The Effect of Long-Term Unilateral Deafness on Auditory Performance / 대한이비인후과학회지

Background and Objectives@#We investigated whether there are differences in auditory performance between the healthy ears of subjects with unilateral deafness (UD) and the control ears of subjects with normal hearing (NH) in both ears.Subjects and Method Sixteen subjects with acquired UD and 16 subjects with NH thresholds for both ears were enrolled. We compared the auditory performance of UD group and control group with NH in both ears. @*Results@#We found no meaningful differences in the three measures of psychoacoustic performance between the total healthy ears of subjects with UD and the ears of the control group. However, in the subgroup comparison, the left ears of subjects with right UD showed significantly poorer spectral-ripple discrimination (SRD) than the right ears of the subjects with left UD (p=0.006) and the ears of control subjects with NH (p=0.004). @*Conclusion@#Our findings indicate that after unilateral auditory deprivation, auditory processing is differentially affected by the side involved. In the subjects with acquired UD, the longterm hearing deprivation on the right side induced the down-regulation of central auditory process for SRD, but hearing deprivation on the left side did not affect SRD.

Translation and Linguistic Validation of Korean Version of Musical Background Questionnaire / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#The Musical Background Questionnaire (MBQ) has been developed to assess formal musical training and listening enjoyment. The aims of this study were to translate MBQ into Korean with subsequent linguistic validation and to evaluate the effectiveness of the Korean version of MBQ (K-MBQ).SUBJECTS AND METHOD: Between 2013 and 2014, a panel affiliated with the questionnaire committee of the Korean Audiological Society reconciled the first draft K-MBQ translated by a bilingual person. A separate bilingual translator, who had never seen the original MBQ, translated the draft K-MBQ back into English, and subsequently, the panel reviewed its equivalence to the original one. K-MBQ was administered to 29 adults (M:F=15:14; aged 21 to 76 years) for cognitive debriefing. Pure tone and speech audiometry were performed in all participants.@*RESULTS@#The translation of K-MBQ was completed through a multi-step process of forward translation, reconciliation, reverse translation, cognitive debriefing and proofreading. Thirteen (45%) of 29 subjects reported formal musical training, and 16 participants (55%) judged themselves as having no musical education and background. No significant correlation was found between musical background and hearing level, whereas self-perceived quality of music and self-perception of music elements quantified by K-MBQ were associated with hearing ability in terms of pure-tone and speech audiometry.@*CONCLUSION@#K-MBQ was translated and linguistically validated. The use of this questionnaire can provide further evaluation of musical background in patients with hearing loss or cochlear implant users.

Prevalence of Superior Semicircular Canal Dehiscence in Coronal Images of Temporal Bone Computed Tomography and Its Diagnostic Value in Korean Population / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study aimed to analyze the prevalence of superior semicircular canal dehiscence (SSCD) in the coronal images of high-resolution temporal bone computed tomography (TBCT) and to evaluate the diagnostic accuracy of coronal images for SSCD syndrome. SUBJECTS AND METHOD: We retrospectively reviewed high-resolution TBCT scans of 217 patients (434 ears) with SSCD due to various causes. The dehiscence ratio (slices showing dehiscence/total slices showing the superior semicircular canal) in the coronal images of TBCT was calculated, and the optimal cutoff value for the diagnosis of SSCD syndrome was determined using the receiver operating characteristics (ROC) curve. RESULTS: Of the 434 ears, 64 (14.7%) presented SSCD in more than one slice of the coronal images of TBCT, but only three patients (0.7%) were confirmed with SSCD syndrome. Based on the ROC curve analysis for the dehiscence ratio of 64 ears, the optimal cutoff value for the diagnosis of SSCD syndrome was 0.67 with 100% sensitivity and 90.2% specificity. CONCLUSION: The majority of cases diagnosed with SSCD syndrome using the coronal images of TBCT were asymptomatic or false-positive. The dehiscence ratio in the coronal images of TBCT combined with a typical symptom can be a highly sensitive and specific diagnostic tool for SSCD syndrome.

