Comparison of Speech Audiometry Using KS Word List and Hahm's List in Hearing Impaired Adults / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare speech audiometry test results of the conventional Hahm's list with those of Korean standard word lists for adults (KS-WL-A) using both live voice and compact disc (CD) speech presentation modes. SUBJECTS AND METHOD: Eighty patients with sensorineural hearing loss and 23 control subjects with normal hearing participated in the study. Each hearing loss group comprised 20 subjects (mild, moderate, moderately severe, and severe hearing loss groups). Speech audiometry was performed to measure the speech recognition threshold (SRT) and word recognition score. KS-WL-A was presented either through a live voice mode or recorded CD materials. Test words from Hahm's list were presented using the live voice mode only. Pure tone audiometry was also conducted for all subjects. RESULTS: Differences between the SRT and pure tone average were within 6 dB in all subgroups in all three stimulation methods, indicating high reliability of the SRT in both the conventional and Korean standard methods. The moderate, moderately severe, and severe hearing loss groups showed lower word recognition scores in the CD mode with KS-WL-A than with the two live voice modes. CONCLUSION: Both the live voice mode and CD mode showed reliable speech audiometry test results in normal and hearing-impaired subjects. Although the CD mode is recommended to standardize test methods and reduce test errors, the live voice mode might be more effective for patients with moderate to severe hearing loss.

Reliability of Speech Recognition Threshold Test Using the Korean Standard Bisyllabic Word List for Adults in Comparison with Conventional Hahm's List / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare a newly developed Korean standard bisyllabic word list for adults (KS-BWL-A) against the conventional Hahm's List based on the reliability in speech recognition threshold (SRT) test. SUBJECTS AND METHOD: Twelve adults with normal hearing and 11 hearing-impaired patients participated in this study. After excluding 10 words that are common in both lists, 26 bisyllabic words from each list were used for comparison in this study. SRTs were obtained using the modified ascending method. RESULTS: The mean SRTs measured by KS-BWL-A were 1.9 dB lower for the normal hearing group and 2.7 dB lower for the hearing-impaired group than those measured by the conventional Hahm's list with statistical significance (p=0.025 and p=0.045). In both groups, the pure tone averages (PTAs) were highly correlated (correlation coefficient >0.7, p<0.001) with SRTs measured using old and new lists, and the differences between PTA and SRT were within 3 dB for both lists. CONCLUSION: These results suggest that both KS-BWL-A and the conventional list are reliable methods as adult SRT tests and that two lists are not considerably different. However, speech recognition was slightly easier by the new list than it was by the conventional list. Authors propose the KS-BWL-A as a standard word list for SRT measurement in Korea.

Diagnostic Value of Cochlear Hydrops Analysis Masking Procedure in Meniere's Disease in Comparison with Electrocochleography / 대한평형의학회지

BACKGROUND AND OBJECTIVES: Patients with Meniere's disease often present with a great variety of symptoms, especially at the onset of the disease. However, there is no single test that is definitive for making the diagnosis of Meniere's disease. Recently, a new diagnostic test, the cochlear hydrops analysis masking procedure (CHAMP) was introduced as a test for endolymphatic hydrops. The aim of this study is to evaluate the diagnostic value of CHAMP test in Meniere's disease in comparison with that of electrocochleography. MATERIALS AND METHODS: The CHAMP test and electrocochleography were simultaneously performed in 14 cases of definite Meniere's disease and 8 normal healthy volunteers (16 ears). Positive criteria were defined as being more than 0.35 in summating potential/action potential (SP/AP) ratio, 0.3 ms or less in latency delay and 0.95 or less in complex amplitude ratio. Measured parameters from each test were compared between the groups, and sensitivity and specificity of each test in diagnosing Meniere's disease were calculated. RESULTS: There was no significant difference in the SP/AP ratio of electrocochleography between the Meniere's disease and control groups. In CHAMP test, the latency delay was shorter and the complex amplitude ratio was smaller (p<0.001). While taking positive results from both test parameters, the sensitivity and specificity of CHAMP test were 85.7% and 87.5%, respectively. CONCLUSION: The CHAMP seems to be a clinically useful tool in diagnosing Meniere's disease and might be better than electrocochleography to detect endolymphatic hydrops.

Clinical Analysis of Delayed Improvement in Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of the study was to evaluate the time-dependent progress and the delayed improvement in patients who were already treated by combination therapy including oral steroid for idiopathic sudden sensorineural hearing loss. SUBJECTS AND METHOD: This study examined patients presenting with idiopathic sudden sensorineural hearing loss at a secondary referral and a university-based center over 10 years. This retrospective study included only those patients who could be followed up for at least 3 months. RESULTS: Of 121 patients who recovered over the 3 months of follow-up period, 9.9% showed a delayed recovery of later than 1 month after discharge. Of 55 patients who did not recover until the discharge but recovered thereafter, 78.2% recovered within 1 month, 5.5% recovered between 1 to 2 months, 12.7% recovered between 2 to 3 months, and 3.6% recovered 3 months later after the discharge. The delayed recovery was found frequently in partial or slightly recovery groups by Siegel's criteria. CONCLUSION: This study demonstrated the presence of delayed recovery in patients who were treated by combination therapy, including oral steroid for idiopathic sudden sensorineural hearing loss, although this result should be further studied by additional research.

