Clinical Usefulness of Otoacoustic Emission Sum in Sudden Sensorineural Hearing Loss Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sudden hearing loss remain a controversial issue with respect to its prognostic indicators. In a recent study, the change in distortion product otoacoustic emission (DPOAE) has been shown to provide useful information about its prognosis. The purpose of this study is to evaluate the relationship between the changes of DPOAE and hearing improvement in sudden deafness patients. SUBJECTS AND METHOD: Sixty-one patients underwent pure tone audiometry (PTA) and DPOAE on their first hospital day; among them 35 patients underwent DPOAE after 2 weeks. These patients were divided into mild ( or =71 dB) group according to their initial hearing thresholds. RESULTS: Of the 22 patients in the moderate to severe group, 11 patients showed a DPOAE response and 5 patients (45%) showed hearing improved. In 11 non-DPOAE response patients, 4 patients (36.4%) had improved. We compared PTA and OAE sum gap results by analyzing 35 patient's initial thresholds with those measured 2 weeks after the therapy. The correlation coefficient between the two group was 0.547 (p<0.05). CONCLUSION: The results show that OAE sum is an efficient and non-invasive objective method and that it can be used to monitor the effects of treatment in sudden hearing loss patients.

A Case of Window Resection and Secondary Reconstruction of the Trachea Invaded by Papillary Thyroid Carcinoma / 대한이비인후과학회지

Generally, the treatment of well-differentiated thyroid cancer is not difficult, but it is so with invasive cancer which invades the airway such as the tracheal or cricoid cartilage. In case of circumferential invasion of the trachea, resection and end-to-end anastomosis is preferred. In the less-than-half involvement of the trachea, conservative management such as sternocleidomastoid periosteal flap, or fenestration and staged closure is feasible. But in more-than-half the involvement of the trachea, these managements are usually not preferred. Authors describe a case of tracheal fenestration and the closure of a tracheal defect, which are not usually found in such of cases. Some techniques and their advantages are presented with a review of related articles.

An Acoustic Study on Voice Change after Tonsillectomy / 고신대학교의과대학학술지

OBJECTIVES: Many people have been concerned about voice change after tonsillectomy. The purpose of this study is to analyze changes in the voice and to think about changes in the vocal tract after surgery by using CSL-MDVP. METHODS: Data of 27 patients who underwent tonsillectomy were prospectively evaluated. Acoustic analysis was performed before, after 1 week, after 1 month from the surgery. Nasometer was also conducted. RESULTS: In acoustic analysis, there were no significant changes in F0, jitter, shimmer, NHR, VTI, SPI. But vAM was statistically increased. Vowels and nasal consonants formant frequency analysis results in patients showed no statistically correlation in 1months after tonsillectomy. Although the statistically increased in the nasal consonants. CONCLUSIONS: Although the temporary increase or decrease in the acoustic factor or formant in the vowels and nasal consonants after tonsillectomy, but most factors are make no difference. The voice change that come postoperatively could be considered as no concern, but surgeons need to aware of various facts, which can affect voice changes before the surgery.

Hearing Results after Tympanoplasty Type I with Cartilage-Perichondrium Composite Island Graft / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Many materials such as fascia, perichondrium and cartilage are used for reconstruction of the tympanic membrane in middle ear surgery. Because of its stiffness, cartilage is resistant to resorption and retraction. However, cartilage grafts result in increased acoustic impedance, so its use has caused controversies as to the acoustic transfer aspect. The aim of this study is to assess hearing results after cartilage tympanoplasty and after fascia tympanoplasty. SUBJECTS AND METHOD: This study included 74 patients who had received tympanoplasty type I between 2007 and 2009, of whom 44 received cartilage and 30 fascia. The middle ear risk index was used to statistically compare the preoperative state of the two groups. Preoperative and six months- postoperative air-bone gaps at the frequency 0.5, 1, 2 and 3 kHz were assessed. RESULTS: Both groups were statistically similar with respect to the severity of middle ear pathology and the preoperative hearing levels. Overall postoperative hearing results showed air-bone gaps (ABG) < or =20 dB in 73% for the fascia group and 71% for the cartilage group. The mean postoperative gains in ABG were 8.97 dB for the fascia group and 10.84 dB for the cartilage group. There were no statistically significant differences in the postoperative frequency specific gains in ABG between the two groups. CONCLUSION: These results demonstrate that hearing results after cartilage tympanoplasty are comparable to those after fascia tympanoplasty. Although cartilage is the ideal grafting material in problem cases, a more liberal application might be suggested in such cases as in tympanoplasty type I without fear of impairing hearing.