Significance of 125 Hz Pure-Tone Thresholds for Dizzy Patients with Low Frequency Sensorineural Hearing Loss / 대한평형의학회지

OBJECTIVES: To measure 125 Hz pure-tone thresholds in patients with low frequency sensorineural hearing loss (LFHL) and vertigo and to evaluate the necessity of 125 Hz thresholds for assessment of LFHL with vertigo. METHODS: Pure tone audiometry including 125 Hz was performed in 25 dizzy patients with LFHL ≤500 Hz and 25 age-matched subjects with normal hearing. Patients with sudden sensorineural hearing loss and vertigo were excluded. Comparison of 125 Hz between LFHL and control groups, and comparison of 125 Hz and other frequencies in LFHL group was made. RESULTS: Mean pure-tone thresholds at 125 Hz in LFHL group (41.7±7.5 dB) was higher than that in normal controls (12.8±6.4 dB). Three (12%) patients had normal thresholds at 125 Hz in LFHL group, whereas all subjects showed normal at 125 Hz in control group. None with average hearing thresholds at 250 and 500 Hz ≥35 dB had normal threshold at 125 Hz. There was a significant correlation between 125 Hz and other low frequencies in LFHL group (250 Hz; r=0.79, 500 Hz; r=0.66). CONCLUSIONS: Not every patient of LFHL with vertigo has abnormal hearing threshold at 125 Hz, although all subjects with normal hearing is within normal limits at 125 Hz. Measurement of 125 Hz pure-tone threshold is highly recommended when a mild LFHL exists.

Intratympanic Steroid Treatment versus Intratympanic Steroid and Diuretics Combination Treatment in Patients with Acute Low Frequency Sensorineural Hearing Loss with Vertigo / 대한평형의학회지

OBJECTIVES: Intratympanic dexamethasone (ITD) is a standard treatment for patients with sudden sensorineural hearing loss. The aim of this study was to evaluate the effectiveness of ITD vs. combination of ITD and diuretics for acute low frequency sensorineural hearing loss (LFHL) with vertigo. METHODS: A total 31 patients with LFHL that had developed within previous 2 weeks were enrolled and categorized into two groups: treated with ITD four times on 4 consecutive days (ITD group; 17 patients) and treated with ITD in the same way and diuretics orally for 2 weeks (combination group; 14 patients). After 6 months, we analyzed treatment outcomes using subjective improvement and audiometric change. RESULTS: Hearing thresholds at low frequencies ≤500 Hz were significantly improved in both ITD only and combination group (p0.05). For subjective symptoms, there were no significant differences of improvement rate in both groups (combination 64.3% vs. ITD only 64.7%, p>0.05). In pure tone audiometry, the improvement rate of combination group was not significantly different from that of ITD only group (71.4% vs. 76.5%, p>0.05). There was a significant correlation between the complete recovery rate and duration of symptoms. CONCLUSION: ITD alone is an effective treatment modality for acute LFHL with vertigo within 2 weeks of development. Combined ITD and diuretics have no additive effect for the recovery of hearing in patients with LFHL.

Translation and Standardization for a Korean Version of the Client Oriented Scale of Improvement / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Client Oriented Scale of Improvement (COSI) has been designed to identify client needs, changes in listening ability, and final listening ability in situations important to each client. The aim of this study was to translate COSI into Korean with subsequent linguistic validation and to determine the reliability of the Korean version of the COSI (K-COSI). SUBJECTS AND METHOD: An expert panel translated the original version of COSI into the Korean language. A bilingual translator back-translated the translated version into English, which was subsequently compared with the original English version. K-COSI was administered at 14 referral hospitals, to 128 patients with hearing disability after cognitive debriefing. Reliability was assessed using correlation study. RESULTS: K-COSI showed an excellent test-retest correlation and high reliability in degree of change (Spearman correlation=0.89, interclass correlation coefficient=0.922). It also showed a fair test-retest correlation and high reliability in final hearing ability (Spearman correlation=0.49, interclass correlation coefficient=0.353) CONCLUSION: K-COSI proved to be highly reliable. The results suggest that the adapted Korean version of COSI is a reliable and valid measure for Korean-speaking patients with hearing loss.

