Retraction: The Effects of Intratympanic Steroid Injection for the Patients with Refractory Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

No abstract available.

Retraction: Systematized Intraoperative Facial Nerve Monitoring in Middle Ear and Mastoid Surgery; 'Surgical Dehiscence' and 'Electrical Dehiscence' / 대한이비인후과학회지

No abstract available.

Two Cases of Artificial Auricular Reconstruction Using an Epithese / 대한이비인후과학회지

One of the most common uses of osseointegration has been to supply patients with craniofacial defects with a bone-anchored epitheses (BAE). BAEs are usually used in the craniofacial defects such as congenital external ear anomalies or facial defects after cancer surgeries or trauma. We report a case of a 26 year-old woman with traumatic auricular amputation due to a traffic accident 4 years ago and a case of 23 year-old man with congenital ear deformity. They took osseointegrated implantations for an auricular prosthesis and are using it without complications. BAEs can be used with good functional and esthetic outcome for artificial auricular reconstruction.

Systematized Intraoperative Facial Nerve Monitoring in Middle Ear and Mastoid Surgery: 'Surgical Dehiscence' and 'Electrical Dehiscence' / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The use of intraoperative facial nerve monitoring (IOFNM) improves facial nerve outcomes in acoustic neuroma surgeries, but the role of IOFNM in middle ear and mastoid surgeries is poorly defined. This study was performed to evaluate the role of IOFNM in middle ear and mastoid surgeries and to systemize IOFNM. SUBJECTS AND METHOD :We carried out a prospective study of 83 patients who undertook middle ear and mastoid surgeries with IOFNM. We checked the facial nerve dehiscence and estimated its location and length using a surgical microscope ('surgical dehiscence'). We stimulated the facial nerve with constant current, unipolar stimulation using Nerve Integrity Monitor (NIM)-2(TM) (Xomed (TM), U.S.A.) and estimated the minimal threshold of electric current making the electromusculography of facial muscle changes. RESULTS: Thirty six (43.4%) of 83 cases showed 'surgical dehiscence' and all responded to 0.7 mA or less of electrical stimulation. The most common site of 'surgical dehiscence' was middle portion of the tympanic segment. We defined the response to electrical stimulation within 0.7 mA as 'electrical dehiscence.' 'Electrical dehiscence' was presented in 63 (75.9%) cases and 82.5% of these cases responded to stimulation of 0.4 mA or less. The mean threshold of minimal electrical stimulation was 0.28 mA for tympanic segment and 0.48 mA for mastoid segment. CONCLUSION: "Electrical dehiscence" based on responses of electrical stimulation is safer than "surgical dehiscence," which is based on microscopic observation in middle ear and mastoid surgery. Based on this study, we recommend the electrical stimulation of 0.7 mA for first screening and 0.4 mA for second exploration in defining facial nerve using intraoperative NIM-2(TM) monitoring in middle ear and mastoid surgeries.

Clinical Analysis of Orbital Complications of Acute Sinusitis according to Age

BACKGROUND AND OBJECTIVES: Acute sinusitis is a mild, self-limiting disease. In children, however, sinusitis may lead to other severe, even life-threatening, conditions. Therefore, appropriate diagnosis and management are needed. Orbital complications from sinusitis are caused by expansion through natural suture lines, foramen, dehiscence of lamina bone and bony erosion due to acute infection and necrosis. The purpose of this study was to analyze the common types of orbital complications and to compare the symptoms, prognoses and treatments of children and of adults, respectively. Materials and Method: Twenty-one children under15 years of age and thirteen adults over 15 were enrolled in the study. Symptoms, durations of treatment, treatment modalities, prognoses, and CT findings were analyzed. RESULTS: Preseptal cellulitis was found in 6 children (28.6%) and 8 adults (61.5%) ; subperiosteal abscess in 9 children (42.9%) and 3 adults (23.1%) ; and orbital cellulitis in 6 children (28.6%) and 2 adults (15.4%). Eye lid swelling was found in all subjects, while diplopia and limitation of eye movement was found in 4 children (19%) and 2 adults (15.4%). Medical treatment was the first line of therapy for both children (76.2%) and adults (61.5%), with the remaining children (23.8%) and adults (38.5%) receiving surgical treatment. CONCLUSION: While generally more severe, orbital complications in children can be treated more conservatively than those arising in adults.

The Effects of Intratympanic Steroid Injection for the Patients with Refractory Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: High-dose steroid therapy has been known as the treatment of choice for sudden sensorineural hearing loss (SSNHL). However, about one third of patients do not generally respond to any treatments, and there seem to be no definitive treatment for the patients with refractory SSNHL. We prospectively studied the effect of intratympanic steroid injection (ITSI) for patients with refractory SSNHL. SUBJECTS AND METHOD: Sixty six patients with SSNHL, who were refractory to a course of oral steroid therapy, were included in this study. Thirty three patients (34 ears) were treated with ITSI and the other 33 patients had no further treatments as control. ITSI was performed with dexamethasone in the supine position on 4 separate occasions over the course of 2 weeks. Hearing was assessed immediately before every injection, and at 1 and 4 weeks after therapy. Hearing improvement was defined as more than 10 dB in pure tone average (PTA). RESULTS: Hearing improvement was observed in 13 (39.4%) of 33 patients who underwent ITSI and in 2 (6.1%) of 33 patients in control group. Five of 13 showed hearing improvement over 20 dB in PTA, and 11 of 20 patients showed no improvement in PTA by ITSI, but showed improvement over 10dB in some frequencies. There were no definite prognostic factors between the patients who responded to ITSI and those who didn't. CONCLUSION: ITSI is a simple and effective therapy for patients with refractory SSNHL.

A Case of Chondrosarcoma in Nasal Septum / 대한이비인후과학회지

Chondrosarcomas are malignant, slow-growing, cartilaginous tumors that are most commonly found in the pelvis, long bones and ribs, with approximately 5% to 10% located in head and neck. These tumors show diverse clinical features according to the morphologies, histological grades, and locations. Because most cases are characterized with nonspecific symptoms such as nasal obstruction and rhinorrhea, it can be misdiagnosed as rhinitis or sinusitis. For this reason, it if often detected when it has already reached locally advanced status. Chondrosarcomas in the head and neck region have a high local recurrence rate but rare distant metastases. The imaging study is essential and computed tomography shows calcified, low density mass occasionally with septal erosion. Magnetic resonance imaging shows low signal intensity in T1 weighted images, and high signal intensity in T2. Surgical resection is the definitive treatment of choice. Radiation and chemotherapy are reserved for residual disease and palliation. We present a case of the chondrosarcoma of nasal septum that was treated with craniofacial resection by craniotomy, and with bicoronal incision and midfacial degloving.