Is BPPV a Prognostic Factor in Idiopathic Sudden Sensory Hearing Loss?

이노희,Jae Ho Ban 대한이비인후과학회 2010 Clinical and Experimental Otorhinolaryngology Vol.3 No.4

Objectives. The prognostic significance of vertigo in patients with idiopathic sudden sensorineural hearing loss (SSNHL) remains a matter of debate because vertigo is associated with many different vestibular disorders. The purpose of this study is to determine the role of benign paroxysmal positional vertigo (BPPV) as a prognostic factor in patients with SSNHL. Methods. We conducted a retrospective study of 298 patients with SSNHL. Hearing outcomes were evaluated by assessments of pre-treatment hearing and hearing gain. Comparative multivariate analyses between prognostic factors and hearing outcome were conducted. Results. Thirty-eight (12.7%) SSNHL patients were found to also have BPPV. BPPV showed significant negative prognostic factors in hearing outcome on multivariate analysis (odds ratio, 0.15). In comparison to average pure tone audiometry (PTA), patients diagnosed with SSNHL with BPPV exhibited poorer hearing in pre- and post-treatment PTA compared to SSNHL without BPPV. Old age (>60 years), pre-treatment hearing, and canal paresis were significant outcome predictors. Conclusion. BPPV in SSNHL patients, representing definitive vestibular damage, was closely related to poor prognosis.

성대 주입술

이노희,진성민,Lee, No-Hee,Jin, Sung-Min 대한후두음성언어의학회 2009 대한후두음성언어의학회지 Vol.20 No.1

Office based injection laryngoplasty for voice and swallow disorders is increasing steadily. In recent years, the application of injection laryngoplasty is extended to inject medicine, such as cidofovir or botox. The reason why office based injection laryngoplasty is increasing in popularity is several potential advantages when compared with other procedures. It can avoid surgical scar and is easily performed with local anesthesia. However, injection can be performed in a variety of settings, depending on several factors, including the goal of the procedure, patient comfort and anatomy, and physician skill. In this article, we describe indication of injection laryngoplasty and discuss about various techniques for procedure.

외전신경 마비를 동반한 추체염

이노희,반재호,박치열,김창규 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.8

Petrous apicitis is an extension of infection from the mastoid air cell tract into petrous apex. Petrous apicitis, a potentially fatalcomplication of suppurative otitis media, presents a variety of symptoms. But the classical findings of petrous apicitis, calledGradenigos syndrome that include abducens nerve palsy, deep facial pain and acute suppurative otitis media, rarely occur.Gradenigos syndrome can be treated with surgery, but the advent of antibiotics and early imaging study allow conservativetreatment in some uncomplicated cases. With the widespread use of antibiotics, petrous apicitis has become an uncommon disease.So most physicians have little clinical experience in their diagnosis and treatment of this disease. We present a case of Gradenigossyndrome, which was unresponsive to conservative treatment. We provide here details of our experience of treating thepatient with surgery without complication. (Korean J Otolaryngol 2006;49:869-72)

Kurz titanium 이식물을 이용한 이소골 재건술의 결과

반재호,이노희,진성민 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.5

Background and Objectives:Various materials have been used for ossicular reconstruction, but there have been no reports for titanium prosthesis in South Korea. The purpose of this study was to ases the hearing results of Kurz titanium prosthesis in ch-Subjects and Method:A retrospective review was made of 62 cases who underwent osicular reconstru-ction using either titanium (TTP-VARIO System) or plastipore (Polycel) prosthesis from January 2003 to July 2005. Post-operative hearing results were analyzed taking in several prognostic factors such as the condition of middle ear mucosa and ossicle, or surgical method. Results:A postoperative air-bone gap of plastipore ossiculoplasty. The Postoperative ABG (air bone gap) show better results in healthy middle ear mucosa and in those cases which contain stapes superstructure. Conclusion:Titanium have a good biocompatibility and low extrusion rates with ex-cellent hearing results. Besides, good visualization and accurate placement were easy to achieve. (Korean J Otolaryngol 2007 ; 50 :404-10)

