolution: Gaps-In-Noise Performance

안용휘,진소영,윤상원,심현준 대한청각학회 2014 Journal of Audiology & Otology Vol.18 No.3

Background and Objectives: The Gaps-In-Noise (GIN) test is a measure to assess auditory temporal resolution, which is the ability to follow rapid changes in the envelope of a sound stimulus over time. We investigated whether unilateral tinnitus affects temporal resolution by the GIN performance. Subjects and Methods: Hearing tests including the GIN test were performed in 120 ears of 60 patients with unilateral tinnitus who showed symmetric hearing within 20 dB HL difference up to 8 kHz (tinnitus-affected ears, 14.6±11.2 dB HL; non-tinnitus ears 15.1±11.5 dB HL) and 60 ears of 30 subjects with normal hearing. Comparisons were made between tinnitus and non-tinnitus side of patients and normal ears of controls. Results: There was no significant difference of the mean GIN thresholds among tinnitus-affected ears (5.18±0.6 ms), non-tinnitus ears (4.98±0.6 ms) and normal ears (4.97±0.8 ms). The mean percentage of correct answers in tinnitus side (67.3±5.5%) was slightly less than that in non-tinnitus side (70.0±5.5%) but it was not significantly different from that in normal ears (69.4±7.5%). Neither the GIN threshold nor the GIN perception level in tinnitus ears has relation to sex, frequency and loudness of tinnitus, and audiometric data. Age only showed a significant correlation with the GIN performance. Conclusions: We found no evidence which supported the influence of unilateral tinnitus on auditory temporal resolution. These results imply that tinnitus may not simply fill in the silent gaps in the background noise.

Glucocorticoid Receptor-β Overexpression According to Nasal Polyp Severity:Immunohistochemical Study

안용휘,이철희,이재서,위지혜,한두희,홍성룡,민양기 대한비과학회 2010 Journal of rhinology Vol.17 No.2

Background and Objectives:The aims of the study were to reintroduce a surgical technique for a “mini” Caldwell-Luc operation and to determine its efficacy. Materials and Methods:A prospective study was performed in 23 patients undergoing the “mini” Caldwell-Luc operation. Improvements in clinical symptoms and endoscopic and computed tomographic (CT) findings were evaluated postoperatively over a follow-up period ranging from 6 to 21 months. All patients were surveyed for nasal symptoms (nasal obstruction, rhinorrhea, posterior nasal drip, headache, and anosmia), complications (tooth or gum pain, numbness, persistent facial pain, and facial hypo-paresthesia), and recurrence. Preoperative nasal polyps were classified by the Gaskins method, and preoperative paranasal sinusitis was graded according to the Kennedy CT staging system. Results:Symptom scores were all significantly reduced postoperatively (paired t-test, p<0.05). There were no major complications specific to this technique. Among 29 maxillary sinuses that received the “mini” Caldwell-Luc operation, seven showed recurrence (24%). Conclusion:The “mini” Caldwell-Luc operation provides an alternative method of obtaining access to the maxillary antrum and is associated with minimal morbidity.

음악적 배경 설문지의 한국어 번역 및 번역본의 언어 타당도

안용휘,최병윤,김봉직,최진웅,박무균,한규철,천병철,심현준,채민석,Kate Gfeller,안정민,문일준,조양선 대한이비인후과학회 2019 대한이비인후과학회지 두경부외과학 Vol.62 No.12

