Retraction: Compressive Technique for Treatment of Auricular Hematoma Using Dental Impression Material / 대한이비인후과학회지

No abstract available.

Retraction: Clinical Characteristics and Diagnostic Classification of Vertigo in Children / 대한이비인후과학회지

No abstract available.

A Case of Cochlear Implantation in a Postlingual Deaf Patient with Behcet Disease / 대한이비인후과학회지

Recurrent iritis and oral/genital ulcers have been described for the first time as a separate pathological entity by the Turkish dermatologist Hulusi Behcet. Behcet disease is a chronic, multi-systemic disorder, which affects many organs as a result of vasculitis. The clinical manifestations are divided into two groups: major (oral ulcers, eye lesions, genital ulcerations, and skin lesions) and minor (arthritis, gastrointestinal lesions, epididymitis, thrombophlebitis, and central nervous system involvement) criteria. The incidence of hearing loss in Behcet disease has been reported as 12% to 80% in several studies. A 37-year-old man diagnosed as Behcet disease was admitted to our department with complaints of profound right hearing loss and dizziness. He was treated with steroid without improvement. After one year, he suffered from complete hearing loss on the left side. A temporal bone CT scan revealed right cochlear ossification. Cochlear implantation was performed within 4 weeks after the completion of steroid therapy in the left cochlea, which was partially obstructed by fibrotic tissue. However, the electrode was fully inserted without resistance. Wound healing complications were not encountered in the postoperative period. The hearing threshold was restored to 30 dBHL, while speech discrimination did not improve as much as expected. We propose that the routine hearing examinations be employed in the evaluation and management of Behcet disease. According to our experience, we find that cochlear implantation should be carried out at an early stage, before the development of labyrinthine ossification.

Treatment Effects of Glutamate Antagonist for Tinnitus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tinnitus is one of the most widespread disorders of the auditory system, affecting approximately 17% of the general population, with the frequency increasing to about 33% in the elderly. However, little is known about the underlying physiological mechanism that causes tinnitus and there is no definite treatment. Recently, several studies have showed that subjective tinnitus is mostly generated at the synapse between inner hair cells and their afferent nerves and in addition, some have showed that glutamate is likely to act as the neurotransmitter. The aim of this study has been to evaluate the effective use of caroverine hydrochloride and memantine hydrochloride for tinnitus treatment and to determine their appropriate indication of glutamate antagonist therapy. MATERIALS AND METHOD: From May 1998 through June 2000, 188 patients with subjective tinnitus were treated with caroverine hydrochloride (Spamon(R)). Of the patients, 153 were followed, and 20 of these patients who did not respond to caroverine hydrochloride were treated additionally with memantine hydrochloride (Akatinol(R)). Audiological evaluations were performed in all of the patients. Pre and post-treatment status was analyzed by handicap inventories. RESULTS: Subjective tinnitus was improved in 55 (35.9%) of 153 patients who were treated with caroverine hydrochloride and 11 (55.0%) of 20 patients with memantine hydrochloride. The response group had tendency of shorter duration history of tinnitus than the non-response group. There was no difference between the response group and the non-response group in age, sex, site, and tinnitus characteristics. CONCLUSION: We suggest that glutamate antagonists such as caroverine hydrochloride and memantine hydrochloride can be used as an alternative modality for treatment of subjective tinnitus.

Clinical Characteristics and Diagnostic Classification of Vertigo in Children / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Vertigo in children is relatively uncommon. The severity of vertigo in children varies from mild balance disturbance to true vertigo with obvious nystagmus and falling. There is not much concern about vertigo in children, thus only a few articles exist. The purpose of this study is to analyze the clinical characteristics and the results of audiological and vestibular evaluation, to classify the diagnostic causes of vertigo, and to provide the information about vertigo in children. MATERIALS AND METHODS: A total of 49 patients with vertigo or dizziness who visited Dizziness Clinic in the Department of Otolaryngology at Ajou University Hospital from January 1995 to December 2001 were included in this study. These patients were retrospectively reviewed based on clinical charts. The average age of the patients was 11.9 years, with a minimum of 3 years and a maximum of 15 years. All patients performed questionnaires and pure tone audiometries. Caloric tests and rotational tests were performed in 39 and 40 patients respectively. In selective cases, computed tomography, magnetic resonance imaging, electroencephalogram and hematologic test were performed. RESULTS: Migraine and benign paroxysmal vertigo of childhood (BPVC) were 32.7% and 20.4% in children with vertigo, respectively. Other causes were trauma, Meniere's disease, delayed endolymphatic hydrops, benign positional vertigo, cerebellopontine angle tumor, seizure, otitis media and unknown causes were 16.3%. Audiometry, caloric and rotational chair tests showed abnormal findings in 11 cases (22%), 5 cases (13%) and 30 cases (75%), respectively. CONCLUSION: Vertigo in children has different causes from adult vertigo, showing migraine and BPVC to be the most frequent causes. The evaluation of vertigo in children should include a complete history (questionnaire) and physical examination, an audiogram, and vestibular function tests. In selective cases, EEG, Hematologic evaluation and scanning of the brain or temporal bone should be performed.

