Electroacoustic Evaluation of Smartphone-Based Hearing Aid Applications

Objectives@#. This study evaluated the electroacoustic characteristics of smartphone-based hearing aid applications (apps). @*Methods@#. We investigated hearing aid apps based on processing delay measurements, hearing instrument testing, simulated real ear measurements, and a head-and-torso simulator. @*Results@#. Many apps exceeded the recommended level for processing delay. Hearing instrument testing showed the highest amplification characteristics and the best sound quality when a hearing aid was used, followed by the high-end apps and then the low-end apps. The simulated real ear measurements results showed that the high-end apps had a better ability to match the amplification targets than the low-end apps, but there was no consistent pattern among apps when controlling the output. Only a few apps could improve the signal-to-noise ratio in the head-and-torso simulator. @*Conclusion@#. Most of the apps showed relatively poor electroacoustic performance in comparison with hearing aids. Generalizing access to hearing care through hearing aid apps induces a wide diversity of hearing performance with no fixed standard for reliability. However, we expect their overall quality to improve over the next few years.

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.

Effects of Residual Hearing on the Auditory Steady State Response for Cochlear Implantation in Children

BACKGROUND AND OBJECTIVES: We aim to explore the effects of residual auditory steady state response (ASSR) on cochlear implantation (CI) outcomes in children lacking auditory brainstem responses (ABRs). SUBJECTS AND METHODS: We retrospectively reviewed the data of child CI recipients lacking ABRs. All ears were divided into two groups: with residual ASSR and without ASSR. For each frequency, the T- and C-levels and the electrical dynamic ranges of postoperative 3-month and 1-year mappings were compared between the groups. To evaluate speech perception, patients who received simultaneous bilateral CIs were divided into two groups: group 1 exhibited responses at all frequencies in both ears; in group 2, at least one ear evidenced no response. The Categories of Auditory Perception (CAP) and Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores were compared between the groups. RESULTS: We enrolled 16 patients. At 2 kHz, the postoperative 3-month and 1-year T-levels of patients with residual hearing were lower than those of hearing loss group (p=0.001, p=0.035). In residual hearing group, the ASSR threshold correlated positively with the postoperative 1-year T-level (p=0.012, R² =0.276) and C-level (p=0.002, R² =0.374). Of 10 simultaneous bilateral CI recipients, 5 exhibited ASSRs at all frequencies and the other 5 showed no response at ≥1 frequency. The latter had higher CAP scores at the postoperative 1-year (p=0.018). CONCLUSIONS: In children exhibiting hearing loss in ABR testing, residual hearing at 2 kHz ASSR correlated positively with the post-CI T-level. Those with ASSRs at all frequencies had significantly lower CAP scores at the postoperative 1year. CI should not be delayed when marginal residual hearing is evident in ASSR.

Noise and Room Acoustic Conditions in a Tertiary Referral Hospital, Seoul National University Hospital

BACKGROUND AND OBJECTIVES: Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital (SNUH) in Korea, are investigated. MATERIALS AND METHODS: Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured including examination rooms, operating rooms, nurse stations, receptions, and patient rooms. RESULTS: The A-weighted equivalent noise level, L(Aeq), ranges from 54 to 56 dBA, which is at least 10 dB lower than the noise levels of 65 to 73 dBA measured in American ERs. In an ICU, the noise level for the first night was 66 dBA, which came down to 56 dBA for the next day. The noise levels during three different ear surgeries vary from 57 to 62 dBA, depending on the use of surgical drills and suctions. The noise levels in a patient room is found to be 47 dBA, while the nurse stations and the receptions have high noise levels up to 64 dBA. The reverberation times in an operation room, examination room, and single patient room are found to be below 0.6 s. CONCLUSIONS: At SNUH, the nurse stations and receptions were found to be quite noisy. The ERs were quieter than in the previous studies. The measured reverberation times seemed low enough but some other nurse stations and examination rooms were not satisfactory according to the questionnaire.

