The Therapeutic Efficacy of Combined Antiviral Treatment in Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The idiopathic sudden sensorineural hearing loss (ISSHL) is a disease occurring instantly or developing over several days. An etiological role for virus families is assumed. Corticosteroids improve the prognosis for hearing recovery in ISSHL, but the effects of acyclovir are still uncertain. The purpose of this study is to evaluate the therapeutic efficacy of antiviral drug acyclovir (Zoylex) in ISSHL. MATERIALS AND METHODS: One hundred thirty four ears were divided into a study (41 ears, using acyclovir and steroid) and a control (93 ears, using steroid only) groups. Prognostic factors such as initial hearing loss, pattern of initial audiogram, coexistence of dizziness or tinnitus were used for parameters of comparison between two groups. RESULTS: The overall recovery rate of the study group (53.7%) was better than that of the control group (46.2%), but it was not statistically significant (p>0.05). The recovery rate of the study group was better than that of the control group on some prognostic factors, especially the period between the symptom attack and the beginning of treatment: however, there were no statistically significant differences either (p>0.05). CONCLUSION: Therefore, no beneficial effects from combining acyclovir with prednisolone could be established in ISSHL.

Non-traumatic Subcutaneous Emphysema in the Head and Neck / 대한이비인후과학회지

Subcutaneous emphysema often occurs as a result of surgery, trauma of the aerodigestive tract, and increased alveolar pressure. Generally, spontaneous emphysema is rare, because "spontaneous" is only used to describe emphysema that has no obvious etiology. We reviewed six cases of non-traumatic subcutaneous emphysema occurring in the head and neck. Among them, four cases were associated with pneumomediastinum. Two occurred without obvious etiology, another two were due to heavy lifting events, one due to severe vomiting, and the last one due to severe blowing. Most cases occurred in young males. Clinical symptoms, commonly involved sites, treatments and results of these cases of spontaneous emphysema were analysed.

Radiologic Laryngeal Parameters in Acute Supraglottitis in Korean Adults

Soft-tissue lateral neck radiography is important for diagnosing acute supraglottitis. This study aimed to determine the objective criteria for a diagnosis of acute supraglottitis from soft-tissue lateral neck radiographs in Korean adults. The parameters in 30 adult patients with acute supraglottitis were compared with those of age- and sex-matched normal 30 Korean adults. The mean of epiglottis width (EW) and aryepiglottic fold width (AEW) in the control group were 4.37 +/- 0.93 mm, 2.45 +/- 0.71 mm, respectively and in the patient group they were 15.87 +/- 3.60 mm, 6.4 +/- 2.55 mm, respectively. The sensitivity and specificity of an EW greater than 7mm were 100%, and 100% respectively. The sensitivity and specificity of an AEW greater than 4.5 mm were 83%, and 100% respectively.

Management of Frontal Sinus Fracture according to the Type and Severity of the Fracture : Analysis of 23 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Frontal sinus fracture can have serious consequences due to proximity of the sinus to the intracranial cavity and the potential for serious combined injuries. Management of the Fractures depends on the type and severity of the fracture and the presence of associated injuries. In this article, we present an overview of fracture treatment options, and offer a simple algorithm for management based on the type and severity of the facture. PATIENTS AND METHODS: Twenty-three patients with frontal sinus fractures were analysed. All patients were male, with the mean age of 31. The average follow-up length was 13 months. Of 23 patients, 8 patients had anterior wall fractures and 15 patients had anterior and posterior wall fractures. Their types of fracture, combined injuries, surgical methods, surgical results, and complications were analysed. RESULTS: Six patients had conservative management and 17 patients had surgery. Of 17 patients who had surgery, 6 patients had only repair of the fracture, 3 patients had repair of the fracture with sinus obliteration, and 8 patients had repair of the fracture with cranialization of the frontal sinus. The most common associated injury was fractures of other facial bones (83%), especially the orbit. Traumatic optic neuropathy was the most common complication associated with the frontal sinus fracture or its accompanying injuries. CONCLUSION: Frontal sinus fractures were safely managed with repair of the fracture, sinus obliteration, or with sinus cranialization which was used irrespective of type and severity of fractures.