Correlation between Anterior Inferior Cerebellar Artery Loop and Otologic Symptoms / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The correlation of anterior inferior cerebellar artery (AICA) vascular loop around cerebellopontine angle (CPA) and otologic symptoms remains controversial. The objective of this study was to evaluate the relationship of the anatomical type of AICA loop and otologic symptoms according to the findings of 3-dimensional Fourier transformation constructive interference in steady state (3DFT-CISS) MRI. SUBJECTS AND METHOD: 316 ears from 165 patients were included in this study. Otologic symptoms and the results of pure tone audiometry, auditory evoked potential, and electronystagmography were checked by retrospective chart review. AICA loops were classified by its configuration on 3DFT-CISS MRI. According to their extension depth in internal auditory canal (IAC), the loops were classified as type I (lying within CPA), type II (from porus acusticus to 50% of the length of IAC), and type III (extending beyond 50% of IAC). In addition, the loops were classified as S (small) and L (large) by comparing the thickness of the loop with adjacent facial nerve. RESULTS: The predominant type of AICA loop was type I (62.0%) and type S (72.8%). Ears with type III loop presented significantly higher rate of hearing impairment than those with type I or II. There were no significant differences in pure tone threshold, hearing loss in 3 consecutive frequencies, canal paresis, and AEP latencies among 3 AICA types classified with the depth of the loop. Ears with type S AICA loop showed significantly higher rate of hearing impairment, elevated threshold, hearing loss in 3 consecutive frequencies, and canal paresis than those with type L loop. CONCLUSION: The small diameter of AICA loop had significant association with hearing impairment and otologic test abnormalities. Impaired blood flow through the vascular loop and resultant hypoperfusion of inner ear may be the pathophysiologic mechanism of vestibulocochlear nerve compression syndrome.

Assessment of the Mastoid Pneumatization in Unilateral Chronic Otitis Media: Is the Underdeveloped Mastoid Air Cells a Cause or a Consequence of Otitis Media? / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We evaluated the cause-and-effect relationship of the mastoid pneumatization and otitis media. SUBJECTS AND METHOD: We assessed the volume of the mastoid pneumatization and several parameters indicating the size of the temporal bone in healthy ears and ears with chronic otitis media (COM). Forty patients with unilateral COM were used for the study, and healthy subjects were chosen as control by matched sampling of corresponding age and sex. Assessment was performed using a quantitative digital image processing computed tomography program. RESULTS: In COM patients, the mastoid volume and one variable indicating the size of the temporal bone were greater on the healthy side than on the diseased side (p0.05). CONCLUSION: The mastoid size may be determined genetically, and environmental factors such as infection may also affect the mastoid size. However, this study supports that environmental factors mainly determine the degree of mastoid penumatization, rather than genetic factors, as far as COM is concerned.

Analysis of Morphologic Differences between Pneumatic and Sclerotic Mastoids in the Unilateral Sclerotic Temporal Bone / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Some pathologies, such as otitis media or E-tube dysfunction, may cause sclerosis in the temporal bone, which then tends to shrink in size. The aim of this study is to evaluate morphologic changes that result from sclerosis in the temporal bone. SUBJECTS AND METHOD: We measured 9 variables on 2 axial images and 7 variables on 2 coronal images in healthy ears and diseased ears of 37 unilateral chronic otitis media patients. We also measured the volume of the mastoid pneumatization. RESULTS: The mastoid volume in the sclerotic temporal bones was significantly smaller than that in the pneumatic ones. The distance from sigmoid sinus to Henle's spine was most significantly correlated to the degree of volume reduction, and it accounted for about 17.7% of the total variation in volume reduction. There was no difference in sigmoid sinus types between sclerotic and pneumatic mastoids. CONCLUSION: The sclerosis of the temporal bone reduces the volume of mastoid pneumatization. However, the large portion of volume reduction may result from the sclerotic change in the air cell system, rather than from the shrinkage of the mastoid bone. So, the location of surgically-important structures in the middle and inner ears is rarely changed in the sclerotic temporal bone.

The Latency of Distortion Product Otoacoustic Emissions in Normal Ears / 대한이비인후과학회지

Distortion-Product Otoacoustic Emissions(DPOAEs) are thought to be generated from the cochlear outer hair cells. DPOAEs can be measured in the external ear canal twofold:amplitude and latency. However, most DPOAE studies deal with amplitude aspects. If DPOAE latency is related to the progression of the traveling wave along the basilar membrane, it may also reflect the cochlear function. The purpose of this study was to investigate if the latency measurement could be used as a clinical test of hearing. For this purpose, DPOAE latency measures were examined as a function of frequency from 1 to 8 kHz in 38 normal ears from 19 adults(7 females and 12 males). Results showed that the latency decreased as frequency increased up to 6 kHz. Test/retest reliability was relatively high in 4-6 kHz and the lowest at 1 kHz. There was no gender effect for all test frequencies. The results suggest that the measurement of DPOAE latency has a clinical potential, but more data be obtained before it can be clinically used.

Nonauditory Factors on Distortion Product Otoacoustic Emissions / 대한이비인후과학회지

Distortion product otoacoustic emissions(DPOAEs) have emerged as a promising clinical tool for measuring hearing status. This investigation examined the influence of four variable (test/retest reliability, test environment, gender and number of measurement points of resolution/octave) on the DPOAE response when obtained using a commercially available system, Otodynamics ILO92. Twenty normal hearing adults(10 males and 10 females) served as participants in this study. DPOAE measurements were obtained over three test sessions(baseline, 1 week retest, and a 10 minute retest following the one week measurement). Results showed that: 1) correlations were high across the three test sessions;2) test environment considerably affected the DPOAE measures below 4kHz;3) DPOAE amplitudes were significantly greater in females than males at 3 and 6kHz;and 4) DPOAE amplitudes were not affected significantly by the number of resolution points employed.