Proposal on the Diagnostic Criteria of Definite Isolated Otolith Dysfunction

BACKGROUND AND OBJECTIVES: Dizzy patients with abnormal otolith function tests, despite a normal caloric response, are defined as having specific (isolated) otolith organ dysfunction. This study was performed to compare the differences in clinical presentation between isolated otolith dysfunction (iOD) patients with lab- and Sx-based iOD group and lab-based iOD symptoms. SUBJECTS AND METHODS: The medical records of 23 iOD patients with normal caloric response but abnormal cervical vestibular evoked myogenic potential (VEMP), ocular VEMP, or subjective visual vertical were reviewed. Non-spinning vertigo was considered as otolith-related symptoms. The patients’ age, onset of dizziness, Numeric Rating Scale on the severity of dizziness, and concomitant vestibular disorders were analyzed. RESULTS: Patients in the lab-based iOD group were significantly older than those in the lab- and Sx-based iOD group. Known vestibular disorders were significantly more common in the lab-based iOD group (83.3%) compared to the lab- and Sx-based iOD group (18.2%). Despite the normal caloric response, catch-up saccade was found in the video head impulse test in more than half (54.5%) of the lab-based iOD group patients. There was no catch-up saccade in the lab- and Sx-based iOD group. There were no significant differences in gender ratio, frequency of dizziness attacks, and duration of illness. CONCLUSIONS: We propose new definitions of definite iOD (lab- and Sx-based iOD) and probable iOD (lab- or Sx-based iOD). These new definitions may help researchers to identify patients who are more likely to have true iOD, and facilitate comparisons of results between different studies.

Decreased Expression of Aquaporins in Otitis Media: What About Chronic Otitis Media?

No abstract available.

The Effects of Air Pollutants on the Prevalence of Common Ear, Nose, and Throat Diseases in South Korea: A National Population-Based Study

OBJECTIVES: The effects of air pollutants on upper airway disease development have been seldom studied. In this study, we evaluated the effects of air pollution on the prevalence of ENT diseases. METHODS: We identified cases of ENT disease occurring in 2009, as recorded by the Korea National Health and Nutrition Examination Survey, and explored their associations with the levels of five air pollutants: sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), carbon monoxide (CO), and particulate matter (PM₁₀ particles; particulates ≤10 μm in aerodynamic diameter). Subjects diagnosed with at least one of the five studied ENT diseases were included in analysis, but those aged under 19 years were excluded. Linear associations between ENT disease frequency and pollutant levels were evaluated by calculating Spearman correlations. After adjusting for age, gender, and geographic region, multivariate logistic regression was used to obtain odds ratios (OR) with 95% confidence intervals (CI). RESULTS: A total of 7,399 subjects with ENT diseases were identified. A linear association was evident between PM₁₀ concentration and the frequency of septal deviation (Spearman coefficient, 0.507; P=0.045). After adjustment, the PM₁₀ level was associated with high odds ratios for chronic rhinosinusitis (1.22; 95% CI, 1.02 to 1.46) and septal deviation (1.43; 95% CI, 1.22 to 1.67). Both of these conditions were more prevalent in males. CONCLUSION: We found that increased ambient concentrations of PM₁₀ particles were clearly associated with increased the risk of chronic rhinosinusitis and septal deviation; the exposure-response relationship was definitive.

Risk Factors for Positional Vertigo and the Impact of Vertigo on Daily Life: The Korean National Health and Nutrition Examination Survey

BACKGROUND AND OBJECTIVES: This study aimed to analyze risk factors for positional vertigo (PV) and the influence thereof on daily life and subjective quality-of-life (QoL). SUBJECT ANDMETHODS: A cross-sectional study was conducted using data of the 2010 Korea National Health and Nutrition Examination Survey. The study population consisted of 1,274 individuals aged >40 years for whom complete dizziness-related data were available. Blood and urine tests were performed, and nutritional intake, QoL, and subjective health status were measured using a questionnaire. The associations between PV and blood/urine test data and nutritional intake were evaluated via multiple logistic regression analysis. RESULTS: A history of PV within the previous year was reported by 98 individuals (7.7%). Advanced age and female gender were both significantly associated with such a history. Serum hemoglobin, creatinine, and triglyceride levels correlated significantly with a history of PV. Carotene, vitamin A, and vitamin B2 intakes were significantly lower in individuals with PV. Multivariate analysis revealed that only age was significantly associated with a history of PV (p=0.003). Although subjective health status score was not significantly lower in subjects with PV, subjective impairments in mobility, self-care, the performance of usual activities, and anxiety/depression were more prominent in individuals with PV. A fall history and limitations of activity were also significantly higher in individuals with PV (p < 0.001 and p=0.003, respectively). CONCLUSIONS: Age was a risk factor for PV, which affected most QoL parameters, fall frequency, and the performance of normal activities.

