Retraction: The Effects of Intratympanic Steroid Injection for the Patients with Refractory Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

No abstract available.

Retraction: The Clinical Characteristics and Treatment Results of Bilateral Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

No abstract available.

The Clinical Characteristics and Treatment Results of Bilateral Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Most cases of sudden deafness remain idiopathic. The majority of these cases are unilateral in their occurrences, whereas bilateral simultaneous involvement is rarely seen. We analyzed the clinical characteristics and treatment results between bilateral and unilateral sudden sensorineural hearing loss (SSNHL), and considered the possible causes and provided available data for planning the appropriate treatment for bilateral SSNHL. SUBJECTS AND METHOD: Three hundred forty seven patients who visited the Department of Otolaryngology in Ajou University Hospital from June, 1994 to February, 2003 were classified into 3 groups. Of these 347 patients, 16 patients (32 ears) had SSNHL simultaneously in both ears (Group I), 23 patients had SSNHL sequentially in both ears (Group II), and 308 patients had unilateral SSNHL (Group III). We reviewed their charts for pure tone audiometry information, medical history and lipid panel information to compare bilateral SSNHL with unilateral SSNHL. RESULTS: The incidence of simultaneous bilateral SSNHL (Group I) was 4.6% of overall patients with SSNHL. Bilateral SSNHL occurs more commonly in patients of older age, with preexisting DM. Lpid panel abnormalities were compared with unilateral SSNHL. The recovery rate of hearing in simultaneous bilateral SSNHL (Group I) was 37.5% for both ears and 62.5% of patients, compared with 56.5% in unilateral SSNHL (Group III). CONCLUSION: Bilateral SSNHL is a very rare disease and the outcome from treatment is important for patients' quality of life. Recognition of similarities and differences between bilateral and unilateral SSNHL can help in counseling and managing the patients.

The Effects of Intratympanic Steroid Injection for the Patients with Refractory Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: High-dose steroid therapy has been known as the treatment of choice for sudden sensorineural hearing loss (SSNHL). However, about one third of patients do not generally respond to any treatments, and there seem to be no definitive treatment for the patients with refractory SSNHL. We prospectively studied the effect of intratympanic steroid injection (ITSI) for patients with refractory SSNHL. SUBJECTS AND METHOD: Sixty six patients with SSNHL, who were refractory to a course of oral steroid therapy, were included in this study. Thirty three patients (34 ears) were treated with ITSI and the other 33 patients had no further treatments as control. ITSI was performed with dexamethasone in the supine position on 4 separate occasions over the course of 2 weeks. Hearing was assessed immediately before every injection, and at 1 and 4 weeks after therapy. Hearing improvement was defined as more than 10 dB in pure tone average (PTA). RESULTS: Hearing improvement was observed in 13 (39.4%) of 33 patients who underwent ITSI and in 2 (6.1%) of 33 patients in control group. Five of 13 showed hearing improvement over 20 dB in PTA, and 11 of 20 patients showed no improvement in PTA by ITSI, but showed improvement over 10dB in some frequencies. There were no definite prognostic factors between the patients who responded to ITSI and those who didn't. CONCLUSION: ITSI is a simple and effective therapy for patients with refractory SSNHL.

Surgical Anatomical Landmarks for Petrous Apex / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Anatomical knowledge of the petrous apex is essential to otolaryngologist to explore the skull base lesions. This study was designed to investigate the surgical anatomy of the petrous apex and the middle cranial fossa. MATERIALS AND METHODS: We dissected 32 temporal bones in order to establish the anatomical relationships of petrous apex structures. We measured distances and angles between different structures so that surgeons can rely on to work in this area. RESULTS: The results of the present study showed distances and angles of the different petrous apex structures. The angle between posterior point-foramen spinosum and porus was 90 degree. CONCLUSION: We could suggest the new indicators to identify the internal acoustic canal.

Surgical Anatomy for the Extended Middle Fossa Approach / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The extended middle fossa approach is an essential method in approaching the internal acoustic canal and the cerebellopontine angle while preserving the hearing function. This work attempted to establish some anatomical landmarks in the petrous apex as it relates to the extended middle fossa approach. MATERIALS AND METHODS: We dissected 49 human skulls of Korean origin by using the extended middle fossa approach. RESULTS: Internal acoustic canal (IAC) was identified in an attempt to find reliable distances and angles to be used in the extended middle fossa approach. In addition, the dimensions of the fundus of IAC and IAC as well as the extension ranges were obtained. CONCLUSION: The extended middle fossa approach is a good method in approaching the internal acoustic canal and cerebellopontine angle. In this study, we have established anatomical landmarks for using this approach in the human skulls of Korean origin.

Surgical Anatomy for the Infracochlear Approach to the Petrous Apex / 대한이비인후과학회지

BACKGROUND: Infracochlear approach indroduced by Ghorayeb et al. in 1988, was performed to reach the petrous apex with the canal wall-down procedure. Giddings et al. described the transcanal infracochlear approach preserving the posterior wall of the external auditory canal for treatment of the cholesterol granuloma in the petrous apex in 1991. OBJECTIVES: Surgical anatomy for the infracochlear approach to the petrous apex was reviewed in order to understand clinical applicability of this approach. MATERIALS AND METHODS: This study was performed using 20 human cadaveric temporal bones by the microscopic dissection. Measurements were obtained between different structures to find reliable angles and distances to guide working in the petrous apex region. RESULTS: The petrous apex was entered through the fenestra between the cochlea, carotid, and jugular bulb. The mean area of the fenestrae was 11.7+/-5.5mm2. The distance from the vertical segment of the facial nerve to the petrous apex was 25.3+/-2.4mm. The angle of the approach to the petrous apex was 37.3+/-5.1degrees to the axis of the internal auditory canal. CONCLUSION: The infracochlear approach could be used to obtain the route for a drainage procedure or a biopsy at the petrous apex without damaging hearing organs and major vessels. The canal-down procedure was needed to assess the petrous apex successfully.