ABSTRACT
BACKGROUND AND OBJECTIVES: The aim of the study was to evaluate the diagnostic efficacy of high resolution computed tomography (HRCT) of the labyrinthine fistulae on the temporal bone. MATERIALS AND METHODS: 47 labyrinthine fistula cases that had undergone preoperative HRCT of the temporal bone were reviewed retrospectively. All the patients were proved to have labyrinthine fistulae during the operation for chronic otitis media with cholesteatoma from January 1983 through July 1999. RESULTS: Fistulae on the lateral semicircular canal were more effectively detected (78.6%) with conventional axial and coronal view than other site (21.4%). Detection rates of fistula were increased with decreased thickness of HRCT slices. CONCLUSION: With decreasing thickness of HRCT slices, the temporal bone CT's detection rate of labyrinthine fistulae were increased. For the fistulae on the superior and posterior semicircular canal, the efficacy of the temporal bone CT was limited.
Subject(s)
Humans , Cholesteatoma , Fistula , Otitis Media , Retrospective Studies , Semicircular Canals , Temporal BoneABSTRACT
BACKGROUND AND OBJECTIVES: Delayed facial nerve palsy (DFNP) following a middle ear surgery is an uncommon event, and is defined to develop 48 or 72 hours after surgery. The pathogenesis of DFNP is not known clearly, but it is presumed to inflammation, neuronal edema or reactivation of herpes virus. The purposes of this study were to provide the clinical aspect of DFNP after middle ear surgery and to discuss the prognostic factors and treatment plan. MATERIAL AND METHOD: From January 1985 to August 1999, in the course of over 5,670 middle ear surgeries, we experienced 12 ipsilateral delayed facial nerve palsies. We analyzed the course of DFNP according to several clinical factors retrospectively. Degree of facial palsy was evaluated with the House-Brackmann grade (HBG). RESULTS: DFNP was developed from 3 day to 14 day after middle ear surgery. The initial degree of facial palsy was HouseBrackmann grade (HBG) II in 6, HBG III in 4, and HBG IV in 2 patients. All patients were treated with steroid and volume expander. The final recovery were HBG I in 11 of the twelve patients. Remaining one patient was found to be HBG Il after a 5-year follow up. In the group who recovered within 1 month, the initial HBG were II or III. CONCLUSION: We obtained satisfactory results with steroid therapy in most patients. The courses of DFNP after middle ear surgery are favorable. The better initial HRG and HBG at 2 weeks are, the earlier recovery can be expected.
Subject(s)
Humans , Ear, Middle , Edema , Facial Nerve , Facial Paralysis , Follow-Up Studies , Inflammation , Neurons , Paralysis , Retrospective StudiesABSTRACT
BACKGROUND AND OBJECTIVES: Cisplatin (cis-diamminodichloroplatinum) exercises its ototoxic effect by damaging hair cells of the inner ear. The effect of cisplatin on the vibratory response of the inner ear was investigated in the apical turn of the cochlea in 11 living guinea pigs. MATERIALS AND METHODS: The exposed turn was sealed and fluid coupled to the objective lens of a slit confocal microscope. Individual cells were identified with the microscope and the vibration was measured with a confocal heterodyne interferometer. The vibration was made in response to tones applied to the ear canalat at selected locations such as the reticular lamina (Hensen cells and outer hair cells), and the basilar membrane adjacent to the outer Hensen cell edge. Vibration measurements were made before and after intravenous injections of cisplatin (16 mg/kg). RESULTS: The drug effect took place approximately 35 minutes after administering cisplatin. The vibration amplitude changes produced by cisplatin were not reversible with time. At the level of the reticular lamina, cisplatin reduced the vibration amplitude at almost all frequencies. However, these effects were small. In contrast to the reticular lamina response, at the basilar membrane, the vibration amplitude increased following cisplatin application. CONCLUSION: These experiments show that damage to the hair cells in the apical turn of the cochlea leads to an increase in the basilar membrane vibration. These observations support the concept of negative Feedback in the apical turn of the cochlea.
