Difference Between the Preferred Gain and the NAL-NL2 Gain in Korean Hearing Aid Users / 대한이비인후과학회지

Background and Objectives@#The purpose of this study was to compare the preferred gain and the National Acoustic Laboratories Nonlinear 2nd edition (NAL-NL2) gain value in Korean language hearing aid users.Subjects and Method In this retrospective study, preferred gain and NAL-NL2 gain data were obtained from 199 monaural hearing aids users who were satisfied with their hearing aid devices. The gain value data were collected from three different sound levels at various frequencies. Several factors were also evaluated to determine a potential impact on the preferred gain. @*Results@#The preferred gain was significantly higher than the NAL-NL2 target gain (p=0.01). This difference was highest with the gain measured with a medium-level sound (65 dB) with 1 kHz tone. There was a tendency of reduced preferred gain with the increased age of the participant (p=0.049). @*Conclusion@#The results indicate that Korean hearing aid users require more gain than the NAL-NL2 target gain. Linguistic characteristics, age, degree of hearing loss, and many other factors may be implicated in this result.

Sleep Disorder in Tinnitus Patients / 대한이비인후과학회지

Background and Objectives@#One of the most common complaint of tinnitus patients has been sleep disorder. The aim of this study was to evaluate the relationship between sleep disorder and tinnitus.Subjects and Method Patients with tinnitus from July 2018 till August 2019 were enrolled. Subjects who had any acute/chronic disease in the inner and middle ear or external auditory canal, sleep apnea and had more than 3 caffeinated beverages a day was excluded. Study participants completed Beck Depression Inventory (BDI), the tinnitus symptom questionnaire, tinnitus handicap inventory (THI), Pittsburg Sleep Quality Inventory (PSQI), pure tone audiometry, a full otologic examination and an interview on past medical history. @*Results@#THI was correlated with PSQI global score and BDI. The PSQI subscale most relevant to THI was PSQI 1 (subjective sleep quality). Hearing impairment was correlated with the THI functional subscale. BDI was individually related to PSQI. @*Conclusion@#Tinnitus is found to be highly related to sleep disorder, suggesting a common pathway of aggravation and treatment target. Tinnitus is also more affected by sleep disorder than by depression. A further examination and treatment of comorbid sleep disorder in tinnitus patients is recommended.

Comparison of Functional Outcomes after PoweredIntracapsular Tonsillectomy with Adenoidectomy andConventional Extracapsular Tonsillectomy withAdenoidectomy for Pediatric Obstructive Sleep Apnea / 대한이비인후과학회지

Background and Objectives@#This study was investigated to compare the clinical outcomes and complications of powered intracapsular tonsillectomy and adenoidectomy (PITA) with those of conventional extracapsular tonsillectomy and adenoidectomy (ECTA) in treatment of pediatric obstructive sleep apnea (OSA).Subjects and Method Eighty-one children with adenotonsillar hyperplasia underwent tonsillectomy and adenoidectomy (46 PITA and 35 ECTA) from December 2016 to July 2017 for OSA. The choice of surgical procedure (PITA vs. ECTA) was determined by the number of episodes of acute tonsillitis. The quality of life measurement was performed using Korean Obstructive Sleep Apnea Survey (KOSA-18) score. Postoperative bleeding was assessed as number of revisit or readmission. Postoperative pain was evaluated by visual analog scale (VAS) at postoperative day 1, 3, and 7. @*Results@#PITA and ECTA significantly reduced KOSA-18 scores postoperatively (p＜0.01, p＜0.01, respectively) and were equally effective in pediatric OSA treatment. Postoperative bleeding was lower in the PITA group, but there was no statistical difference due to small number of cases. VAS score for postoperative pain was significantly lower in the PITA group at day 1, 3, and 7 (p=0.03, p＜0.01, and p＜0.01, respectively). @*Conclusion@#PITA is effective in pediatric OSA treatment with less morbidity, and less complications.

Cardiac Perforation Caused by Bone Cements as a Complication of Cement Augmented Pedicle Screw Fixation Using the Fenestrated Pedicle Screw: A Case Report / 대한신경손상학회지

Cement-augmented fenestrated pedicle screw fixation is becoming more popular for osteoporotic patients. Although several reports have been published on leakage-related problems with bone cement, no cases of cardiac perforation after cement-augmented pedicle screw fixation have been reported. We present a case of cardiac perforation after cement-augmented fenestrated pedicle screw fixation. A 67-year-old female was admitted to our hospital with complaints of dyspnea and chest pain after lumbar surgery. She had been treated with L4–5 lumbar interbody fusion and percutaneous pedicle screw fixation with bone cement augmentation seven days earlier for degenerative spondylolisthesis. The right chest pain was observed a day after the surgery; she was treated conservatively but it did not improve for 7 days after surgery. Chest computed tomography (CT) revealed a hemothorax and a large sharp bone cement fragment that perforated the right atrium. Bone cement can be removed with thoracotomy surgery. We have to be aware of cement leakage through the normal venous drain system around the vertebral body. We also have to consider a detailed cardiac workup, which may include chest CT or echocardiography, if a patient complains of chest pain or dyspnea after cement augmentation.

