Intratympanic Steroid and Oral Diuretics Combination Therapy for Acute Low Frequency Sensorineural Hearing Loss without Vertigo / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The effectiveness of intratympanic dexamethasone injections (ITD) alone is compared against the combination therapy of ITD and oral diuretics as treatments for acute low frequency sensorineural hearing loss (LFHL) without vertigo. SUBJECTS AND METHOD: A total of 36 patients, with LFHL 0.05). For subjective symptoms, there were no statistically significant differences in the improvement rate in either group (combination 58.8% vs. ITD only 63.2%, p>0.05). In pure tone audiometry, the improvement rate of the combination group was not significantly different from that of the ITD only group (76.5% vs. 73.7%, p>0.05). There was a significant correlation between the complete recovery rate and duration of symptoms. CONCLUSION: ITD alone is an effective treatment modality for LFHL within 1 month after onset. Diuretics have no additive effect for the recovery of hearing in patients with acute LFHL without vertigo.

Frontoethmoidal Cells on Computed Tomographic Analysis: The Prevalence and Relationship to Frontal Sinus/Recess Mucosal Thickening

OBJECTIVES: To determine the prevalence of frontoethmoidal cells (FECs) in patients with and without frontal sinus/recess mucosal thickening and to establish the relationship between the FECs and the frontal sinus/recess mucosal thickening. MATERIALS AND METHODS: We retrospectively reviewed 245 consecutive ostiomeatal CT scans (490 sides). The normal and frontal sinus/recess mucosal thickening groups were categorized based on these images. The latter group was sub-categorized into the frontal sinus mucosal thickening group (FS group) and the frontal recess mucosal thickening group (FR group). RESULTS: Types 1, 2, 3 and 4 frontal cells were found in 17.5, 6.7, 8.3 and 0% of 326 normal sides, respectively. The prevalence of agger nasi, suprabullar, frontal bullar, supraorbital ethmoid and interfrontal sinus septal cells was 85.6, 43.3, 4.9, 4.3 and 17.2% of the same 326 normal sides, respectively. Type 3 frontal cells, frontal bullar cells and suprabullar cells were more prevalent in the FS and FR groups than in the normal group. All types of cells were more prevalent in the FS group, but only the suprabullar cells were more prevalent in the FR group than in the normal group. CONCLUSION: These findings suggest that type 3 frontal cells, frontal bullar cells and suprabullar cells may have a significant association with frontal sinus/recess mucosal thickening.

Correction of Hump Nose Considering the Characteristics of Korean Nose / 대한이비인후과학회지

The Korean hump nose often differs from Caucasian hump nose in that the size of the nasal hump is not prominent and the hump is frequently associated with a low nasal dorsum and radix with under-projected nasal tip. Therefore, typical reductive rhinoplasty techniques are not effective in managing the characteristic anatomy of the Korean hump nose. Because Korean hump nose patients have all kinds of nasal deformity including low dorsal profile, abnormal tip projection, tip rotation and deviation, surgeons should be skilled at various techniques of rhinoplasty. Removal of hump should be performed gradually considering the balance of nasal tip and nasal dorsum and radix. Small hump with low radix can be corrected by radix augmentation. If the hump is big, the hump should not be remained by too conservative removal of the hump. Most hump in Korean nose may be corrected well by using nasal tip and dorsal augmentation with the appropriate hump removal. The strengthening and augmentation of nasal structure using autologous cartilage may accomplish the balanced correction of hump nose aesthetically and functionally with tailored removal of hump in Korean patients.

Comparison of the Effectiveness of Monitoring Cisplatin-Induced Ototoxicity with Extended High-Frequency Pure-Tone Audiometry or Distortion-Product Otoacoustic Emission

BACKGROUND AND OBJECTIVES: To compare the effectiveness of monitoring cisplatin-induced ototoxicity in adult patients using extended high-frequency pure-tone audiometry (EHF-PTA) or distortion-product otoacoustic emission (DP-OAE) and to evaluate the concurrence of ototoxicity and nephrotoxicity in cisplatin-treated patients. SUBJECTS AND METHODS: EHF-PTA was measured at frequencies of 0.25, 0.5, 1, 2, 3, 4, 6, 8, 9, 11.2, 12.5, 14, 16, 18, and 20 kHz and DP-OAE at frequencies of 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, and 8 kHz in cisplatin-treated patients (n=10). Baseline evaluations were made immediately before chemotherapy and additional tests were performed before each of six cycles of cisplatin treatment. Laboratory tests to monitor nephrotoxicity were included before every cycle of chemotherapy. RESULTS: Four of 10 patients showed threshold changes on EHF-PTA. Five of 10 patients showed reductions in DP-OAE, but one was a false-positive result. The results of EHF-PTA and DP-OAE were consistent in two patients. Only one patient displayed nephrotoxicity on laboratory tests after the third cycle. CONCLUSIONS: In our study, the incidence rate of cisplatin-induced ototoxicity was 40% with EHF-PTA or DP-OAE. Although both EHF-PTA and DP-OAE showed the same sensitivity in detecting ototoxicity, they did not produce the same results in all patients. These two hearing tests could be used to complement one another. Clinicians should use both tests simultaneously in every cycle of chemotherapy to ensure the detection of ototoxicity.