Validation of the Korean Version of the Spatial Hearing Questionnaire for Assessing the Severity and Symmetry of Hearing Impairment

PURPOSE: Spatial hearing refers to the ability to understand speech and identify sounds in various environments. We assessed the validity of the Korean version of the Spatial Hearing Questionnaire (K-SHQ). MATERIALS AND METHODS: We performed forward translation of the original English SHQ to Korean and backward translation from the Korean to English. Forty-eight patients who were able to read and understand Korean and received a score of 24 or higher on the Mini-Mental Status Examination were included in the study. Patients underwent pure tone audiometry (PTA) using a standard protocol and completed the K-SHQ. Internal consistency was evaluated using Cronbach's alpha, and factor analysis was performed to prove reliability. Construct validity was tested by comparing K-SHQ scores from patients with normal hearing to those with hearing impairment. Scores were compared between subjects with unilateral or bilateral hearing loss and between symmetrical and asymmetrical hearing impairment. RESULTS: Cronbach's alpha showed good internal consistency (0.982). Two factors were identified by factor analysis: There was a significant difference in K-SHQ scores for patients with normal hearing compared to those with hearing impairment. Patients with asymmetric hearing impairment had higher K-SHQ scores than those with symmetric hearing impairment. This is related to a lower threshold of PTA in the better ear of subjects. The hearing ability of the better ear is correlated with K-SHQ score. CONCLUSION: The K-SHQ is a reliable and valid tool with which to assess spatial hearing in patients who speak and read Korean. K-SHQ score reflects the severity and symmetry of hearing impairment.

Is Alcohol Swabbing Sufficient to Clean Otoscopes in Hospitals? / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An otoscope is a basic instrument used by otorhinolaryngologists. An inappropriately sterilized otoscope has been reported to be a possible bacterial vector for infection. In this regard, we decided to investigate contaminated otoscopes for possible bacterial contamination and evaluate the efficacy of the otoscope disinfection methods. MATERIALS AND METHOD: We randomly drew 22 otoscope cones from university hospitals and 10 from private hospitals. Cones were divided into three groups accordingly to their sterilization methods: group 1 was wiped with 70% isopropyl alcohol, group 2 was soaked for 20 min in 70% isopropyl alcohol, and group 3 was soaked in CIDEX solution. The samples were cultured twice, first before the disinfection process and then after the disinfection process. Otoscopes were cleaned for a week by employing these techniques. RESULTS: Most of the pre-sterilized otoscopes (20/22) were obtained from the hospitals which demonstrated contamination with microorganisms. Staphylococcus was the most common bacteria found (16/22). After a week of cleansing, no bacteria were seen in group 1 (0%, 0/8), whereas group 2 (14.3%, 1/7), and group 3 (28.6%, 2/7) still showed remaining microorganisms. The three methods were significantly effective on sterilizing microorganisms. CONCLUSION: An otoscope can be a vector for spreading infection. We found that disinfection by alcohol-swabbing alone is sufficient for sterilizing otoscope cones. Clinically, this information may be useful to otorhinolaryngologists. However, further studies are required to establish the most appropriate disinfection protocol to prevent infection from microorganisms.

Clinical Features and Prognosis of Sudden Sensorineural Hearing Loss Secondary to Intralabyrinthine Hemorrhage

