Is Pediatric Otitis Media Correlated with an Increased Risk of Bronchial Asthma?: An II-Year Nationwide Population-Based Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Pediatric otitis media is closely related to upper respiratory illness and is one of the most common causes of hospital visiting and antibiotic prescription. Although there are many studies of asthma with other upper respiratory tract infections, few studies have investigated the relationship between asthma and otitis media. This study estimated whether pediatric otitis media is associated with the risk of asthma using the Korean National Health Insurance Service National Sample Cohort (NHIS-NSC 2002-2013) data. SUBJECTS AND METHOD: In using the NHIS-NSC 2002-2013 data, children diagnosed as otitis media or bronchial asthma in 2002 were excluded from children from 1 to 8 years old in 2003. The patients who were diagnosed and treated as otitis media (n=8506) and the comparison group (n=65886) were enrolled in 2003. During a 10-year follow-up period until December 2013, the incidence of asthma between two groups was analyzed and the result was adjusted for the impact of comorbidities such as atopic dermatitis, allergic rhinitis with multivariate linear regression analyses. RESULTS: In 2003, 20.88% of first-year-old children were treated with otitis media. The prevalence of otitis media was maintained at 15% until age 4 and decreased rapidly after 5 years of age. Asthma incidence was reported higher in patients with otitis media compared to the comparison group, with an adjusted odds ratio of 1.196 [95% confidence interval (CI) 1.127-1.269] followed by patients with atopic dermatitis [hazard ratio (HR) 1.261, 95% CI 1.196-1.33], allergic rhinitis (HR 1.473, 95% CI 1.409-1.54). CONCLUSION: Pediatric otitis media appeared to be associated with an increased risk of developing bronchial asthma after adjusting for other risk factors.

A Case of Petrous Apex Mucocele with Unilateral Ear Fullness Treated with Endoscopic Sphenoid Marsupialization / 대한이비인후과학회지

Mucocele is a benign, encapsulated lesion, lined by epithelium and filled with mucus. Found mostly in the frontal and ethmoid sinus, sinonasal mucoceles cause several symptoms depending on the location. We report a case of mucocele found in the petrous apex that caused ear fullness. It was completely treated with endoscopic sphenoid marsupialization.

What Really Decides the Facial Function of Vestibular Schwannoma Surgery?

OBJECTIVES: To find the main cause of facial nerve dysfunction in vestibular schwannoma (VS) surgery and review the prognosis of facial function in relation to tumor size, preoperative facial function and surgical approach. METHODS: We reviewed the surgical outcome of 134 patients with VS treated in our department between 1994 and 2008. All patients included in the study had postoperative facial paralysis after surgical management of their VS. There were 14 women and 7 men. The mean age was 48.5 years, with a mean follow-up period of 57 months. RESULTS: Twenty-one patients (sustained facial palsy, 4; newly developed facial palsy, 17) had facial nerve paralysis after surgery: ten patients in large VS and eleven patients in small VS. In large VS group, 4 patients had facial nerve function of HB grade II, 3 patients had HB grade III, and 3 patients had HB grade IV. In small VS group, 9 patients had HB grade II and 2 patients had HB grade IV. Middle cranial fossa approach rather than translabyrinthine approach for the preservation of hearing, led to facial nerve deterioration and the patients who had facial nerve paralysis perioperatively, had resulted in permanent facial paralysis. CONCLUSION: The tumor size in VS is certainly one of the most important prognostic factors. However, VS tumor size alone should not be considered a unique prognostic indicator. The surgical approach used, which may be related to tumor size, based on the surgeon's experience, can be a deciding factor, and the status of the facial nerve injured by the tumor can influence postoperative facial nerve function.

Features of Facial Asymmetry Following Incomplete Recovery from Facial Paralysis

PURPOSE: The purpose of this study is to investigate peculiar patterns of facial asymmetry following incomplete recovery from facial paralysis that require optimal physical therapy for effective facial rehabilitation, and to decrease the incidence of avoidable facial sequelae. MATERIALS AND METHODS: This study involved 41 patients who had facial sequelae following the treatment of various facial nerve diseases from March 2000 to March 2007. All patients with a follow-up of at least 1 year after the onset of facial paralysis or hyperactive function of the facial nerve were evaluated with the global and regional House-Brackmann (HB) grading systems. The mean global HB scores and regional HB scores with standard deviations were calculated. Other factors were also analyzed. RESULTS: Four patterns of facial asymmetry can be observed in patients with incomplete facial recovery. The most frequently deteriorated facial movement is frontal wrinkling, followed by an open mouth, smile, or lip pucker in patients with sequelae following facial nerve injury. The most common type of synkinesis was unintended eye closure with an effort to smile. CONCLUSION: We described common configurations of facial asymmetry seen in incomplete recovery following facial nerve injury in an attempt to develop an optimal strategy for physical therapy for complete and effective facial recovery, and to decrease the incidence of avoidable sequelae.