The Effect of Smoking on Outcome in Endoscopic Sinus Surgery

BACKGROUND AND OBJECTIVES: This study is designed to assess the effect of smoking on the outcome of endoscopic sinus surgery. MATERIALS AND METHODS: A total of 66 patients who underwent endoscopic sinus surgery with the diagnosis of chronic sinusitis were evaluated. They were divided into 3 groups; non-smoking, quit-smoking and still-smoking groups. Preoperative and postoperative visual analogue scale (VAS), Sinonasal Outcome Test (SNOT), and endoscopic score for each group were obtained and compared. RESULTS: There were statistically significant correlations between VAS, SNOT score and smoking. However, all patients showed a similar degree of improvement on the subjective symptoms regardless of smoking or nonsmoking. And, postoperative relief of subjective symptoms was not apparent after smoking cessation. In objective findings, postoperative endoscopic scores were 1.6 in non-smoking group, 1.8 in quit-smoking group and 2.7 in still-smoking group. Stillsmoking group had the worst endoscopic result, However, these differences did not reach a statistical significance. CONCLUSION: This study suggests that smoking had a negative effect on subjective symptoms but not in objective endoscopic findings. In addition, the cessation of smoking after sinus surgery may have no meaningful benefit on the outcome of surgery.

Ocular Vestibular Evoked Myogenic Potential in Healthy Subjects: A Comparative Study with Cervical Vestibular Evoked Myogenic Potential / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: While vestibular evoked myogenic potentials (VEMPs) can be measured from extra-ocular muscle as well as cervical muscle, there are uncertainties about the patterns and discomfort level of ocular vestibular evoked myogenic potentials (oVEMPs). This study is to identify the properties of oVEMPs parameters and degree of subjective discomfort when compared to cervical vestibular evoked myogenic potentials (cVEMPs) in healthy subjects. SUBJECTS AND METHOD: Twenty volunteers with normal hearing were enrolled in this study. The oVEMPs were recorded from electrodes placed beneath the eyes using ipsilateral and contralateral acoustic stimulation with 500 Hz short tone bursts with subjects in sitting position and maximal upward gaze. The cVEMPs were measured using 500 Hz short tone bursts with subject in supine position and their head elevated and turned away from the test side. The latency, interlatency and interamplitude of oVEMPs responses were compared to those of cVEMPs. The subjective discomfort levels of oVEMPs and cVEMPs were compared using a questionnaire survey. RESULTS: The cVEMPs appeared as positive-negative biphasic responses in all 40 ears whereas oVEMPs were measured in 27 ears (67.5%) with ipsilateral stimulation and 20 ears (85%) with contralateral stimulation which appeared as negative-positive biphasic responses. The oVEMPs had smaller amplitude than the cVEMPs. The oVEMPs thresholds tended to have higher level than the cVEMPs thresholds. The 18 subjects (90%) reported that the discomfort level of oVEMPs measurement was lower or equal to that of cVEMPs measurement. CONCLUSION: oVEMPs test may be used as a complementary and comfortable diagnostic tool for evaluating the integrity of vestibular-ocular system.

Pneumolabyrinth Associated with Otic Capsule-Violating Fracture: Diagnosis and Clinical Features / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Pneumolabyrinth, the presence of air in the inner ear is an evidence of a pathological connection between the fluid-filled space of inner ear and the air-filled space of mastoid/middle ear cavity. The aim of this study is to evaluate the clinical characteristics of pneumolabyrinth combined with temporal bone fracture. SUBJECTS AND METHOD: Among 51 patients with temporal bone fracture, those who visited a secondary referral center between January 2005 to March 2008, 6 patients (7 ears, one bilateral case) with pneumolabyrinth were selected for a retrospective review on their medical records and radiologic findings. RESULTS: All six patients were male, and had concomitant otic capsule-violating fracture in the affected side. All pneumolabyrinths were diagnosed in the CT images taken on the date of trauma, and in one case, the pneumolabyrinth disappeared in a follow-up CT which was taken after 5 days. Six affected ears out of 5 patients showed profound sensorineural hearing loss and one patient with down-sloping severe sensorineural hearing loss showed partial recovery of hearing threshold a month later. Vestibular function tests were performed in four cases and vestibular weaknesses were identified in all affected ears. CONCLUSION: Immediate high-resolution CT might improve the detection rate of pneumolabyrinth combined with temporal bone fracture. Otic capsule-disrupting fracture has been considered to be synonymous with irreversibly severe to profound sensorineural hearing loss, but one case showed partial recovery in this study. Follow-up audiometric tests are needed to check the recovery of hearing threshold.