한국어판 The Speech, Spatial and Qualities of Hearing Scale의 표준화: 타당도 및 신뢰도 연구

김봉직,안용휘,최진웅,박무균,안중호,이승환,박경호,천병철,최병윤,조양선,한규철 대한이비인후과학회 2017 대한이비인후과학회지 두경부외과학 Vol.60 No.6

Background and Objectives The Speech, Spatial and Qualities of Hearing Scale (SSQ) was designed to measure self-reported auditory disability in a wide variety of listening situations. Its 49 items cover many aspects of speech perception, spatial hearing, and qualities of hearing, which constitute the three parts of SSQ. However, there has been no reliable and valid Korean version of SSQ (K-SSQ), which made the measurement of auditory disability difficult. The aim of this study is to develop a K-SSQ and to determine its reliability and validity for clinical or academic use. Subjects and Method An expert panel translated the original SSQ into Korean. A bilingual translator back-translated the translated version into English, which was then compared with the original version. After cognitive debriefing, K-SSQ was administered to 400 patients with hearing disability in 14 referral hospitals. Reliability was assessed using Cronbach’s alpha coefficient and correlation study. Validity was evaluated by factor analysis and criterion validity based on the results of pure tone audiometry. Results K-SSQ showed good reliability with high internal consistency (Cronbach’s α=0.99), and strong positive correlations across all three parts of SSQ. Construct validity was confirmed by the results of factor analysis and criterion validity demonstrated positive correlations between each part of SSQ and the results of pure tone audiometry. Conclusion The K-SSQ is a reliable and valid tool for use as a behavioral measure of hearing ability in Korean-speaking patients, and it will provide a very useful evaluation tool for both clinicians and researchers. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(6):279-94

Age-Related Changes in Cognition and Speech Perception

김봉직,오승하 대한청각학회 2013 Journal of Audiology & Otology Vol.17 No.2

Aging is one of the most evident biological processes, but its mechanisms are still poorly understood. Studies of cognitive aging suggest that age is associated with cognitive decline; however, there may be individual differences such that not all older adults will experience cognitive decline. That is, cognitive decline is not intrinsic to aging, but there is some heterogeneity. Many researchers have shown that speech recognition declines with increasing age. Some of the age-related decline in speech perception can be accounted for by peripheral sensory problems but cognitive aging can also be a contributing factor. The potential sources of reduced recognition for rapid speech in the aged are reduction in processing time and reduction of the acoustic information in the signal. However, other studies also indicated that speech perception does not decline with age. Cognitive abilities are inherently involved in speech processing. Two cognitive factors that decline with age may influence speech perception performance. The first factor is working memory capacity and the second factor concerns the rate of information processing, defined generally as the speed at which an individual can extract content and construct meaning from a rapid signal. Cognitive function shows the adaptive processes with age which are consistent with the view that the brain itself has potentially a life-long capacity for neural plasticity. Assessing the speech perception difficulty in older adults, cognitive function could be considered in the evaluation and management of speech perception problem.

Effect of Different Sounds on the Treatment Outcome of Tinnitus Retraining Therapy

김봉직,정성원,정재윤,서명환 대한이비인후과학회 2014 Clinical and Experimental Otorhinolaryngology Vol.7 No.2

Objectives. The purpose of this study was to evaluate the therapeutic effect of three different types of sounds on tinnitus patients undergoing tinnitus retraining therapy (TRT). Methods. This is a single-institution retrospective study, performed in one tertiary otological referral center. Thirty-eight adults with subjective idiopathic tinnitus who were followed for at least 9 weeks were enrolled. Sound therapy was delivered in 3 different ways: narrowband noise TRT (nTRT); mixed band noise TRT (mTRT); broadband noise TRT (bTRT). Treatment response was measured through validated psychometric questionnaires: Tinnitus Handicap Inven- tory (THI), visual analog scale (VAS) on annoyance, and numerical description of hours of tinnitus perception (awareness hours). Results. A total of 38 patients were followed for at least 9 weeks. In nTRT group, all outcome measures including THI, VAS, and the awareness hours, decreased over 9 weeks with no statistical significance. In mTRT group, all outcome mea- sures except for awareness hours significantly improved 9 weeks after the beginning of the treatment. In bTRT group, all outcome measures decreased significantly in 9 weeks. When therapeutic success is defined as improvement in THI 7 or more, bTRT group (77.8%) showed a higher success rate than other groups for 38 patients with the minimum follow-up of 9 weeks. Conclusion. All three sounds can provide relief in patients with annoying tinnitus after TRT. However, there is difference in the therapeutic effect according to sound types. Broadband sound seems to be better than narrowband sound or mixed sound in relieving the patients from tinnitus. Therefore, sound therapy with broadband noise may be more ap- propriate during TRT, but further evidence is needed for precise conclusion.

