Psychological Analysis with Symptom Check List-90-Revision in Patients with Tinnitus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Psychological distress may develop from tinnitus, or that recognition of tinnitus may even be greater during exposure to environmental stress. So, patients with tinnitus need to consider the psychologic aspect in their diagnosis and treatment. The aim of this study is to evaluate the degree and characteristics of the psychologic factors associated in patients undergoing tinnitus retraining therapy. MATERIALS AND METHOD: 119 patients with tinnitus who received the Symptom Check List-90-Revision (SCL-90-R) and a control group without tinnitus were compared first; and then 92 out of 119 patients performed the follow up study after three months of tinnitus retraining therapy. RESULTS: The results were as follows. 1. The tinnitus group scored higher than the control group in somatization, anxiety, phobic anxiety (p0.05). 3. The psychologic aspect of patients with tinnitus were related to loudness, pitch, annoyance (p<0.05). 4. The follow-up study of 3 months on patients who underwent tinnitus retraining therapy showed diminished score in all components of SCL-90-R, except phobic anxiety, and paranoid (p<0.05). CONCLUSION: This study indicated that the compliant behaviour of tinnitus is related closely with intrinsic psychodynamic mechanism.

Laryngeal Chondrosarcoma Arising from the Cricoid Cartilage / 대한이비인후과학회지

Laryngeal chondrosarcoma is an uncommon cartilaginous tumor very rarely encountered in the head and neck but most commonly in the sarcoma of the larynx. They occur most often in middle aged and older men. The prognosis of this tumor is potentially poor and surgical resection is generally recommended for the treatment. No benefit of chemotherapy or radiotherapy in chondrosarcoma has been documented in the literature. A 57 year-old male visited our clinic with history of dyspnea and hoarseness. Direct laryngoscopy showed a submucoid, intraluminal mass in subglottic space arising from posterolateral part of the cricoid cartilage. Neck computed tomography revealed a large calcified mass in the larynx. The perioperative frozen section showed it to be grade I chondrosarcoma of the cricoid cartilage. Conservative surgery with complete excision of tumor was performed through laryngofissure approach after tracheostomy. Follow up assesment was performed under close check up at 12 months after the surgery, but we found neither recurrence nor metastasis.

A Case of Pregnancy Induced Venous Hum Treated by Ligation of the Internal Jugular Vein / 대한이비인후과학회지

The patient with pulsatile tinnitus can bo annoying and the tinnitus can be the only clue to a potentially devastating and life-threatening disease, too. This tinnitus may originate from the arterial, arteriovenous, venous vessels and the myoclonus. Occasionally it is the cause of underlying condition in increased flow volume such as anemia, hyperthyroidism, pregnancy, medication or increased intracranial pressure. And then control of these underlying condition is important treatment in those occasions. If anyone suffered from venous pulsatile tinnitus, then simple ligation of the internal jugular vein could be the simplest treatment. Recently the authors experienced a case of 28-year-old woman with left pulsatile tinnitus originating from venous hum. The tinnitus had developed at fourth month of pregnancy and persisted after 20 months of delivery. The patient was treated by ligation of the internal jugular vein in local anesthesia. The proper ligation site was decided by angiography. She remains free of symptoms and complications 7 months after treatment.

The Efficacy of Palatine Tonsillectomy Under Local Anesthesia: Comparative Analysis with Tonsillectomy Under General Anesthesia / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tonsillectomy is one of the most common surgical procedures in otolaryngologic field and it can be carried out under general anesthesia or local anesthesia. The author compared tonsillectomy under local anesthesia to general anesthesia with respect to operation, anesthesia and recovery time as well as satisfaction of the patients. SUBJECTS AND METHOD: Fifty patients who underwent tonsillectomy were divided into a local anesthesia group (25 patients) and a general anesthesia group (25 patients). Parameters such as time spent for anesthesia, operation, recovery time, episodes of cautery, initiation of normal daily life including normal diet, pain, and complication were compared between the two groups. Paired student t-tests were used for statistical analysis. RESULTS: Among other parameters, local tonsillectomy was superior in terms of saving time during anesthesia, operation, recovery as well as hospital course compared to tonsillectomy under general anesthesia. However, ease on the initiation of normal daily life including normal diet, pain, and complication did not differ between the two groups. CONCLUSION: The author feels that local tonsillectomy should be advocated not only for time saving during operation, anesthesia and recovery but also for the satisfaction or compliance of the patients. In these respects, it is suggested that more active training should be provided to surgeons during their residency on tonsillectomy under local anesthesia.

