Minimally Invasive Horizontal Intercartilaginous Incision during Tracheostomy – A Cadaveric Study / 체질인류학회지

The paper describes a minimally invasive tracheostomy technique that uses an intercartilaginous incision without resection of the tracheal cartilage and discusses its feasibility. A total of 20 adult cadavers (13 males and 7 females) were included in this study. The distance from the arch of the cricoid cartilage to the thyroid isthmus, maximal displacement of the thyroid isthmus, number of tracheal rings underneath the thyroid isthmus, and maximally opened distance resulting from an intercartilaginous incision were measured. The mean distance from the arch of the cricoid cartilage to the thyroid isthmus was 21.4±5.0 mm. The thyroid isthmus mainly overlaid the 3rd and 4th tracheal rings. The mean maximal displacement of the thyroid isthmus was 9.0±2.8 mm. Minimally invasive tracheostomy via an intercartilaginous incision is a feasible technique. A skin incision 2 cm below the cricoid cartilage enables exposure of the thyroid isthmus and anular ligament between the 2nd and 3rd tracheal rings. The intercartilaginous incision allows sufficient space for the tracheostomy tube. An intercartilaginous incision without resection of a tracheal ring can be a good alternative tracheostomy technique, especially for patients who require transient tracheostomy.

The Efficacy of Endoscopic Exploratory Tympanotomy in Conductive Hearing Loss Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study is to investigate the effectiveness of the endoscopic exclusive transcanalar approach for the management of conductive hearing loss. SUBJECTS AND METHOD: This was a retrospective comparative study of 106 patients who underwent exploratory tympanotomy at Chonnam National University Hospital from January 2008 to March 2016. The subjects were classified into two groups; endoscopic tympanotomy (ET, n=26) and microscopic tympanotomy (MT, n=80). Demographic data, operation time, postoperative admission days, pure tone audiometric results of pre-operation and post-operation at 3 months, and hearing success rate were evaluated. RESULTS: The mean operation time of MT (101.7±24.8 minutes) was longer than that of ET (59.8±23.2 minutes) with a statistical significance (p<0.01). The mean postoperative admission days of MT (4.4±1.3) was longer than that of ET (2.0±0.6) with a statistical significance (p<0.01). Hearing gain (air-conduction) and air-bone gap improvements were not significantly different between the groups. However, the hearing success rate of ET [partial ossicular replacement prosthesis (PORP) 85.7%, total ossicular replacement prosthesis (TORP) 81.8%] was significantly improved enormously compared to that of MT (PORP 62.9%, TORP 64.3%). CONCLUSION: With regards to conductive hearing loss, the endoscopic approach provided a better surgical view and less invasiveness compared with the microscopic approach. In conclusion, endoscopic exploratory tympanotomy had several advantages in operation time, admission days and hearing success rate.

A Case of Nonfunctioning Parathyroid Cyst in the Mediastinum / 대한이비인후과학회지

Parathyroid cysts, which are classified as either functioning or nonfunctioning, are rarely observed as neck masses, especially in the mediastinum. Herein, we present a 38-year-old woman with a nonfunctioning parathyroid cyst in the mediastinum. Physical and radiologic examinations of parathyroid cysts are not specific and preoperative diagnosis is usually difficult. Therefore, clinicians should consider the possibility that parathyroid cysts occuring in the mediastinum mimick other more frequently observed lesions.

Comparison between Pure Tone Audiometry and Auditory Steady-State Responses in Korean Children and Adult / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Assessing accurate audiometry might be an important index treating patients with hearing loss. So far there have been no studies on analysis of correlations between pure tone audiometry (PTA) and auditory steady-state response (ASSR) for children in Korea. We analyzed correlations between PTA and ASSR in order to investigate the usefulness of ASSR. SUBJECTS AND METHOD: Past medical records were retrieved from the patients who visited Department of Otolaryngology at Tertiary Referral Hospital from January 2012 to December 2012 and underwent the correlation study between ASSR and PTA with a correlation analysis of frequency. The participants over the age of 15 were classified into the adult group and those below in the children group. RESULTS: There was a statistically significant correlation between the average hearing threshold of ASSR and PTA (correlation coefficient=0.934). There was a strong correlation between children and adult group, too. With the frequency range of 500, 1000, 2000, and 4000 Hz, the correlation coefficients were 0.875, 0.896, 0.915, and 0.900, respectively. The degree of hearing loss was classified by using PTA follows: below 25 dB as normal; between 26-55 dB as moderate hearing loss; above 56 dB as severe hearing loss. Correlation coefficients for the above hearing ranges were 0.527, 0.670, and 0.744, respectively. Strong correlation was found between children and adult group, too. CONCLUSION: The comparison results between the average hearing threshold of ASSR and PTA indicated that the threshold of ASSR could well reflect the results of both children and adult group.