Comparisons in Outcome and Subject Comfort between Rotation Chair Systems

김봉직,원유경,나우성,정재윤,서명환,현재환 대한청각학회 2017 Journal of Audiology & Otology Vol.21 No.2

Background and Objectives: A rotation chair test has been used to evaluate the functionof the horizontal semicircular canals. Currently, two chair systems according to the presenceof cylindrical darkroom are used in a clinic setting. However, it has not been thoroughly investigatedwhether one system is superior to the other system or not. In this study, weaimed to compare test outcomes and subject convenience between two systems. Subjectsand Methods: Twenty subjects with no history of otologic disease were enrolled. Subjectswere tested with two systems: system [A] with a cylindrical chamber and system [B] with nochamber. The results of sinusoidal harmonic acceleration (SHA), step velocity (SV), and visualfixation (VFX) tests were compared between the systems. Subject convenience was assessedwith a questionnaire survey and results were compared between the systems. Results:There were no significant differences in gain or asymmetry in SHA test between thesystems. However, the phase of system [A] was significantly lower than that of system [B] at0.16 Hz. There was no significant difference between the systems in directional preponderance(DP) gain or DP time constant. Regarding the VFX test, gain was higher in system [A]than system [B]. Subjects reported less stuffiness and less anxiety with system [B] than system[A], while preferring the system [A] goggles. Conclusions: A rotation chair system withouta darkroom can provide a more comfortable experience for subjects in terms of stuffinessand anxiety, while showing comparable results in SHA and SV tests with a darkroomsystem.

Endoscopic Versus Traditional Craniofacial Resection for Patients with Sinonasal Tumors Involving the Anterior Skull Base

김봉직,김대우,김시환,한두희,김동영,이재서,이철희 대한이비인후과학회 2008 Clinical and Experimental Otorhinolaryngology Vol.1 No.3

Objectives. With the advent of microdebriders and image guidance systems, endoscope-assisted surgery is now more widely used for the treatment of tumors involving the base of the skull. The aim of this study was to analyze the clinical features of tumors involving the anterior skull base and to evaluate the treatment outcomes according to the surgical approach, which included the traditional craniofacial resection (TCFR) and the endoscopic craniofacial resection with craniotomy (ECFR). Methods. Forty-six patients who underwent craniofacial resection from 1989 through 2006 at Seoul National University Hospital and Seoul National University Bundang Hospital were included in this study. Demographics, histology, surgical management, surgical outcomes, complications, and morbidity were analyzed. Results. The number of malignant and benign lesions was 40 and 6 cases respectively. The most common diagnosis was olfactory neuroblastoma occurring in 41% of the cases followed by squamous cell carcinoma and malignant melanoma. Thirty-six patients underwent TCFR, while ECFR was performed with or without adjunctive chemotherapy or radiotherapy in 10 patients. The overall five-year survival rate for patients with malignant tumors of the anterior skull base was 47.4%. Out of 19 patients with olfactory neuroblastomas, 10 patients had TCFR and six among them died of their disease. Nine patients underwent ECFR, and none of them died of their disease. The ECFR group had lower morbidity and cosmetic deformity than did the TCFR group. Conclusion. The ECFR may be considered as an alternative option for the treatment of selected tumors with anterior skull base invasion. This approach offers the advantages of avoiding facial incisions with comparable treatment results. Objectives. With the advent of microdebriders and image guidance systems, endoscope-assisted surgery is now more widely used for the treatment of tumors involving the base of the skull. The aim of this study was to analyze the clinical features of tumors involving the anterior skull base and to evaluate the treatment outcomes according to the surgical approach, which included the traditional craniofacial resection (TCFR) and the endoscopic craniofacial resection with craniotomy (ECFR). Methods. Forty-six patients who underwent craniofacial resection from 1989 through 2006 at Seoul National University Hospital and Seoul National University Bundang Hospital were included in this study. Demographics, histology, surgical management, surgical outcomes, complications, and morbidity were analyzed. Results. The number of malignant and benign lesions was 40 and 6 cases respectively. The most common diagnosis was olfactory neuroblastoma occurring in 41% of the cases followed by squamous cell carcinoma and malignant melanoma. Thirty-six patients underwent TCFR, while ECFR was performed with or without adjunctive chemotherapy or radiotherapy in 10 patients. The overall five-year survival rate for patients with malignant tumors of the anterior skull base was 47.4%. Out of 19 patients with olfactory neuroblastomas, 10 patients had TCFR and six among them died of their disease. Nine patients underwent ECFR, and none of them died of their disease. The ECFR group had lower morbidity and cosmetic deformity than did the TCFR group. Conclusion. The ECFR may be considered as an alternative option for the treatment of selected tumors with anterior skull base invasion. This approach offers the advantages of avoiding facial incisions with comparable treatment results.