Validation of the Korean Version of the Abbreviated Profile of Hearing Aid Benefit / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The quantification of hearing aid benefit is important in hearing aid fitting. The abbreviated profile of hearing aid benefit (APHAB) is a useful tool for measuring the benefit of using hearing aids. In this study, we developed a Korean version of APHAB (K-APHAB) and determined its validity and reliability. SUBJECTS AND METHOD: An expert panel translated the original version of APHAB into Korean language. Two bilingual translators back-translated the first translated version into English and it was compared with the original version. After cognitive debriefing, the translation of APHAB into the Korean version was completed. One hundred ninety-seven subjects using hearing aids participated in this study and completed K-APHAB. Reliability was assessed using Cronbach's alpha coefficient, and validity was evaluated by factor analysis and criterion validity. RESULTS: K-APHAB had a good internal consistency (α=0.80). Confirmatory factor analysis showed that K-APHAB is comprised of four subsections, namely ‘communication in daily life’, ‘aversiveness’, communication in ‘background noise’ or ‘reverberation’. CONCLUSION: The K-APHAB is a useful tool for evaluating the benefit of hearing aids in Korean hearing-impaired individuals.

Standardization for a Korean Version of the Speech, Spatial and Qualities of Hearing Scale: Study of Validity and Reliability / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The Speech, Spatial and Qualities of Hearing Scale (SSQ) was designed to measure self-reported auditory disability in a wide variety of listening situations. Its 49 items cover many aspects of speech perception, spatial hearing, and qualities of hearing, which constitute the three parts of SSQ. However, there has been no reliable and valid Korean version of SSQ (K-SSQ), which made the measurement of auditory disability difficult. The aim of this study is to develop a K-SSQ and to determine its reliability and validity for clinical or academic use. SUBJECTS AND METHOD: An expert panel translated the original SSQ into Korean. A bilingual translator back-translated the translated version into English, which was then compared with the original version. After cognitive debriefing, K-SSQ was administered to 400 patients with hearing disability in 14 referral hospitals. Reliability was assessed using Cronbach's alpha coefficient and correlation study. Validity was evaluated by factor analysis and criterion validity based on the results of pure tone audiometry. RESULTS: K-SSQ showed good reliability with high internal consistency (Cronbach's α=0.99), and strong positive correlations across all three parts of SSQ. Construct validity was confirmed by the results of factor analysis and criterion validity demonstrated positive correlations between each part of SSQ and the results of pure tone audiometry. CONCLUSION: The K-SSQ is a reliable and valid tool for use as a behavioral measure of hearing ability in Korean-speaking patients, and it will provide a very useful evaluation tool for both clinicians and researchers.

Significance of 125 Hz Pure-Tone Thresholds for Acute Low Frequency Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To analyze the 125 Hz pure-tone thresholds in patients with acute low frequency sensorineural hearing loss (LFHL) and to investigate the value of 125 Hz thresholds for the assessment of LFHL. SUBJECTS AND METHOD: Hearing tests including 125 Hz pure-tone were performed in 91 patients with acute LFHL ≤500 Hz and in 46 subjects with normal hearing. Patients with sudden sensorineural hearing loss or Meniere's disease were excluded. Inter-group and intra-group comparison of 125 Hz was made between LFHL and the control groups. RESULTS: There was a significant difference of mean pure-tone thresholds at 125 Hz between the acute LFHL and the normal groups (39.8±8.9 vs. 14.3±6.7 dB). Eight (8.8%) patients in the LFHL group showed normal thresholds at 125 Hz, but all other subjects were normal at 125 Hz in the control group. None with the average hearing thresholds at 250 and 500 Hz ≥40 dB had normal threshold at 125 Hz. There was a significant correlation between 125 Hz and other low frequencies in the LFHL group (250 Hz; r=0.81, 500 Hz; r=0.63). CONCLUSION: Not all patients with acute LFHL show abnormal hearing threshold at 125 Hz although every subject with normal hearing is within the normal limits at 125 Hz. Threshold assessment should be made at 125 Hz when a mild LFHL exists in the conventional pure tone audiometry.