Study on Assessment and Treatment Patterns of Speech-Language Pathologists in Pediatric Vocal Problem Through Multicenter Survey

BACKGROUND AND OBJECTIVES: Pediatric vocal health problems are relatively common. However, it is not yet well studied whether uniform diagnosis and treatment is done properly in South Korea. The purpose of this study was to investigate the methods that the Korean speech therapists use to diagnose and treat pediatric voice problem. MATERIALS AND METHOD: An anonymous online questionnaire was administered to 32 speech language therapists registered at the Korean laryngeal speech linguistics society detailing demographics, employment institution, general management of pediatric patients with vocal problem including assessment and treatment procedures. RESULTS: Current practice patterns were analyzed on 32 speech language therapists providing services in South Korea mostly working at tertiary university hospital. One third of pediatric patients were assessed without proceeding to treatment. One fifth of patients were treated without assessment. Perceptual assessment was the main pre-treatment assessment methods used. Treatment was done in the following order : Voice rest, SOVT, yawn-sigh and resonant voice. Post-treatment evaluation was used in the following order : Instrumental assessment, clinical judgment, and recording comparison. CONCLUSION: Speech language therapists practice in South Korea mostly follows the ASHA practice guidelines. However, there are still great amount of cases in which only the evaluation was done without appropriate treatment. Further research is needed to make SPLs more systematic and efficient for evaluating and treating pediatric vocal patients.

Subtalar Distraction Arthrodesis for Calcaneal Malunion

PURPOSE: To evaluate the results and efficacy of the subtalar distraction arthrodesis on patients with complications due to malunion after intra-articular calcaneal fracture. MATERIALS AND METHODS: From October 2001 to September 2004, we operated on 10 patients (14 cases). There were 9 male patients and one female; their mean age was 41 years old. Ten cases among them were operated initially. The mean period between initial injury and arthrodesis was 18 months. The mean follow up period was 16 months. During the operation, we used extensile lateral approach and arthrodesis was performed using tricortical bone block and cannulated screws. The ankle-hindfoot scale was used for clinical evaluation. In radiologic analysis, plain X-ray and CT of the both feet were examined for union and various parameters. RESULTS: Thriteen cases achieved radiologic bone union. The mean ankle-hindfoot scale (maximum: 94 points) increased from 52.4 points preoperatively to points 77.2 at the final follow-up. The radiologic analysis of the pre and postoperative standing lateral radiograph showed mean increase of 6.9 mm in talo-calcaneal height, 5.2 degrees in talocalcaneal angle, 4.3 degrees in talar declination angle and average decrease of 4.5 degrees in talo-first metatarsal angle. CONCLUSION: The short term result of the subtalar distraction arthrodesis using tricortical bone block was promising, but longer follow-up will be needed.

Pedicle Screw Fixation in Pediatric Spinal Deformities: Results for patients under 10 years old / 대한정형외과학회잡지

PURPOSE: We wanted to determine the efficacy of performing pedicle screw fixation to treat pediatric spinal deformities and we also wanted to evaluate its long-term effects on the growing spine. MATERIALS AND METHODS: Thirty-eight consecutive spinal deformity patients (25 congenital, 9 idiopathic and 4 other etiologies) under 10 years old at the time of the surgery who underwent pedicle screw instrumentation were reviewed after a minimum follow up of 2 years (range: 2 to 7 years). To evaluate the effect of the pedicle screws on the growing spine, a thin slice CT scan was performed in 27 patients (72%) at the last follow up. The patients were treated by posterior fusion with segmental pedicle screw fixation being performed in 21 patients, vertebral column resection combined with segmental pedicle screw fixation was done in 16 patients and combined anterior and posterior correction was done in 1 patient. RESULTS: The frontal correction was 67.2% in the posterior fusion group, 71.5% in the posterior resection group and 64.7% in the patients who underwent combined anterior and posterior correction. A mean correction of 20degrees was obtained in the sagittal plane. A total of 341 pedicle screws were inserted (an average of 8.9 screws per patient). The complications were comprised of 7 screw malpositions (2.1%), 1 loss of fixation (screw pull-out), 1 recurrence of deformity and one superficial infection. There were no significant neurological or vascular complications. Any Symptoms or radiological evidence suggestive of spinal stenosis were not detected in any of the patients. CONCLUSION: Pedicle screw fixation may be used with the same efficacy for pediatric spinal deformities, and even for the patients under 10 years old, without causing any hazard of iatrogenic spinal stenosis.