BACKGROUND AND OBJECTIVES: A number of etiologies of idiopathic sudden sensorineural hearing loss (ISSNHL) have been proposed, including viral infection, vascular disturbance, and immune-mediated mechanisms. Intralabyrinthine hemorrhage (ILH) as a cause of SSNHL is extremely rare, and there have been no studies defining the characteristics of hearing impairment and prognosis in patients with ISSNHL due to ILH. This study aimed to investigate the difference in impaired hearing patterns and prognosis for hearing recovery between patients with ISSNHL due to ILH confirmed by magnetic resonance imaging (MRI) and sex- and age-matched patients with ISSNHL due to causes other than ILH. SUBJECTS AND METHODS: We compared the results of audiometry and MRI in 12 patients who had ILH on MRI (hemorrhage group) and in 23 sex- and age-matched controls without abnormal findings related to their hearing loss on MRI (non-hemorrhage group). Initial hearing impairment, progression, and recovery of hearing loss were compared between the two groups. RESULTS: A majority of patients (92%) in the hemorrhage group complained of dizziness. Initial hearing impairment was more frequent in the hemorrhage group than in the non-hemorrhage group (94.09±35.9 vs. 66.66±30.1, p-value=0.036). The final recovery threshold in the hemorrhage group was worse (78.19±46.26 vs. 37.17±31.96, p-value=0.014) than that in the non-hemorrhage group. In the hemorrhage group, hearing recovery seemed to occur less often at high frequencies (2,000, 4,000, and 8,000 Hz) than at low frequencies (250, 500, and 1,000 Hz). CONCLUSIONS: The presence of ILH was associated with poor hearing prognosis and the occurrence of vertigo. The abrupt onset of hearing loss associated with vertigo and the presence of hyperresonance on fat-suppressed T1-weighted MRI images of labyrinthic fluid strongly suggests acute intralabyrinthine hemorrhage, and is predictive of considerable hearing impairment and poor prognosis.

Laryngeal Trauma / 대한이비인후과학회지

The external laryngeal trauma is a rare but clinically important injury. The blunt trauma is more common than penetrating one. As other trauma, early suspicion and accurate diagnosis of acute laryngeal and tracheal injuries are crucial. If the airway obstruction is impending, secure airway should be made before diagnosis or treatment. The computed tomography scans play an important role in diagnosis and combined cervical esophageal injury should be evaluated. Proper restoration of the laryngeal framework with appropriately timed open reduction and internal fixation is critical for optimal recovery of the airway, voice, and swallowing.

A Case of Sinonasal Tearatocarcinosarcoma of Nasal Cavity / 대한이비인후과학회지

Sinonasal teratocarcinosarcoma is extremely invasive malignant tumor that has a histological characteristic of having both more than one epithelial and mesothelial tissue components. It is a rare cancer of having less than 50 cases reported until now and domestically. This case presents a 51 year-old male who had nasal stuffiness for 2 months. A mass was noticed in his right nasal cavity, and histopathologic findings revealed the mass as a teratocarcinosarcoma. Computed tomography and magnetic resonance imaging showed that the mass originated from right nasal septum and did not invade the sinuses and that it was touching the inferior turbinate. No cervical lymph node metastasis was observed (T2N0M0, Stage II). Wide excision of the mass was performed, and no invasion in the resection margin was confirmed. Radiotherapy was performed postoperatively. Currently, the patient has been followed up on a regular basis for 28 months. Thus, the authors present a report of very rare sinonasal teratocarcinosarcoma.

Search for Genes Potentially Related to Germ Tube Formation in Candida albicans by Differential-Display Reverse Transcription Polymerase Chain Reaction

Candida albicans exhibits the ability to grow in either a yeast or a mycelia form in response to different environmental factors. The mycelia form, found in infected tissues, is important as a virulence factor in the adherence of the organism to the host epithelium. In vitro, the morphological transition can be induced by environmental shifts in the growing conditions, or by a variety of exogenous factors, including ambient pH, nutritional status and temperature. The differential-display reverse transcription polymerase chain reaction (DDRT-PCR) is a powerful technique for comparing gene expression between cell types, stages of development or differentiation. Hyphae related genes were identified and characterized using a PCR-based differential display. Candida albicans formed a germ tube when cultured in rabbit serum, RPMI 1640 medium or 39degrees C-YPD medium. We gained 21 cDNA bands showing a different expression pattern from that of the uninduced culture. DNA was extracted from the same location of the isolated bands, and PCR was performed under the same conditions, which reamplified the PCR product, showing the specific expression patterns according to the culture conditions. We cloned 18 germ tube-related cDNA clones (inserts average size is 80 - 700 bp) and sequenced them. The nucleotide sequences of the 18 clones were identified through in the present study from GenBank, and were found to have the accession number (AF405213-AF405230). We could not find any nucleotide sequence having a high homology with these clones. This study could form a part of the projects in the search for genes related to the germ tube formation of C. albicans.

