The Relationship between the Change of Otoacoustic Emission and Temporary Threshold Shift after Broad Band Noise Stimulation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A distortion product otoacoustic emission (DPOAE) is a non-invasive method which is commonly used to assess the hearing function of the cochlea and to reflect objective information of specific frequency in the cochlea. We hypothesize that after applying a broad band noise (BBN), the outer hair cell's function will change and cause reduction in the amplitude of DPOAEs and signal to noise ratio (SNR). SUBJECTS AND METHOD: We performed the examination on 40 subjects (80 ears) who have a normal hearing function. DPOAEs were recorded before and after BBN stimulation (intensity: 90 dB HL, duration: 10 minutes). RESULTS: After the BBN stimulation, the amplitude of DPOAEs and SNR were decreased at all frequencies. The amplitude of DPOAEs and SNR decreased 0.3-1.6 dB SPL, 0.6-1.5 dB SPL, respectively. Decreases in the amplitude had statistical significances after 3 and 6 minutes in 1 kHz, 3 and 6 minutes in 2 kHz, immediately after noise exposure, and after 3 and 6 minutes in 6 kHz. However, the SNR changes had statistical significance only after 3 minutes in 1 kHz. After the stimulation, pure tone threshold at 4 kHz increased 3.2+/-3.9 dB HL. After the BBN exposure, the amplitude of DPOAEs and SNR decreased at all frequencies and most of them recovered within 12 minutes. CONCLUSION: These results suggest that DPOAE could be a clinically useful method for the purpose of screening, managing and assessing the prognosis of acoustic trauma and noise induced sensorineural hearing loss.

Analysis of Otorhinolaryngologic Disease in Patients with Human Immunodeficiency Virus Infection / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: As human immunodeficiency virus (HIV) infection increases in prevalence and new medical therapies prolong the survival of HIV-infected patients, otolaryngologists will see a larger number of patients with head and neck manifestations of HIV infection. The aims of study were to evaluate the various otorhinolaryngologic diseases and to analyze the useful markers for predicting immune function in HIV-infected patients. SUBJECTS AND METHOD: Of 380 HIV-infected patients, 40 patients (10.5% ; 39 males and 1 female, age ranging from 23 to 55) were referred to otorhinolaryngologists. Spectrum of disease and correlation between various surrogate markers (HIV RNA, leukocyte count, neutrophil, lymphocyte, CD3, CD4, CD8 T cell percentage and count, CD4/CD8 ratio) and risk of infectious otorhinolaryngologic diseases were analyzed. RESULTS: Thirty-three patients (82.5%) were infectious, 6 patients (15.0%) had non-infectious diseases and 1 patient (2.5%) malignancy. In otologic diseases, acute otitis media and chronic otitis media were frequently found in the mentioned order. In rhinologic diseases, rhinosinusitis and vestibulitis were frequently found in the mentioned order, with one primary extra nodal non-Hodgkin's lymphoma. In laryngologic diseases, pharyngolaryngitis, oral candidiasis, stomatitis were frequently found. In the surrogate markers of immune function, CD4 percentage, CD4 count and CD4/CD8 ratio were found significantly lower in the infectious diseases than in the non-infectious disease. CONCLUSION: Of HIV-infected patients, 10.5% had seen an otolaryngologist, and the majority had infectious diseases. The risk of infectious diseases was strongly correlated with the CD4 percentage, count and CD4/CD8 ratio.

Clinical Characteristics of Multifocal Papillary Thyroid Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Papillary thyroid cancers (PTCs) often present as multifocal tumors. Whether multifocal tumors are associated with increased risk of recurrence and mortality is still the subject of controversy. The aim of current study was to individualize factors associated with multifocality of papillary thyroid cancer and determine the clinical significance of multifocal thyroid cancer. SUBJECTS AND METHOD: We undertook a retrospective study of 403 patients treated between January, 2003 and June, 2007 for papillary thyroid carcinoma by total thyroidectomy and central compartment neck dissection (n=403) with or without comprehensive lateral neck dissection. There were 342 women and 61 men whose mean age was 47.3 years old. Following criteria were used to study the pattern of and factors related with multifocality : sex, age, extracapsular extension, central compartment lymph node metastasis, the involvement of lateral neck lymph node, AMES risk group, distant metastasis. RESULTS: Of those factors, sex (p=0.0481), central compartment lymph node metastasis (p=0.0007), the involvement of lateral neck lymph node (p=0.0001) were significantly related factors for multifocality of papillary thyroid cancer. Age, primary tumor size, AMES risk group were not significantly related with multifocality. Bilateral or contralateral central compartment lymph node metastasis occurred more frequently in multifocal PTCs (64.0%) than solitary PTCs (46.9)(p=0.012). CONCLUSION: Our data suggest that the multifocal tumors in patients with papillary thyroid carcinoma are associated with increased risk of bilateral central compartment and lateral cervical lymph node metastasis. Therefore, total thyroidectomy and bilateral central compartment lymph node dissection should be recommended as a routine procedure in multifocal papillary carcinoma