Analysis of Results and Prognostic Factors according to the Beginning Time of Treatment of Lasix, Vitamin and Carbogen Inhalation Therapy on Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sudden sensorineural hearing loss generally refers to hearing losses of sensorineural origin, which have evolved over a period of a few hours to a few days. Therapy follows a polypragmatic approach based on the different theories of its origin. Therefore, drugs applied are mainly antiinflammatory, antiviral and vasoactive in nature. The likelihood of recovery is influenced by the shape of the audiogram, the age of the patients, and the presence or absence of vertigo. Very little information is available about the results of therapy for sudden sensorineural hearing loss with the delayed treatment. In this study, we evaluated the prognostic factors and therapeutic results of Lasix-Vitamin and carbogen inhalation therapy on sudden sensorineural hearing loss depending on the initiation time of treatment. SUBJECTS AND METHOD: We studied 167 cases of sudden sensorineural hearing loss, which were treated with Lasix-Vitamin and carbogen inhalation therapy at the Chung-Ang University Hospital from May 1990 to April 2004. In a retrospective chart review, we evaluated the prognostic factors and the results depending on different beginning time of treatment. RESULTS: The therapeutic results showed that 90 cases (53.9%) gained hearing recovery. Patients who were treated within 7 days of onset showed recovery in 64 cases (76.2%), but 26 cases (31.3%) of the patients with who began treatment later than 8 days showed improvement of 15 dB or more in hearing threshold in pure tone audiometry. Among many prognostic factor, dizziness showed statistically significant correlation with the final result of hearing recovery in the delayed treatment group. CONCLUSION: The patients with sudden sensorineural hearing loss must be treated within 7 days, and dizziness is significant prognostic factor of patient with delayed treatment.

2 Cases of Adenoid Cystic Carcinoma of the External Auditory Canal / 대한이비인후과학회지

Adenoid cystic carcinoma (ACC) is rare malignant tumor that affects major and minor salivary gland, ceruminous glands, and occasionally excretory gland of the female genital tract. While ACC accounts for less than 1% of all head and neck malignancies and approximately 10% of all salivary neoplasm, this tumor is one of the most common malignancies of the submandibular and minor salivary glands. ACC is characterized by a slow rate of progression, a tendency for perineural invasion, and a high recurrence rate after intensive surgery and adjuvant radiotherapy. ACC is divided into 3 types according to a distinctive histologic pattern. It is well known that the histologic pattern of ACC correlates well with the grade of tumors and prognosis. There are no clear guidelines for the treatment of ACC, but recently a combination of surgery and postoperative radiotherapy has been recommended. The most significant prognostic factors are clinical stage and distant metastasis. We present two cases of ACC arising from external auditory canal with a review of literature.

Predisposing Factors and Change of Organism Strains that Cause Severe Acute Tonsillitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Acute tonsillitis is a clinical condition of gross tonsillar infection. Since previous studies focused on immunology of tonsils and group A beta-hemolytic streptococcus, we have not had sufficient clinical analyses of acute tonsillitis, such as predisposing factors and change of organism strains causing tonsillitis. This study aims to explain many factors that seem to be related to severe acute tonsillitis, such as age, sex, seasonal distribution, days from initial symptoms to visit, body temperature, symptoms, past history, duration of hospitalization, number of patients of culture positive group, culture organisms and antibiotic sensitivity of common organism strains. SUBJECTS AND METHOD: In this study, researchers clinically reviewed 283 patients who were hospitalized at the Chung-Ang University Hospital at any time from January 1993 to December 2002. Throat smear was done at the surface of inflammed tonsils. RESULTS: Among 283 cases, 125 cases yielded pus plug. Seven strains of bacteria were isolated in 115 culture-positive cases. There were significant differences between Group A (from January 1993 to December 1997) and Group B (from January 1998 to December 2002) regarding organism strains isolated. In both Group A and B, group A beta-hemolytic streptococcus was the most common organism that caused severe acute tonsillitis. However, in Group B, other organism strains, such as Pseudomonas aeruginosa and Enterococcus, increased in number and in their resistance to penicillin and cephalothin. The researchers found no predisposing factors that were related to severe acute tonsillitis. CONCLUSION: To sum up, this study demonstrates that we may reconsider the use of antibiotics such as penicillin and cephalothin for severe acute tonsillitis. This study calls for further studies about the change of organism strains that cause severe acute tonsillitis and about the predisposing factors that affect severe acute tonsillitis.