Analysis of P1 Latency in Normal Hearing and Profound Sensorineural Hearing Loss

Jang, Jeong Hun,Jang, Hyun Kyung,Kim, Sung Eun,Oh, Seung Ha,Chang, Sun O,Lee, Jun Ho Korean Society of Otorhinolaryngology-Head and Nec 2010 Clinical and Experimental Otorhinolaryngology Vol.3 No.4

<P><B>Objectives</B></P><P>P1 is a robust positivity at a latency of 50-150 msec in the auditory evoked potential of young children. It has been reported that over the first 2-3 years of life, there is a rapid decrease of the latency and the mean P1 latency in adults with normal hearing is approximately 60 msec. This study was designed to evaluate the change of the P1 latency in Koreans with normal hearing according to age and to compare this with the P1 latency of young patients with profound sensorineural hearing loss before and/or after cochlear implantation.</P><P><B>Methods</B></P><P>Among the patients who visited the Department of Otorhinolaryngology at Seoul National University Hospital from June 2007 to September 2009, the P1 response was recorded in 53 patients in the normal hearing group, in 13 patients in the pre-cochlear implantation (CI) group and in 10 patients in the post-CI group. A synthesized consonant-vowel syllable /ba/ was used to elicit the evoked responses. The evoked responses were collected using the center of the frontal head. For each subject, an individual grand average waveform was computed by averaging the ten recordings. The P1 latency was visually identified as a robust positivity in the waveform.</P><P><B>Results</B></P><P>For the normal hearing group, the P1 latency showed the pattern of shortening as the age increased (coefficient, -0.758; <I>P</I><0.001). For the pre-CI group, 10 cases showed delayed latencies and 3 cases did not show the P1 wave. For the post-CI group, the P1 latencies showed a less delayed tendency than those of the pre-CI group, but this was not statistically different.</P><P><B>Conclusion</B></P><P>This report provides the standard value of the P1 latency at each age in Koreans for the first time and the findings support that the maturation of the central auditory pathways could be measured objectively using the P1 latency.</P>

Sex Differences in a Cross Sectional Study of Age-related Hearing Loss in Korean

Kim, SungHee,Lim, Eun Jung,Kim, Hak Soo,Park, Jun Ho,Jarng, Soon Suck,Lee, Sang Heun Korean Society of Otorhinolaryngology-Head and Nec 2010 Clinical and Experimental Otorhinolaryngology Vol.3 No.1

<P><B>Objectives</B></P><P>The purpose of this study was to obtain sex- and age-specific reference level for hearing threshold of normal aging in Korean and to determine if the rate of change in pure-tone hearing thresholds differed by sex.</P><P><B>Methods</B></P><P>Subjects were clients who visited the Health Promotion Center, Daegu Fatima Hospital, Daegu, Korea, from January 2004 to September 2005. Pure-tone audiometric measures were obtained from 3,470 subjects who also completed a hearing questionnaire. The slope of a linear regression was used to estimate the rate of change in pure-tone thresholds at 0.25 to 8 kHz for each ear in 214 men and 902 women without past history of otorrhea, usage of ototoxic drugs, head injury, job in noisy environment, and military service.</P><P><B>Results</B></P><P>Hearing thresholds were elevated with age in all test frequencies. Significant sex differences were found in pure-tone thresholds at 4 and 8 kHz after adjusting for age using analysis of covariance. In those high frequencies, hearing was worse in men than in women. The average rate of change in threshold was 0.28 and 0.24 dB per year at 0.25 kHz, increasing gradually to 1.27 and 1.05 dB per year at 8 kHz for men and women, respectively. Men had significantly faster rates of threshold increase at 4 and 8 kHz than women.</P><P><B>Conclusion</B></P><P>These cross-sectional measures of hearing levels and rate of threshold increases at 4 and 8 kHz showed significant sex differences in Korean men and women with little evidence of noise-induced hearing loss.</P>

