Clinical Implication of Magnetic Resonance Imaging in Bell's Palsy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Magnetic resonance imaging(MRI) with gadolimiun, an intravenous paramagnetic agent, shows non-enhancement of the cranial nerves in normal subjects. In the presence of inflammation or edema, gadolinium is absorbed into these tissues, resulting in enhancement on T1-weighted images. The purpose of this study was to evaluate the clinical implication of gadolinium-enhanced MRI in Bell's palsy. MATERIALS AND METHODS: From 1994 to 1998, 19 patients with Bell's palsy were evaluated to assess the efficacy of gadolinium-enhanced MRI in determining the frequency, the site of facial nerve enhancement, and the relationship between electroneuronography(ENoG) findings and gadolinium-enhanced MRI. The data was compared to 40 patients with sudden sensorineural hearing loss who had temporal bone MRI. RESULTS: On gadolinium-enhanced MRI, 16 of 19 patients had abnormal contrast enhancement of the facial nerve, but nobody had abnormal contrast enhancement of the facial nerve in the control group. In particular, facial nerve enhancement was identified in the distal portion of the internal auditory canal, geniculate ganglion, labyrinthine segment (n=10), tympanic segment (n=10), and mastoid segment (n=7) of the facial nerve. The facial nerve was enhanced more frequently in patients in whom the degeneration of ENoG was more than 50%. The facial nerve was more frequently enhanced in patients who had a higher House-Blackmann grade. CONCLUSION: Gadolinium-enhanced MRI plays a important role in diagnosing Bell's palsy and in predicting the location of pathology of the facial nerve.

Incidence of presbycusis of Korean populations in Seoul, Kyunggi and Kangwon provinces

Presbycusis, a bilateral sensorineural hearing loss caused by changes in the inner ear, is related to multiple factors such as noise exposure and otologic disease. In institute-based studies, we tried to determine the incidence of presbycusis in Korean populations living in Seoul, Kyunggi and Kangwon provinces by gender and age groups. The subjects were people who had visited health promotion centers. Pure tone audiometry was done over 20 years on 6,028 subjects. In a community-based study, the subjects were elderly residents of Kanghwa-do area. There were no obvious factors that could cause hearing impairment in the subjects. For the pure tone audiometry, hearing threshold was obtained by using the six-dimension method. The incidence of presbycusis for subjects aged 65 years and older was 37.8% and 8.3% for > or = 27 dB HL criterion and > or = 41 dB HL criterion, respectively. The incidence increased with age. A statistically significant difference in the hearing threshold was found between men and women aged 65 years or older. No differences were found between the community-based study and the institute- based studies. There was a high incidence (about 40%) of presbycusis among Koreans aged 65 years or older (for > or = 27 dB HL criterion). With an aging population, we anticipate that this report could be used to provide a basic data for the study of presbycusis.

Effects of Preoperative Midazolam and Ketorolac Tromethamin Treatment in Septoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study was to investigate the effect of preoperative administration of midazolam and ketorolac for postoperative pain and antegrade amnesia in septoplasty under local anesthesia. MATERIALS AND METHODS: We studied 40 patients who underwent septoplasty under local anesthesia. The patients were divided into four groups, each consisting 10 patients (N=40). The groups received different treatment, with the first group receiving ketorolac, the second group ketorolac and diazepam, and the third group ketorolac and midazolam. The fourth group received midazolam only. Postoperative pain was evaluated according to Verbal Rating Pain Scores (VRP), and Visual Analogue Pain Scores (VAS) at 2, 4, 6, 12, 24 and 48 hours after operation. Antegrade amnesia was evaluated also. RESULTS: Postoperative pain was decreased at 6, 12, 24 hours in the third and fourth group. Antegrade amnesia was noted in the third and fourth group. The third group showed strong antegrade amnesia. CONCLUSION: Preoperative administration of ketorolac and midazolam were effective for postoperative pain and antegrade amnesia in septoplasty.