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Background and Objectives@#Epistaxis is one of the most common emergencies in otolaryngology, and the recently developed Rapid Rhino nasal pack, a balloon-type nasal packing device, is widely used in emergency departments. Rebleeding after initial treatment increases patients’ discomfort and medical costs. The aim of this study was to investigate risk factors for rebleeding in patients treated with Rapid Rhino packing. @*Methods@#In this retrospective study, 93 patients with epistaxis treated with Rapid Rhino from January 2020 to November 2022 were divided into the well-controlled group (39 patients) and the rebleeding group (54 patients), and the baseline characteristics, management methods, and complications were compared between these groups. The rebleeding group was divided according to whether patients experienced a single episode of rebleeding (38 patients) or multiple rebleeding episodes (16 patients), and the differences between these two groups were compared. @*Results@#Oral anticoagulation therapy was associated with a higher risk of rebleeding after Rapid Rhino packing (odds ratio [OR]=8.41, p=0.047). A history of nasal surgery was associated with multiple rebleeding (OR=22.55, p=0.009). Age, sex, the management method, complications, and the site of bleeding were not found to be related to rebleeding. @*Conclusion@#Patients with rebleeding after Rapid Rhino nasal packing had a higher rate of concurrent oral anticoagulation therapy. A history of nasal surgery was strongly associated with multiple episodes of rebleeding. A detailed medical history can be important for assessing the risk of rebleeding in epistaxis patients treated with Rapid Rhino packing.
ABSTRACT
BACKGROUND AND OBJECTIVES@#We reviewed the selection processes of contralateral routing of signal (CROS) hearing aids (HAs) and bone-conduction (BC) Has, and compared aided and unaided hearing thresholds.SUBJECTS AND METHOD: Twenty-four patients with asymmetrical hearing loss who used BC HAs (n=12) and CROS HAs (n=12) were enrolled. The choice of two different HAs were compared with respect to the degree of hearing loss, the unaided hearing thresholds and functional gains.@*RESULTS@#When the hearing thresholds of the better hearing ears were >30 dB HL, most (92%, 11 of 12) chose CROS rather than BC HAs, with significant difference (p=0.001). Both CROS and BC HAs groups showed significantly improved functional gains (46.6 dB and 53.4 dB, respectively). Aided air-conduction (AC) thresholds (40.2 dB HL) in the CROS group were similar to the AC thresholds (43.1 dB HL) of better hearing ears. However, the hearing threshold of Aided AC thresholds (35.8 dB HL) in BC HAs group were less than the BC thresholds (17.3 dB HL) of better hearing ears by 19 dB (p30 dB HL. The CROS group showed aided thresholds similar to the thresholds of better hearing ears, but the BC HAs group showed poorer aided thresholds than the thresholds of better hearing ears. For patients with asymmetric hearing loss, HAs should be selected based on the degree and types of hearing loss and the maximum output level of the selected device.
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OBJECTIVES: We aimed to compare clinical outcomes including hearing improvement and cholesteatoma recurrence between endoscopic and conventional microscopic surgeries in patients with attic cholesteatoma. METHODS: We collected data from patients with attic cholesteatoma who were treated using endoscopic (10 patients) and microscopic (10 patients) approaches by a single surgeon. The data were retrospectively reviewed for patient characteristics, intraoperative findings, hearing levels, and follow-up clinical status. Recurrence of the cholesteatoma, improvement of hearing, and operation time were evaluated. RESULTS: Ossiculoplasty was performed in four patients in the endoscopic group and two patients in the microscopic group. Lempert endaural incision II was used in all the patients in the microscopic group, whereas Lempert I incision was used in all the patients in the endoscopic approach group. There were no significant differences between the two groups regarding hearing improvement and operating time. And, there were no recurrences during the follow-up period in both groups. CONCLUSION: The endoscopic approach for the management of attic cholesteatoma is as useful as the microscopic approach.
Subject(s)
Humans , Cholesteatoma , Ear , Endoscopy , Follow-Up Studies , Hearing , Otitis Media , Recurrence , Retrospective StudiesABSTRACT
BACKGROUND AND OBJECTIVES: We reviewed the selection processes of contralateral routing of signal (CROS) hearing aids (HAs) and bone-conduction (BC) Has, and compared aided and unaided hearing thresholds. SUBJECTS AND METHOD: Twenty-four patients with asymmetrical hearing loss who used BC HAs (n=12) and CROS HAs (n=12) were enrolled. The choice of two different HAs were compared with respect to the degree of hearing loss, the unaided hearing thresholds and functional gains. RESULTS: When the hearing thresholds of the better hearing ears were >30 dB HL, most (92%, 11 of 12) chose CROS rather than BC HAs, with significant difference (p=0.001). Both CROS and BC HAs groups showed significantly improved functional gains (46.6 dB and 53.4 dB, respectively). Aided air-conduction (AC) thresholds (40.2 dB HL) in the CROS group were similar to the AC thresholds (43.1 dB HL) of better hearing ears. However, the hearing threshold of Aided AC thresholds (35.8 dB HL) in BC HAs group were less than the BC thresholds (17.3 dB HL) of better hearing ears by 19 dB (p30 dB HL. The CROS group showed aided thresholds similar to the thresholds of better hearing ears, but the BC HAs group showed poorer aided thresholds than the thresholds of better hearing ears. For patients with asymmetric hearing loss, HAs should be selected based on the degree and types of hearing loss and the maximum output level of the selected device.