Clinical Characteristics of the Patients with Dizziness after Car Accidents / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: With increasing frequency of car accidents, patients of dizziness caused by car accidents are also increasing. Various types of dizziness or vertigo can occur from car accidents depending on different injury mechanisms. Since accurate diagnosis is important for providing proper treatments, we evaluated clinical characteristics related to vestibular function of patients with dizziness caused car accidents. SUBJECTS AND METHOD: In this retrospective case review study that runs from January 2011 to March 2013, a total of 82 patients with dizziness following car accident were enrolled consecutively. We analyzed the final diagnosis of dizziness according to different mechanisms of injury during car accident through clinical record review. Patients who developed dizziness within one month of car accident were included, excluding those who had temporal bone fracture and previous history of dizziness. RESULTS: Of the different types observed, 36.6% was head injury, 24.4% whiplash injury, 3.7% complex injury, 2.4% others and the rest was unknown. In the final diagnosis, the different types included 36.6% benign paroxysmal positional vertigo (BPPV), 23.2% unclassifiable dizziness, 18.3% cervical vertigo, 7.3% labyrinthine concussion, 3.7% BPPV with labyrinthine concussion and the rest was others. Of the different types of dizziness symptoms, 58.5% was headache, 45.1% was audiologic symptoms, and others included earfullness, tinnitus and hearing disturbance. Tinitogram and pure tone audiogram results show that 2.9% (27 people) of patients have tinnitus and 7.3% (6 people) have hearing disturbance. CONCLUSION: An accurate diagnosis and timely management would be very important in forming a proper approach for post traumatic vertigo patients.

Tinnitus Assessment / 한양의대학술지

Tinnitus is a common medical condition where patients perceive unwanted noise in the absence of environmental stimuli. However, it is very difficult to find out definite causes of each patient's tinnitus. According to tinnitus classification systems, there are many different diagnostic tools. Representatively, tinnitus can be divided into objective and subjective tinnitus. Also, there are many etiologic factors for each classified tinnitus. Tinnitus assessment is defined as finding out the exact cause of tinnitus and prediction of treatment effect. It starts from history taking and physical examination to audiologic evaluations. Also, it is an important part in the relationship with the patient, as well as tinnitus objectification in the treatment process. And, it affects the consequent management of tinnitus. Otherwise, assessment of tinnitus is a challenging task due its subjective nature. Therefore, a multidimensional diagnostic approach to tinnitus is very important in appropriate treatment of tinnitus and in predicting the effect of the management.

Endoscopic Endonasal Skull Base Repair with Nasoseptal Flap / 대한이비인후과학회지

Endoscopic endonasal approach (EEA) for the skull base surgery has been widely accepted since the advent of image guidance system and new reconstruction method. EEA has the advantage of being non-invasive approach with low morbidity. Among many reconstructive methods nasoseptal flap is the method of choice because of the proximity to the skull base and hypervascularity as a pedicled flap. In this review, the authors introduce the indication, surgical techniques and postoperative complications of nasoseptal flap.

Influence of Head and Neck Muscle Contraction on Tinnitus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tinnitus can be classified into two types, otogenic and somatic tinnitus. Somatic tinnitus can occur even when the ear is normal, as it is known that tinnitus can occur after there is movement in the muscles of the head and neck. This study aims to characterize tinnitus and clarify the nature of tinnitus when it occurs from the contraction of the head and neck muscle. SUBJECTS AND METHOD: Thirty-five people with normal hearing, who had no history of otitis media or inner ear disease, were taken as subjects. First, we investigated whether the natural tinnitus occurred or not in the silent environment and checked its characteristics for five minutes. We then implemented eight different kinds of muscle contractions maneuver and measured whether the tinnitus occurred and the recorded the onset time, duration and location of the occurrence of the tinnitus. RESULTS: Among the total of 35 subjects inspected, 15 (42.9%) people felt the natural tinnitus. In terms of natural tinnitus, ringing was the most common characteristic and heard most often from both sides. Twenty (57.1%) subjects out of total 35 subjects inspected felt tinnitus after the contraction of the head and neck muscles. Tinnitus after the resistance to a force applied by the people to the occiput was the most common for 14 (40.0%) people, followed by parietal and right temporal area. The most common location was the left side for 6 (17.1%) subjects followed by right side and both sides. For the type of tinnitus after the contraction of muscles, ringing was observed the most by 6 (17.1%) subjects, followed by high frequency and pulsatile sound. The average onset time of the tinnitus was 8.8 seconds and the average duration was 29.6 seconds. CONCLUSION: The study showed that the muscle contraction of head and neck affects the occurrence of tinnitus for people who had no tinnitus. By clarifying the occurrence of tinnitus due to the contraction of muscles, the study identified the basic features of hearing and the role of the somatic tinnitus.