Assessment of Attentional Demand in Patients with Dizziness Using Dual Task Test / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Even patients with compensated peripheral vestibular dysfunction may report a sense of disequilibrium during daily activities, which often fail conventional vestibular function tests as attentional demand required for postural control may increase in these patients. The study aims to assess the feasibility of dual task test using concurrent cognitive tasks in a modified clinical test of sensory interaction on balance (mCTSIB) to measure increased attentional demand for posture control. SUBJECTS AND METHOD: Nineteen patients suspected with chronic dizziness were recruited by history reviews and physical examinations. Data for center of pressure (COP) variability and mean velocity during mCTSIB on a force long plate were analyzed, and time taken to react to the auditory stimuli were used to measure the attentional demand required for adequate postural control during platform perturbation. RESULTS: The mean COP range and velocity during mCTSIB were comparable between single and dual task conditions in patients with dizziness. Reaction time (RT) to auditory stimulus of 1 kHz pure tone in patients with chronic dizziness was also comparable to normal subjects. Interestingly, there was a tendency for increased RT in patients with documented caloric weakness, suggesting that attentional demand is increased in these patients. CONCLUSION: RT of dual task tests using auditory stimuli during mCTSIB may provide additional information about increased attentional demand for postural control in patients with vestibular dysfunction.

A Case Report of Incidental Endotracheal Tube Firing in Operating Room during CO2 Laser-Assisted Laryngomicrosurgery / 대한이비인후과학회지

Operating room fires are a rare but preventable danger in modern operating rooms. But sometimes accidental fires in operating room can be life threatening. Surgical fires require an ignition source, oxidizer, and fuel. Recently, laser as an ignition source in the presence of anesthetic gases has been associated with operating room fires in otorhinolaryngologic field. We describe a 30-year-old patient diagnosed with recurrent laryngeal papillomatosis treated by CO2 laser-assisted laryngomicrosurgery. In this case, we experienced endotracheal tube flaring during CO2 vaporization and then incidental endotracheal tube firing due to CO2 laser under high O2 circumference. Shortly after removal of firing endotracheal tube, the anesthesiologist considered careful re-intubation. To minimize the risk of operating room fires, surgeons must familiarize with the common possibilities where fire is known to occur. Furthermore, the prevention of operating room firing should be strongly considered during all operations using lasers.

A Case of Horizontal Partial Laryngectomy for Laryngeal Trauma / 대한이비인후과학회지

Laryngeal trauma is rare compared to other head and neck traumas, but it occurs, it can be life threatening. As for treatment, a laryngeal fracture that involves displacement of cartilage or extensive injury requires appropriate surgical treatments. For severe laryngeal fractures, conservative management is usually preferred with placing a stent to prevent laryngeal stenosis. But the downside of placing stents in the larynx includes the risk of granulation and infection. In this report, the authors describe a 35-year-old patient, who was diagnosed with blunt laryngeal trauma and treated by Horizontal partial laryngectomy. The patient's post-operative breathing and voice were fair, and airway stenosis did not occur afterwards.

Analysis of Prevalence and Risk Factors of Chronic Rhinosinusitis in Hyperlipidemia Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: According to previous studies, acute and chronic cholesterol depletion in the cell membranes of human airway epithelial cells suppresses MUC5AC gene expression. Also statins and lipid-lowering drugs are known to have anti-inflammatory effects. From these results, we hypothesize that the use of statin decreases the prevalence of chronic rhinosinusitis (CRS). Therefore, this study aimed to analyze the correlation between hyperlipidemia and the use of statin and prevalence of CRS in Korea. SUBJECTS AND METHOD: The data were based on the Korean National Health and Nutrition Examination Survey in 2010 and 2011. Symptom-based criteria of European Position Paper on Rhinosinusitis and Nasal Polyps 2012 were used to define CRS. 12000 people were enrolled in this study. RESULTS: The CRS prevalence of hyperlipidemia group (14.13%) was significantly higher than that of non-hyperlipidemia group (10.87%) (p=0.0005). However, the CRS prevalence between statin users (14.27%) and nonusers (13.94%) in hyperlipidemia group showed no significant differences. Thus, hyperlipidemia itself was a risk factor of CRS regardless of using statin. Allergic rhinitis was the only significant risk factor of CRS in hyperlipidemia group in multivariate regression analysis. CONCLUSION: Hyperlipidemia patients who have allergic rhinitis are at risk of CRS regardless of whether they use statins; however, further study using objective data will be required to verify this result.

Long-Term Outcomes of Acute Low-Tone Hearing Loss

BACKGROUND AND OBJECTIVES: Although acute low-tone hearing loss has been associated with cochlear hydrops or early stage Meniere's disease, its prognosis in the short-term has been reported to be better than sudden hearing loss. However, recurrence of hearing loss and possible progression to Meniere's disease remain important concerns in the clinical setting. This study aims to investigate the long-term audiological outcomes of acute low-tone hearing loss. SUBJECTS AND METHODS: A retrospective review of patients presenting with a first attack of acute low-tone hearing loss was performed. Of the 77 patients, 33 were followed up for more than 3 months. Progression, recovery of hearing loss and recurrence of hearing loss were examined. Also, correlation between long-term outcomes and associated clinical factors were analyzed. RESULTS: Twenty-five patients (75.7%) had complete hearing recovery, five patients (15.1%) had partial recovery, two patients (6.0%) had no recovery, and one patient (3.0%) had progression of hearing loss 1 month after initial treatment. Thirty-three patients were followed up for more than 3 months (mean 22 months, range 3-79 months). Recurrences of acute low-tone hearing loss were observed in five patients (15.2%). All of the recurrences occurred during the first 12 months of follow-up. Long-term prognosis correlated with the initial therapy results (R2=0.693). CONCLUSIONS: Recurrences of hearing loss were documented in five patients (15.2%), and all of these cases occurred within one year of the first attack. Audiological outcomes after initial therapy may predict the recurrence of acute low-tone hearing loss.