Major Contribution of GREB1L Alterations to Severe Inner Ear Malformation Largely in a Non-mendelian Fashion

김봉직,전형원,이상연,이나영,한진희,서고훈,오승하,최병윤 대한이비인후과학회 2022 Clinical and Experimental Otorhinolaryngology Vol.15 No.1

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Does Transcranial Direct Current Stimulation Have a Role in the Treatment of Tinnitus?

김봉직,박용호 대한의학회 2019 Journal of Korean medical science Vol.34 No.3

불포화 점성토의 압밀 및 전단특성

김종범,이봉직 대한토목학회 2003 대한토목학회논문집 C Vol.23 No.5

메니에르병 환자의 치료경과 및 고실 내 겐타마이신 주입술에 대한 고찰

나윤찬,김봉직,송재진,홍성광,김지수,구자원 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.12

Background and Objectives Several treatment options have been introduced to control Meniere’s disease (MD). Among them, intratympanic injection of gentamicin (ITGM) is now accepted as a standard treatment method for intractable vertigo in patients with hearing impaired MD. The purpose of this study was to analyze the clinical course and treatment flow in patients with MD and to analyze the efficacy and problems after ITGM. Subjects and Method A retrospective study was performed on 458 patients who were diagnosed as definite MD from May 2003 to October 2007 and were followed up at least 1 year. The authors investigated the course of disease and the results in our patients according to the treatment options. Several clinical parameters including frequency of vertigo, audiometry, caloric and rotation test were reviewed and analyzed according to the guideline of the AAO-HNS (1995), if necessary. Efficacy and problems after ITGM were reviewed. Results Among 458 patients, vertigo was resolved or improved in 399 patients (87.1%) with medical management. Fifty-nine patients needed further treatment (endolymphatic sac decompression: 4, Meniette: 2, ITGM: 53). Among 53 patients who got ITGM, 40 patients were followed up for more than 1 year after injection. Thirty-six patients (87.5%) showed successful control of vertigo. The average pure-tone threshold was changed from 54.1 dB to 56.9 dB after treatment. Three patients (7.5%) revealed more than 20 dB aggravation. Conclusion Vertigo was controlled by supportive treatments or medication in 87% of definite MD patients. And ITGM could effectively and reasonably control vertigo for intractable MD patients.

Chemocauterization of Congenital Fistula from the Accessory Parotid Gland

하정훈,김봉직,성명훈,김광현 대한이비인후과학회 2008 Clinical and Experimental Otorhinolaryngology Vol.1 No.2

Congenital sialo-cutaneous fistula arising from the accessory parotid gland is extremely rare. Although the fistula tract can be successfully excised after making a skin incision along the skin tension line around the fistula opening, a facial scar inevitably remains. We here report a case of sialo-cutaneous fistula that was treated with chemocauterization with trichloroacetic acid (TCA). TCA cauterization is an easy and effective option for the treatment of congenital fistula from an accessory parotid gland, especially from the aesthetic point of view. Congenital sialo-cutaneous fistula arising from the accessory parotid gland is extremely rare. Although the fistula tract can be successfully excised after making a skin incision along the skin tension line around the fistula opening, a facial scar inevitably remains. We here report a case of sialo-cutaneous fistula that was treated with chemocauterization with trichloroacetic acid (TCA). TCA cauterization is an easy and effective option for the treatment of congenital fistula from an accessory parotid gland, especially from the aesthetic point of view.