Scapular Tip Free Flap for Head and Neck Reconstruction

Choi, Nayeon,Cho, Jae-Keun,Jang, Jeon Yeob,Cho, Jung Kyu,Cho, Young Sang,Baek, Chung-Hwan Korean Society of Otorhinolaryngology-Head and Nec 2015 Clinical and Experimental Otorhinolaryngology Vol.8 No.4

<P><B>Objectives</B></P><P>Head and neck reconstruction is still challenging in terms of esthetic and functional outcomes. This study investigated the feasibility of the angular branch-based scapular tip free flap (STFF).</P><P><B>Methods</B></P><P>This was a retrospective study of 17 patients undergoing maxillectomy and mandibulectomy and either primary or secondary reconstruction by STFF. This study included surgical, esthetic, and functional outcomes, and detailed data are presented regarding the flap, such as pedicle length, size of the harvested bone, and failure rate. Medical photographs were used to estimate the esthetic outcome, and computed tomography was used to check the flap status postoperatively.</P><P><B>Results</B></P><P>The data were collected from April 2013 to April 2014. Eight patients underwent maxillary reconstruction, and nine underwent mandibular reconstruction. Maxillary defects usually included unilateral alveolar structures and the palate; mandibular defects were usually those involving mandibular angle and short segment. Vein grafting was not required in any of the patients. Flap failure occurred in one of the 17 patients (5.9%) with successful reconstruction after revision. Of the eight maxillectomy patients, orbital revisions for diplopia after maxillary reconstruction were performed in two patients (25%), and oroantral fistula repair was performed in one patient (12.5%).</P><P><B>Conclusion</B></P><P>This study demonstrated the reconstructive advantages of the angular branch-based STFF, long pedicle, low flap failure, 3-dimensional nature of bone and soft tissues (chimeric flap), and small rate of donor site morbidity with free ambulation. This flap is an excellent option for use in complex three-dimensional head and neck reconstruction.</P>

Pneumatization Pattern of the Frontal Recess: Relationship of the Anterior-to-Posterior Length of Frontal Isthmus and/or Frontal Recess with the Volume of Agger Nasi Cell

Park, Seong-Soo,Yoon, Bit-Na,Cho, Kyu-Sup,Roh, Hwan-Jung Korean Society of Otorhinolaryngology-Head and Nec 2010 Clinical and Experimental Otorhinolaryngology Vol.3 No.2

<P><B>Objectives</B></P><P>We analyzed the pneumatization pattern of the frontal recess (FR) in a Korean population. We also determined the correlation between the volume of the agger nasi cell (ANC) and the anterior-to-posterior (A-P) length of the frontal isthmus (FI) and FR.</P><P><B>Methods</B></P><P>Multiplanar paranasal sinus computed tomography (CT) images from 105 patients who underwent endoscopic sinus surgery were reviewed. The prevalence of frontal recess cells (FRCs), thickness of the frontal beak (FB), volume of the ANC, A-P length of the FI, and FR were evaluated.</P><P><B>Results</B></P><P>The ANC was identified in 96% of the patients and frontal cells (FCs) in 32% (FC type 1, 24.2%; type 2, 4.2%; type 3, 3.1%; and type 4, 0%). The prevalences of frontal bullar, suprabullar, supraorbital ethmoidal, and interfrontal sinus septal cells were 10%, 7.8%, 3.6%, and 6.8%, respectively. The A-P lengths of the FR and FI were 10.1±3.1 and 8.4±2.9 mm, respectively. The thickness of the FB was 7.8±1.8 mm and the volume of the ANC averaged 394.1±240.5 mm<SUP>3</SUP>. The thickness of the FB did not correlate with the volume of the ANC. In contrast, the A-P length of the FI and FR were positively correlated with the volume of the ANC.</P><P><B>Conclusion</B></P><P>ANCs and FCs were found in 96% and 32% of the cases in this series. FC type 4 was not seen. What appeared to be FC4 on conventional CT was identified as FBC from reconstructed parasagittal images. A large ANC increased the A-P length of the FI and FR, regardless of the thickness of the FB.</P>