Various Causes of Vertigo in Children with Normal Eardrum

BACKGROUND AND OBJECTIVES: The differential diagnosis of vertigo in children is extensive. Otitis media and middle ear effusion could be most common causes of vertigo in children, but there are some problems in detecting the other causes for vertigo because they are one of most popular diseases in childhood. The purpose of this study is to review the clinical characteristics and both the audiological and vestibular findings of vertigo in children with normal eardrums, who do not show otitis media or middle ear effusion, and assist in making a differential diagnosis of vertigo. MATERIALS AND METHOD: The sixty eight children (less than 16 years old) with vertigo, who visited the Department of Otolaryngology, Ajou University Hospital, Suwon, Korea between January 1995 and April 2003 were selected for this study. These excluded the patients with abnormal eardrums/tympanograms or those that did not perform questionnaires, audiological, or vestibular evaluations. They were retrospectively analyzed for clinical symptoms, audiograms, vestibular functions, and differential diagnosis. RESULTS: The most common causes for vertigo in children were benign paroxysmal vertigo of childhood (BPVC) in 21 (30.9%) and migraine in 20 (29.4%). Other less frequent causes included four cases of trauma, three cases of acute vestibular neuritis. two cases each of Meniere's disease, delayed endolymphatic hydrops, benign positional vertigo, and one case only for cerebellopontine angle tumor, seizure, juvenile rheumatoid arthritis, leaving eleven cases (16.2%) as unclassified. Abnormal findings were noted in 14 (20.6%) in pure tone audiogram, 3 (4.4%) in positioning test, 11 (16.2%) in bithermal caloric test, and 47 (69.1%) in rotation chair test. CONCLUSIONS: The vertigo in children with normal eardrums, who did not show otitis media or middle ear effusion, was most commonly caused by BPVC and migraine. These findings have shown to be very different from those with adult vertigo. The evaluation of vertigo in children requires a questionnaire for extensive and complete history taking, audiograms and vestibular function tests. And in selected cases, electroencephalography, hematological evaluation, imaging of the brain or temporal bone should be performed.

Compressive Technique for Treatment of Auricular Hematoma Using Dental Impression Material / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Several methods for treatment of auricular hematoma have been introduced to prevent the recurrence and cauliflower deformity of ear. However, these methods are not convenient to both patients and doctors, because they are time-consuming and complex and must be performed under sterile conditions. The aim of this article is to introduce a new technique for effective treatment of auricular hematoma using a dental impression material and to evaluate the effectiveness of this compressive technique compared with the results of other methods. MATERIALS AND METHOD: The subjects were 45 patients who were diagnosed with auricular hematoma at the Ajou University Hospital from June, 1994 to July, 2001. We analyzed the results, complications, number of visits, treatment duration according to treatment methods on the basis of outpatient charts, retrospectively. For the treatment of auricular hematoma, we aspirated hematoma with a large bore needle and then placed mixed base and catalyst of Exaflex? (GC America Inc., Illinois) type O on the anterior and posterior surfaces of the auricle in the shape of an inverted U. The patients were checked on the 3rd day following the procedure and the impression material was removed on the 7th day. RESULTS: Using the dental impression material, we treated 9 patients with excellent cosmetic results and one patient with minimal deformity. Eight patients were treated with collodion-cotton cast and 16 of 19 patients were successfully treated with cotton dental rolls. All patients treated with the dental impression material required an average of 3.1 visits to the hospital and 8.6 days for treatment compared to 6.9 hospital visits and 13.8 treatment days in cases using cotton dental rolls. CONCLUSION: We believe that this technique using the dental impression material is appropriate for treatment of auricular hematoma. It showed excellent cosmetic results and is simple and convenient for both patients and doctors.

A Functional Study of Gap Junction in GJB2 Mutations Associated with Hereditary Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: GJB2 (Connexin 26), the gene of the gap-junction proteins, was found to be the main causative gene of autosomal recessive nonsyndromic hearing loss (DFNB1). Whereas 35delG was known as the major type mutation in the western countries, 235delC was reported as the specific form of mutation in Asian population. The objective of this study is to identify how two mutations (235 delC, E114G) found in the Korean population affect the function of GJB2 using the molecular biology techniques. MATERIALS AND METHODS: 235delC and E114G types of mutations were cloned in the pcDNA3 vector. HeLa cells were transfected with these cloned vectors by the liposome complex method. 1) The expression and subcellular localization of Cx26 were determined using antibodies against amino acid sequences in the intracellular loop (IL) and N-terminal (NT) portions of Cx26. 2) To analyze functions of the GJB2, we examined the lucifer yellow dye transfer between cells with scrape-loaded technique. We used the wild-type (WT) Cx26 of normal hearing as a positive control, and mock cells as a negative control. RESULTS: The immunocytochemical analysis showed that cells transfected with E114G and WT gave characteristic punctuated patterns of reaction in the cell membrane with both antibodies. However, 235delC cells were not stained with the anti-IL antibody but only with the anti-NT antibody slightly around the nucleus regions. In the functional study of GJB2, transfer of lucifer yellow dye into contiguous cells was detected in E114G but not in 235delC. CONCLUSION: The 235delC type of mutation showed loss of their targeting activity on the cell membrane. As a result, the function of gap junction channels were severely deteriorated. With the E114G type mutation, we didn't find any difference when compared with the WT transfected cells. Above data indicate that types of GJB2 mutation are closely related to the status of hearing loss due to altered function of gap junction protein.