양성 돌발성두위현훈 환자에서 이석치환술 후 잔존하는 주관적 증상에 대한 평가

반재호,이노희,이종규,권희준,이성진,이남훈 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.6

Canalith repositioning procedure (CRP) provides rapid and long-lasting relief of symptoms in most patients with benign paroxysmal positional vertigo (BPPV). However, some patients express nonspecific symptoms such as anxiety or discomfort after CRP, even after the disappearance of nystagmus and vertigo. The purpose of this study is to assess the residual symptoms after CRP in patients with BPPV using questionnaire. Subjects and Method:CRP was performed in 135 patients until nystagmus and vertigo disappeared, and the patients were asked to complete the Dizziness Handicap Inventory (DHI) before and five to seven days after treatment. For the control group, 135 normal volunteers were selected, and cross matched according to the age and sex with the patient group. The DHI were compared among pre CRP, post CRP and control group. Results: There were statistically significant differences between the pre-CRP and post-CRP DHI scores and also between the post-CRP and control group. Comparison between the pre and post-CRP DHI scores, and post-CRP and control group both showed incomplete improvement with respect to some items. Conclusion:Even after the successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms was presented. Thus, additional follow up and management may be needed. (Korean J Otorhinolaryngol- Head Neck Surg 2008;51:508-12)

Surgical Treatment Using an Allograft Dermal Matrix for Nasal Septal Perforation

이경철,이노희,반재호,진성민 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.2

Purpose: Numerous methods have been utilized to repair nasal septal perforation with varying degrees of success; however, no consensus has been reached on nasoseptal perforation repair. Here, the authors describe a surgical method based on human dermal allograft (SuredermTM, Hans Biomed Corp. Korea) for the repair of nasal septal perforations. Materials and Methods: Eleven patients with a nasal septal perforation were included in this study. The causes of these septal perforations included previous nasal surgery, trauma, foreign body (button battery), and idiopathy. There were several sites of perforation: 9 in the central area, 1 in the posterior-central area, and 1 in the anterior area. An interpositional graft incorporating SuredermTM was positioned between bilateral mucoperichondrial flaps using an intranasal approach. A silastic sheet was then left in the nasal septum bilaterally until complete healing had occurred through new nasal mucosa, which took a mean duration of 6 weeks. Results: Outcomes in ten of the eleven patients were successful, with complete septal perforation closure. The remaining perforation, which was caused by a button battery, closed incompletely; however, its initial size of 2cm was reduced to 5mm. Conclusion: The described technique has a high success rate and can be performed under local anesthesia without external scarring. In the absence of donor site morbidity, this technique can also be utilized to repair posterior or multiple septal perforations without difficulty.

후두 결핵의 후두 내시경 소견과 임상 양상 분석

이상혁,이승석,이노희,반재호,이경철,진성민,Lee, Sang-Hyuk,Lee, Seung-Suk,Lee, No-Hee,Ban, Jae-Ho,Lee, Kyung-Chul,Jin, Sung-Min 대한후두음성언어의학회 2006 대한후두음성언어의학회지 Vol.17 No.1

Background and Objectives: There has been a gradual decline in the incidence of laryngeal tuberculosis due to effective an-tituberculous chemotherapy and improvement in the standard of living. During the last decade, however, the disease has changed its clinical pattern. We aimed to study a clinical and telescopic evaluation of laryngeal tuberculosis. Materials and Method: A retrospective clinical analysis was done for 16 patients who diagnosed laryngeal tuberculosis from January 2000 through December 2004. All patients had a complete clinical and laboratory work-up including telescopy, chest X-rays, sputum cultures, Tbc PCR(polymerase chain reaction). Laryngeal biopsies were performed in some cases. All the patients received proper antituberculous chemotherapy. Results: The patients age ranged from 21 to 59 with a mean age 43. The male to female ratio was 10:6. The prominent presenting symptom was hoarseness. The various telescopic findings were categorized: 7 patients showed ulcerative, 4 patients granulomatous, 3 patients ulcerofungative, 2 patients had nonspecific inflammatory lesions. Involving sites were true vocal cord most commonly in 12 patients. Three of 16 patients had normal chest X-ray fmding. Among 16 patients, 4 patients showed positive response for AFB stain, 13 patients showed positive for Tbc PCR. Biopsy was done for 3 patients who were not confirmed in initial tuberculous test. All patients responded satisfactorily to antituberculous medication. Conclusion: The telescopic findings and clinical manifestations of laryngeal tuberculosis have changed and seemed to be different from those of classic reports. Thus, the clinicians who deal with the various symptoms and diseases should be aware of the existence of laryngeal tuberculosis and the changing patterns of the disease.

