Adherence to Positive Airway Pressure therapy as Severity of Adult Obstructive Sleep Apnea / 대한이비인후과학회지

Background and Objectives@#The aim of this study was to compare adherence to positive airway pressure (PAP) therapy in patients with obstructive sleep apnea (OSA) of different severity.Subjects and Method We conducted a retrospective study including 270 adult OSA patients who used a PAP device for at least 3 months. We assessed the percentage of days on which the device was used, the percentage of days on which the device was used for ≥4 h, and the average duration of PAP device usage at 12 weeks of PAP therapy. We also evaluated adequate adherence to PAP therapy using a PAP device for ≥4 h/day and during ≥70% of nights. @*Results@#The percentage of days on which a PAP device used did not differ significantly according to OSA severity (median [Q1-Q3]; mild: 91.40% [81.25%-97.65%], moderate: 94.50% [86.90%-100%], severe: 95.90% [88.10%-100%], p=0.268). We also found that the percentage of days on which a PAP device was used during sleep for ≥4 h was not significantly different in patients with different OSA severity (median [Q1-Q3], mild: 76.20% [69.70%-89.90%], moderate: 89.30% [67.65%-95.70%], severe: 85.70% [75.85%-95.45%], p=0.097). The percentage of patients with adequate PAP adherence did not differ significantly according to OSA severity (mild: 74.2%, moderate: 72.1%, severe: 83.0%, p=0.084). Moreover, the mean duration (minutes) of PAP device usage during sleep did not differ significantly according to OSA severity in the mild, moderate, and severe OSA groups (mean±standard deviation, mild: 348.03± 47.78 min, moderate: 358.58±85.22 min, severe: 363.79±57.21 min, p=0.440). @*Conclusion@#Adherence to PAP therapy did not differ significantly according to OSA severity. Therefore, it is necessary to continuously expand and maintain the insurance for health promotion in OSA patient in South Korea.

Trend of Olfactory and Gustatory Dysfunction in COVID-19 Patients in a Quarantine Facility

Background@#Olfactory and gustatory dysfunction has been reported as characteristic symptoms of coronavirus disease 2019 (COVID-19). This study evaluated olfactory and gustatory dysfunction in mild COVID-19 patients using validated assessment methods. @*Methods@#A prospective surveillance study was conducted for mild COVID-19 patients who were isolated at the Gyeonggi International Living and Treatment Support Center (LTSC), Korea.Olfactory function was assessed using the Korean version of the Questionnaire of Olfactory Disorders (QOD) and Cross-Cultural Smell Identification Test (CC-SIT). Gustatory function was assessed using an 11-point Likert scale and 6-n-propylthiouracil, phenylthiocarbamide, and control strips. All patients underwent nasal and oral cavity endoscopic examination. @*Results@#Of the 62 patients at the LTSC, 15 patients (24.2%) complained of olfactory or gustatory dysfunction on admission. Four of 10 patients who underwent functional evaluation did not have general symptoms and 2 were asymptomatic. The mean short version of QOD-negative statements and QOD-visual analogue scale scores were 13 ± 6 and 4.7 ± 3.6, respectively. The mean CC-SIT score was 8 ± 2. No patients showed anatomical abnormalities associated with olfactory dysfunction on endoscopic examination. The mean Likert scale score for function was 8 ± 2, and there were no abnormal lesions in the oral cavity of any patient. @*Conclusions@#The prevalence of olfactory and gustatory dysfunction was 24.2% in mild COVID-19 patients. All patients had hyposmia due to sensorineural olfactory dysfunction, which was confirmed using validated olfactory and gustatory evaluation methods and endoscopic examination. Olfactory and gustatory dysfunction may be characteristic indicators of mild COVID-19.

Treatment of Acute Retinal Necrosis with Acute Kidney Injury after Intravenous Antiviral Injection

PURPOSE: In the present study, a case of acute retinal necrosis with acute renal injury due to high-dose intravenous antiviral injection which was treated by intravitreal ganciclovir injection is reported. CASE SUMMARY: A 46-year-old female visited our clinic complaining of red eye and decreased vision in the right eye. At the first visit, her corrected visual acuity was finger count in the right eye, and 20/20 in the left eye. Fundus examination of the right eye revealed multiple peripheral arterial occlusion, papilledema, and whitish necrotic infiltration at the periphery. Clinically diagnosed as acute retinal necrosis, the patient was started on intravenous acyclovir. Two days after injection, her serum creatinine level increased, therefore, intravenous acyclovir was discontinued and she was started on intravitreal ganciclovir. Five days after the intravenous injection was discontinued, the serum creatinine level returned to normal range. Four months after the first visit, visual acuity was 20/100 and no recurrence was observed. CONCLUSIONS: Intravitreal ganciclovir injection can be an effective alternative in patients with acute retinal necrosis and poor kidney function.

Validation of a Korean Version of the Tinnitus Handicap Questionnaire

OBJECTIVES: The goal of the present study was to evaluate the reliability and validity of the Korean version of the tinnitus handicap questionnaire (THQ-K). METHODS: A total of 60 patients were included in this study. Patients responded to the THQ-K, the tinnitus handicap inventory (THI), Beck's depression index (BDI), and the visual analogue scale (VAS) for loudness and pitch, loudness match, and minimum masking level (MML) test were performed. RESULTS: Internal consistency of the THQ-K was examined using Cronbach coefficient alpha. Cronbach alpha was 0.96. The THQ-K showed a significant correlation with THI, BDI, VAS for distress, and VAS for loudness, but no significant correlation with psychoacoustic measurement of tinnitus, such as loudness match, pitch match, and MML. CONCLUSION: The THQ-K is a reliable and valid test for evaluating the degree of handicap due to tinnitus for both research and clinical use.

Rotational pectoral musculocutaneous flap for the repair of gastric conduit necrosis in cervical esophagogastrostomy / 대한외과학회지

We experienced a case of wide necrosis of the cervical gastric conduit during esophageal cancer surgery. We attempted to repair this defect with various methods including conservative care, stents two times, and sternocleidomastoid muscle flap without successful results. Finally, we were able to reconstruct the gastric conduit defect with rotational pectoralis major musculocutaneous (PMM) flap. PMM flap is thought to be a reconstruction method applicable to the intractable gastric conduit defect.