Validation of a Korean Version of the Tinnitus Handicap Questionnaire

OBJECTIVES: The goal of the present study was to evaluate the reliability and validity of the Korean version of the tinnitus handicap questionnaire (THQ-K). METHODS: A total of 60 patients were included in this study. Patients responded to the THQ-K, the tinnitus handicap inventory (THI), Beck's depression index (BDI), and the visual analogue scale (VAS) for loudness and pitch, loudness match, and minimum masking level (MML) test were performed. RESULTS: Internal consistency of the THQ-K was examined using Cronbach coefficient alpha. Cronbach alpha was 0.96. The THQ-K showed a significant correlation with THI, BDI, VAS for distress, and VAS for loudness, but no significant correlation with psychoacoustic measurement of tinnitus, such as loudness match, pitch match, and MML. CONCLUSION: The THQ-K is a reliable and valid test for evaluating the degree of handicap due to tinnitus for both research and clinical use.

Is Hypozincemia Related to Tinnitus?: A Population Study Using Data From the Korea National Health and Nutrition Examination Survey

OBJECTIVES: The aim of present study was to determine the relationship between serum zinc level and tinnitus using data from the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: The present study examined the relationship between serum zinc level and tinnitus using data from the KNHANES. A total of 2,225 KNHANES participants responded to the tinnitus questionnaire and provided blood samples to measure serum zinc concentration. Based on questionnaire responses, participants were categorized into control, mild tinnitus, moderate tinnitus, and severe tinnitus subgroups. RESULTS: There were no significant differences between groups in serum zinc level after adjustment for sex, age, and hearing loss. CONCLUSION: It was concluded that hypozincemia is not related to tinnitus in a large population.

Cognitive Behavioral Therapy for Tinnitus: Evidence and Efficacy

Tinnitus is defined as auditory perception without external sound. There is currently no cure for tinnitus. Cognitive behavioral therapy (CBT) is a tinnitus treatment that addresses the affected individual's reaction to tinnitus. It aims not to eliminate auditory perception as sound but to reduce or correct one's negative response to tinnitus. CBT identifies negative automatic thought and then evaluates its validity with the patient. It also aims to change negative automatic thought to more positive and realistic thought. In this way, tinnitus sufferers can function well despite the presence of tinnitus. Many studies have supported the efficacy of CBT for treating tinnitus. A meta-analysis of CBT for tinnitus also concluded that CBT is effective in treating tinnitus. Thus, CBT is considered a good option for treating tinnitus. We herein discuss the use of CBT for tinnitus with a literature review.

Effectiveness of Stapes Mobilization in Tympanosclerotic Stapes Fixation

BACKGROUND AND OBJECTIVES: Tympanosclerosis is a nonspecific and irreversible result of chronic inflammation or infection of the middle ear. However, there remains disagreement about how best to surgically treat tympanosclerotic ossicular fixation, with the controversy over its management when stapes is involved. The aim of this study was to evaluate operative findings and hearing results of tympanosclerosis involving the ossicular chain, which in turn would establish better surgical treatment of tympanosclerotic ossicular fixation. SUBJECTS AND METHODS: In this prospective study conducted from Mar 2000 to Dec 2007, 38 patients with tympanosclerosis who had undergone surgical treatment were evaluated. The clinical and operational records and pre- and postoperative pure tone audiograms were reviewed. RESULTS: Operative findings showed stapes fixation is the most common. In 8 patients (21.1%), stapes was mobile, while, in the remaining 30 patients (78.9%), stapes fixation was found. In all cases with stapes fixation, stapes mobilization was possible. Following hearing result reporting guideline by the Korean Otological Society, the success rate of middle ear surgery was 68.4% (26 of 38 patients). In cases with stapes fixation, the success rate was 66.6% (20 of 30 patients), while, in cases with no stapes fixation, the success rate was 75.0% (6 of 8 patients). However, there was no statistical significance between the two groups. CONCLUSION: Stapes fixation was found in 78.9% of tympanosclerotic ossicular fixation. In management of tympanosclerotic stapes fixation, meticulous excision of tympanosclerotic plaques and removal of new bone formation around stapes footplate after adequate exposure could achieve a relatively good hearing result without stapes surgery.