Clinical Implication and Proposed Mechanism of Direction Changing Vibration Induced Nystagmus in Unilateral Vestibular Hypofunction / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We evaluated the clinical characteristics and vestibular function of patients with direction changing vibration induced nystagmus (DC VIN) and unilateral vestibular hypofunction and suggest clinical implication and a proposed mechanism of DC VIN. SUBJECTS AND METHOD: The records of 315 patients who underwent the VIN test were reviewed retrospectively. Among these, 18 patients (5.7%) showed DC VIN, and out of whom, 15 patients (4.8%) were diagnosed as unilateral vestibular hypofunction by caloric, rotation chair (RCT), and video head impulse test (vHIT). We analyzed the relationship between DC VIN and the dizziness characteristics, duration of disease, and the outcome of the vestibular function test. RESULTS: The mean age of 15 patients was 67.4±10.7 years and the mean duration of dizziness was 13.6±29.7 months. The caloric test revealed 25% of the patients to have significant canal paresis [Caloric vestibular neuritis (VN)], while 75% showed normal caloric response. However, unilateral vestibular hypofunction was observed by abnormal results in RCT or vHIT (Non-caloric VN). Seven patients showed ipsilateral DC VIN (nystagmus to vibrated side) and eight patients contralateral DC VIN (nystagmus to opposite side of vibration). Patients with ipsilateral DC VIN were shown to have a significant longer duration of dizziness than those with contralateral DC VIN. CONCLUSION: Although rare, DC VIN can also be found in patients with unilateral vestibular hypofunction. Patients with DC VIN had a mild vestibular asymmetry with Non-caloric VN or Caloric VN in the process of compensation. The mechanism of ipsilateral DC VIN seems to be due to the small amount of vestibular asymmetry, which is smaller than the interaural attenuation of vibration.

Validation of the Korean Version of the Abbreviated Profile of Hearing Aid Benefit / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The quantification of hearing aid benefit is important in hearing aid fitting. The abbreviated profile of hearing aid benefit (APHAB) is a useful tool for measuring the benefit of using hearing aids. In this study, we developed a Korean version of APHAB (K-APHAB) and determined its validity and reliability. SUBJECTS AND METHOD: An expert panel translated the original version of APHAB into Korean language. Two bilingual translators back-translated the first translated version into English and it was compared with the original version. After cognitive debriefing, the translation of APHAB into the Korean version was completed. One hundred ninety-seven subjects using hearing aids participated in this study and completed K-APHAB. Reliability was assessed using Cronbach's alpha coefficient, and validity was evaluated by factor analysis and criterion validity. RESULTS: K-APHAB had a good internal consistency (α=0.80). Confirmatory factor analysis showed that K-APHAB is comprised of four subsections, namely ‘communication in daily life’, ‘aversiveness’, communication in ‘background noise’ or ‘reverberation’. CONCLUSION: The K-APHAB is a useful tool for evaluating the benefit of hearing aids in Korean hearing-impaired individuals.

Clinical Applications of Wideband Tympanometry / 대한이비인후과학회지

Conventional impedance audiometry uses only specific tympanometric frequencies (e.g., 226 Hz) and cannot test above 1500 Hz. As many hearing frequencies must be evaluated when diagnosing middle ear pathologies, wideband clicks stimulating tympanometric receptors from 226 to 8000 Hz are commonly delivered. Since wideband tympanometry (WBT) was introduced in 1993, several studies have explored its clinical utility. WBT yields information on absorbances at various frequencies and pressures. Recently, WBT has become increasingly used to diagnose and monitor the hearing of newborns and patients with otosclerosis, ossicular chain disruptions, tympanic perforations, superior semicanal dehiscence syndrome, and middle ear effusions. WBT is also employed for pre/postoperative monitoring using non-pressurized wideband absorbance. Here, we review the concept of WBT, the basic mechanism, and the clinical applications.