Decreased Serum Epinephrine in Children With Positive Skin Prick Test

Hong, Seok-Chan,Suh, Jeffrey D.,Chung, Sochung,Lee, Seung-Hoon,Choi, Ji Ho,Oh, Jeong In,Kim, In-Tae,Kim, Jin Kook,Cho, Jae Hoon Korean Society of Otorhinolaryngology-Head and Nec 2015 Clinical and Experimental Otorhinolaryngology Vol.8 No.4

<P><B>Objectives</B></P><P>To evaluate the association between catecholamine levels and skin prick test results among children.</P><P><B>Methods</B></P><P>Two hundred eight first grade children from one elementary school were invited to participate in this study. Skin prick test (SPT) for six allergens (2 house dust mites, cat, dog, mugwort, and pollen mixture) was performed, and patient demographic information was recorded. The parents were surveyed using questionnaires about rhinitis-related symptoms. Finally, venous blood sampling was done to measure catecholamine levels (epinephrine, norepinephrine, and dopamine) by high-performance liquid chromatography.</P><P><B>Results</B></P><P>Out of 208 children, 174 (106 boys and 68 girls) enrolled in this study. Ninety-six of the children (55%) had negative SPT (nonsensitization group), while 78 (45%) had a positive SPT to at least one of six allergens (sensitization group). The diagnosis of chronic rhinitis was more prevalent in the sensitization group (35.9%) than nonsensitization group (26.0%), however the finding was not significant (<I>P</I>=0.186). Epinephrine levels were decreased between the sensitization group compared to the nonsensitization group (<I>P</I>=0.004). There was no difference in norepinephrine and dopamine levels (<I>P</I>>0.05).</P><P><B>Conclusion</B></P><P>Epinephrine levels are lower in children with positive SPT compared to controls, however, the level of the catecholamine was not associated with the presence or absence of rhinitis symptoms.</P>

The Value of Measuring Eustachian Tube Aeration on Temporal Bone CT in Patients with Chronic Otitis Media

Shim, Hyun Joon,Choi, A Young,Yoon, Sang Won,Kwon, Kee Hwan,Yeo, Seung Geun Korean Society of Otorhinolaryngology-Head and Nec 2010 Clinical and Experimental Otorhinolaryngology Vol.3 No.2

<P><B>Objectives</B></P><P>To evaluate that the cross-sectional area of the air space in the Eustachian tube (ET) on computed tomography (CT) images could be useful for predicting the postoperative aeration of the middle ear.</P><P><B>Methods</B></P><P>The patient group consisted of 80 patients (80 ears) with chronic otitis media and who underwent middle ear surgery from 2006-2007 and who were followed up for more than 1 yr. The control group consisted of 100 ears of 50 individuals with normal tympanic membranes and who underwent CT for other causes (such as tinnitus or hearing loss). The largest cross-sectional areas of the aerated ET were measured on the coronal images of the temporal bone CT by a single otologist using the computer-based 'Region of Interest' picture archiving and communications system. The patient group was divided into two subgroups, 1) those with good postoperative aeration and 2) those with poor postoperative aeration. The largest cross-sectional areas of the aerated ETs were compared between the patients and the controls, and between the patients with good aeration and the patients with poor aeration.</P><P><B>Results</B></P><P>The mean cross-sectional areas significantly differed between the patient group and the control group, and between the good and poor aeration subgroups (<I>P</I><0.05 each). The mean area of the poor aeration subgroup was smaller than that of the control group (<I>P</I><0.05), but the mean area of the good aeration subgroup did not significantly differ from that of the controls.</P><P><B>Conclusion</B></P><P>The cross-sectional area of the aerated ET, as measured on the preoperative coronal images of temporal bone CT scans, may be useful for predicting the postoperative condition of the tympanic cavity.</P>