A Case of Myxolipoma in Parapharyngeal Space: First Report of a Case / 대한이비인후과학회지

Myxolipomas, or myxoid lipomas, are unusual histologic types of lipoma in which components of the tumor are replaced by mucoid substances. Lipomas of the parapharyngeal space are extremely rare with only a few cases having been reported. The presence of myxolipoma in the parapharyngeal space has not yet been reported in the literature. We present the first report of a 14-year-old female with myxolipoma in the left parapharyngeal space which was excised via a transcervical approach.

A Case of Malignant Myoepithelioma in Parotid Gland / 대한이비인후과학회지

Myoepithelial cells are a significant component of most types of salivary gland neoplasms, but, pure myoepitheliomas are rare, comprising less than 1% of all salivary gland tumors. Malignant myoepithelioma, or myoepithelial carcinoma, is even more rare. It occurs most frequently in the parotid gland among salivary glands, and is similar to benign myoepitheliomas. The palate is the most common intraoral site of involvement. As far as the treatment of myoepithelial carcinoma is concerned, surgical excision is the mainstay of therapy. The role of radiation therapy and chemotherapy is not yet established. We present a case of malignant myoepithelioma of the left parotid gland in a 67-year-old female patient who was treated with surgical excision followed by adjuvant radiation therapy.

External Fixation for Inappropriate Closed Reduction of Nasal Bone Fracture

Nasal bone fracture is the most common fracture among facial fractures. The nasal bone fracture has a very complex and infinitive variety but often is undermanaged only by closed reduction. The prognosis and outcome after operation had been reported by many surgeons and it's result is dependant upon many factors such as etiology, experience of surgeons, type of anesthesia and maintenance of fixation after surgery. In our study, we have grouped our fractures as favorable and unfavorable fractures. Favorable fractures are simple fractures that are easily reduced by closed reduction, whereas unfavorable fractures were fractures that remain unstable after reduction. In our opinion, the method of reduction and fixation after reduction plays an important role in unfavdrable fracture. We applied a new method of external fixation for unfavorable fractures After closed reduction to gain optimal reduction and maintenance.

Two Cases of Deep Neck Infection with Mediastinal Involvement / 대한이비인후과학회지

Deep neck space infections affect fascial compartments of the head and neck, and their contents. Acute mediastinitis occasionally occurs as a complication of neck infections resulting in neck sepsis, which spreads to the mediastinum via the cervical fascial planes, and this is best referred to as descending necrotizing mediastinitis (DNM). We recently experienced two cases of deep neck infection dissecting along cervical fascial planes into the mediastinum causing a virulent mediastinitis. Aggressive antibiotic treatment of the deep neck infections along with prompt complete mediastinal drainage are recommended for optimal outcome.

Melnick-Fraser Syndrome in the Same Family / 대한이비인후과학회지

Melnick-Fraser syndrome is a rare congenital anomaly that is characterized by preauricular fistula, branchial fistula, hearing impairment, and is often combined with renal anomaly. Preauricular fistula and branchial fistula can occur in the same individual, but their association with hearing impairment is very rare. The condition is inherited in an autosomal dominant mode. Recently, we experienced a case of Melnick-Fraser syndrome in a 32 years old male patient with familial tendency. We report this case with a review of literature.

Management of Acute Laryngeal Trauma Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Laryngeal trauma is an uncommon but potentially catastrophic injury. The purpose of this study was to analyze the association between injury mechanism and the degree of injury, and to assess the outcome after the treatment. MATERIALS AND METHOD: A 10-year retrospective study of 21 patients with acute laryngeal trauma seen from 1988 to 1997 at Wonju Christian Hospital is presented. All patients are classified by injury mechanism (penetrating vs blunt) and degree of injury (Group I through V). These patients have been studied with attention to clinical manifestation, injury mechanism, degree of injury and outcome after the treatment. RESULTS: The main presenting symptoms and signs were dyspnea, hoarseness, tenderness and subcutaneous emphysema. Eleven cases were categorized as penetrating injury and the other ten cases as blunt injury. Sites of laryngeal injury included thyroid cartilage fracture, soft tissue laceration, cricoid cartilage fracture, pyriform sinus perforation and vocal folds injury. All patients were decannulated. Sixteen patients made a full return to normal voice, four were assessed fair but one was graded as poor. CONCLUSION: Conservative treatment of group II injuries was effective. In this cases, the greater the actual trauma, the poorer the results. Also, blunt trauma proved more serious than penetrating trauma and early surgical intervention was associated with better outcome. Authors suggest esophagoscopy to be performed at the time of operation.

