Recordings of Cortical Auditory Evoked Potentials in Cochlear Implant Listeners: A Preliminary Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There is a need for fast and reliable objective measures of cochlear implant (CI) performance, especially in young children. The aim of the study was to investigate the detection and characterization of cortical auditory evoked potentials (CAEP) of different types of sound stimulation in CI listeners using a commercially available system, HEARLab™. SUBJECTS AND METHOD: Sound field CAEPs were obtained from 10 CI listeners, using three natural speech sounds (/m/, /g/, and /t/) presented at 55, 65, and 75 dB SPL. Detection rates, the latencies and amplitudes of CAEP waves were analyzed and compared with those of the normal hearing (NH) group. RESULTS: It was possible to detect CAEP responses in all CI listeners. Of the three stimuli (/m/, /g/, /t/), /g/ was the most robust waveform, although this was not statistically significant. Latencies for the /m/ stimulus were relatively longer than those for /t/ and especially for /g/, suggesting that CI listeners hear high-frequency sounds better than low-frequency sounds. When compared to the NH group, CAEP of CI listeners tended to show smaller amplitudes of various waves and longer latencies especially at P1 wave. CONCLUSION: CAEP responses could be obtained in all CI listeners and normal adults successfully, indicating that CAEP can be applied clinically as an objective assessment tool of hearing. Further studies are needed for CI listeners especially in infants and toddlers using this protocol to assess its clinical usefulness.

A Case of Superior Semicircular Canal Dehiscence Syndrome with Coexisting Otosclerosis / 대한이비인후과학회지

Superior semicircular canal dehiscence (SSCD) syndrome and otosclerosis have overlapping clinical manifestations that can be difficult to distinguish. Audiovestibular symptoms are caused by noise or straining in SSCD, which is associated with the presence of an air-bone gap that overlaps with the characteristic of otosclerosis. We recently examined a 51-year-old woman presenting with unilateral pulsatile tinnitus and ipsilateral hearing loss in the left ear. Computerized tomography, audiometry and vestibular function test confirmed the diagnosis of ipsilateral SSCD syndrome with coexisting ipsilateral otosclerosis. The patient underwent surgical repair of dehiscence by middle fossa approach and stapes surgery for otosclerosis sequentially. She has not had pulsatile tinnitus postoperatively, and hearing improved with the closure of air-bone gap at most frequencies. In conclusion, when SSCD syndrome and otosclerosis coexist and patient has representative symptoms of both ear pathologies, a sequential surgery can be an effective treatment option.

The Effect of Korean Red Ginseng on Symptoms and Quality of Life in Chronic Tinnitus: A Randomized, Open-Label Pilot Study

BACKGROUND AND OBJECTIVES: The major mechanism of inner ear cell damage is the production of reactive oxygen species (ROS). Korean red ginseng (KRG) has an anti-ROS effect; thus we hypothesized that KRG may be of use for the treatment of chronic idiopathic tinnitus. The aim of the study is to investigate clinical outcomes and health-related quality of life (QoL) in chronic tinnitus patients after taking KRG. SUBJECTS AND METHODS: This study was an open-label randomized controlled trial. Sixty-one patients with chronic tinnitus were enrolled and randomized to three groups. The control group was treated for 4 weeks with 160 mg/day Ginkgo biloba extract, and two other groups receiving 1500 mg/day or 3000 mg/day KRG for 4 weeks. Clinical assessments were performed using the tinnitus handicap inventory (THI), Visual Analogue Scale (VAS) and QoL was assessed by Short Form-36 Health Survey (SF-36) questionnaire. RESULTS: Fifty-nine patients completed the planned protocol. Significant improvements were observed between initial and post-treatment THI scores in patients receiving 3000 mg/day KRG. There was no statistically significant difference between initial and post-treatment VAS scores in all groups. Treatment with 3000 mg/day KRG for 4 weeks significantly improved role emotional and mental health scores in the SF-36 survey. CONCLUSIONS: These results suggest that KRG may improve tinnitus symptoms and mental wellbeing in chronic tinnitus patients.