Two Cases of Skull Base Osteomyelitis in Elderly Patients after Mastoidectomy

Skull base osteomyelitis (SBO) is a rare disease and may develop as a complication of paranasal sinusitis or other regional infectious process. The characteristic symptom of SBO is headache and paralysis of cranial nerve. A potentially life-threatening disease, it requires aggressive antibiotic treatment. We present 2 cases of SBO. One case who were not immunocompromised or diabetics had paralysis of lower cranial nerves. The patient was effectively treated with complete mastoidectomy and antibiotics, so had a complete recovery. But, the other patient who were insulin-dependent diabetes mellitus was died due to meningitis and pons palsy.

A Case of Superior Semicircular Canal Dehiscence Syndrome Treated with Surgical Repair / 대한이비인후과학회지

Superior semicircular canal dehiscence syndrome (SCDS) is a rare disease caused by dehiscence in the bone overlying superior semicircular canal. Patients with SCDS present vestibular and auditory manifestations including dizziness and hyperacusis. These manifestations can be controlled by surgical repair of the dehiscence such as plugging or resurfacing the defect. We report a case of a 25 year-old man with SCDS who underwent surgical repair of dehiscence through middle fossa approach.

Regulation of Gap Junctional Intercellular Communication in Human Keratinocyte Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Unlike the normal skin, cholesteatomas characterized by hyperproliferative keratinocytes exhibits up-regulation of connexins (Cxs) and gap junctional intercellular communication (GJIC). Currently, there are no appropriate clinical methods that can inhibit cholesteatoma progression nor are there available optimal in vitro models of cholesteatomas. The objectives of this study were to identify the regulating materials that control GJIC using human keratinocyte cells (HaCaT) and to get preliminary information about how to inhibit cholesteatoma progression with an aim to make in vitro models. MATERIALS AND METHOD: Acetic acid (AA), H2O2, dexamethasone, retinoic acid (RA), or green tea extracts-epicatechin (EC) and epigallocatechin gallate (EGCG) were used for this study. After HaCaT cells were cultured with chemicals for 24 hours, cytotoxicity was quantitatively analyzed by cell counting and Neutral-red uptake test. Reverse transcriptase-polymerase chain reaction, Western blot and immunocytochemistry were performed to analyze the change of Cx expression. GJIC was functionally evaluated with scrape-loading dye transfer (SLDT). RESULTS: After the 24-hour culture, H2O2 or EGCG (100 microM) were observed to have interfered with cell growth. In the Western blot, Cx26 and Cx30 showed higher up-regulation by EGCG or dexamethasone, but less down-regulation by AA or H2O2 than the control. In comparison with the control, immunocytochemistry (Cx26, Cx43) showed less expression and abnormal location of Cxs under AA, H2O2, or 50 microM EGCG than the control, and increased up-regulation or equal expression under 5microM EGCG, EC, RA, or dexamethasone was greater than the control. In SLDT, dye transfer was significantly lower in AA-, H2O2-, dexamethasone-, or RA-treated cells than in the control cells. EC showed higher dye transfer than the control cells. CONCLUSION: The expression of Cxs and GJIC on human HaCaT keratinocytes can be up- or down-regulated by chemicals such as AA, H2O2, dexamethasone, or EC. These results may be useful information in understanding the progression or inhibition mechanisms of cholesteatomas.

Intranasal Phototherapy in the Patients with Perennial Allergic Rhinitis

BACKGROUND AND OBJECTIVES: Phototherapy has a profound immuno- suppressive effect and is widely used for the treatment of immune- mediated skin diseases. The purpose of this study was to investigate the effectiveness of intranasal phototherapy in treating patients with perennial allergic rhinitis. MATERIALS AND METHODS: We conducted a study on 19 patients with perennial allergic rhinitis from January 2008 to July 2008. Each intranasal cavity was illuminated three times in the first week and then once a week the following five weeks. Symptom scores and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were assessed. RESULTS: Phototherapy was well tolerated by the patients and resulted in a significant improvement of clinical symptoms for rhinorrhea, nasal obstruction, nasal itching, sneezing and total nasal score. In addition, significant improvements were achieved for itching of eyes, itching of the palate and total non-nasal symptom score except tearing and redness of eyes. After six weeks, the overall RQLQ scores significantly improved by 51% from the baseline in the treatment. CONCLUSION: These Results suggest that phototherapy is an effective modality for treating clinical symptoms of perennial allergic rhinitis and represents an alternative treatment for perennial allergic rhinitis.