Background and Objectives The Musical Background Questionnaire (MBQ) has been developedto assess formal musical training and listening enjoyment. The aims of this studywere to translate MBQ into Korean with subsequent linguistic validation and to evaluate theeffectiveness of the Korean version of MBQ (K-MBQ). Subjects and Method Between 2013 and 2014, a panel affiliated with the questionnaire committeeof the Korean Audiological Society reconciled the first draft K-MBQ translated by a bilingualperson. A separate bilingual translator, who had never seen the original MBQ, translatedthe draft K-MBQ back into English, and subsequently, the panel reviewed its equivalence to theoriginal one. K-MBQ was administered to 29 adults (M:F=15:14; aged 21 to 76 years) for cognitivedebriefing. Pure tone and speech audiometry were performed in all participants. Results The translation of K-MBQ was completed through a multi-step process of forwardtranslation, reconciliation, reverse translation, cognitive debriefing and proofreading. Thirteen(45%) of 29 subjects reported formal musical training, and 16 participants (55%) judged themselvesas having no musical education and background. No significant correlation was foundbetween musical background and hearing level, whereas self-perceived quality of music andself-perception of music elements quantified by K-MBQ were associated with hearing abilityin terms of pure-tone and speech audiometry. Conclusion K-MBQ was translated and linguistically validated. The use of this questionnairecan provide further evaluation of musical background in patients with hearing loss orcochlear implant users.

저주파 감각신경성 난청을 동반한 어지럼 환자에서 125 Hz 순음 역치의 중요성

안용휘,심현준 대한평형의학회 2017 Research in Vestibular Science Vol.16 No.4

Objectives: To measure 125 Hz pure-tone thresholds in patients with low frequency sensorineural hearing loss (LFHL) and vertigo and to evaluate the necessity of 125 Hz thresholds for assessment of LFHL with vertigo.Methods: Pure tone audiometry including 125 Hz was performed in 25 dizzy patients with LFHL ≤500 Hz and 25 age-matched subjects with normal hearing. Patients with sudden sensorineural hearing loss and vertigo were excluded. Comparison of 125 Hz between LFHL and control groups, and comparison of 125 Hz and other frequencies in LFHL group was made.Results: Mean pure-tone thresholds at 125 Hz in LFHL group (41.7±7.5 dB) was higher than that in normal controls (12.8±6.4 dB). Three (12%) patients had normal thresholds at 125 Hz in LFHL group, whereas all subjects showed normal at 125 Hz in control group. None with average hearing thresholds at 250 and 500 Hz ≥35 dB had normal threshold at 125 Hz. There was a significant correlation between 125 Hz and other low frequencies in LFHL group (250 Hz; r=0.79, 500 Hz; r=0.66).Conclusions: Not every patient of LFHL with vertigo has abnormal hearing threshold at 125 Hz, although all subjects with normal hearing is within normal limits at 125 Hz. Measurement of 125 Hz pure-tone threshold is highly recommended when a mild LFHL exists.

어지럼증이 동반된 급성저주파감각신경성난청 환자에서 고실 내 스테로이드 주입술과 경구 이뇨제의 치료 결과 비교

안용휘,심현준 대한평형의학회 2019 Research in Vestibular Science Vol.18 No.4

Objectives: Sudden sensorineural hearing loss and Meniere disease can be man-aged with intratympanic steroid injection (ITSI) as a primary treatment. The aim of this study was to compare the effectiveness of ITSI versus oral diuretics for acute low frequency sensorineural hearing loss (LFHL) with vertigo.Methods: A total 76 patients with LFHL that had developed within previous 2 weeks were enrolled and categorized into 2 groups: treated with ITSI four times on 4 consecutive days (ITSI group; 42 patients) and treated with diuretics orally for 2 weeks (diuretics group; 34 patients). After 6 months, we analyzed treatment outcomes using subjective improvement and audiometric change. Results: Hearing thresholds at low frequencies ≤500 Hz were significantly im-proved in both ITSI and diuretics group (p<0.05). The cure rate of ITSI group was not significantly higher than that of diuretics group (54.8% vs. 52.9%, p>0.05). For subjective symptoms, there were no significant differences of im-provement rate in both groups (ITSI 64.3% vs. diuretics 61.8%, p>0.05). In pure tone audiometry, the improvement rate of ITSI group was not significantly dif-ferent from that of diuretics group (78.6% vs. 70.6%, p>0.05). There was a significant correlation between the cure rate and duration of symptoms. Conclusions: Both ITSI and diuretics are effective treatment modalities for acute LFHL with vertigo within 2 weeks of development. There is no difference of treatment outcomes between ITSI and diuretics in patients with acute LFHL and vertigo.

