Usefullness of 1000 Hz Tympanometry in the Results of Newborn Hearing Screening / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study aimed to verify and compare the results of newborn hearing screening (NHS) with that of 1000 Hz tympanometry conducted for newborns. SUBJECTS AND METHOD: For the hospitalized group, NHS and the portable 1000 Hz tympanometry were performed for 148 newborns (296 ears) from June through October in 2015. For the outpatient group, 93 newborns (186 ears) who had been referred after the 1st NHS results were reviewed from 2009 to 2014. We conducted NHS with the automated otoacoustic emissions for healthy babies and automated auditory brainstem response for the babies in the neonatal intensive care unit (NICU). NHS and 1000 Hz tympanometry were performed for all newborns simultaneously. For the impedance audiometry, B type was categorized separately from A and C type. RESULTS: There was a significantly higher incidence of B type of tympanometry in the referred newborns compared to the other newborns in both hospitalized and outpatient group (p<0.01). In the outpatient group, the ears referred from the 1st NHS showed middle ear effusion in 100% of the well babies and 78.6% of the NICU babies. CONCLUSION: 1000 Hz tympanometry can help estimate the causes and middle ear function of the referred newborns after the hearing screening test. Parents could feel relieved by being explained that the refer result of NHS was due to middle ear or ear canal problem rather than to inner ear or neural problem.

Preservation of the Facial Artery during Submandibular Gland Resection: Preoperative Sonographic Assessment of Facial Artery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The traditional surgical method for submandibular gland resection includes ligation of facial artery. In this study, we used ultrasound preoperatively and tried to preserve the facial artery if facial artery passed on an extra-glandular course with a glandular branch. SUBJECTS AND METHOD: Patients undergoing submandibular gland resection either because of submandibular gland tumor or submandibular gland stone were prospectively included. Preoperative sonographic assessment was done to evaluate the intra-glandular or extra-glandular course of facial artery. For the cases with extra-glandular course with a glandular branch of facial artery, we tried to preserve facial artery by ligation of the glandular branch. RESULTS: A total of 34 cases were included in this study. Among them, 6 cases (17%) hadfacial artery passing on an extraglandular course with glandular branching. For these 6 cases, we easily could find the facial artery and glandular branch in the operative field and were able to preserve the facial artery. For the remaining 28 cases, however, the facial artery penetrated through the submandibular gland, thus we opted for the ligation of facial artery rather than preserving it to minimize bleeding or trauma during the surgery. There were no statistic difference between two groups with respect to clinical and surgical variables. CONCLUSION: Extra-glandular course of facial artery was easily assessed by preoperative ultrasound. In those cases, we could preserve facial artery easily without bleeding or trauma to the submandibular gland by ligation of glandular branch. As facial artery is animportant vessel for reconstruction and facial rejuvenation, it is preferable to preserve this artery if the course of this artery makes it possible to preserve.

Clinical Analysis of Positional Vertigo without Nystagmus at Initial Examinations / 대한평형의학회지

OBJECTIVE: Patients with benign paroxysmal positional vertigo (BPPV) visit clinics with typical position evoked vertigo. However, typical nystagmus are concealed according to many factors We evaluated the demographic, clinical and nystagmographic features of patients, who visited clinics with typical BPPV symptoms but did not have positional test evoked nystagmus. METHODS: Among 306 patients with history of positional vertigo, we excluded 252 patients who had positional test evoked nystagmus on video Frenzel glass in clinics, and analyzed 54 patients who did not have positional test evoked nystagmus. We divided 54 patients into two groups; patients without subjective vertigo in positional test and patients with subjective vertigo in positional test. We analyzed the serial nystagmographic findings, causes, duration of disease, previous history of medical or rehabilitation treatments, coexisting vestbular disorders, recovery time and recurrence. RESULTS: Etiology, history of previous treatment, coexisting vestibular disorders and recurrence did not differ statistically in both groups. However, the nystagmographic features were significantly different in both groups. CONCLUSION: When patient has positional test evoked vertigo, repeated positional maneuver seemed to increase the expression of positional nystagmus.

Is Intratympanic Dexamathasone Injection Effective for the Treatment of Idiopathic Sudden Sensorineural Hearing Loss?

BACKGROUND AND OBJECTIVES: The purpose of this study is to identify the effectiveness of intratympanic (IT) steroids when used as an initial therapy in sudden sensorineural hearing loss (SSNHL), and when it is used as a salvage therapy in a refractory SSNHL. SUBJECTS AND METHODS: This retrospective study included 122 patients with SSNHL. First, patients were divided into three groups according to the initial treatment; IT steroid, systemic steroid and combined (systemic and IT steroid) groups. Second, patients were divided into two groups according to the salvage treatment in a refractory SSNHL; IT steroid and the control (non IT group). Fifty eight patients who did not respond to initial therapy were included in the second analysis. Hearing was assessed immediately before the treatment and 2 weeks, 4 weeks and 3 months after the treatments. Hearing recovery was defined as an improvement of >15 dB and the final hearing of 25-45 dB in the audiogram. RESULTS: When we analyzed the hearing recovery in initial treatment, the comparison of audiogram among three groups did not result in significantly different outcomes. There were no differences in the recovery rate in 2 and 4 weeks throughout all the frequencies. Also, the analysis of the salvage treatment demonstrated that neither IT steroid group nor control group was significantly effective in treating the refractory SSNHL. CONCLUSIONS: The results suggest that initial treatment of SSNHL with IT steroid alone is as effective as systemic steroid alone or a combination therapy. Also, salvage IT steroids for refractory SSNHL did not have any additional beneficial effects.

A Study on the Relationship Between Oral Malodor and Periodontal Disease / 대한치주과학회지

Putrefactive activity within the oral cavity is the principal cause of halitosis. The most common intraoral sites of oral malodor production are tongue, interdental and subgingival areas. The other foci may include faulty restorations, sites of food impaction and abscesses. Periodontal disease frequently involves pathological oral malodor, which is caused mainly by volatile sulfur compounds(VSC), such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. The purpose of this study is to evaluate the association between oral malodor and periodontal status. Volatile sulfur compounds in mouth air were estimated by portable sulfide monitor(Halimeter(TM)). The results were as follows : 1.The levels of volatile sulfur compounds were significantly greater in a periodontitis group than in a control group(P0.05). 3.In the periodontitis group, VSC concentrations of pre-treatment significantly decreased after scaling and root planing(P<0.01). 4.No statistically significant correlation was found between VSC concentrations and sex / age in the periodontitis group. The above results indicate that periodontal disease may play a role as an important factor of oral malodor and deep periodontal pockets are a source of volatile sulfur compounds.