Tinnitus Masking Effects Using Various Kinds of Sound and Music / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Even though various methods have been tried to diagnose and treat tinnitus, researchers have fallen short of providing the accurate characteristics since most tinnitus are presented as a subjective symptom. A few researchers have tried to assimilate tinnitus using computer and music synthesizers, however, their efforts have not yet been developed as generalized treatment modalities. In this study, we attempted to induce not only tinnitus masking but also psychological stability with various kinds of sound and music and to analyse its treatment effects. The aim of this study is to make a step toward developing tinnitus treatment. MAERIALS AND METHODS: The subjects were 28 patients with constant tinnitus, who visited the otolaryngology department of Seoul Paik Hospital, Medical College of Inje University from June to December of 1997. We tried to objectify the tinnitus as close to the actual sound as possible by synthesizing the modulation of the broad band noises and recording not only the existing pure tones and broad band noises but also the natural and artificial sounds which the patients could easily hear from their surroundings. And then we tried to mask tinitus with various natural, artificial and synthetic sounds, including its frequency band. We also let them hear the tapes for contemplation and various music. RESULTS: The results were as follows. 1) As for the quality of tinnitus, 13 patients reported similarity to the pure tone (46.4%), seven to narrow band noise (25%), eight to natural environmental sounds (21.4%), one each to artificial environmental sound and white noise (3.6%) and no one to synthetic sound. 2) The sound that masked tinnitus well was three octave broad band noise including the tinnitus frequency. 3) Twenty four patients (85.7%) chose music as the most comfortable sound to listen to. 4) Three patients (10.7%) replied that their tinnitus were decreased in amplitude and 15 patients (53.6%) reported that it was easier to stand the tinnitus even though their tinnitus persisted. CONCLUSION: Based on these results, it can be concluded that music therapy provides psycological stability in addtion to inducing masking effect, even though it can't directly decrease nor completely remove tinnitus. Thus we believe that a more effective result can be obtained if music therapy is implemented on a gradual basis as a part of the whole treatment process.

Effects of Salicylate on ABR and ECoG in Guinea Pig / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has been recognized that salicylate induces ototoxicity in animals and humans. Many studies have been done to identify the mechanisms of ototoxicity of salicylate with histopathological, biochemical and electrophysiological methods. Among these methods, the electrophysiological method is useful for clinical diagnosis and evaluation of therapeutic effect. The studies reported here were aimed at performing electrophysiological effects of salicylate by using Auditory Brainstem Response (ABR) and Electrocochleography (EcoG) through non-invasive approach. MATERIAL AND METHODS: Auditory brainstem response and electrocochleogram were observed by non-invasive approaching method after the intraperitoneal injection of 450 mg/kg of lysine salicylate on 10 ears of 5 guinea pigs. RESULTS: The threshold shifting of ABR and ECoG were less than 10 dB. The latency of ABR waves and Summating Potential were increased after salicylate was administered especially at low intensity sound stimulation. CONCLUSION: The latency of ABR wave and SP would be useful in diagnosing ototoxicity and evaluating the therapeutic effect in ototoxic patients.

Differentiation characteristics of cholesteatoma epithelium determined by expression of transglutaminase isoenzymes

Transglutaminase (TGase) isoenzymes are involved in the process of the differentiation and cornification of keratinocytes in the epidermis. This study investigates the presence and localization of three TGase isoenzymes to elucidate the nature and differentiation status of the squamous epithelium in human aural cholesteatoma. Twenty cholesteatoma specimens were used. The presence and localization of three TGase isoenzymes were studied by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. mRNA expression of three TGase isoenzymes were detected in the tested cholesteatomas with variable levels. The immunohistochemical staining patterns of three TGase isoenzymes showed variations within specimens, relating to keratinizing activity. TGase K is the most abundant among three isoenzymes. Keratinizing epithelium of cholesteatoma have similar expression profiles of TGase isoenzymes with those of epidermis of the skin. Other areas, particularly those showing non-keratinizing epithelium, showed weak immunostaining of TGase E and C, suggesting its different maturation status from keratinizing epithelium. The results of this study indicate that epithelium of cholesteatoma undergoes same direction of maturation and differentiation characteristics as the epidermis of skin, evidenced by similar expressions of TGases both in mRNA level and immunohistochemistry.

