Adult-onset Otitis Media with Effusion / 대한이비인후과학회지

Otitis media with effusion(OME) is a very common disease of young children, but adult-on-set otitis media with effusion is rarely considered. A few of factors contribute to pathogenesis of otitis media with effusion, which are poor tubal dysfunction, upper respiratory viral infection, bacterial adherence, and immune status of the host. Otologic complaints are dominant in many of adult-onset OME patients. Sinusitis is the most common causal disease of adult-onset OME in our study. In our study, we conclude that adult-onset OME is a relatively common disease in contrast to the current thought and that we must carefully evaluate upper airway, especially sinuses and nasopharynx, and systemic aspects in adult-onset OME.

8 Cases of Nasopharyngeal Angiofibromas / 대한이비인후과학회지

INTRODUCTION: Nasopharyngeal angiofibroma is a rare histologically benign tumor which occurs almost exclusively in adolescent boys. The morbidity and mortality associated with this tumor are related to its prominent vascularity and its propensity for aggresive local growth. MATERIALS AND METHOD: From November 1990 through February 1996, 8 patients with a diagnosis of nasopharyngeal angiofibroma were managed at Asan Medical Center. For the devasculation of the tumor before the surgery, preoperative arterial embolization was performed on 6 patients. RESULTS: The main tumor supplying vessel was ipsilateral internal maxillary artery in all cases. According to Chandler classfication(Table 1), stage II was 4 cases and stage III was 4 cases. Operative procedures were midfacial degloving approach(4 cases), transpalatal approach(1 case), transantral approach(1 case), combined approach(1 case: Caldwell-Luc op & endoscopic op), medial maxillectomy(1 case). There were no treatment-related deaths and no major surgical complications.

Diagnostic Value of the Audiometric Tests in the Acoustic Neuroma / 대한이비인후과학회지

BACKGROUND: With the advance of diagnostic technology such as the magnetic resonance imaging, small sized acoustic neuroma has been detected more early and easily. However, the significance of the audiologic examinations could not be ignored because of simplicity of the test procedures as a screening for the acoustic neuroma. OBJECTIVES: This study analyzed the results of preoperative audiologic tests in the surgically confirmed acoustic tumors and compared the diagnostic accuracy and clinical significances. MATERIALS AND METHODS: From May 1990 to April 1997, histopathologically confirmed 26 cases of acoustic neuromas were retrospectively reviewed and analyzed. All the patients were examined pure tone, speech, and auditory brainstem response audiometry. Special audiometric tests for the differential diagnosis of the retrocochlear lesion were performed in selected patents. RESULTS: Tumor size and correlation of the pure tone and speech audiometry were analyzed. The correlations were poor both in pure tone audiometry(p=0.3987 r2=0.03) and speech discrimination score(p=0.3932, r2=0.043). Diagnostic significance of the other audiometric tests showed various results: Suprathreshold adaptation was positive in 5 among 7(71.4%): Roll over phenomenon were showed in 2 among 3: Tone decay test was positive in 4 among 8(50%): Stapedial reflex was decayed in 2 among 5 patients. In the auditory brainstem response(ABR), 16(61.6%) patients showed any waves and 5(19.2%) patients showed only wave I or wave I and II. In five patients(19.2%) showed delayed I-V inter-peak latency. CONCLUSIONS: Among series of the audiologic tests in the acoustic neuroma, ABR was the most valuable diagnostic test and other audiologic tests were showed less sensitivity for the diagnosis of retrocochlear lesion.