Comparison of the Short-Term Effect of Steroid Dosage Regimens in Patients with Idiopathic Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: For idiopathic sudden sensorineural hearing loss (ISSHL) patients, steroids are one of the most important therapies which are used to reduce inflammation in the inner ear. However, dosage regimens of oral steroid therapy have not been well established. This study aims to investigate the progression in recovery from ISSHL, and the optimal dosage regimen with steroids. SUBJECTS AND METHOD: We undertook a retrospective study of 149 patients diagnosed with ISSHL at our institution. We compared various clinical parameters such as age, gender, vertigo, tinnitus, the interval between disease onset and initial treatment, and severity of hearing loss. The 149 patients were divided based on their steroid regimens into two groups: group 1 (which received 40 mg of prednisolone in the morning and 20 mg at night) and group 2 (which received 20 mg of prednisolone three times daily). We then compared the results of group 1 with that of group 2. RESULTS: Recovery rates in group 1 (58/90, 64.4%) were significantly higher in ISSHL than those in group 2 (27/59, 45.8%). In particular, the complete recovery rates of Siegel's criteria in group 1 (35/90, 38.9%) were higher than those in group 2 (12/59, 20.3%). Therapeutic results were affected by the presence of tinnitus. Of the patients with tinnitus, 64.3% in group 1, and 43.9% in group 2 recovered. CONCLUSION: In the group treated with twice-daily regimens, greater hearing improvements were observed compared with the group treated with three times-daily regimens. These findings suggest that higher dose for a single administration may be an important prognostic factor.

A Case of Middle Turbinate Headache Syndrome Caused by Middle Turbinate Concha Bullosa Included Fungal Ball / 대한이비인후과학회지

Middle turbinate headache syndrome was the first reported by Wolff and the incidence is rare. It is caused by pneumatization or hypertrophy of the middle turbinate contacts between the nasal septum and the lateral nasal wall, resulting in headache in the periorbital region. The diagnosis is made by anterior rhinoscopy, computerized tomography, and confirmation by the lidocaine test. Treatment is achieved by relieving the contact point by medical or surgical means. We report a 51-year-old female patient who suffered from left periorbital pain, and left posterior nasal drip for 30 years. The patient had middle concha bullosa which contained a fungal ball that caused periorbital headache. Anterior ethmoidectomy, middle meatalantrostomy, and middle concha bullosectomy were performed using nasal endoscopy, and subsequently the symptoms disappeared. We report on this case of middle turbinate headache syndrome and the successful results of endoscopic surgical treatment.