The Normative Value of Acceptable Noise Level Test for Korean Young Listeners with Normal Hearing and Its Relationship with Auditory Brainstem Response Latency / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Acceptable noise level (ANL) test has been developed as a method to measure the background noise acceptance when listening to speech presented at the most comfortable level. The study was aimed to investigate normal-hearing in young subjects’ performance on ANL test and to evaluate the relationship between ANL and auditory evoked potentials. SUBJECTS AND METHOD: Fifty-three young adults (23 male and 30 female; aged 21 to 39 years) with normal hearing participated in this study. ANL and auditory brainstem response (ABR) tests were administered to subjects who were certified by pure tone audiometry that they had normal hearing threshold. RESULTS: The ANL test showed a large inter-subject variability in the acceptance of back-ground noise, ranging from -5 to 15 dB with the mean of ANL of 5.0±4.1 dB (4.5±4.5 dB in male and 5.4±3.8 dB in female). The mean most comfortable listening level was 35.2±5.3 dB, and the mean background noise level was 30.2±6.1 dB. There were no significant differences between male and female in the parameters of ANL test. There were no differences between the subjects with low versus high ANLs and ABR latencies. CONCLUSION: We obtained the normative data of the ANL test administered to Korean young adults with normal hearing. There is no relationship between ANL and the latency of ABR in this study population.

Neuroglial Choristoma of the Middle Ear with Massive Tympanosclerosis: A Case Report and Literature Review

Neuroglialchoristoma is a rare cerebral heterotopia typically involving extracranial midline structures of the head and neck, including the nose, nasopharynx and oral cavity. It rarely involves non-midline structures, such as the middle ear, mastoid and orbit. We report the case of a 63-year-old woman with right-sided hearing loss and aural fullness who was diagnosed with neuroglialchoristoma of the middle ear and mastoid. To our knowledge, this is the first report on neuroglialchoristomawith massive tympanosclerosis. The presence of combination supported the inhalation theory of neuroglialchoristoma, given that tympanosclerosis is typically caused by Eustachian tube dysfunction.

Feasibility and Safety of Transcutaneous Vagus Nerve Stimulation Paired with Notched Music Therapy for the Treatment of Chronic Tinnitus

BACKGROUND AND OBJECTIVES: A recent study demonstrated that tinnitus could be eliminated by vagus nerve stimulation (VNS) paired with notched sounds in a rat tinnitus model. The aims of this clinical study were to investigate the effects and safety of transcutaneous VNS (tVNS) by patch-type electrode paired with notched music for treating chronic tinnitus. SUBJECTS AND METHODS: Thirty patients with refractory chronic tinnitus for >12 months were included in this study. A patch-type electrode was attached to the auricular concha of the patient's left ear and tVNS was performed for 30 min (pulse rate 25 Hz, pulse width 200 micros, and amplitude 1-10 mA) using a transcutaneous electric nerve stimulation eco2. During tVNS, the patients listened to notched music cleared of the frequency spectrum corresponding to the tinnitus with a 0.5 octave notch width. RESULTS: After 10 treatment sessions, 15/30 patients (50%) reported symptom relief in terms of a global improvement questionnaire. The mean tinnitus loudness (10-point scale) and the mean tinnitus awareness score (%) improved significantly from 6.32+/-2.06 to 5.16+/-1.52 and from 82.40+/-24.37% to 65.60+/-28.15%, respectively (both p<0.05). None of the patients had any specific side effects, such as changes in heart rate or blood pressure. CONCLUSIONS: This study has demonstrated the feasibility and safety of tVNS paired with notched music therapy in patients with chronic tinnitus, with the use of a pad-type electrode attached to the auricular concha.

