The Relation between Early Allergic Response and Nasobronchial Relationship and the Associated Factors of Bronchial Hyperreactivity in Allergic Rhinitis Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There are evidences that allergic rhinitis and asthma represent a continuity of disease. It is known that bronchial hyperreactivity is a most contributing factor for asthma, yet it remains controversial whether there is a direct cause-and-effect relationship between the upper and lower airway. This study was performed to evaluate a direct cause-and-effect relationship between the two diseases by using early allergic responses and to define the clinical factors for predicting bronchial hyperreactivity in allergic rhinitis patients. SUBJECTS AND METHOD: Seventy three patients with allergic rhinitis and 36 patients without allergic rhinitis were included in this study, where exclusion criteria were diagnosed asthma, chronic obstructive pulmonary diseases, nasal polyp and chronic paranasal sinusitis. Nasal provocation tests with allergen were applied to 29 allergic rhinitis patients. After 30 minutes, we investigated lower airway using symptom scores, bronchial provocation test with methacholine and pulmonary function test. Bronchial provocation test with methacholine was applied to 44 allergic rhinitis patients and 36 non-allergic rhinitis patient. We checked nasal symptom scores and the change of nasal volume by VAS and acoustic rhinometry, respectively. We also investigated the incidence and the predictive factors of bronchial hyperreactivity in allergic rhinitis patients. RESULTS: The early allergic response provocated at nasal cavity had little effect on bronchus. Bronchial stimuli with methacholine did not affect nasal cavity. The incidence of bronchial hyperreactivity is significantly higher in allergic rhinitis patients than in non-allergic rhinitis patients. Type of allergic rhinitis (especially persistent, moderate-severe group) and the disease-durations are valuable predictive factors of the bronchial hyperreactivity. CONCLUSION: Although early allergic response has little effect on the nasobronchial relationship, there may be a significant correlation between allergic rhinitis and bronchial hyperreactivity. The correlation is more significant in the persistent, moderate-severe group of allergic rhinitis with long disease duration.

The Effectiveness of Myprodol(R) on the Post-tonsillectomy Pain Control and Time to Return to Normal Daily Activities / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Pain is one of most troublesome discomfort after tonsillectomy. Although various analgesics have been administrated for pain control, it has not been effectively controlled until now. This study was performed to evaluate the effectiveness of Myprodol(R) codein combination analgesics, on the pain control and time to return to normal daily activities. SUBJECTS AND METHOD: Ninety adult patients undergoing tonsillectomy were included in this study. Patients were randomly divided into a Myprodol(R) group (n=30), a NSAID group (n=30) and a codeine group (n=30). They received Myprodol(R) NSAID and codeine, respectively, from the 3rd to 14th postoperative days. On the 1st, 7th and 14th postoperative days, which consisted of rising, breakfast, lunch and supper time, we assessed pain intensity by visual analogue scale. And on the 21st postoperative day, we investigated time to return to normal daily activities and adverse effects of analgesics. RESULTS: When pain intensity on the 1st postoperative day was compared, there was no significant difference among 3 groups. On the 7th postoperative day, the Myprodol(R) group showed significant pain decrease compared with the codeine group but did not with the NSAID group. On the 14th postoperative day, the Myprodol(R) group showed significant pain decrease compared with both NSAID and codeine groups. The Myprodol(R) group also showed shortened recovery time compared with the others and there was no significant adverse effects in any of the groups. CONCLUSION: We find that Myprodol(R) is an effective and safe oral analgesics for pain control and shortens time to return to normal daily activities.

The Application of the Satisfaction with Amplification in Daily Life Scale in Hearing Aid Users / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The evaluation of subjective satisfaction by hearing aid users is important in view of improving pre-assessment needs and predicting treatment outcome. We evaluated the subjective satisfaction by hearing aid users accodin to the Satisfaction with Amplification in Daily Life (SADL) scale, which emphasizes nonauditory factors contributing to satisfaction as well as benefit. SUBJECTS AND METHOD: The SADL scale was completed by 42 patients who received hearing aid fitting at Kyung Hee University Hospital from October 2002 to April 2003 ; each 4 subscales of the SADL were evaluated according to the type and degree of hearing loss, the pure tone audiogram pattern and shape and type of the hearing aid. RESULTS: The mixed type hearing loss group showed higher satisfaction than the sensorineural hearing loss group with respect to positive effect and personal image. Mild and moderate hearing loss groups showed a higher overall satisfaction than severe hearing loss group. There were no statistical differences of scores between pure tone audiogram patterns, and shapes and types of hearing aids, but female users showed higher personal image score when using small (ITC, CIC) hearing aids than large (BTE, ITE) ones. Ascending, descending, and peak type pure tone audiogram patterns users showed a higher satisfaction in positive effect and service and cost when using digital hearing aids than analogue ones. CONCLUSION: Satisfaction is affected by different variables that could be measured by the SADL scales that evaluate independent domains. Assessing patient's subjective satisfaction can be helpful in planning appropriate intervention.

The Effect of the Postoperative Weight Reduction on the Quality of the Life in the Patients with Obstructive Sleep Apnea Syndrome and Obesity / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The incidence of obstructive sleep apnea syndrome (OSAS) among obese patients is about three times higher than that of non-obese patients. Obesity is the most significant risk factor of OSAS. But in the treatment of OSAS, we tended to neglect treating obesity till now. The aim of this study was to assess the effect of weight loss after surgery on the quality of the life in OSAS patients with obesity. SUBJECTS AND METHOD: Twenty OSAS patients with obesity (body mass index >25) completed the preoperative SF-36v2TM questionnaire. All patients were treated by LAUP or UPPP. Ten of them (experimental group) were induced to lose weight by 10 mg of sibutramine for 3 months whereas nothing was done in the others (control group). And then all patients completed the same questionnaire again. The changes of the SF-36v2TM scores have been assessed. RESULTS: In the experimental group, the mean BMI decreased from 30.2 to 28.4 (p<0.05), the mean physical component sum-mary of SF-36v2TM scores was increased from 50.2 to 54.6 (p<0.05) and mean mental component summary was also increased from 45.8 to 49.6 (p0.05). But in the control group, only mean mental component summary was statistically increased from 49.1 to 50.8. CONCLUSION: This study demonstrates that the trial of postoperative weight loss may improve the quality of life in OSAS patients with obesity. So we must consider the positive trial of weight loss as well as the surgeries in the treatment of OSAS patients with obesity.

A Case of Angioleiomyoma of the Nasal Dorsum / 대한이비인후과학회지

Angiomyoma is a benign myogenic tumor which can be found wherever smooth muscle is present. They are most commonly found in the alimentary tract, female genito-urinary tract, skin and subcutaneous tissues, but are rare in the area of the head and neck due to the scarcity of smooth muscle tissue. Because of their rarity, these tumors are often clinically misdiagnosed and identified only after histological examination. We present a case of angioleiomyoma which was found in the nasal dorsum and was excised by open rhinoplasty approach.