RESUMO
BACKGROUND AND OBJECTIVES: Dizziness has been known as a prognostic factor in sudden sensorineural hearing loss (SSHL), but it is difficult to describe and quantify its subjective symptoms. Also, dizziness itself cannot imply vestibular dysfunction in SSHL. Comprehensive evaluation of vestibular function may help us understand the extent of lesions in sudden deafness. The purpose of this study is to determine whether an impaired caloric response is associated with disease severity and hearing outcome. SUBJECTS AND METHOD: A retrospective chart review was conducted of 488 patients diagnosed as unilateral SSHL. The patients were divided into two, an abnormal caloric group (canal paresis >20%) and normal caloric group (canal paresis ≤20%). Initial demographic and audiologic findings and final hearing outcomes were compared between the two groups. RESULTS: The initial pure tone averages of SSHL patients of abnormal caloric group and normal caloric group were 75.4±28.4 dB HL and 68.2±25.4 dB HL (p=0.004), respectively. Patients of abnormal caloric test group showed worse hearing outcome across all frequencies compared to those of the normal caloric group. Also, a significant correlation was noted between the magnitude of hearing recovery and canal paresis (r=-0.223, p < 0.001). CONCLUSION: SSHL patients of abnormal caloric test showed worse initial hearing level and poorer hearing outcome. Evaluation of vestibular function in SSHL patients is important because subjective symptoms alone cannot account for vestibular hypofunction patients, and the caloric test can help in the counseling of patients and prediction of hearing outcome in SSHL patients.
Assuntos
Humanos , Testes Calóricos , Aconselhamento , Tontura , Audição , Perda Auditiva Neurossensorial , Perda Auditiva Súbita , Métodos , Paresia , Estudos RetrospectivosRESUMO
BACKGROUND AND OBJECTIVES: Since rhinoplasty techniques require meticulous and delicate manipulation, proper anesthesia is essential. The aim of the current study is to compare patient satisfaction and complication of rhinoplasty performed under local anesthesia against general anesthesia. SUBJECTS AND METHOD: Patients who underwent rhinoplasty by a single surgeon between March 2014 and January 2017 were enrolled in this study. Midazolam was utilized to sedate the patient during local anesthesia. Pain and memory of surgery under local anesthesia, satisfaction of anesthesia, and willingness to undergo the surgery with the same anesthesia method again were evaluated. Cardiopulmonary events, nausea, and vomiting were assessed as complications. Aesthetic satisfaction of patients and the doctor was evaluated 6 month after the surgery. The parameters were compared between local and general anesthesia. RESULTS: A total 120 patients were included in this study. The degree of pain was low during surgery under local anesthesia. Although most of patients remembered the process of surgery during local anesthesia, satisfaction of local anesthesia was high. The satisfaction of anesthesia and willingness to undergo surgery with same anesthesia were not signifcantly different between local and general anesthesia. No serious complications developed during local anesthesia and there were no signifcant differences of aesthetic satisfaction between local and general anesthesia. CONCLUSION: Patient satisfaction and aesthetic results of rhinoplasty performed under local anesthesia were comparable to general anesthesia, indicating that surgeons do not need to be afraid of applying local anesthesia in rhinoplasty.
Assuntos
Humanos , Anestesia , Anestesia Geral , Anestesia Local , Memória , Métodos , Midazolam , Náusea , Satisfação do Paciente , Rinoplastia , Cirurgiões , VômitoRESUMO
Adenocarcinomas of the sinonasal tract are relatively rare. Such tumors are divided into salivary and nonsalivary types as classified by the World Health Organization. Nonsalivary sinonasal adenocarcinomas are further classified as intestinal (ITAC) and non-intestinal (non-ITAC), which can be separated even further into high-grade and low-grade. Low grade non-ITACs are more uncommon than ITACs. In this study, we present a case of low-grade non-ITAC in a 61-year-old woman who was successfully treated with wide excision without radiotherapy, and we also provide a review of the literature.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Adenocarcinoma , Cavidade Nasal , Septo Nasal , Radioterapia , Organização Mundial da SaúdeRESUMO
BACKGROUND AND OBJECTIVES: Bone conduction (BC) auditory brainstem response (ABR) is an important factor in determining the type of hearing loss especially in infants and other difficult-to-test populations. However, multiple constraints including technical difficulties make evaluating BC ABR less feasible in the clinic, and there is also lack of information that guides clinicians how to evaluate it. The purpose of this study is to compare the latency of wave V in BC and air conduction (AC) ABR in normal hearing infants and gather reference values for wave V latency of BC ABR. SUBJECTS AND METHOD: A total of 210 ears of normal hearing, of those not belong to the hearing loss risk group, were included. All the infants underwent ABR evoked by clicks via AC (3A insert phone) and BC (Radioear B-71, vibrator positioned on the mastoid) under sedation. The latency of wave V at 30 dB nHL by BC and AC was compared and analyzed according to age. RESULTS: The results revealed that in every age group in the study, wave V latency at 30 dB nHL of BC ABR was shorter than that of AC ABR. There was a significant decrease in BC and AC latencies with age, but among each consecutive age group, significant latency change was not identified after 6 months old. CONCLUSION: The latency of BC ABR in young children was shorter than that of AC ABR, and it decreased significantly as age increased. However, the reference data should be considered by taking each laboratory's test parameter into consideration.