Subject(s)
Animals , Basilar Membrane , Cisplatin , Cochlea , Ear , Ear, Inner , Exercise , Guinea Pigs , Guinea , Hair , Injections, Intravenous , VibrationABSTRACT
BACKGROUND AND OBJECTIVES: The aim of this study is to analyze ciliary beat frequency (CBF)and ciliary morphology of the middle ear bulla and the upper respiratory tract in mice. MATERIALS AND METHODS: Fifteen mice with 37-42 gram weight were dissected and specimens were taken from the middle ear bulla, the eustachian tube, the inferior turbinate, the nasopharynx, and the upper trachea. The CBF of each specimen was measured using a video-computerized analysis system and the morphology of cilia was also studied using scanning electron microscopy (SEM). RESULTS: The measured CBF ranged from 9.38 Hz to 13.59 Hz, and there were no significant differences in the CBF values among the middle ear bulla, the eustachian tube, the inferior turbinate and the nasopharynx, except for the upper trachea. The mean CBF value of the upper trachea was 11.6 Hz, which was significantly lower than those of other parts. SEM showed that the cilia of the upper tracheal region were shorter than those of other parts. CONCLUSION: The CBF value of the middle ear bulla is similar to those of other parts in the upper respiratory tract except for the upper trachea. In the upper trachea, the CBF is lower and ciliary lenghth of epithelium is shorter than those of other parts.
Subject(s)
Animals , Mice , Cilia , Ear, Middle , Epithelium , Eustachian Tube , Microscopy, Electron, Scanning , Nasopharynx , Respiratory System , Trachea , TurbinatesABSTRACT
OBJECTIVES: The purpose of this study is to evaluate the effectiveness of skull base surgery on local control and survival of skull base lesions. In addition, the complications and their impact on the tumor control status as well as postoperative morbidity are considered. MATERIALS AND METHODS: We report our experience on 35 patients with skull base lesions. The patients were divided into two subgroups: (1) anterior skull base group (n=27) and (2) middle skull base group (n=8). RESULTS: For the anterior skull base group, the overall survival rate for malignant tumor (n=15) at 16 months was 53% without regard to histologic types. The overall operative mortality rate was 0% and the complication rate was 25% with craniofacial resection for control of neoplasm (n=20) and all of these complications were managed successfully without any sequelae. The technique of craniofacial resection was applied to the management of skull base trauma (n=4) and encephaloceles (n=3) successfully. The middle skull base group consisted of 5 patients with juvenile nasopharyngeal angiofibroma, and one patient each with malignant meningioma, meningioma, fibrous dysplasia, respectively. All JNA patients were managed with a combined intracranial and transmaxillary/transpalatal approach. Among them, 4 patients were cured and one patient developed a recurrence near the cavernous sinus. Surgical morbidity was minimal and there was no mortality. Facial translocation approach to the skull base was utilized in 2 patients. CONCLUSION: Craniofacial resection is a valid surgical technique for surgical management of tumors involving the anterior skull base and also can be applied to the treatment of selected trauma and malformations. The combined intracranial and transmaxillary/transpalatal approach is a safe and reliable method to remove nasopharyngeal angiofibroma with intracranial invasion.
Subject(s)
Humans , Angiofibroma , Cavernous Sinus , Encephalocele , Meningioma , Mortality , Recurrence , Skull Base , Skull , Survival RateABSTRACT
BACKGROUND AND OBJECTIVES: Despite the continued research on the pathology of Meniner's disease, it still remains largely uncertain. Since endolymphatic hydrops is known to occur in Meniner's disease, this study was conducted with experimentally induced endolymphatic hydrops. We evaluated the usefulness of click evoked otoacoustic emissions (CEOAE) and electro-cochleogram (ECoG) in studying endolymphatic hydrops. MATERIALS AND METHODS: Animal endolymphatic hydrops was induced in giunea pigs by mechanically obliterating the right endolympatic sacs and their ducts. The left ears were used as controls. In twelve weeks following the induction of endolymphatic hydrops, CEOAE and ECoG were measured. RESULTS: 1) The endolymphatic hydrops induced group responded to CEOAE with 33.3% positivity, whereas the control group responded with 87.6% positivity. The echo response and reproducibility were significantly low in the endolymphatic hydrops group, for which the negative echo response was more pronounced. For the CEOAE positive endolymphatic hydrops group, the average peak frequency of the response curves was shifted significantly to a higher frequency. 2) The tone burst stimulated ECoG response showed the permanant summating potential. The tone bursts with the intensity of 95 dB and frequencies of 4 or 8 kHz were found to be suitable stimuli for the study of endolymphatic hydrops. On click stimulation, the latency of the first negative peak (AN1) in the endolymphatic hydrops group was prolonged. The ratios of the summating potential amplitude to the action potential were observed to be significantly high.
Subject(s)
Animals , Action Potentials , Ear , Endolymphatic Hydrops , Guinea Pigs , Guinea , Pathology , SwineABSTRACT
Labyrinthine fistula is not infrequent findings in cholesteatoma surgery. Fistula most commonly involve the horizontal semicircular canal, but a fistula into the cochlea is rare. The authors describe two cases of cochlear fistulas in chronic otitis media with cholesteatoma.
