Clincal Analysis of Stapedial Fixation with Stapedotomy Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Stapedial fixation is most commonly found in congenital anomaly of middle ear. Congenital middle ear anomaly without anomaly of the auricle and inner ear is rare. The surgery of stapedial fixation has evolved during the last 50 years from total to partial stapedectomy, and finally to stapedotomy. Stapedotomy is less likely to induce iatrogenic inner ear lesions and results in better hearing in the higher frequencies than stapedectomy. In recent years, stapedectomy has increasing tendency to be replaced by stapedotomy. This study was carried out to analyse clinical features of stapedial fixation and evaluate the degree of the auditory improvement, and also to analyse the factors affecting the results after stapedotomy. MATERIALS AND METHOD: From Jan. 1992 to Aug. 2001, we analysed 25 cases (23 patients) of stapedotomy operated by one surgeon for stapedial fixation at Asan Medical Center. The clinical features, preoperative and postoperative audiologic findings, postoperative complication and factors affecting the results were analysed. RESULTS: Preoperative mean bone and air conduction thresholds were 26.5 dB, 64.0 dB, respectively and mean air-bone gap was 36.5 dB. After stapedotomy, mean bone and air conduction thresholds were 24.9 dB, 37.0 dB, respectively at the last audiologic follow-up. In one case, sensorineural hearing loss was observed. There were no significant differences of results associated with bilaterality, length of piston wire and con-commitent other ossicular anomaly. CONCLUSION: Stapedotomy is effective and safe for stapedial fixation. But there is a need for carefulness and meticulousness because of complication. There may need various operative trials and larger scale studies to study about factors affecting the results after stapedotomy.

Comparative Analysis of Sleepstrip Versus Laboratory Polysomnography in the Diagnosis of Sleep Disordered Breathing / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Polysomnography is regarded as the gold standard in the diagnosis of sleep disordered breathing, although it is too expensive and uncomfortable to use. There has been a need for more simple and cost-effective techniques to screen large populations for suspected sleep disordered breathing. The aim of this study was to compare sleep parameters between Sleepstrip and laboratory polysomnography in the diagnosis of sleep disordered breathing. MATERIALS AND METHOD: A prospective study was undertaken in 20 patients in whom polysomnography and Sleepstrip were performed simultaneously before surgery from January 2001 to March 2001. Sleepstrip monitored the patients' respiration during sleep, analyzed respiration patterns in real time, and displayed the computed apnea hypopnea index (AHI) on its built-in display the following morning. RESULTS: The correlation between respiratory disturbance index (RDI) of polysomnography and AHI of Sleepstrip was 0.661 (p<.01). When the polysomnography threshold for a positive diagnosis for sleep disordered breathing was set at RDI=20 and the threshold for Sleepstrip 5, sensitivity and specificity of the device were found to be 0.875 and 0.833, respectively. CONCLUSION: Availability of Sleepstrip at a fraction of the cost of a whole night polysomnographic recordings may greatly facilitate the clinical diagnosis of large majorities of yet undiagnosed sleep disordered breathing. Sleepstrip may also prove useful for large scale epidemiological studies and for long term follow-up's of patients after surgery.

Cholesterol granuloma of the paranasal sinuses: Report of five cases / 대한이비인후과학회지

It is common to find cholesterol granuloma in the mastoid antrum and air cells of the temporal bone, but it is very rare in paranasal sinuses, especially in ethmoid sinus. Diagnosis is rarely suspected preoperatively, and depends on the finding of characteristic histological picture. It is currently thought that disturbed ventilation, impaired drainage and hemorrhage play a significant role in the formation of cholesterol granuloma. Five cases with cholesterol granuloma of the paranasal sinus, one that was limited to ethmoid sinus and the others of the maxillary sinuses, are presented and discussed.