Effect of TiO₂ Nanoparticles on Inflammasome-Mediated Airway Inflammation and Responsiveness

PURPOSE: Nanoparticles (NPs) may cause cell and tissue damage, leading to local and systemic inflammatory responses and adverse effects on health due to the inhalation of particulate matter. The inflammasome is a major regulator of inflammation through its activation of pro-caspase-1, which cleaves pro-interleukin-1β (pro-IL-1β) into its mature form and may induce acute and chronic immune responses to NPs. However, little is known about the response of the inflammasome to NP exposure via the airways in asthma. The aim of this study was to identify the impact of titanium dioxide (TiO2) NPs on inflammasome in a mouse model of allergic asthma. METHODS: Mice were treated with ovalbumin (OVA) or TiO₂ NPs. IL-1β, IL-18, NAIP, CIITA, HET-E, TP-2 (NACHT), leucine-rich repeat (LRR), pyrin domain-containing protein 3 (NLRP3), and caspase-1 were assessed by Western blotting. Caspase-1 was assessed by immunohistochemistry (IHC). Levels of reactive oxygen species (ROS)—as markers of oxidative damage—and the mediators 8-isoprostane and carbonyl were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Airway hyperresponsiveness (AHR) and inflammation were increased in OVA-sensitized/challenged mice, and these responses were exacerbated by exposure to TiO₂ NPs. NP treatment increased IL-1β and IL-18 expression in OVA-sensitized/challenged mice. NPs augmented the expression of NLRP3 and caspase-1, leading to production of active caspase-1 in the lung. Caspase-1 expression was increased and exacerbated by TiO₂ NP exposure in OVA-sensitized/challenged mice. ROS levels tended to be increased in OVA-sensitized/challenged and OVA-sensitized/challenged-plus-TiO₂ NP-exposed mice. CONCLUSIONS: Our data demonstrated that inflammasome activation occured in asthmatic lungs following NP exposure, suggesting that targeting the inflammasome may assist in controling NP-induced airway inflammation and hyperresponsiveness.

Bacterial Species and Antibiotic Sensitivity in Korean Patients Diagnosed with Acute Otitis Media and Otitis Media with Effusion

Changes over time in pathogens and their antibiotic sensitivity resulting from the recent overuse and misuse of antibiotics in otitis media (OM) have complicated treatment. This study evaluated changes over 5 years in principal pathogens and their antibiotic sensitivity in patients in Korea diagnosed with acute OM (AOM) and OM with effusion (OME). The study population consisted of 683 patients who visited the outpatient department of otorhinolaryngology in 7 tertiary hospitals in Korea between January 2010 and May 2015 and were diagnosed with acute AOM or OME. Aural discharge or middle ear fluid were collected from patients in the operating room or outpatient department and subjected to tests of bacterial identification and antibiotic sensitivity. The overall bacteria detection rate of AOM was 62.3% and OME was 40.9%. The most frequently isolated Gram-positive bacterial species was coagulase negative Staphylococcus aureus (CNS) followed by methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), and Streptococcus pneumonia (SP), whereas the most frequently isolated Gram-negative bacterium was Pseudomonas aeruginosa (PA). Regardless of OM subtype, ≥ 80% of CNS and MRSA strains were resistant to penicillin (PC) and tetracycline (TC); isolated MRSA strains showed low sensitivity to other antibiotics, with 100% resistant to PC, TC, cefoxitin (CFT), and erythromycin (EM); and isolated PA showed low sensitivity to quinolone antibiotics, including ciprofloxacin (CIP) and levofloxacin (LFX), and to aminoglycosides. Bacterial species and antibiotic sensitivity did not change significantly over 5 years. The rate of detection of MRSA was higher in OME than in previous studies. As bacterial predominance and antibiotic sensitivity could change over time, continuous and periodic surveillance is necessary in guiding appropriate antibacterial therapy.