Efficacy and Safety of Guardcel Nasal Packing After Endoscopic Sinus Surgery: A Prospective, Single-Blind, Randomized Controlled Study

Kang, Byungjin,Kim, Jeong-Rok,Shin, Jae-Min,Park, Il-Ho,Lee, Heung-Man Korean Society of Otorhinolaryngology-Head and Nec 2017 Clinical and Experimental Otorhinolaryngology Vol.10 No.3

<P><B>Objectives</B></P><P>Nasal packing after endoscopic sinus surgery is frequently used to control postoperative bleeding, enhance the wound healing process, and prevent lateralization of the middle turbinate, which causes insufficient ventilation. Many biodegradable materials have been developed to reduce pain and mucosal damage during packing removal. The purpose of this study was to compare the efficacy of Guardcel (Genewel Co.) middle meatal packing with a traditional nonabsorbable middle meatal packing, Merocel (Medtronic Xomed), on wound healing and patient satisfaction.</P><P><B>Methods</B></P><P>In this prospective, single-blind, randomized controlled study, we enrolled 32 consecutive patients (64 nostrils) undergoing bilateral endoscopic sinus surgery at Korea University Guro Hospital from February 2015 to August 2015. Guardcel and Merocel were inserted postoperatively into a randomly assigned side. Objective findings about bleeding, hemostasis, adhesion, and infection were evaluated with nasal endoscopy. Patients’ symptoms including pain and nasal obstruction were evaluated with a visual analog scale. Each evaluation was done at 2–3 days, 1 week, 2 weeks, and 4 weeks after surgery.</P><P><B>Results</B></P><P>At 2–3 days after endoscopic sinus surgery, the Guardcel side had a significantly less hemostasis time than the Merocel side (<I>P</I>=0.001). During this period, the pain during packing removal was significantly lower on the Guardcel-inserted side than the Merocel-inserted side (<I>P</I>=0.002). At two weeks after surgery, the adhesion score on the Guardcel side was significantly lower than that of the Merocel side (<I>P</I>=0.011). Other parameters during the study follow-up periods were not statistically significant. There were no severe adverse reactions.</P><P><B>Conclusion</B></P><P>Guardcel, a newly developed packing material, appeared to shorten the hemostasis time and reduce pain sensation at 2–3 days after surgery; it also prevented adhesion formation 2 weeks after surgery when compared with the control. Guardcel can be an effective and safe candidate to replace conventional packing materials after endoscopic sinus surgery.</P>

Comparison of Sudden Deafness in Adults and Children

Na, Se Young,Kim, Myung Gu,Hong, Seok Min,Chung, Ji Hyun,Kang, Ho Min,Yeo, Seung Geun Korean Society of Otorhinolaryngology-Head and Nec 2014 Clinical and Experimental Otorhinolaryngology Vol.7 No.3

<P><B>Objectives</B></P><P>Although many studies have assessed sudden deafness in adults, sudden deafness has not been evaluated in children. We therefore evaluated the differences in sudden deafness between children and adults.</P><P><B>Methods</B></P><P>We compared clinical manifestations, including gender, audiogram pattern of initial hearing loss, and recovery rate after treatment in 87 children and 707 adults diagnosed with sudden deafness from September 2003 and August 2012.</P><P><B>Results</B></P><P>There were no differences in sex, side, or audiogram between children and adults (<I>P</I>>0.05 each). Hearing recovery rates in children and adults were 72.4% and 70.6%, respectively (<I>P</I>>0.05). Both children and adults with mild hearing loss showed significantly greater hearing recovery rates than individuals with profound hearing loss (<I>P</I><0.05 each). The percentage with initially mild and moderate hearing loss was higher in children than in adults, as were the recovery rates of children compared to adults with initially mild, moderate-severe, and profound hearing loss (<I>P</I><0.05 each). In regard to final hearing outcome after treatment, a low percentage of children showed no improvement whereas a high percentage showed complete recovery; a higher percentage of children than of adults showed complete recovery (<I>P</I><0.05). Recovery rate from profound hearing loss was significantly higher in children than in adults (60.0% vs. 45.4%, <I>P</I><0.05).</P><P><B>Conclusion</B></P><P>Degree of hearing loss, gender, side, and recovery rate were similar in children and adults, but the rate of complete recovery was higher in children.</P>