MALT Lymphoma in Both Parotid Glands of a Patient with Systemic Lupus Erythematosus / 대한이비인후과학회지

Malignant lymphoma of salivary gland is rare and takes 2-5% of all neoplasm of salivary glands. Mucosa-associated lymphoid tissue (MALT) lymphoma is known as a unique subtype of Non-Hodgkin's lymphoma. Since MALT lymphoma tends to be an indolent and localized disease, complete surgical resection is able to be performed as a single treatment. In this article, we present a case of MALT lymphoma in both parotid glands of the patient with systemic lupus erythematosus, who underwent both superficial parotidectomy

A Study for the Characteristic Frequency of Korean Disyllabic Word List / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Speech audiometry is a useful test for obtaining practical information which could not be gotten from the pure-tone audiometer test. Nowadays, Hahm's Korean disyllabic word lists are the most commonly used word lists for the speech reception threshold test in Korea. The disyllabic word lists should be composed of spondaic words (equally stressed words). The aim of this study is to evaluate the characteristic frequency of Hahm's disyllabic word lists. SUBJECTS AND METHOD: Two of the Hahm's disyllabic word lists were evaluated. The word lists were analyzed using an acoustic analysis program that has the MATLAB function. RESULTS: The percentage of disyllabic words in the Hahm's disyllabic word lists that had the spondaic words pattern were 33%. The characteristic frequencies of these words were equally stressed above 1,000 Hz. Other disyllabic words showed an unequally stressed pattern. The percentage of words that had the first syllable stressed pattern was 31% and the percentage of second syllable stressed pattern was 36%. CONCLUSION: Some words, which are commonly used in the Hahm's disyllabic words lists, had an unequally stressed pattern. A new Korean dissyllabic word list needs to use more balanced words that have the characteristic frequency of each word.

Clinical Significance of the Survivin Expression in Intrahepatic Cholangiocarcinoma with Hepatolithiasis

PURPOSE: Hepatolithiasis has been regarded as having a potential of to invoke cholangiocarcinogenesis. The aim of this study was to examine the expression of survivin in hepatolithiasis and cholangiocarcinoma, and to try to predict whether hepatolithiasis plays a role in the carcinogenesis of cholangiocarcinoma. We also investigated the expression of survivin according to subcellular sites (cytoplasmic and nuclear) in the cholangiocarcinoma specimens and to correlation this with the clinical outcome. METHODS: Thirty-four surgically resected hepatolithiasis specimens and ten stone-containing cholangiocarcinoma specimens were the focus of this study. Immunohistochemical staining was done to check the expression of survivin in the hepatolithiasis and cholangiocarcinoma specimens. We classified the survivin positive group according to the subcellular sites in the cholangiocarcinoma specimens. RESULTS: The expression rate of survivin was 5.9% in the hyperplasia specimens, 47.1% in the dysplasia specimens and 90% in the adenocarcinoma specimens (p < 0.01), respectively. The over expression of nuclear and cytoplasmic survivin was seen in 3 specimens and 6 specimens, respectively, among the survivin positive specimens (9 total specimens) of the cholangiocarcinoma specimens. The median survival time of the nuclear and cytoplasmic expression groups of patients was 1.5 months and 10 months, respectively. CONCLUSION: We conclude that the overexpression of survivin in hepatolithiasis could be associated with cholangiocarcinoma based on the sequentially increased survivin expression. We purpose that the nuclear survivin expression predicts aggressive clinical behavior of cholangiocarcninoma.

Regional Lymph Node Involvement by Renal Angiomyolipoma / 대한비뇨기과학회지

Renal angiomyolipomas are benign mixed mesenchymal tumors, which are composed of atypical blood vessel, smooth muscle and fat cells. A 34-year-old woman presented with a palpable right abdominal mass, accompanied with discomfort. A CT scan showed a large right perinephric mass, with heterogeneous density, surrounding the kidney, with enlargement of the regional lymph nodes. The presumptive diagnosis was one of a malignant tumor of the retroperitoneum, with lymph node metastasis or an angiomyolipoma, involving both the kidney and lymph nodes. A right radical nephrectomy, including the tumor, was performed. The final diagnosis was an angiomyolipoma arising from the kidney, with the dissected lymph nodes having the same pathology. There was no evidence of a tumor recurrence during the six month follow-up period. This was an unusual case of a multicentric angiomyolipoma.