Predictive and Prognostic Biomarkers of Respiratory Diseases due to Particulate Matter Exposure

Air pollution is getting severe and concerns about its toxicity effects on airway and lung disease are also increasing. Particulate matter (PM) is major component of air pollutant. It causes respiratory diseases, such as asthma, chronic obstructive pulmonary disease, lung cancer, and so on. PM particles enter the airway and lung by inhalation, causing damages to them. Especially, PM2.5 can penetrate into the alveolus and pass to the systemic circulation. It can affect the cardiopulmonary system and cause cardiopulmonary disorders. In this review, we focused on PM-inducing toxicity mechanisms in the framework of oxidative stress, inflammation, and epigenetic changes. We also reviewed its correlation with respiratory diseases. In addition, we reviewed biomarkers related to PM-induced respiratory diseases. These biomarkers might be used for disease prediction and early diagnosis. With recent trend of using genomic analysis tools in the field of toxicogenomics, respiratory disease biomarkers associated with PM will be continuously investigated. Effective biomarkers derived from earlier studies and further studies might be utilized to reduce respiratory diseases.

Standardization for a Korean Version of the Speech, Spatial and Qualities of Hearing Scale: Study of Validity and Reliability / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The Speech, Spatial and Qualities of Hearing Scale (SSQ) was designed to measure self-reported auditory disability in a wide variety of listening situations. Its 49 items cover many aspects of speech perception, spatial hearing, and qualities of hearing, which constitute the three parts of SSQ. However, there has been no reliable and valid Korean version of SSQ (K-SSQ), which made the measurement of auditory disability difficult. The aim of this study is to develop a K-SSQ and to determine its reliability and validity for clinical or academic use. SUBJECTS AND METHOD: An expert panel translated the original SSQ into Korean. A bilingual translator back-translated the translated version into English, which was then compared with the original version. After cognitive debriefing, K-SSQ was administered to 400 patients with hearing disability in 14 referral hospitals. Reliability was assessed using Cronbach's alpha coefficient and correlation study. Validity was evaluated by factor analysis and criterion validity based on the results of pure tone audiometry. RESULTS: K-SSQ showed good reliability with high internal consistency (Cronbach's α=0.99), and strong positive correlations across all three parts of SSQ. Construct validity was confirmed by the results of factor analysis and criterion validity demonstrated positive correlations between each part of SSQ and the results of pure tone audiometry. CONCLUSION: The K-SSQ is a reliable and valid tool for use as a behavioral measure of hearing ability in Korean-speaking patients, and it will provide a very useful evaluation tool for both clinicians and researchers.

Translation and Standardization for a Korean Version of the Client Oriented Scale of Improvement / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Client Oriented Scale of Improvement (COSI) has been designed to identify client needs, changes in listening ability, and final listening ability in situations important to each client. The aim of this study was to translate COSI into Korean with subsequent linguistic validation and to determine the reliability of the Korean version of the COSI (K-COSI). SUBJECTS AND METHOD: An expert panel translated the original version of COSI into the Korean language. A bilingual translator back-translated the translated version into English, which was subsequently compared with the original English version. K-COSI was administered at 14 referral hospitals, to 128 patients with hearing disability after cognitive debriefing. Reliability was assessed using correlation study. RESULTS: K-COSI showed an excellent test-retest correlation and high reliability in degree of change (Spearman correlation=0.89, interclass correlation coefficient=0.922). It also showed a fair test-retest correlation and high reliability in final hearing ability (Spearman correlation=0.49, interclass correlation coefficient=0.353) CONCLUSION: K-COSI proved to be highly reliable. The results suggest that the adapted Korean version of COSI is a reliable and valid measure for Korean-speaking patients with hearing loss.

Development of a More Effective Hearing Screening Questionnaire for Infants and Children during Medical Check-Ups / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To improve hearing screening, we developed a more effective hearing screening questionnaire for infants and children to be utilized during medical check-ups. SUBJECTS AND METHOD: Through literature review and discussions with an advisory council, we selected 10 questions to ask parents at each of the seven screening periods for their infants and children. In total, 223 parents of infants and children with and without hearing impairment (119 normal hearing, 104 hearing impaired) answered questionnaires at seven university hospitals in Korea. The advisory council modified questions with regard to sensitivity, specificity, positive, and negative prediction rate, preventing duplication among screening periods, and to address other questions related to development. RESULTS: For hearing screens, we asked five questions per screening period. Collectively, these questions had 40-100% sensitivity and 45-90% specificity at each of the seven screening periods. CONCLUSION: Although we do not advise that hearing questionnaires replace hearing tests, we developed in this study a more effective questionnaire that we suggest could be utilized during medical check-ups to enhance the hearing screening process.