Fine Needle Aspiration Cytology of Cervical Chordoma: A Case Report / 대한세포병리학회지

A case of cervical chordoma diagnosed by fine needle aspiration is discussed. A 41year-old male was admitted due to dyspnea on neck flexion. Radiologic image revealed a retrotracheal superior mediastinal solid mass. Aspiration cytology showed many clusters of oval or large polygonal cells having abundant eosinophilic or bubbly cytoplasm in an amorphous blue-gray mucoid background. The nuclei were round and showed size variation, coarse granular chromatin, and indistinct nucleoli. Some cells contained brown granular pigments in the cytoplasm. Mitoses were rarely found. The cytoplasm was strongly positive for PAS stain. Immunohistochemical stains using cell block revealed positive reaction for cytokerain, EMA, vimentin, and S-100 protein. The confirmative diagnosis was made by following excisional biopsy. Electron microscopic study revealed large pools of intracytoplasmic glycogen and microfilaments. This is the first case of cervical chordoma diagnosed by aspiration cytology to our knowledge in Korean literature.

Expansion and New Creation of Human Septal Cartilage from Biopsied Fragment: Using in vivo 3-D Culture of Chondrocytes / 대한이비인후과학회지

BACKGROUND: The use of autogenous cartilage has the problem of donor site morbidity and limited supply in reconstructive surgery. OBJECTIVES: The purpose of this study is to increase the size and the volume of the autogenous small cartilage by the new three dimensional culture technique. MATERIALS AND METHODS: The chondrocytes from biopsied human septal cartilage were subcultured. The increased cells were encapsulated with calcium alginate and were injected to the subcutaneous tissue of the athymic nude mouse for in vivo 3-dimensional culture. RESULTS: After 8 weeks of the injection, the implanted subcutaneous nodule was seemed to be the natural cartilage and the histoarchtectures revealed characteristics of the hyaline cartilage. CONCLUSION: This results suggest that the small biopsied cartilage can be expanded by the techniques of subculture and the 3-dimensional culture., and can potentially overcome the limited availability of autogenous donor cartilage.

The Immunoreactivity of Endothelin-1: A Comparison Study between Healthy and Diseased Nasal Mucosa / 대한이비인후과학회지

BACKGROUND: ndothelin-1(ET1) has been reported about it's versatile pharmagological and physiological influences to airway calibre. Some investigators suggested that ET1 exisit in the nasal mucosa, and may play a part in the exaggerated symptoms of asthma and in controlling the nasal mucosal physiology. OBJECTIVES: In order to clarify the alterations of expression of ET1 in the pathologic nasal mucosa, we investigated the distribution of ET1 by immunohistochemistry at the allergic rhinitis mucosa and the polyp tissues. MATERIALS AND METHODS: The mucosal specimens were obtained from the inferior turbinate of normal persons(n=5) and from patients with allergic rhinitis(n=10), and the polyps from the lateral nasal wall of non-allergic patients(n=10). The immunoreactivity of the ET1 was evaluated by the immunohistochemical stainig with the anti-ET1 monoclonal antibody. RESULTS: The immunoreactivity of ET1 could be observed weakely in the epithelium, in the vascular endotheluim, and in the submucosal gland. But the feature was not constant and showed no statistical significance in each group. On the other hand, strong positive immunoreactivity was noted in the cytoplasm of the granulated large cells and bilobed nuclear leukocytes in the submucosa. These cells were proved to be the mast cells and the eosinophils respectively by means of the toluidine blue and the H & E staining. CONCLUSION: These findings would be reasonable to suggested that the ET1 existed in the mast cells and the eosinophils as like cytokines, and the ET1 activity may be affected by the quantity of these cells in allergic rhinitis or nasal polyps.

A case of rupture of the common carotid artery by gunshot injury / 대한이비인후과학회지

No abstract available.

Clinical diagnosis of cervical tuberculous lymphadenitis / 대한이비인후과학회지

No abstract available.

A case of Kimura's disease / 대한이비인후과학회지

No abstract available.

Clinical analysis of cystic lesions of the head and neck / 대한이비인후과학회지

No abstract available.