성인의 청력장애 판정에서 순음청력검사 및 청성뇌간반응과 청성지속반응의 상관관계 비교

안용휘,윤지향,오현식,이은섭,김동현,윤지은,심현준 대한이비인후과학회 부산,울산,경남 지부회 2017 임상이비인후과 Vol.28 No.2

Background and Objectives:To compare correlation between the pure tone audiometry (PTA), the auditory brainstem response (ABR) and the auditory steady-state response (ASSR) for the assessment of hearing disability in adults. Subjects and Methods:One hundred sixty adult patients who underwent ASSR for the disability evaluation of hearing from 2010 to 2016 were enrolled to this study. Correlations between PTA, ABR and ASSR thresholds were analyzed. Results:Both ABR and ABBR showed a positive linear correlation with the average hearing threshold of PTA, but the correlation between ASSR and PTA was significantly higher than that between ABR and ABR. The highest correlation between ASSR and PTA was observed at an average of 2 kHz; ABR and PTA at 4 kHz. The lowest correlation between ASSR and PTA was observed at an average of 4 kHz ; ABR and PTA at 0.5 kHz. Conclusions:Compared to ABR, ASSR showed greater correlation with PTA to assess the hearing disability in adults. ASSR can provide additional audiometric information for accurately predicting the hearing level.

정상 청력인 한국인 젊은 성인에서의 수용소음레벨 검사의 정상 범위 및 청성뇌간반응 잠복기와의 관계

안용휘,이은섭,심현준 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.12

Background and Objectives Acceptable noise level (ANL) test has been developed as a method to measure the background noise acceptance when listening to speech presented at the most comfortable level. The study was aimed to investigate normal-hearing in young subjects’ performance on ANL test and to evaluate the relationship between ANL and auditory evoked potentials. Subjects and Method Fifty-three young adults (23 male and 30 female; aged 21 to 39 years) with normal hearing participated in this study. ANL and auditory brainstem response (ABR) tests were administered to subjects who were certified by pure tone audiometry that they had normal hearing threshold. Results The ANL test showed a large inter-subject variability in the acceptance of background noise, ranging from -5 to 15 dB with the mean of ANL of 5.0±4.1 dB (4.5±4.5 dB in male and 5.4±3.8 dB in female). The mean most comfortable listening level was 35.2±5.3 dB, and the mean background noise level was 30.2±6.1 dB. There were no significant differences between male and female in the parameters of ANL test. There were no differences between the subjects with low versus high ANLs and ABR latencies. Conclusion We obtained the normative data of the ANL test administered to Korean young adults with normal hearing. There is no relationship between ANL and the latency of ABR in this study population. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(12):825-30

급성 저주파 감각신경성 난청에서 125 Hz 순음 역치의 중요성

안용휘,이은섭,김효정,강용경,오현식,심현준 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.8

Background and Objectives To analyze the 125 Hz pure-tone thresholds in patients with acute low frequency sensorineural hearing loss (LFHL) and to investigate the value of 125 Hz thresholds for the assessment of LFHL. Subjects and Method Hearing tests including 125 Hz pure-tone were performed in 91 patients with acute LFHL ≤500 Hz and in 46 subjects with normal hearing. Patients with sudden sensorineural hearing loss or Meniere’s disease were excluded. Inter-group and intra-group comparison of 125 Hz was made between LFHL and the control groups. Results There was a significant difference of mean pure-tone thresholds at 125 Hz between the acute LFHL and the normal groups (39.8±8.9 vs. 14.3±6.7 dB). Eight (8.8%) patients in the LFHL group showed normal thresholds at 125 Hz, but all other subjects were normal at 125 Hz in the control group. None with the average hearing thresholds at 250 and 500 Hz ≥40 dB had normal threshold at 125 Hz. There was a significant correlation between 125 Hz and other low frequencies in the LFHL group (250 Hz; r=0.81, 500 Hz; r=0.63). Conclusion Not all patients with acute LFHL show abnormal hearing threshold at 125 Hz although every subject with normal hearing is within the normal limits at 125 Hz. Threshold assessment should be made at 125 Hz when a mild LFHL exists in the conventional pure tone audiometry. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(8):583-7