Subject(s)
Cholesteatoma , Cochlea , Fistula , Otitis Media , Semicircular CanalsABSTRACT
It is well known that sensorineural heating loss(SNHL) may be frequently associated with mitochondrial DNA(mtDNA) mutations. Mitochondrial DNA mutations associated SNHL have previously described in aminoglycoside-induced hearing loss(A1553G in the mitochondrial 12S ribosomal RNA gene) and diabetes with hearing loss(A3243G in the mitochondrial transfer RNA(Leu(UUR)) gene. The authors report a case of SNHL and diabetes mellitus associated with mtDNA mutation(A3243G). Patient had adult-onset maternally inherited diabetes mellitus. The SNHL appeared to be in progess since adolescence and was bilateral and symmetric. Bilateral hearing was impaired in all frequencies and was deteriorated more severely at high frequencies. Audiometric test results suggested that hearing loss involved in the cochlear rather than the retrocochlear. The point mutation of mtDNA should be suspected in patients with progressive cochlear hearing loss when they also have a family history of diabetes and/or hearing impairment.
Subject(s)
Adolescent , Humans , Diabetes Mellitus , DNA, Mitochondrial , Hearing Loss , Hearing Loss, Sensorineural , Hearing , Heating , Hot Temperature , Point Mutation , RNA, RibosomalABSTRACT
BACKGROUND: Despite numerous investigations, the pathogenesis of Meniere's disease is uncertain. Endolymphatic hydrops (ELH) has been the main histologic finding of Meniere's disease. Experimentally induced ELH in animal model has been developed in order to understand better the consequences of this morphopathology on inner ear structure and function. OBJECTIVES: The aim of this study is to develope the animal model of ELH. MATERIAL AND METHODS: We made an animal endolymphatic hydrops model on giunea pigs by mechanically obliterating the right endolympatic sac and duct. The left ears were used as a controls. RESULTS: After twelve weeks, the temporal bones were prepared for light and electron microscopic examination. The light microscopic study showed the distension and folding of Reissner's membrane, however other pathologic changes were uncertain in hydropic aminal. Under scanning electron microscopic examination, the cellular population of Reissner membrane remained normal but the microvilli of Reissner membrane were significantly decreased in hydrops group. The damage pattern of stereocilia were most severe in the apical turns, followed by the middle and the basal turns, in the order of severeity. The outer hair cell third row was most severely damaged in the entire cochlea, whereas the outer hair cell first row was relatively spared. On the single hair cell examination, abnormal distensions of the tip of stereocilia started from longer stereocilia. The number of microvilli on marginal cell was reduced in stria vascularis, but atrophic change was not observed.
Subject(s)
Animals , Cochlea , Ear , Ear, Inner , Edema , Endolymphatic Hydrops , Guinea Pigs , Guinea , Hair , Membranes , Meniere Disease , Microvilli , Models, Animal , Stereocilia , Stria Vascularis , Swine , Temporal BoneABSTRACT
No abstract available.
Subject(s)
Cross-Sectional Studies , Korea , Otitis Media , Otitis , PrevalenceABSTRACT
A nation-wide survey was conducted to estimate the prevalence of otitis media and allied diseases through physical examination by otolaryngologic doctors from July to October, 1991. A sample study population was selected from a panel to be representative of the Korean population by multistage clustered and stratified random sampling method based on the National Census Data, 1990. Total number of subjects undertaken were 9,321, Which were drawn from 2,899 households residing in 60 different areas throughout the country. The overall prevalence of otitis media was 2.85% (3.10% of males and 2.61% of females). Prevalence of each subtype was as follows; acute otitis media, 0.02%; middle ear effusion, 0.60%; chronic otitis media, 2.19%, respectively. The prevalence of otitis media did not vary by sex, nor by urban-rural difference. There was an increasing tendency of the prevalence of otitis media by age. However, the prevalence of both middle ear effusion and acute otitis media showed a decreasing pattern by age. Particularly noteworthy was a significant geographic variation in the prevalence of otitis media by provinces. The prevalence rate of septal deviation was 21.93% and the presence of septal deviation was significantly related to that of otitis media (p < 0.05). The prevalence rates of nasal allergic symptoms, nasal polyposis and evident cleft palate were 1.14%, 1.00% and 0.07%, respectively. The presence of otitis media was significantly correlated with both nasal allergic symptoms (P < 0.1) and evident cleft palate (P < 0.05), but not with that of nasal polyposis.