Comparison of the Effect of High-Dose Steroid with That of Super-High-Dose Steroid Therapy in Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Corticosteroids have been used for therapeutic management of sudden sensorineural hearing loss (SSNHL). Because the levels of steroid within inner ear after systemic administration is very low, high-dose steroid regimens have been used. The purpose of this study is to compare the effect of high-dose (HD) steroid therapy with that of super-highdose (SHD) steroid therapy in SSNHL. SUBJECTS AND METHOD: The study group consisted of 97 patients diagnosed as SSNHL. They were divided into two groups : those who were administered 60 mg prednisolone as the initial high dose (HD group) and those who were administered 1,200 mg hydrocortisone (about 300 mg prednisone) as the super high dose (SHD group). RESULTS: Hearing improvement was observed in 76.8% of HD group and in 67.9% of SHD group and there was no statistically significant difference in the rate of hearing improvement between HD group and SHD group. CONCLUSION: Super-high-dose steroid regimen is not superior to high-dose steroid regimen in the treatment of SSNHL.

Is Helicobacter Pylori the Pathogen of Chronic Tonsillitis? / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tonsillar tissue is a component of mucosa-associated lymphoid tissue (MALT), which has evolved to protect vulnerable mucosal surfaces. Helicobacter pylori, implicated as an etiological factor in duodenal ulcer and gastritis, induces the appearance of lymphoid aggregates in the stomach. Therefore, we investigate the possibility that tonsils can be extragastric reservoir and target tissue for H. pylori. SUBJECTS AND METHOD: Campylobacter-Like Organism (CLO) test and immunohistochemical (IHC) analysis for H. pylori was performed on 98 patients undergoing tonsillectomy. Chronic tonsillitis group (62 patients) and controlled group (36 patients) were enrolled in this study. Tissue samples were collected from excised palatine tonsils. Two millimeter diameter tissue piece that had been obtained from palatine tonsil specimens were placed in the CLO test kit. Remnant tonsils were sent to the Department of Pathology for IHC analysis. RESULTS: Using the CLO test, H. pylori was detected in 60 (61.2%) of the 98 patients, 39 (62.9%) of 62 in chronic tonsillitis group and 21 (58.3%) of 36 in control group. Using the IHC analysis, it was detected in 54 (55.1%) of the 98 patients, 35 (56.5%) of 62 in chronic tonsillitis group and 19 (52.8%) of 36 in control group. There are no significant differences between chronic tonsillitis group and control group with regard to both CLO & IHC analysis. CONCLUSION: This result suggests that palatine tonsil represents an extragastric reservoir for H. pylori infection, but not a target tissue.

Two Cases of Medial Displacement of the Superior Cornu of the Thyroid Cartilage without Laryngeal Injury Resulting in Foreign Body Sense in Pharynx and Larynx / 대한이비인후과학회지

Foreign body sensation is a nonspecific symptom of aerodigestrive tract diseases. Symptoms may be the result of gastroesophageal reflux, esophageal motility disorder, psychological factor and malignant lesion. Rarely, a unilateral bulging of the hypopharynx as a result of medial displaced superior cornu of the thyroid cartilage can be a reason. The appropriate diagnosis is made by fiberoptic laryngoscopy and CT scanning. Surgical removal of the portion of the superior cornu bulging toward the hypopharynx improves the foreign body sensation. We experienced two cases of medially displaced superior cornu of the thyroid cartilage without laryngeal injury. This unusual presentation is discussed with a review of the literature.

A Case of Isolated Aspergillus Sphenoid Sinusitis

Isolated Aspergillus infection originating within the sphenoid sinus is most often associated with the immunocompromised patient. A 53-year-old healthy woman presented with a 3-week history of headache and subsequent left 6th nerve palsy. Brain MRI demonstrated a space-occupying lesion within sphenoid sinus. Histological analysis through transnasal-transsphenoidal approach revealed numerous Aspergillus hyphae. Postoperatively, all symptoms resolved completely without anti-fungal treatment. Isolated Aspergillus sphenoid sinusitis should be routinely included in the differential diagnosis of patients with acute or subacute headache, even in nonimmunosuppressed patients.