Therapeutic Effect of Zinc and Lipoprostaglandin E1 for Idiopathic Sudden Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We aimed to analyze the therapeutic effect of zinc, lipoprostaglandin E1 in addition to systemic steroid therapy on hearing improvement for the treatment of idiopathic sudden hearing loss. SUBJECTS AND METHOD: Retrospective medical chart reviews of 500 patients who had been diagnosed with unilateral idiopathic sudden hearing loss between May 2006 and April 2014 were performed. Then, we conducted a multiple linear regression analysis using the data of individual patients. RESULTS: Better hearing gain was associated with low tone hearing loss (p<0.001), better initial contralateral hearing (p<0.001), and the absence of dizziness (p=0.015). Patients who underwent intratympanic steroid treatment as salvage treatment showed a lower hearing gain (p<0.001). Zinc supplementation was effective for the treatment of patients with mild hearing loss (p<0.001). On the contrary, significant improvements in hearing gain were found in patients with profound hearing loss who were treated with an additional lipoprostaglandin E1 (p<0.001). CONCLUSION: An additional use of zinc and lipoprostaglandin E1 may enhance hearing improvement for the treatment of idiopathic sudden hearing loss.

Clinical Study of the Intranasal Hemangioma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hemangioma of the nasal cavity is an uncommon benign vascular tumor. This study aimed to analyze the clinical manifestations, radiologic findings, treatment modalities, and outcomes of intranasal hemangiomas. SUBJECTS AND METHOD: Retrospective reviews of the medical record were performed on 13 patients, who were treated for intranasal hemangioma from 2005 to 2014. RESULTS: Of the 13 patients identified, there were seven males and six females ranging from 11 to 80 years of age (mean age of 48.1+/-21.5). Epistaxis was the most common presenting symptom. Most common site of origin was the inferior turbinate. CT scans showed variable enhancement of the nasal mass without bony erosion. Preoperative diagnosis accuracy rate was 76.9%. The tumor was histopathologically classified as follows: capillary hemangioma (n=6, 46.1%), cavernous hemangioma (n=3, 23.1%), venous hemangioma (n=2, 15.4%), and mixed hemangioma (n=2, 15.4%). Endoscopic excisional surgery (n=11, 94.6%) and local excision (n=2, 15.4%) were performed for complete removal of the hemangioma. Preoperative selective embolization was performed on one patient. No evidence of recurrence after the surgery was observed. CONCLUSION: Intranasal hemangioma was usually found to occur in the inferior turbinate and the most common symptom was epistaxis. Capillary hemangioma was the most common type. Complete excision was recommended to prevent recurrence.

Selective Arterial Embolization in Intractable Recurrent Epistaxis: A Clinical Analysis with Literature Review / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Epistaxis usually responds to conservative therapy such as nasal packing or electrocauterization. But sometimes more invasive techniques such as selective embolization is justified. We report our experience of 10 patients with selective endovascular embolization for refractory epistaxis. SUBJECTS AND METHOD: Ten patients were referred for selective arterial embolization for refractory epistaxis. Medical records were reviewed for clinical data, recurrence, and complication. RESULTS: Early rebleeding requiring treatment occurred in 1 patient (10%) and initial success rate of embolization was 90%. There was no major complication. Minor complications such as mild fever, groin pain, and voiding difficulty occurred in 2 patients (20%). CONCLUSION: Selective arterial embolization for refractory epistaxis is safe and effective for treatment of refractory intractable epistaxis.

Unidentified Bright Objects on Brain Magnetic Resonance Imaging Affect Vestibular Neuritis

OBJECTIVES: The aim of this study was to investigate the differences in clinical manifestations of in two groups of vestibular neuritis (VN) patients with or without unidentified bright objects (UBOs). METHODS: A prospective, observational study with 46 patients diagnosed with VN between May 2013 and November 2013 was executed. A caloric test, a cervical vestibular-evoked myogenic potentials (cVEMPs) test, brain magnetic resonance imaging (MRI), spontaneous nystagmus test, head impulse test, and head-shaking nystagmus test were performed. RESULTS: Of the patients, 56.5% (n=26) were classified as UBO-positive by MRI. These showed lower caloric weakness and more prominent cVEMP asymmetry compared with the UBO-negative group (P0.05). CONCLUSION: UBOs on T2-weighted or fluid attenuated inversion recovery MRI may affect the patterns of the vestibular nerve in patients with VN.