Asian Sand Dust Enhances the Inflammatory Response and Mucin Gene Expression in the Middle Ear

OBJECTIVES: Asia sand dust (ASD) is known to cause various human diseases including respiratory infection. The aim of this study was to examine the effect of ASD on inflammatory response in human middle ear epithelial cells (HMEECs) in vitro and in vivo. METHODS: Cell viability was assessed using the cell counting kit-8 assay. The mRNA levels of various genes including COX-2, TNF-a, MUC 5AC, MUC 5B, TP53, BAX, BCL-2, NOX4, and SOD1 were analyzed using semiquantitative realtime polymerase chain reaction. COX-2 protein levels were determined by western blot analysis. Sprague Dawley rats were used for in vivo investigations of inflammatory reactions in the middle ear epithelium as a result of ASD injection. RESULTS: We observed dose-dependent decrease in HMEEC viability. ASD exposure significantly increased COX-2, TNF-a, MUC5AC, and MUC5B mRNA expression. Also, ASD affected the mRNA levels of apoptosis- and oxidative stress-related genes. Western blot analysis revealed a dose-dependent increase in COX-2 production. Animal studies also demonstrated an ASD-induced inflammatory response in the middle ear epithelium. CONCLUSION: Environmental ASD exposure can result in the development of otitis media.

Central Apogeotropic Direction Changing Positional Nystagmus due to Fourth Ventricle Mass Mimicking Horizontal Canal Cupulolithiasis Benign Paroxysmal Positional Vertigo / 대한평형의학회지

In some dizzy patients the apogeotropic direction changing positional nystagmus (DCPN) can be caused by a central disorder such as a mass lesion near the fourth ventricle or infaction. We have recently encountered a patient who showed a central DCPN mimicing a horizontal canal cupulolithiasis benign paroxysmal positional vertigo (BPPV). A 4.1 cm sized tumor was filling the fourth ventricle before the operation. When the head was turned to the left side vigorous right beting nystagmus was found. When the head was turned to the right side vigorous left beting nystagmus was found. But unlinke the typical horizontal canal BPPV, bowing and lying down position did not elicit any nystagmus. In order to see if the central DCPN was a transient finding or a persistent finding, we checked the nystagmus 3 weeks after the first testing. The same pattern of nystagmus was found again. The video head impulse test gain of all six canals were within the normal limit. In this article we discuss the points how to suspect a central DCPN in such cases.

Microarray Analysis of Gene Expression Alteration in Human Middle Ear Epithelial Cells Induced by Asian Sand Dust

OBJECTIVES: The primary aim of this study is to evaluate the gene expression profile of Asian sand dust (ASD)-treated human middle ear epithelial cell (HMEEC) using microarray analysis. METHODS: The HMEEC was treated with ASD (400 microg/mL) and total RNA was extracted for microarray analysis. Molecular pathways among differentially expressed genes were further analyzed. For selected genes, the changes in gene expression were confirmed by real-time polymerase chain reaction. RESULTS: A total of 1,274 genes were differentially expressed by ASD. Among them, 1,138 genes were 2 folds up-regulated, whereas 136 genes were 2 folds down-regulated. Up-regulated genes were mainly involved in cellular processes, including apoptosis, cell differentiation, and cell proliferation. Down-regulated genes affected cellular processes, including apoptosis, cell cycle, cell differentiation, and cell proliferation. The 10 genes including ADM, CCL5, EDN1, EGR1, FOS, GHRL, JUN, SOCS3, TNF, and TNFSF10 were identified as main modulators in up-regulated genes. A total of 11 genes including CSF3, DKK1, FOSL1, FST, TERT, MMP13, PTHLH, SPRY2, TGFBR2, THBS1, and TIMP1 acted as main components of pathway associated with 2-fold down regulated genes. CONCLUSION: We identified the differentially expressed genes in ASD-treated HMEEC. Our work indicates that air pollutant like ASD, may play an important role in the pathogenesis of otitis media.