Intratympanic Steroid and Oral Diuretics Combination Therapy for Acute Low Frequency Sensorineural Hearing Loss without Vertigo / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The effectiveness of intratympanic dexamethasone injections (ITD) alone is compared against the combination therapy of ITD and oral diuretics as treatments for acute low frequency sensorineural hearing loss (LFHL) without vertigo. SUBJECTS AND METHOD: A total of 36 patients, with LFHL 0.05). For subjective symptoms, there were no statistically significant differences in the improvement rate in either group (combination 58.8% vs. ITD only 63.2%, p>0.05). In pure tone audiometry, the improvement rate of the combination group was not significantly different from that of the ITD only group (76.5% vs. 73.7%, p>0.05). There was a significant correlation between the complete recovery rate and duration of symptoms. CONCLUSION: ITD alone is an effective treatment modality for LFHL within 1 month after onset. Diuretics have no additive effect for the recovery of hearing in patients with acute LFHL without vertigo.

The Effect of High Frequency Sensorineural Hearing Loss on Auditory Temporal Resolution: Gaps-In-Noise Test Performance in Older and Young Adults with Normal Hearing / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Auditory temporal resolution, which refers to the time-related aspects of acoustic processing, can be evaluated by the Gaps-In-Noise (GIN) test. We investigated whether the presence of high frequency sensorineural hearing loss (HF-SNHL) affects the temporal resolution of GIN performance in older adults with normal hearing. SUBJECTS AND METHOD: Hearing tests including the GIN test were performed in 87 subjects with normal pure tone average. The GIN threshold and percentage of correct answers were compared among 4 groups of participants; older adults with normal hearing (n=18), older adults with HF-SNHL (n=24), young adults with normal hearing (n=24) and young adults with HF-SNHL (n=21). RESULTS: There was no significant difference in the mean GIN thresholds between the HF-SNHL group (5.8+/-0.8 msec) and the normal hearing group (6.0+/-0.8 msec) in older adults, whereas the mean GIN thresholds of HF-SNHL group was higher than that of the normal group in young adults (4.6+/-0.3 msec vs. 4.2+/-0.5 msec, p<0.05). The mean percentage of correct answers of HF-SNHL group (62.5+/-5.5%) was not significantly different from that of the normal hearing group (60.6+/-3.9%) in the old, unlike in the young (71.3+/-4.0% with HF-SNHL vs. 76.9+/-4.3% with normal hearing, p<0.05). Age only showed a significant correlation with the GIN performance. Neither the GIN threshold nor the GIN perception level had any relation with the presence of HF-SNHL in older adults. CONCLUSION: We found no evidence that supported the influence of HF-SNHL on auditory temporal resolution in older adults. These results imply that HF-SNHL may be of little importance in gap detection after age-related changes in central auditory system.