Relationships between Lymph Node Metastasis and Expression of CD31, D2-40, and Vascular Endothelial Growth Factors A and C in Papillary Thyroid Cancer

이상혁,이성진,진성민,이노희,김동훈,채승완,손진희,김원석 대한이비인후과학회 2012 Clinical and Experimental Otorhinolaryngology Vol.5 No.3

Objectives. To investigate the relationships between lymph node metastasis (LNM) and expression of CD31, D2-40 and vascular endothelial growth factors (VEGF)-A and -C in patients with papillary thyroid cancer (PTC). Methods. Paraffin-embedded thyroid tissues of 72 patients were evaluated, which included 25 patients with thyroid nodular hyperplasia (TNH), 24 PTC patients without LNM, and 23 PTC patients with LNM. Three pathologists, who were blinded to the patient’s clinical information, assessed the immunohistochemical staining results. The amount of expression was scored as high (>25% of cells stained) or low (0-25%). Results. A higher level of VEGF-A expression was observed in the PTC groups regardless of LNM when compared to the group with TNH (91.3%, 79.2%, 4.0%, respectively). VEGF-C expression in the PTC with LNM group was significantly higher than the other two groups (P<0.05). No difference in microvessel density (MVD) scores was observed using CD31 among the three groups. The lymphatic vessel density (LVD) score using D2-40 was significantly higher in patients having PTC with LNM than the other groups (P<0.05). Conclusion. VEGF-C and D2-40 were more highly expressed in patients having PTC with LNM than in patients having PTC without LNM or in those having TNH. Analysis of VEGF-C level and LVD using D2-40 may be helpful in the diagnosis of PTC and the evaluation of LNM potential in patients with PTC.

협부 종물 2례:부이하선의 다형선종과 혈관 평활근종

이상혁(Sang Hyuk Lee),이노희(No Hee Lee),박일석(Il Seok Park),김진환(Jin Hwan Kim) 대한두경부종양학회 2007 대한두경부 종양학회지 Vol.23 No.1

The differential diagnosis of lesions in buccal area include lipoma, neurofibromas, epidermoid cyst, salivary ducts calculus, hemangioma, lymphadenopathy. Accessory parotid glands is defined as salivary gland tissue adjacent to the parotid duct, but separated from the body of parotid and it may be found in approximately 20% of human parotid glands. The appearance of an accessory parotid tumor is rare, with a reported frequency of 7.7% of all parotid neoplasm. Angiomyoma, which is also termed angioleiomyoma, is a rare solitary subcu-taneous tumors arising from the vascular smooth muscle. It often occur in the extremities and is rarely found in buccal area. We present 2 cases of rare tumor in buccal mass and resected surgically without facial nerve palsy.

Vocal Analysis Related to Changes in Frequency of Pure Tone Auditory Feedback

이상혁,이경철,반재호,이노희,진성민 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.4

Purpose: Many studies have shown that subjects show a change of vocal fundamental frequency (F0) when phonating subjects hear their vocal pitch feedback shifted upward or downward. This study was performed to demonstrate whether vocal parameters [F0, intensity, jitter, shimmer, and noise to harmonic ratio (NHR)] in normal males respond to changes in frequency of pure tone masking. Materials and Methods: Twenty healthy male subjects participated in this study. Subjects vocalized /a/ vowel sounds while listening to a pitch- shift pure tone through headphones (upward pitch-shift in succession: 1kHz to 2kHz and 1kHz to 4kHz at 50dB or 80dB, respectively, downward pitch-shift in succession: 1kHz to 250Hz and 1kH to 500Hz at 50dB or 80dB, respectively). Results: Vocal intensity, F0, was increased, whereas jitter was decreased as the pitch of pure tone was shifted upward. However, there was no correlation between shimmer and NHR with pitch-shift feedback for pure tones. Unlike vocal pitch- shift feedback in other studies, upward pitch-shift feedback of pure tones caused the vocal F0 and intensity to change in the same direction as pitch-shift. Conclusion: The results of this study demonstrated that auditory kinesthetic feedback is affected by pitch-shift in pure tone.