A Study on the Proliferative Activity of the Squamous Epithelium of the Cholesteatoma Using Argyrophilic Nucleolar Organizer Regions / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The Nucleolar organizer regions (NORs) are one of markers of cellular proliferation. Because the NORs can be visualized by a silver staining technique, the NORs are called the argyrophilic nucleolar organizer regions (AgNORs). The expression patterns of proliferative markers have been reported in the cholesteatoma, but the AgNORs have not been studied in the cholesteatoma. We investigated the proliferative activities of the cholesteatoma by the AgNORs and the usefulness of the AgNORs as a proliferative index in the cholesteatoma. MATERIALS AND METHODS: We assessed 5 postauricular skin samples and 20 cholesteatoma specimens by the numbers of the total AgNORs and the large AgNORs (large AgNOR means a diameter of over 6 nm) in high power fields and each cell. And the total areas of the AgNORs in high power fields (HPF) were calculated. RESULTS: The numbers of the large AgNORs in HPF, the numbers of AgNORs in each cell and the total areas of the AgNORs in HPF of the cholesteatoma were higher than those of the controls (p<0.05). In the cholesteatoma, the numbers of the large AgNORs and the total areas of the AgNORs in HPF were the highest in the keratinizing squamous epithelium of thick portion followed by the non-keratinizing squamous epithelium, and the keratinizing epithelium of thin portion. The numbers of the large AgNORs in each cell of the basal and superficial layers were the highest in the thick keratinizing squamous epithelium. In the suprabasal layer, the non-keratinizing squamous epithelium showed higher numbers of the large AgNORs but showed no statistical significance. CONCLUSION: 1) The proliferative capacity of the epithelium of cholesteatoma is reactive proliferative status. 2) The proliferative activity is varied with the differentiation status of the squamous epithelium in the cholesteatoma.

Comparative Analysis on Anatomical Measurements of Paranasal Sinuses Using Nasal Endoscope and CT / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is rare to find any studies reporting on the practical measurements of landmarks in the paranasal sinuses that are done intraoperatively as well as comparative analysis on the anatomical and radiological measurements of the paranasal sinuses. The aim of this study was to analyze the anatomical measurements of the paranasal sinuses using nasal endoscope and CT scout films to determine the statistical significance. MATERIALS AND METHODS: In 130 patients the authors used bayonet forceps and seekers to measure the distances from the anterior nares to some of the intranasal structures, such as the uncinate process, bulla ethmoidalis, basal lamella, maxillary ostium, posterior wall of ethmoid sinus, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus. Then, using the CT scout films, we measured the distances between the anterior nasal spine and the basal lamella (B.L.), the anterior wall of sphenoid sinus (A.W.S.), and the posterior wall of sphenoid sinus (P.W.S.). We analyzed the mean values of the basal lamella, the anterior and posterior wall of sphenoid sinus from all the available data in order to compare the endoscopic and radiologic measurements, and carried out a paired t-test. RESULTS: There was a statistically significant discrepancy in the comparative analysis of the CT scout film and the endoscopic measurements of the basal lamella, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus, althought there were no significant discrepancy for basal lamella in female patients (p>0.05). CONCLUSION: The differnces between the CT and operative measurements observed in this study were due to differnt measuring points, differences in the measuring angles, and inaccurate locations of the landmarks on the CT scout films owing to their small sizes. These findings indicate that a more accurate method need to be introduced in using the CT films to measure the anatomical landmarks in the paranasl sinuses.

Three Cases of Fungal Sinusitis with Orbital Complication / 대한이비인후과학회지

The most commonly involves observed in the fungal infection of sinus is the maxillary sinus, followed by ethmoid sinus. On the other hand, sphenoid sinus is only occasionally affected. In the sphenoidal fungal sinusitis, however, its complication may cause fatal outcome when the adjacent vital structures are involveed. The orbital involvement of invasive fungal sinusitis has been rarely reported, which may occur via the direct spread of invasive disease or through the communicating veins despite intact sinus walls. The invasive fungal sinusitis needs aggressive therapy, including endoscopic sinus surgery. But, when there is evidence of spread to the adjacent structure, adjuvant antifungal chemotherapy can be used. We recently experienced three cases of fungal sinusitis with orbital complication. The first case was limited to the left sphenoid sinus and treated with surgery. Adjuvant antifungal chemotherapy was tried but discontinued due to poor general condition. The other two cases involved the ethmoid and sphenoid sinus have been treated with surgery and adequate antifungal chemotherapy. The orbital complication in the first case was improved, but the patient died after 3 months due to poor gerneral condition. In the other two cases, patients completely recovered from fungal sinusitis and the orbital complication.

Pure tone and speech audiometry before and after surgery of chronic otitis media / 대한이비인후과학회지

No abstract available.

A case of huge cholesterol granuloma in fibrous dysplasia of temporal bone / 대한이비인후과학회지

No abstract available.

Complement system in otitis media with effusion / 대한이비인후과학회지

No abstract available.