Audiologic Status of Children with Confirmed Cytomegalovirus Infection: a Case Series

Background@#Congenital cytomegalovirus (CMV) infection is the most common non-genetic cause of sensorineural hearing loss (SHNL) in children. Only about 10% to 15% of children with congenital CMV are symptomatic, and most are not diagnosed at birth. About 7% to 15% of clinically asymptomatic patients may develop later complications, including SNHL, which is the most common sequela in clinically asymptomatic patients. In this study, hearing status was investigated in children with confirmed CMV infection and neonatal hearing screening (NHS) histories were reviewed to explore hearing loss caused by CMV. @*Methods@#The medical records of 58 children who were diagnosed with confirmed CMV infection were reviewed for clinical symptoms and signs of CMV infection. Hearing status was evaluated with age-appropriate audiological test batteries. @*Results@#A total of 58 children (M:F = 32:26 patients; age at study: mean, 5.62 years, range, 1-10 years) were diagnosed serologically with CMV infection (14 patients, 21.1%), or diagnosed via PCR of serum (5, 7.9%) and/or PCR from urine (19, 26.8%). Hearing loss was confirmed in 11 children (19.0%), being bilateral in 6 (54.5%), and unilateral in 5 (45.5%). Note that 7 of 17 ears with hearing loss passed NHS and were diagnosed only after re-evaluation when CMV infection was identified. @*Conclusion@#Hearing loss is a serious complication of CMV infection in children. Our results highlight the importance of timely audiological evaluation in children with clinically symptomatic CMV infection even if they pass NHS.

Role of Emotional Distress in Prolongation of Dizziness: A Cross-Sectional Study

BACKGROUND AND OBJECTIVES: Dizziness is a common condition in outpatient clinics. Comorbid conditions such as anxiety and/or depression often complicate a patient’s ability to cope with dizziness. The purpose of the present study was to explore the extent of psychiatric distress using the Hospital Anxiety and Depression Scale (HADS) and to compare the results with the subjective severity of dizziness. SUBJECTS AND METHODS: The cross-sectional study included a total of 456 consecutive patients presenting with acute (n=327) and chronic (n=127) dizziness symptoms. The HADS was used to estimate emotional distress and compare between patients with acute and chronic dizziness symptoms. Also, we calculated correlations between subjective dizziness handicap scores and emotional distress using the total and subscale scores of the Dizziness Handicap Inventory (DHI), Disability Scale (DS), and HADS. RESULTS: The HADS total and subscale scores were significantly increased in patients with chronic dizziness (p<0.01) compared with those with acute symptoms. In patients with symptoms of both acute and chronic dizziness, moderate correlations were evident between the DHI and HADS total scores. When we compared DHI subscale scores with the HADS scores, the emotional DHI subscale scores correlated more highly with the HADS total scores and the scores on the anxiety and depression subscales, than did the functional or physical DHI subscale scores. CONCLUSIONS: Increased levels of distress measured using the HADS in patients with chronic symptoms suggest that emotional status of the patients may contribute to prolongation of dizziness symptoms from the acute phase.

Comparison of Acceptable Noise Levels Using Korean and Non-Semantic Speech Signals in Normal Hearing Subjects / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The acceptable noise level (ANL) test measures the maximum noise level that a subject can tolerate while following speech. Given the limited investigation of ANL across different languages, this study aimed to compare ANLs using both Korean semantic speech and non-semantic speech signals (reversed Korean speech and international speech test signal, ISTS) in normal-hearing subjects. SUBJECTS AND METHOD: Twenty-five subjects with normal hearing (9 males, 16 females, with the mean age of 28.5±3.15 years) were included in the study. ANLs were obtained using three speech materials (Korean speech, reversed Korean speech, and ISTS) as the target speech material and an eight-talker babble noise as the competing background noise. RESULTS: Generally, the inter-subject variability was large. The ANLs did not differ statistically regardless of the type of speech signal. CONCLUSION: The ANLs seemed to be unaffected by the meaningfulness or semantic contents of the target speech, at least in normal-hearing adults. Thus, non-meaningful speech signals or non-semantic material can be considered as the target signal for the implementation of ANL test.

A Case of Incus Vibroplasty: Postoperative Changes in Residual Hearing

In patients with mild to severe hearing loss, conventional hearing aids offer limited benefits and several problems with feedback and cosmesis. Middle ear implants are a feasible option for patients with moderate to severe hearing loss who are unable to achieve adequate benefit from or cannot tolerate hearing aids for various reasons. Here we present a case of middle ear implant surgery using Vibrant Soundbridge with incus vibroplasty technique, and describe the hearing changes during postoperative follow-up.

Long-Term Outcomes of Acute Low-Tone Hearing Loss

BACKGROUND AND OBJECTIVES: Although acute low-tone hearing loss has been associated with cochlear hydrops or early stage Meniere's disease, its prognosis in the short-term has been reported to be better than sudden hearing loss. However, recurrence of hearing loss and possible progression to Meniere's disease remain important concerns in the clinical setting. This study aims to investigate the long-term audiological outcomes of acute low-tone hearing loss. SUBJECTS AND METHODS: A retrospective review of patients presenting with a first attack of acute low-tone hearing loss was performed. Of the 77 patients, 33 were followed up for more than 3 months. Progression, recovery of hearing loss and recurrence of hearing loss were examined. Also, correlation between long-term outcomes and associated clinical factors were analyzed. RESULTS: Twenty-five patients (75.7%) had complete hearing recovery, five patients (15.1%) had partial recovery, two patients (6.0%) had no recovery, and one patient (3.0%) had progression of hearing loss 1 month after initial treatment. Thirty-three patients were followed up for more than 3 months (mean 22 months, range 3-79 months). Recurrences of acute low-tone hearing loss were observed in five patients (15.2%). All of the recurrences occurred during the first 12 months of follow-up. Long-term prognosis correlated with the initial therapy results (R2=0.693). CONCLUSIONS: Recurrences of hearing loss were documented in five patients (15.2%), and all of these cases occurred within one year of the first attack. Audiological outcomes after initial therapy may predict the recurrence of acute low-tone hearing loss.

The Difference of External Auditory Canal pH in 3 Groups of Otitis Externa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The change of pH in the external auditory canal (EAC) is an important factor in the pathogenesis of otitis externa. However, there is a lack of study focused in this area. Thus, we investigated the differences in the pH in the EAC between several different patient groups of otitis externa and the control group. SUBJECTS AND METHOD: There were 100 patients with otitis externa and 150 normal controls participated in this study. Patients with otitis externa were divided into 3 groups; acute or subacute infective otitis externa, chronic infective otitis externa and chronic allergic otitis externa. The pH of the EAC was measured in otitis externa patients and control subjects on their first visit. RESULTS: The mean EAC pH of the normal control subjects was significantly higher than that of the skin of other parts of the body. The pH difference among the 3 patient groups was statistically significant (the pH of acute or subacute infective otitis externa=6.83+/-0.64; the pH of chronic infective otitis externa=6.16+/-0.67 and the pH of chronic allergic otitis externa=5.78+/-0.59). CONCLUSION: The change in the pH of EAC can be considered as a predisposing factor of otitis externa. We quantified the level of pH at the EAC among three groups of otitis externa patients, and the results showed that the pH difference among the three patient groups was statistically significant. This study warrants a further investigation focusing on the proper choice of eardrops for otitis externa patients according to their pH at the EAC.