Aggravation of Relapsing Polychondritis due to the Infection and Its Manifestation on a Nasal Tip Graft

Relapsing polychondritis (RP) is an uncommon systemic disease that is characterized by episodic and progressive inflammation of the cartilaginous structures, which can be very debilitating and in some instances life-threatening. The pathogenic pathways of RP are largely unknown. However, several hypothesis have been suggested. We had an interesting case of aggravation of RP due to the infection. Graft cartilage on the nasal tip was affected by RP also. This case can give a clue of revealing the pathogenesis of RP. We introduce a case with a review of the literature.

Audiologic Characteristics of Unilateral Tinnitus Patients without Subjective Hearing Disturbance / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tinnitus is an audiologic sensation without external sound stimuli. The aim of this study is to assess characterisistics in unilateral tinnitus patients without subjective hearing loss by analyzing their audiologic test results. SUBJECTS AND METHOD: We used results of audiologic tests including pure tone audiogram (PTA), tinnitogram and distortion products of otoacoustic emissions (DPOAE) from 96 unilateral tinnitus patients without subjective hearing loss. We compared the results of tinnitus ear with non-tinnitus ear individually, and also analyzed these data according to their age, symptom and duration. RESULTS: The hearing level of PTA of tinnitus ears compared to non-tinnitus ears was statistically significant at 4000 Hz and 8000 Hz, and it was more prominent at age over forty. DPOAE results were significantly low at 4000 Hz level in tinnitus ears compared to non-tinnitus ears. Loudness and duration of symptoms were louder and longer when hearing loss was accompanied. CONCLUSION: In unilateral tinnitus patients without subjective hearing disturbance, a pattern of high frequency hearing loss was found in PTA and DPOAE. The patients with hearing loss above 25 dB HL at any frequency are older and have longer duration with high pitch-louder tinnitus. Therefore, even though tinnitus patient has no subjective hearing loss, it is important to make treatment plan by sufficient audiologic evaluation.

Clinical Analysis of Characteristics of Patients Who Visit Otorhinolaryngology Clinic in Secondary General Hospital / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Common cold is an upper airway viral infection and can be managed by conservative treatment. According to the hospital referral system, mild diseases like common cold should be treated first at a primary physician clinic. However, now in Korea, visiting high-level hospitals for mild diseases is not impossible officially and even the rate of visiting high-level general hospital has increased in spite of the current hospital referral system. This study aimed to provide data of characteristics of patients who choose high-level hospitals for mild diseases like common cold. SUBJECTS AND METHOD: We conducted a survey targeting those who visit general hospitals for common cold. The questionnaire comprised of asking first choice of contact hospital, sex, age, awareness and use of antibiotics when visiting primary physician, medical examinations and duration of treatment, and reasons for thinking that general hospitals are superior to primary hospitals. Subjects were categorized according to their choice of first contact hospital with common cold, primary physician or general hospital. For each group, independent sample t-test and chi-square test were applied to variables. RESULTS: Among the variables for the two groups, statistical significances were found in age, duration of treatment and whether medical examinations were performed or not. CONCLUSION: Underestimation for primary physician and vague faith in medical examinations were most influential factors that lead patients with mild diseases to visit general hospitals. This study finds that programs for educating the public are necessary to make them understand that primary physician clinics are enough to treat common cold and that an institutional framework will be needed to support the hospital referral system.

A Case of Multiple Bony Dehiscences of Semicircular Canals and Vestibule Presenting as Dizziness and Hearing Loss / 대한이비인후과학회지

Dehiscence of the bone overlying the semicircular canals has been shown to have effects on vestibular and auditory function. This case report presents a 48-year-old man presenting atypical vestibular manifestations and bilateral hearing loss. His temporal bone CT scans demonstrated bony dehiscence of posterior semicircular canal and vestibule in the right, superior and posterior semicircular canals in the left.