Current Trends in the Assessment of Patients with Tinnitus and the Proposal of Tinnitus Assessment in Korea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The effective management of tinnitus should start with an accurate diagnosis, but no concensus has been developed in Korea concerning how to measure the features of tinnitus. This study surveyed otologists in the training hospitals and hospitals specialized in otologic care in Korea to identify the current status in the assessment of patients with tinnitus. SUBJECTS AND METHOD: The questionnaire on the assessment of tinnitus was sent by email to otologists in training and to specialized hospitals specializing in otologics in Korea. The questionnaire included inquiry about various types of tests conducted, such as the audiologic test, tinnitus test, blood test, radiologic test, and the methods of history taking and physical examination for somatic tinnitus. RESULTS: Regarding the audiologic assessment of tinnitus, all the otologist were using pure tone audiometry, 97% speech audiometry, and 87% tinnitus test. For the psychophysical measure of tinnitus, both loudness and pitch matching were conducted by all the otologists. The performance rate of blood test were 38.5%, and the most preferred radiologic test in pulsatile tinnitus was temporal bone computed tomography (59%). Finally, the rate of investigation including the history taking and physical examination of somatic tinnitus was between 74-84%. CONCLUSION: Our results showed that although the tests perfermed by otologists varied, the essential tests for assessing tinnitus were commonly practiced. We analyzed the current status of tinnitus assessment and supplemented guidlines to help measure tinnitus. Further concensus on tinnitus diagnosis is needed, particularly about the standadized and unified principles.

Comparison of the Effectiveness of Monitoring Cisplatin-Induced Ototoxicity with Extended High-Frequency Pure-Tone Audiometry or Distortion-Product Otoacoustic Emission

BACKGROUND AND OBJECTIVES: To compare the effectiveness of monitoring cisplatin-induced ototoxicity in adult patients using extended high-frequency pure-tone audiometry (EHF-PTA) or distortion-product otoacoustic emission (DP-OAE) and to evaluate the concurrence of ototoxicity and nephrotoxicity in cisplatin-treated patients. SUBJECTS AND METHODS: EHF-PTA was measured at frequencies of 0.25, 0.5, 1, 2, 3, 4, 6, 8, 9, 11.2, 12.5, 14, 16, 18, and 20 kHz and DP-OAE at frequencies of 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, and 8 kHz in cisplatin-treated patients (n=10). Baseline evaluations were made immediately before chemotherapy and additional tests were performed before each of six cycles of cisplatin treatment. Laboratory tests to monitor nephrotoxicity were included before every cycle of chemotherapy. RESULTS: Four of 10 patients showed threshold changes on EHF-PTA. Five of 10 patients showed reductions in DP-OAE, but one was a false-positive result. The results of EHF-PTA and DP-OAE were consistent in two patients. Only one patient displayed nephrotoxicity on laboratory tests after the third cycle. CONCLUSIONS: In our study, the incidence rate of cisplatin-induced ototoxicity was 40% with EHF-PTA or DP-OAE. Although both EHF-PTA and DP-OAE showed the same sensitivity in detecting ototoxicity, they did not produce the same results in all patients. These two hearing tests could be used to complement one another. Clinicians should use both tests simultaneously in every cycle of chemotherapy to ensure the detection of ototoxicity.

The Effects of Unilateral Tinnitus on Auditory Temporal Resolution: Gaps-In-Noise Performance

BACKGROUND AND OBJECTIVES: The Gaps-In-Noise (GIN) test is a measure to assess auditory temporal resolution, which is the ability to follow rapid changes in the envelope of a sound stimulus over time. We investigated whether unilateral tinnitus affects temporal resolution by the GIN performance. SUBJECTS AND METHODS: Hearing tests including the GIN test were performed in 120 ears of 60 patients with unilateral tinnitus who showed symmetric hearing within 20 dB HL difference up to 8 kHz (tinnitus-affected ears, 14.6+/-11.2 dB HL; non-tinnitus ears 15.1+/-11.5 dB HL) and 60 ears of 30 subjects with normal hearing. Comparisons were made between tinnitus and non-tinnitus side of patients and normal ears of controls. RESULTS: There was no significant difference of the mean GIN thresholds among tinnitus-affected ears (5.18+/-0.6 ms), non-tinnitus ears (4.98+/-0.6 ms) and normal ears (4.97+/-0.8 ms). The mean percentage of correct answers in tinnitus side (67.3+/-5.5%) was slightly less than that in non-tinnitus side (70.0+/-5.5%) but it was not significantly different from that in normal ears (69.4+/-7.5%). Neither the GIN threshold nor the GIN perception level in tinnitus ears has relation to sex, frequency and loudness of tinnitus, and audiometric data. Age only showed a significant correlation with the GIN performance. CONCLUSIONS: We found no evidence which supported the influence of unilateral tinnitus on auditory temporal resolution. These results imply that tinnitus may not simply fill in the silent gaps in the background noise.

