Comparison of the Effects of Intratympanic Steroid Injection at Different Intervals in Sudden Sensorineural Hearing Loss

Background and Objectives@#Systemic steroid therapy (SST) and intratympanic steroid injection (ISI) have been the treatment of choice for sudden sensorineural hearing loss (SSNHL). We studied the effect of ISI administered at different intervals on hearing outcomes in patients with SSNHL. @*Subjects and Methods@#We performed a retrospective study of 427 patients diagnosed with SSNHL at Bundang Jesaeng Hospital, of whom 51 patients with SSNHL who received SST and four ISIs were included in this study. Patients were treated with four ISIs either every day for 4 days (group 1) or at intervals (mean duration of interval: 2.21 days) (group 2). Hearing outcomes were evaluated using the pure-tone test before the injection and 14 days, 1 month, and 3 months after the final injection. Recovery rates were classified based on Siegel’s criteria. @*Results@#The amount of improvement was 27.67 dB (±20.45) in group 1 and 32.79 dB (±21.42) in group 2. However, there were no significant differences between the two groups (p= 0.714). The recovery rates based on Siegel’s criteria were 18/27 (66.7%) and 16/24 (66.7%) in groups 1 and 2, respectively, with no significant difference (p=1.000). Considering only complete recoveries in hearing recovery, the recovery rates were 15/27 (55.6%) and 14/24 (58.3%) in groups 1 and 2, respectively, with no significant difference (p=0.842). @*Conclusions@#There were no significant differences in hearing outcomes or recovery rates after ISI administration every day or at intervals of 2-3 days.

A Case of Nasal Septal and Oral Cavity Abscesses Resulting from Mucormycosis in an Immunocompromised Patient / 대한이비인후과학회지

Mucormycosis is a rare invasive and highly aggressive fungal infection, which shows rapid progression with life threatening complications in immunocompromised patients. Therefore, it is important to quickly recognize fungal infection in immunocompromised patients and start treatment with antifungal agents or perform surgical debridement. Most nasal septal abscesses are caused by post-traumatic hematoma and subsequent bacterial infection. In immunocompromised patients, nasal septal abscess can develop without trauma and may involve atypical pathogens like fungus. Herein we report a case of mucormycosis presenting with abscesses of nasal septum and gingivobuccal mucosa in an immunocompromised patient.

A Case of Nasal Septal and Oral Cavity Abscesses Resulting from Mucormycosis in an Immunocompromised Patient / 대한이비인후과학회지

Mucormycosis is a rare invasive and highly aggressive fungal infection, which shows rapid progression with life threatening complications in immunocompromised patients. Therefore, it is important to quickly recognize fungal infection in immunocompromised patients and start treatment with antifungal agents or perform surgical debridement. Most nasal septal abscesses are caused by post-traumatic hematoma and subsequent bacterial infection. In immunocompromised patients, nasal septal abscess can develop without trauma and may involve atypical pathogens like fungus. Herein we report a case of mucormycosis presenting with abscesses of nasal septum and gingivobuccal mucosa in an immunocompromised patient.

A Case of Secondary Trigeminal Neuralgia Caused by Infected Postoperative Maxillary Cyst

Postoperative maxillary cyst (POMC) is relatively common complication among patients who underwent Caldwell-Luc surgery. Patients with POMC usually have no symptoms, although cyst extension can result in bone destruction or cystic infection with pain. The trigeminal nerve consists of the ophthalmic nerve, maxillary nerve, and mandibular nerve. Among these branches, the maxillary nerve runs to the lateral and frontal sides of the maxillary sinus wall. POMC can rarely lead to trigeminal neuropathy caused by cyst enlargement that compresses some branches of the trigeminal nerve. Recently, we experienced a case with trigeminal neuralgia due to POMC. The patient was successfully treated with inferior meatal antrostomy. We report this rare case with a literature review.

Hearing Preservation with the Transcrusal Approach to the Skull Base Lesion Combined with Other Transcranial Approach: Results of Consecutive Series of 5 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study reviewed our experience and outcomes of surgery via transcrusal approach to the skull base lesions. SUBJECTS AND METHOD: We performed transcrusal approach technique on five patients with skull base lesions (Cavernous malformation, Petroclival meningioma, Craniopharyngioma, Anaplastic astrocytoma, and Trigerminal epidermoid cyst) aiming at preserving hearing. Pre-and post-operative pure tone audiometry (PTA) and caloric test were performed in all patients. The transcrusal approach technique was performed as reported in the previous references. The approach included trephination of the superior and posterior semicircular canals from the ampullae to the common crus. The main outcome of this study was preserving hearing and the vestibular function after surgery, which was determined by PTA and caloric test. RESULTS: The average diameter of skull base lesion of the five patients was 3.68 cm. The mean follow up period was 114.2 days. The pre-operative mean PTA of five patients was 11 dB. The mean PTA of five patients within seven days after surgery was 28 dB. The last measured mean PTA was 29.8 dB. The pre and post-operative caloric results measured revealed vestibular function deficit in all of the patients after surgery (mean decreased value: 64%). All patients were stable during the surgery. Complications included two cerebrospinal fluid leak (40%) and one cranial VI nerve deficit (20%). CONCLUSION: Transcrusal approach is a method that can simultaneously preserve hearing and afford enough exposure of the skull base lesion if appropriately combined with other transcranial approach. We performed transcrusal approach targeting skull base lesion with hearing preservation, and we found excellent hearing result with this technique.