Benefits of Surgeon-Performed Office-Based Ultrasonography / 대한이비인후과학회지

Background and Objectives@#The purpose of this study was to examine the benefits of ultrasonography performed by a surgeon rather than a radiologist.Subjects and Method This retrospective study enrolled 122 cases of ultrasonography performed by a head and neck surgeon and 116 cases of the same examination performed by a radiologist before surgery. The time intervals between the first visit and surgery were compared in both groups. @*Results@#The average waiting time for surgery after the first hospital visit was significantly reduced when a surgeon performed the ultrasound examination. Furthermore, there was no significant difference in sampling inadequacy rate on thyroid fine needle aspiration (FNA) between FNA performed by a head and neck surgeon and a radiologist. @*Conclusion@#Surgeons can utilize ultrasound as a diagnostic and therapeutic tool in an office-based setting. For patients, diagnosis and treatment provided by a single doctor will lead to more efficient outcomes.

The Influence of Non-Linear Frequency Compression on the Perception of Speech and Music in Patients with High Frequency Hearing Loss

Background and Objectives@#Non-linear frequency compression (NLFC) technology compresses and shifts higher frequencies into a lower frequency area that has better residual hearing. Because consonants are uttered in the high-frequency area, NLFC could provide better speech understanding. The aim of this study was to investigate the clinical effectiveness of NLFC technology on the perception of speech and music in patients with high-frequency hearing loss. @*Subjects and Methods@#Twelve participants with high-frequency hearing loss were tested in a counter-balanced order, and had two weeks of daily experience with NLFC set on/off prior to testing. Performance was repeatedly evaluated with consonant tests in quiet and noise environments, speech perception in noise, music perception and acceptableness of sound quality rating tasks. Additionally, two questionnaires (the Abbreviated Profile of Hearing Aid Benefit and the Korean version of the International Outcome Inventory-Hearing Aids) were administered. @*Results@#Consonant and speech perception improved with hearing aids (NLFC on/off conditions), but there was no significant difference between NLFC on and off states. Music perception performances revealed no notable difference among unaided and NLFC on and off states. The benefits and satisfaction ratings between NLFC on and off conditions were also not significantly different, based on questionnaires, however great individual variability preferences were noted. @*Conclusions@#Speech perception as well as music perception both in quiet and noise environments was similar between NLFC on and off states, indicating that real world benefits from NLFC technology may be limited in Korean adult hearing aid users.

Sensorineural Hearing Loss of Suspected Autoimmune Etiology: Two Cases of Cogan’s Syndrome / 대한이비인후과학회지

Cogan’s syndrome is a rare inflammatory disease characterized by non-syphilitic keratitis and vestibulo-auditory symptoms including hearing loss, tinnitus, and vertigo. Although its precise pathogenesis is not known, Cogan’s syndrome is generally considered an autoimmune disease. This hypothesis is supported by the frequently successful remission of hearing loss after steroid administration and the association with other autoimmune disorders such as rheumatoid arthritis. Medical treatment of Cogan’s syndrome depends on disease severity and on how extensive the disease is. The involvement of inner ear pathology requires systemic corticosteroid therapy. In cases of treatment failure or the need for a corticosteroid-sparing effect, other immunosuppressive drugs can be used. We experienced two patients with typical Cogan’s syndrome, presenting bilateral progressive sensorineural hearing loss and dizziness with ocular involvement, which we have successfully treated with systemic steroid administration and immunosuppressive therapy.

Translation and Linguistic Validation of Korean Version of Musical Background Questionnaire / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#The Musical Background Questionnaire (MBQ) has been developed to assess formal musical training and listening enjoyment. The aims of this study were to translate MBQ into Korean with subsequent linguistic validation and to evaluate the effectiveness of the Korean version of MBQ (K-MBQ).SUBJECTS AND METHOD: Between 2013 and 2014, a panel affiliated with the questionnaire committee of the Korean Audiological Society reconciled the first draft K-MBQ translated by a bilingual person. A separate bilingual translator, who had never seen the original MBQ, translated the draft K-MBQ back into English, and subsequently, the panel reviewed its equivalence to the original one. K-MBQ was administered to 29 adults (M:F=15:14; aged 21 to 76 years) for cognitive debriefing. Pure tone and speech audiometry were performed in all participants.@*RESULTS@#The translation of K-MBQ was completed through a multi-step process of forward translation, reconciliation, reverse translation, cognitive debriefing and proofreading. Thirteen (45%) of 29 subjects reported formal musical training, and 16 participants (55%) judged themselves as having no musical education and background. No significant correlation was found between musical background and hearing level, whereas self-perceived quality of music and self-perception of music elements quantified by K-MBQ were associated with hearing ability in terms of pure-tone and speech audiometry.@*CONCLUSION@#K-MBQ was translated and linguistically validated. The use of this questionnaire can provide further evaluation of musical background in patients with hearing loss or cochlear implant users.

A Case of Lipoma in the Middle Ear / 대한이비인후과학회지

Lipoma is a common benign tumor found at various sites in the body, but it is rarely encountered in the middle ear. We report a case of a 5-month-old girl who presented a middle ear lipoma, which was successfully removed by canal wall up mastoidectomy. To the best our knowledge, this is the youngest case of rare middle ear lipoma, which has ever been reported in the literature.