Results of High-Frequency and High-Acceleration Rotary Chair Test in Patients with Acute Unilateral Vestibular Neuritis / 대한평형의학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the results of high-frequency and high-acceleration rotary chair test in patients with acute unilateral vestibular neuritis. MATERIALS AND METHODS: Twenty-four patients who were diagnosed as acute vestibular neuritis and underwent rotational chair and caloric tests during March 2012 to March 2013 were included. Slow harmonic acceleration (SHA) test was performed at 0.01, 0.04, 0.16, 0.64, 1.28, and 2.00 Hz. Step velocity tests at the peak velocity of 100degrees/sec (low-acceleration) and 240degrees/sec (high-acceleration) were performed. Gains and phases in SHA test and gains and time constants (Tc) in step velocity test were analyzed. RESULTS: In SHA test, decreased gain and phase lead was observed mostly in low frequencies. Gains (phases) at 0.01, 0.04, 0.16, 0.64, 1.28, and 2.00 Hz were 0.2+/-0.1 (62.2+/-15.4), 0.3+/-0.2 (24.5+/-13.0), 0.4+/-0.2 (7.2+/-18.8), 0.5+/-0.1 (7.2+/-11.3), 0.7+/-0.2 (11.0+/-7.5), and 0.8+/-0.3 (4.4+/-14.4), respectively. In step velocity (SV) test, gains stimulating the lesion side were significantly lower than those stimulating the intact side in both low- and high-acceleration SV test (p<0.05) and per-rotatory gain stimulating the lesion side in high-acceleration SV test was significantly lower than that in low-acceleration SV test. Tc stimulating the lesion side were significantly shorter than those stimulating the intact side in low- acceleration SV test (p<0.05) but not in high-acceleration SV test. Per- and post-rotatory Tc in high-acceleration SV test stimulating the intact side was significantly lower than those in low-acceleration SV test (p<0.05). CONCLUSION: At high-frequency SHA test, gain was pretty normal and phase lead was observed in some patients. High-acceleration SV test showed shortened Tc regardless of the sides, suggesting that high-acceleration SV test can reveal the impaired velocity storage system in patients with vestibular neuritis more frequently than low-acceleration SV test.

Mucosal Melanoma of the Sinonasal Tract: Retrospective Analysis of 38 Patients of a Single Institution / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mucosal melanoma comprises 1.3% of all malignant melanomas and mainly occurs at the oropharynx and the sinonasal cavity in the head and neck area. Five year survival rate is about 10-46%. We aimed to investigate the clinical features and treatment outcomes of 38 patients with sinonasal malignant melanoma (SNMM). SUBJECTS AND METHOD: A retrospective review of medical records was carried out on 38 patients who were diagnosed as SNMM between August 1995 and December 2012. Clinical features were evaluated and tumors were staged according to the TNM staging system. The Kaplan-Meier method was used to assess survival in the cohort. RESULTS: The 38 patients consisted of 18 males and 20 females, ranging in age from 36 to 91 years, with a median age of 59 years at diagnosis. Common symptoms were nasal obstruction and epistaxis, and mean symptom duration to diagnosis was 2.0 months. The main treatment modalities were surgery only (n=18) or surgery plus adjuvant radiotherapy (n=9). Distant metastases were detected in 15 patients (39.5%) at 8 months after initial therapy. Overall 5-year survival rate was 45.6%. There was no significant difference in survival rate between patients who underwent surgery only and those who had surgery with postoperative radiation (p=0.359). CONCLUSION: Sinonasal mucosal melanoma is a highly recurrent tumor (80% recurrence rate) with poor prognosis (5-year survival rate; 46%). As radiation treatment and/or chemotherapy are not so effective for the recurrent tumor, early detection and surgical resection are mandatory at present. New treatment modality should be developed to improve the survival rate.

A Case of Facial Nerve Paralysis Following Parotid Abscess Treated by Catheter Drainage / 대한이비인후과학회지

Facial nerve paralysis is one of the complications of parotid abscess. Although a few cases of benign tumor and inflammatory condition of parotid gland with the facial nerve paralysis have been reported, the occurrence of facial nerve palsy following parotid abscess without coexisting tumor is very rare. The mechanism of facial nerve paralysis is not clear, but facial nerve paralysis is usually improved after the treatment of parotid abscess. The treatment of parotid abscess is composed of antibiotics based on proper culture study and drainages. Most of parotid abscess is drained by surgical approach, but catheter drainage is also recommended for selected patients. Here, we report a case of parotid abscess treated by pig-tail catheter drainage.