Surgical Findings and Results of Stapes Surgery for Stapedial Fixation in Adults / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Stapes surgery has been reported to improve hearing for stapedial fixation. This study aimed to review the surgical findings and hearing results of stapes surgeries for 20 ears with stapedial fixation. SUBJECTS AND METHOD: We reviewed the medical records and video recordings of 20 consecutive stapes surgeries between 2011 and 2014. Patient age ranged from 20 to 64 years, representing 5 males and 12 females. Mean audiologic follow-up duration was 11 months. Hearing improvement at the final pure-tone audiometry was determined to be successful when air-bone gap (ABG) was reduced to 20 dB or less, and excellent when ABG was reduced to 10 dB or less. Surgery-related deterioration of bone-conduction (BC) was determined to be positive when the difference between final and preoperative BC was more than 15 dB, and over-closure positive when final air-conduction (AC) was better than preoperative BC. RESULTS: Pre-operative threshold frequency for BC and AC were 39.8+/-15.8 and 66.4+/-15.3 dB HL, respectively, and ABG was 26.6+/-10.2 dB. After the stapes surgery, the thresholds for BC and AC were 36.8+/-16.3 and 42.0+/-16.2 dB HL, respectively, and ABG was 5.2+/-6.5 dB during the last follow-up. After surgery, BC threshold was significantly improved at 2 kHz, whereas AC threshold improved at all frequencies. Excellent hearing improvement was accomplished in 16 ears (80%) and successful improvement in all ears (100%). Over-closure was observed in 7 ears (35%). There were no patients with surgery-related sensorineural hearing loss. CONCLUSION: Stapes surgery is effective for improving hearing for stapedial fixation. Operator should be able to cope with various situations during or after the stapes surgery.

Changes of the Video Head Impulse Test Gains by the Directions of Head Rotation at Different Target Distances and Rotation Speeds / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The conventional instrument for video head impulse test (vHIT) records the movement of the right eye only. The aim of this study was to evaluate the changes in the gain of vHIT results qdue to different directions of head rotation directons at different target distances and rotation speeds. SUBJECTS AND METHOD: Horizontal head impulse was recorded by vHIT in 20 normal subjects. vestibulo-ocular reflex (VOR) gains to the right and left directions were compared at different test conditions. Two different impulses with low (50-150 deg/sec) and high (200-300 deg/sec) peak-head-velocities were tested and the subjects were also instructed to fixate a laser dot on a screen at different distances of 60, 100, and 200 cm. Eye movements were recorded on the right eye. RESULTS: Regardless of the target distances and peak-head-velocities, the VOR gains to the rightward head rotation were significantly greater than those to the leftward head rotation. In more than 85% of normal subjects, vHIT gain to the rightward head rotation was greater than that to the leftward head rotation. Mean gain asymmetries were 2.16-3.33% and the mean interaural vHIT gain differences were 0.04-0.07. CONCLUSION: Regardless of the target distances and peak-head-velocities, the VOR gains to the rightward head rotation were significantly greater than those to the leftward head rotation. Directional asymmetry of VOR gain should be considered when interpreting vHIT results in patients with vestibular disorders.

A Case of Recurred Follicular Lymphoma in Sublingual Gland after Complete Remission / 대한이비인후과학회지

Non-Hodgkin's lymphoma (NHL) is a group of neoplasm affecting the lymphoid system. Follicular lymphoma is typically a slow-growing, indolent form of NHL that accounts for 1/3 of all NHL. It is one of the B-cell lymphomas, generally characterized by multiple relapses after responses to a variety of therapies. When lymphoma relapses, it may occur in the same or a different part of the body from where it occurred originally. Recurrence in the primary site is most common but recurrence in other parts is rarely observed. We experienced a rare case of 70-year-old woman who complained of swelling in the left mouth floor and was diagonosed with a recurrent NHL. It recurred in the sublingual gland after a complete remission of the follicular lymphoma.

Clinical Analysis of High Resolution Manometry (HRM) in Patients with Laryngopharyngeal Reflux Disease / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: High resolution manometry (HRM), a newly developed device that uses 36 channels to plot pressure topography of esophagus, has recently been applied to evaluate the esophageal and upper esophageal sphincter (UES) status; however, its definite role in laryngopharyngeal reflux disease (LPRD) is not well elucidated. The aim of this study was to evaluate clinical usefulness of HRM and to elucidate the association between HRM findings and dysphasia in LPRD patients. SUBJECTS AND METHOD: A total of 56 patients who had been diagnosed LPRD from July 2010 to July 2011 were prospectively enrolled in this study. Patients consisted of 20 men and 36 women, with the mean age of 51.4 years. Every patient performed the questionnaire and HRM examination. A comparative analysis was performed to evaluate the correlation between the HRM results and LPRD. RESULTS: Of 30 patients (53.6%), there were 11 peristaltic dysfunction (19.7%), 6 relaxation impairment of lower esophageal sphincter (LES)(10.7%), 4 diffuse esophageal spasm (7.1%), 4 hypotensive LES (7.1%), 3 Nutcracker esophagus (5.4%), and 2 relaxation impairment of UES (3.6%). The mean distance of UES from the nostril was 17.88+/-2.17 cm and the mean UES basal pressure was 63.10+/-24.49 mm Hg. Differences between the prevalence of abnormal findings shown by HRM and dysphasia symptoms were not statistically significant. CONCLUSION: In this study, a considerable amount of abnormalities in esophageal function were observed using HRM, and thus we think that HRM could provide useful information about esophagus dysfunction in LPRD patients.

A Case of Bronchogenic Cyst in the Retropharyngeal Space / 대한이비인후과학회지

The bronchogenic cyst is an uncommon benign congenital anomaly of the primitive ventral foregut. They usually occur in the mediastinum and intrapulmonary regions. Localization in the cervical area is unusual and the majority of cases reported have been found in the pediatric population. Radiologically, it can not be differentiated from other cystic lesions. Therefore, it is pa-thologically confirmed only when there are bronchial tissues such as pseudostratified ciliated columnar epithelium, smooth muscle, mucous gland or cartilage. Since this cyst has potential for complication, a complete excision is mandatory. We recently experienced a case of retropharyngeal bronchogenic cyst presenting as a lump sensation in 32-year-old male. In this article, we reviewed the etiology, the diagnosis, and the treatment of this case with a review of the literatures.

Chromosoal Anomaly Diagnosed by Obstetric Ultra Sound / 이화의대지

No abstract available.