Comparison Analysis between Korean Central Institute for the Deaf Sentence and Korean Hearing in Noise Test Sentence / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hearing in Noise Test (HINT) sentences and Central Institute for the Deaf (CID) sentences are tools that are used for assessing speech cognition. The Korean versions of HINT and CID, KHINT and KCID, have been made and used for the selection of cochlear implant candidates. In this study, we analyzed the compatibility of sentences of KCID and KHINT as testing material for assessing speech performance. MATERIALS AND METHODS: A total of 36 patients selected for the study were divided into 2 groups. Group A, whose mean age was 49.9 years, was composed of 18 patients with hearing aid (range, 24 to 68 years); Group B, whose mean age was 23.5 years, was composed of 18 patients with cochlear implant (range, 10 to 63 years). Open set recognition scores of 2 sentences were compared in each group, by randomly selecting one list each of the KCID and KHINT sentences. Sentences were stimulated using recorded voice and live voice for Group A and B, respectively. RESULTS: There were no statistically significant differences between mean scores of KCID and KHINT sentences in each group (p=0.289, 0.208), respectively. However, there were statistically significant linear correlations between KCID and KHINT sentences in each group and total group (R2=0.961, 0.945, 0.923, respectively; p<0.01, <0.01, <0.01, respectively). CONCLUSION: KCID sentences can be used as a speech performance test material and might serve as a compatible test material for selection of the cochlear implant candidacy.

Glucocorticoid Receptor-beta Overexpression According to Nasal Polyp Severity: Immunohistochemical Study

BACKGROUND AND OBJECTIVES: The aims of the study were to reintroduce a surgical technique for a "mini" Caldwell-Luc operation and to determine its efficacy. MATERIALS AND METHODS: A prospective study was performed in 23 patients undergoing the "mini" Caldwell-Luc operation. Improvements in clinical symptoms and endoscopic and computed tomographic (CT) findings were evaluated postoperatively over a follow-up period ranging from 6 to 21 months. All patients were surveyed for nasal symptoms (nasal obstruction, rhinorrhea, posterior nasal drip, headache, and anosmia), complications (tooth or gum pain, numbness, persistent facial pain, and facial hypo-paresthesia), and recurrence. Preoperative nasal polyps were classified by the Gaskins method, and preoperative paranasal sinusitis was graded according to the Kennedy CT staging system. RESULTS: Symptom scores were all significantly reduced postoperatively (paired t-test, p<0.05). There were no major complications specific to this technique. Among 29 maxillary sinuses that received the "mini" Caldwell-Luc operation, seven showed recurrence (24%). CONCLUSION: The "mini" Caldwell-Luc operation provides an alternative method of obtaining access to the maxillary antrum and is associated with minimal morbidity.

Three Cases of Toxoplasma Lymphadenitis Arising in the Posterior Neck: Case Report and Literature Review / 대한이비인후과학회지

Toxoplasmosis is a disease caused by the infection with an obligate intracellular parasite, Toxoplasma gondii. The most common manifestation of acute toxoplasmosis in an immunocompetent patients is a cervical lymphadenitis. The prevalence of toxoplasmosis in Korea is much lower than in those of other countries, including the United States and most European countries. We report three cases of toxoplasma lymphadenitis arising in the posterior cervical lymph nodes of immunocompetent patients with typical histologic findings and positive serologic results. The etiology, epidemiology, clinical features, diagnostic methods, and management of toxoplasmosis are also reviewed.