Music Perception Ability of Korean Adult Cochlear Implant Listeners

Kim, Eunoak,Lee, Hyo-Jeong,Kim, Hyung-Jong Korean Society of Otorhinolaryngology-Head and Nec 2012 Clinical and Experimental Otorhinolaryngology Vol.5 No.suppl1

<P><B>Objectives</B></P><P>Although the cochlear implant (CI) is successful for understanding speech in patients with severe to profound hearing loss, listening to music is a challenging task to most CI listeners. The purpose of this study was to assess music perception ability and to provide clinically useful information regarding CI rehabilitation.</P><P><B>Methods</B></P><P>Ten normal hearing and ten CI listeners with implant experience, ranging 2 to 6 years, participated in the subtests of pitch, rhythm, melody, and instrument. A synthesized piano tone was used as musical stimuli. Participants were asked to discriminate two different tones during the pitch subtest. The rhythm subtest was constructed with sets of five, six, and seven intervals. The melody & instrument subtests assessed recognition of eight familiar melodies and five musical instruments from a closed set, respectively.</P><P><B>Results</B></P><P>CI listeners performed significantly poorer than normal hearing listeners in pitch, melody, and instrument identification tasks. No significant differences were observed in rhythm recognition between groups. Correlations were not found between music perception ability and word recognition scores.</P><P><B>Conclusion</B></P><P>The results are consistent with previous studies that have shown that pitch, melody, and instrument identifications are difficult to identify for CI users. Our results can provide fundamental information concerning the development of CI rehabilitation tools.</P>

Decreased Pattern-Recognition Receptor-Mediated Cytokine mRNA Expression in Obese Children With Otitis Media With Effusion

Kim, Youn Jung,Cha, Sung Ho,Lee, Ho Yun,Lee, Sun Kyu,Chung, Hee Yong,Yeo, Joon Hyung,Kim, Young Il,Yeo, Seung Geun Korean Society of Otorhinolaryngology-Head and Nec 2014 Clinical and Experimental Otorhinolaryngology Vol.7 No.1

<P><B>Objectives</B></P><P>To assess innate and humoral immune responses in middle ear effusion of obese pediatric patients with otitis media with effusion (OME).</P><P><B>Methods</B></P><P>We evaluated 219 children with OME, of whom 21 were obese and 198 were non-obese. We compared the expression in middle ear effusion of mRNAs encoding toll-like receptors (TLR) 2, 4, 5, and 9; nucleotide-binding oligomerization domains (NOD) 1 and 2; retinoic acid-inducible gene (RIG)-I; interleukins (IL)-6, -10, and -12; interferon (IFN)-γ; and tumor necrosis factor (TNF)-α mRNAs. We also compared the expression of immunoglobulins IgG, IgA, and IgM and the bacterial detection rate in the two groups.</P><P><B>Results</B></P><P>TLR2-mediated expression of IL-6 mRNA, TLR4-mediated expression of IL-6 and IL-10 mRNA, TLR5-mediated expression of IL-6, IL-10, and TNF-α mRNA, TLR9-mediated expression of IL-6 mRNA, and NOD2-mediated expression of IL-6, IL-12, and TNF-α mRNA were significantly lower in obese than in non-obese children (<I>P</I><0.05). However, concentrations of IgG, IgA, and IgM in middle ear effusion were lower in obese than in non-obese children, but none of these differences was significant (<I>P</I>>0.05).</P><P><B>Conclusion</B></P><P>Mean body mass index was higher and pattern-recognition receptor-mediated cytokine mRNA expression was lower in obese than in non-obese children with OME.</P>