A Case of Patent Foramen of Huschke Confirmed during Tympanoplasty / 대한이비인후과학회지

Herniation of the temporomandibular joint (TMJ) into the external auditory canal (EAC) has been reported to occur spontaneously or as a result of trauma, neoplasia, infection, or inflammatory processes. It was postulated that spontaneous herniations were attributable to a patent foramen of Huschke, which represents a non-ossified portion of the tympanic plate. Eight cases of spontaneous herniation of the TMJ into the EAC were reported internationally. Recently, we experienced a case of a patent foramen of Huschke confirmed during a tympanoplasty. We reviewed the intimate relation of the TMJ to the temporal bone as well as the characteristic location, clinical and radiographic findings of a patent foramen of Huschke.

The Effect of Middle Ear Effusion on Otoacoustic Emissions / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The transmission properties of the middle ear directly influence otoacoustic emissions (OAEs) which are transmitted from the cochlea to the ear canal via middle ear. The purpose of this study is to evaluate the effects of middle ear effusion (MEE) on detectability of various OAEs and to assess the potential applicability of DPOAE measurements in monitoring the middle ear status. MATERIALS AND METHOD: Spontaneous otoacoustic emissions (SOAEs), transiently evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) were recorded for 44 normal ears and 32 ears with MEE. DPOAEs were collected in two basic forms consisting of distortion product audiograms(DPgrams) and input-output (I-O) functions, elicited by two primary tones fl and f2 with varying geometric mean frequencies between 1-6 kHz. RESULTS: SOAEs were absent in 21 ears of 32 ears with MEE, TEOAEs were diminished in 28 ears with MEE, and DPgrams were eliminated in 17 ears with MEE. I-O function curves at 3 kHz and 4 kHz were significantly diminished by equal levels of fl and f2 primary tones of 45 & 55 dB SPL under the condition of MEE (p<0.05). CONCLUSION: The results suggest that MEE affects the detectability of various OAEs and that the DP I-O function curve measurement at 3 and 4 kHz may be valuable to monitor the middle ear status in pediatric patients.

Functional Results of Tongue Reconstruction Using Free Flaps after Total Glossectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Total glossectomy and postoperative radiotherapy is the treatment of choice for advanced carcinoma of the floor of mouth and tongue. But, it has the potential for causing severe speech impairment and disrupting the deglutition and may cause life-threatening aspiration. Proper reconstruction is essential for the postoperative functional rehabilitation. The aim of the present study is to evaluate the oncologic results and the results of speech and swallowing function tests in patients who were reconstructed using surgical flaps after total glossectomy. MATERIALS AND METHODS: We reviewed the medical records of 7 patients who underwent total glossectomy (Jul. 1995 to Feb. 2000). Modified barium swallow (MRS) according to Longmann's method was done in 5 patients and speech function tests which comprised of Kim's method, Bzoch's method and Allison's method were done in 4 patients. RESULTS: Six patients were found to be stage T4 primary tumors and one was stage a T3 primary tumor. The lateral thigh free flap was most commonly was used in five cases. In two cases, either a rectus abdominis free flap or a radial forearm free flap was used. Six patients received postoperative radiotherapy. Currently, four patients are completely cured but three developed recurrence, of whom two have expired and one is living. Six patients regained swallowing and independent oral alimentation. MBS showed poor intraoral transport but, good propulsive pharyngeal emptying. Also, they regained intelligible speech. Speech intelligibility was grade 4 in all patients. CONCLUSION: The reconstruction with the free flap after total glossectomy provides considerably satisfactory functional results in swallowing and speech as well as providing better oncologic results in advanced tongue cancers.

A Case of Acute Myelogenic Leukemia Accompanying Facial Nerve Paralysis / 대한이비인후과학회지

Leukemic involement of the temporal bone is not uncommon, but facial paralysis is rare as the presenting sign. A 16-year-old boy suddenly developed otalgia, facial nerve paralysis, tinnitus and vertigo. Four months ago, acute myelogenic leukemia was detected and chemotherapy was done with incomplete resolution. The initial examination revealed facial nerve paralysis, mixed hearing loss, spontaneous nystagmus but peripheral blood picture was normal. On the fourth hospital day, simple mastoidectomy was performed for drainage and diagnosis. The harvested tissue showed leukemic infiltration and subsequent peripheral blood picture revealed immature cells. Patient refused further evaluation and chemotherapy, and three months later he died of intracranial hemorrhage. We report a case of acute myelogenic leukemia with facial nerve paralysis.