The Analysis of Loudness Discomfort Level and Hyperacusis in Tinnitus Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hyperacusis is an abnormally strong reaction which occurs within auditory pathways resulting from exposure to moderate sound. More patients are inflicted with it than with tinnitus, accounting for a relatively high proportion of the total tinnitus patients. However, no single test could pass as an objective diagnostic test of hyperacusis. Among various psychoacoustic evaluations, loudness discomfort level (LDL) is frequently used in the evaluation of hyperacusis. Thus, this study aimed to demonstrate a proportion of hyperacusis in tinnitus patients and characterize LDL in hyperacusis and tinnitus patients as a diagnostic test. MATERIALS AND METHOD: Using 186 patients with tinnitus as experiment group and 35 acoustically normal persons as control group, pure tone audiometry (PTA), LDL, and dynamic range (DR) were checked. RESULTS: Amongst the total number of tinnitus patients, there were 10 hyperacusis patients (5.38%). Those hyperacusis patients had much lower LDL (73.50 dB) and DR (41.50 dB) than tinnitus patients without hyperacusis (LDL: 100.90 dB, DR: 67.20 dB) as well as the control group (LDL: 104.86 dB, DR: 93.98 dB). CONCLUSION: Hyperacusis patients consist 5.38% (10/186) and have much lower LDL than tinnitus patients without hyperacusis and the control group. There is a positive correlation between hyperacusis and LDL. Therefore, in a diagnosis of hyperacusis, it is essential to check LDL and take a careful look into the history from patients.

Clinical Study of Frontal Sinus Fractures: A Review of 14 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The incidence of frontal sinus fractures has increased as traffic and industrial accidents have increased. However, they are still uncommon compared to other facial traumas because of the arch configuration and the thickness of the anterior wall of the frontal sinus. Accurate evaluation is highly recommended in cases of frontal sinus fractures because they are likely to result in serious complications, including frontal sinusitis, meningitis, and mucocele. In this paper, we reviewed 14 cases of frontal sinus fractures and investigated the clinical characteristics and treatment results. MATERIALS AND METHODS: A retrospective review was performed on 14 patients with frontal sinus fractures who had been treated in our department from June, 1995 to August, 1997. RESULTS: Eleven patients were treated with surgery, including osteoplastic frontal sinus surgery with fat obliteration (5 patients), open reduction and internal fixation of the anterior wall (4 patients), and cranialization (2 patients). Three patients were treated with conservative methods. There were no complications such as infection, meningitis, and mucocele formation in the patients who underwent surgery for an average follow-up period of 19 months. CONCLUSION: Our results show that an aggressive approach is justified for treatment of frontal sinus fractures.