ABSTRACT
Background and Objectives@#The diagnosis of hearing impairment is based on repeated audiometry, including pure tone audiometry (PTA), speech reception threshold test (SRT), and speech discrimination test (SDT). SDT results particularly show a wide discrepancy upon repeated testing, while malingering is suspected when having more than 12% difference between 3 individual SDT results. Therefore, in this study, we compared the proportion of malingering found in repeated SDT with that found in other audiometric tests and analyzed the characteristics of malingering group in order to reevaluate the current criteria of defining malingering.Subjects and Method We retrospectively assessed the audiometry results of 113 patients (226 ears) with hearing impairment. Each ear was divided into a malingering group and a true hearing loss group. The proportion of ears corresponding to each malingering criterion was compared using a chi-square test. An independent sample t-test was performed to identify the differences between the characteristics between the two groups. @*Results@#The number of ears that met the malingering criteria were 19 (8.41%) in PTA, 15 (6.64%) in SRT, and 75 (33.19%) in SDT. There was a significant difference in the proportion of malingering between the 3 hearing test modalities (p<0.001). There was no significant difference in auditory brainstem response, mean age and sex distribution between the malingering group and the true hearing loss group. @*Conclusion@#When conducting repeated SDT, there is a risk of misdiagnosing an actual hearing loss patient as a malingering patient under the current malingering criteria. Therefore, the current criteria on SDT requires reevaluation.
ABSTRACT
Painful post-traumatic trigeminal neuropathy (PPTTN) is a distinctive facial pain syndrome characterized by facial and/or oral pain along the sensory distribution of the fifth cranial nerve with a clear history of a traumatic event. To our knowledge, PPTTN after endoscopic sinus surgery (ESS) has not been reported in the literature. We present a case of an elderly woman who experienced unilateral neuralgic pain after undergoing ESS. Following ESS of the left sphenoid sinus to remove suspicious fungus balls, the patient complained of intermittent facial pain occurring in the left periorbital and forehead area. Clinical diagnosis of PPTTN was established after a comprehensive multidisciplinary assessment. The pain disappeared completely after a 5-week medical treatment with gabapentin. Since PPTTN cases associated with ESS are extremely rare, our case demonstrates that PPTTN should be considered in the differential diagnosis of facial pain developing after ESS and can be successfully treated with medical therapy.
ABSTRACT
PURPOSE: The laser processability of dental prosthesis is investigated using two ceramic composites, including 3M, Lava Ultimate and Ivoclar vivadent, IPS e.max. MATERIALS AND METHODS: The CO₂ laser, picosecond laser and femtosecond laser are used to assess the processing power of dental prosthetic materials Lava Ultimate and IPS e.max and the line processing shape was measured using a confocal microscope. RESULTS: The brittleness, carbonization and micro crack of the ceramic composite were influenced by heat accumulation of the material and could be controlled by the laser power and pulse time. CONCLUSION: In the case of CO₂ lasers, micro crack and carbonation occurred immediately, and in the picosecond laser processing, the micro cracks are partially improved, but the carbonization occurs continuously. Finally, we confirmed the high efficiency of laser processing with femtosecond laser. In particular, Lava Ultimate, a ceramic resin composite material, showed the best processability when processed using a femtosecond laser.
Subject(s)
Carbon , Ceramics , Dental Prosthesis , Hot Temperature , Lasers, GasABSTRACT
A fungus ball is the most common manifestation of fungal sinusitis. Bilateral involvement of fungus balls is rare, and bilateral sphenoid involvement is even more uncommon. The authors report two cases of bilateral fungus balls with sphenoid sinus involvement successfully treated with endoscopic sinus surgery. Both patients complained of nonspecific headache; diagnoses were made with CT and histopathological examinations, and surgical removal was achieved via transostial approach. Bilateral fungus balls involving the sphenoid sinus are rare but do occur; their removal is possible through endoscopic sinus surgery with a high cure rate. We thus recommend using CT scanning to identify typical findings of a sphenoid fungus ball even in bilateral paranasal sinusitis and perform aggressive surgical treatment.
ABSTRACT
A fungus ball is the most common manifestation of fungal sinusitis. Bilateral involvement of fungus balls is rare, and bilateral sphenoid involvement is even more uncommon. The authors report two cases of bilateral fungus balls with sphenoid sinus involvement successfully treated with endoscopic sinus surgery. Both patients complained of nonspecific headache; diagnoses were made with CT and histopathological examinations, and surgical removal was achieved via transostial approach. Bilateral fungus balls involving the sphenoid sinus are rare but do occur; their removal is possible through endoscopic sinus surgery with a high cure rate. We thus recommend using CT scanning to identify typical findings of a sphenoid fungus ball even in bilateral paranasal sinusitis and perform aggressive surgical treatment.