Correction of Caudal Septal Dislocation or Subluxation with Excision and Suturing the Cartilage to the Premaxilla Bone / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is difficult to correct anterior nasal septal dislocation and subluxation. This study reviewed our surgical technique for correcting septal dislocation and subluxation. SUBJECTS AND METHOD: This retrospective study reviewed the medical records of 20 patients who underwent septal reconstructive suturing of the cartilage to the premaxilla. Acoustic rhinometry, endoscopic pictures, visual analogue scale (VAS) scores, and patient satisfaction were evaluated. RESULTS: The results of acoustic rhinometry showed that there was significant (p<0.05) improvement in the minimum cross-sectional area on both sides of the nasal cavity. The nasal cavity volume was also increased bilaterally, although not significantly on the convex side (convex side, p=0.108; concave side, p=0.007). Thirteen patients had complete correction of the septal deformity on the endoscopic pictures and seven had incomplete correction. The VAS score for nasal obstruction was decreased significantly (p<0.05). Most patients (85%) felt satisfied with the surgery. Only one patient complained about a mild deformity of the external nose. No other major complications were encountered. CONCLUSION: The correction of caudal septal dislocation or subluxation with the excision of excessive septal cartilage and suturing the cartilage to the premaxilla are both successful methods for treating septal deformities.

A Clinical Analysis of Sudden Sensorineural Hearing Loss Cases

BACKGROUND AND OBJECTIVES: High-dose systemic steroid therapy is the mainstay treatment for sudden sensorineural hearing loss (SSNHL). Recovery rates from SSNHL range are about 47-63% and are influenced by various prognostic factors. To evaluate the prognostic value of specific clinical parameters, we reviewed 289 cases by clinical and statistical analysis. SUBJECTS AND METHODS: This study included 289 patients with SSNHL who visited the Department of Otolaryngology at Soonchunhyang University Hospital from January 2005 to December 2012. The cases were reviewed retrospectively based on clinical charts. Hearing improvement was evaluated in relation to pure-tone audiogram results, duration between SSNHL onset and time of initial treatment, seasonal incidence, dizziness, patient age, degree of hearing loss, patterns of initial pure-tone audiogram and presence of underlying disease. RESULTS: Hearing improvement was observed in 196 of 289 (67.8%) patients; such improvement began within 7 days in most patients, followed by rapid hearing recovery. Cases that failed to show improvement within 14 days were unlikely to achieve hearing recovery. The more severe the hearing loss during the early stage, the lower the hearing recovery rates. Patients aged less than 60 years appear to have better prognosis of hearing improvement compared to those who are over 60 years. CONCLUSIONS: Important prognostic factors for recovery in patients with SSNHL include the time of initiating treatment after symptom onset, the degree of early-stage hearing loss, and the age of the affected patient.

A Case of Glomangiopericytoma of the Ethmoid Sinus / 대한이비인후과학회지

Glomangiopericytoma, a new term referring to the sinonasal type hemangiopericytoma, is a rare sinonasal tumor arising from modified perivascular glomus-like myoid cells. It is a borderline, low grade malignancy tumor, which has good prognosis following a complete surgical resection. Recently, we experienced a case of a glomangiopericytoma in a 68-year-old woman who presented with epistaxis and unilateral nasal obstruction. Endoscopic examinations revealed polypoid mass with bleeding tendency in the left middle meatus. The tumor was located mainly in the left ethmoid sinus and we removed it successfully by endoscopic approach. Histological examination and immunohistochemistry confirmed the diagnosis of glomangiopericytoma. We present the clinical and histological characteristics, therapeutic principles, and prognosis of this rare disease entity with a literature review.

Vestibular Function Test of Dizziness Patients by Vestibular Evoked Myogenic Potential / 대한평형의학회지

BACKGROUND AND OBJECTIVES: Because the saccule, next to the cochlea, is the second most frequent site of hydrops formation, we evaluated whether vestibular evoked myogenic potential (VEMP) responses can reflect the diagnosis and the stage of Meniere's disease. And we studied about other vestibular disease such as vestibular neuritis and benign paroxysmal positional vertigo. MATERIALS AND METHODS: Retrospectively, we analyzed the results of VEMP in 22 patients (12 men and 10 women) with unilateral definite Meniere's disease, 21 patients (5 men and 16 women) with vestibular neuritis, and 23 patient (4 men and 19 women) with benign paroxysmal positional vertigo (BPPV). All subjects underwent VEMP testing using ipsilateral 1 KHz-tone burst sound with 105 dB nHL. RESULTS: VEMP was present in 86% of Meniere affected ear. The latency of p13 of affected ears in patients with Meniere's disease, vestibular neuritis (VN), BPPV was not significantly prolonged than that of normal ears in the control group except left n23 latency in meniere's disease. In the patients with Meniere's disease, the amplitude-ratio was larger than that of the control group, statistically (p=0.006). And relationship was found in amplitude ratio among groups classified by the stage of Meniere's disease. CONCLUSION: This study shows that amplitude ratio of VEMP response is useful method to determine the severity and prognosis of Meniere's disease. We recommend VEMP to explain to the patient about severity of Meniere's disease quantitatively.