Case Series Outcomes of Cochlear Implantation in Children with Noonan Syndrome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#Hearing loss is a common complication associated with Noonan syndrome (NS), and the level of hearing loss for NS patients with sensorineural loss ranged from normal to severe. Additional insights into the outcome of cochlear implantation (CI)in children with NS with or without comorbidities are needed.SUBJECTS AND METHOD: In this study, five patients with NS, four with a mutation in PTPN11 and one who tested negative in mutation screening, diagnosed with the clinical scoring systemand underwent CI at ages ranging from 16 to 50 months were retrospectively reviewed. Patientswere evaluated for auditory perception (Categories of Auditory Performance), speech production (Korean Version of the Ling's Stage), and language ability (Receptive and Expressive Vocabulary Test).@*RESULTS@#In five of the children with NS, CI was performed without any complications. Threepatients who received CI before 30 months of age showed outstanding outcomes. One patientwho received CI at 50 months showed limited benefit. One patient who was diagnosed with developmental delay and cochlear nerve hypoplasia underwent CI at 28 months with poor outcome.DISCUSSION: Our report suggests that although the benefit may be influenced by comorbidities associated with NS or delay in hearing rehabilitation, profound hearing loss in patientswith NS may be restored to normal levels in terms of auditory/speech perception and vocabulary/language development. The variable hearing outcomes also underscore the need for earlyscreening and detection of profound hearing loss, and regular follow-up for hearing evaluationin patients with NS.

A Case of Lipoma in the Middle Ear / 대한이비인후과학회지

Lipoma is a common benign tumor found at various sites in the body, but it is rarely encountered in the middle ear. We report a case of a 5-month-old girl who presented a middle ear lipoma, which was successfully removed by canal wall up mastoidectomy. To the best our knowledge, this is the youngest case of rare middle ear lipoma, which has ever been reported in the literature.

Case Series Outcomes of Cochlear Implantation in Children with Noonan Syndrome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hearing loss is a common complication associated with Noonan syndrome (NS), and the level of hearing loss for NS patients with sensorineural loss ranged from normal to severe. Additional insights into the outcome of cochlear implantation (CI)in children with NS with or without comorbidities are needed. SUBJECTS AND METHOD: In this study, five patients with NS, four with a mutation in PTPN11 and one who tested negative in mutation screening, diagnosed with the clinical scoring systemand underwent CI at ages ranging from 16 to 50 months were retrospectively reviewed. Patientswere evaluated for auditory perception (Categories of Auditory Performance), speech production (Korean Version of the Ling's Stage), and language ability (Receptive and Expressive Vocabulary Test). RESULTS: In five of the children with NS, CI was performed without any complications. Threepatients who received CI before 30 months of age showed outstanding outcomes. One patientwho received CI at 50 months showed limited benefit. One patient who was diagnosed with developmental delay and cochlear nerve hypoplasia underwent CI at 28 months with poor outcome. DISCUSSION: Our report suggests that although the benefit may be influenced by comorbidities associated with NS or delay in hearing rehabilitation, profound hearing loss in patientswith NS may be restored to normal levels in terms of auditory/speech perception and vocabulary/language development. The variable hearing outcomes also underscore the need for earlyscreening and detection of profound hearing loss, and regular follow-up for hearing evaluationin patients with NS.

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma

OBJECTIVES: As endoscopic instrumentation, techniques and knowledges have significantly improved recently, endoscopic ear surgery has become increasingly popular. Transcanal endoscopic ear surgery (TEES) can provide better visualization of hidden areas in the middle ear cavity during congenital cholesteatoma removal. We aimed to describe outcomes for TEES for congenital cholesteatoma in a pediatric population. METHODS: Twenty-five children (age, 17 months to 9 years) with congenital cholesteatoma confined to the middle ear underwent TEES by an experienced surgeon; 13 children had been classified as Potsic stage I, seven as stage II, and five as stage III. The mean follow-up period was 24 months. Recurrence of congenital cholesteatoma and surgical complication was observed. RESULTS: Congenital cholesteatoma can be removed successfully via transcanal endoscopic approach in all patients, and no surgical complications occurred; only one patient with a stage II cholesteatoma showed recurrence during the follow-up visit, and the patient underwent revision surgery. The other patients underwent one-stage operations and showed no cholesteatoma recurrence at their last visits. Two patients underwent second-stage ossicular reconstruction. CONCLUSION: Although the follow-up period and number of patients were limited, pediatric congenital cholesteatoma limited to the middle ear cavity could be safely and effectively removed using TEES.

Microsurgical Extirpation of Intracordal Cyst with a Microflap Technique

BACKGROUND AND OBJECTIVES: Microsurgical resection of intracordal cysts is technically difficult and challenging because the wall of cysts may be tightly attached to underlying vocal ligament and/or overlying epithelium, and therefore their thin wall will easily rupture during surgical dissection. We aimed to evaluate the voice outcomes of standard microflap subepithelial resection and the recurrence rate depending on the intraoperative rupturing of the cyst. MATERIALS AND METHODS: Medical records of Samsung Medical Center, Seoul, Korea, were reviewed for sixty-four consecutive patients who received surgical resection of vocal cyst using microflap subepithelial dissection technique between the year 2004 and 2013. Meticulous dissection was performed to completely remove the cyst wall while preserving the mucosa and the lamina propria as much as possible. Voice outcomes and recurrence rates were compared according to the type, size and the intraoperative rupture of cyst. RESULTS: Presence or absence of cyst rupture was clearly described in the operation records of 41 patients. Intraoperative rupture of the cyst occurred in 32 of 41 (78%) patients. The recurrence was detected in 5 of 64 (7.8%) total cases and 4 of 32 (12.5%) cases of ruptured cyst, but not in 9 cases of intact extirpation. Rupture was more common in case of mucous retention cyst compared with epidermoid cyst (p=0.036). Subjective and objective voice parameters were measured at before and 3 months after surgery, which improved regardless of the cyst rupture. CONCLUSION: Although complete microsurgical extirpation of intracordal cyst while keeping the cyst wall intact is technically difficult, meticulous dissection with maximal preservation of surrounding tissue may warrant the improvement of voice outcomes.