Hearing Rehabilitation of Single-Sided Deafness: Benefit and Selection Criteria of Bone Anchored Hearing Aid and Contralateral Routing of Signal Hearing Aid / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There are two ways to route sound from a deaf hemifield to a functional ear: the bone anchored hearing aid (BAHA) and the contralateral routing of signal hearing aid (CROS HA). BAHA uses transcranial bone conduction; on the other hand, CROS HA uses air conduction. The objectives of this study were to evaluate the benefit of these auditory rehabilitation devices objectively and subjectively, and to analyze factors that affect daily using time. SUBJECTS AND METHOD: We retrospectively reviewed the medical records of 19 patients who selected BAHA and 9 patients who selected CROS HA to undergo rehabilitation of unilateral hearing loss. Preoperative pure tone air and bone conduction thresholds, BAHA-aided thresholds and CROS HA-aided thresholds were measured. Hearing in noise test (HINT) was measured with unaided and aided in signal to noise ratio 10 (signal 75 dB HL, noise 65 dBA). Bern Benefit in Single-Sided Deafness Questionnaire (BBSS) was evaluated for all patients to assess subjective satisfaction and also, daily device using time was investigated. RESULTS: The aided pure tone audiometry was 44.58 dB HL, 42.71 dB HL for in BAHA and CROS HA, respectively, whereas the unaided PTA was 111.29, 103.28 dB HL for BAHA and CROS HA, respectively. The aided HINT was 63.03 and 64.06%, whereas the unaided HINT was 22.13% and 37.44% for BAHA and CROS, respectively. BBSS showed more satisfactory results with BAHA and CROS HA when compared unaided in all items. Daily using time did not correlate with the degree of satisfaction, better ear hearing levels or etiology. CONCLUSION: It was found that not only the preoperative BAHA rod test and HA trials but also the customized and detail counseling were needed for single sided deaf patients to use auditory rehabilitation devices frequently.

Korean Clinical Practice Guidelines: Otitis Media in Children

Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media.

Surgical Management of the Facial Nerve Schwannoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The facial nerve schwannoma, hard to diagnose due to its rareness and relatively slow growth rate, is best managed by surgical procedures. We have tried to find the most useful management strategy for the facial nerve schwannoma. MATERIALS AND METHODS: We reviewed 11 cases of facial nerve schwannoma which were surgically treated. We analyzed the treatment results according to the age of the patient, the size and site of the tumor and accompanying symptoms. RESULTS: The clinical manifestations were various and surgical approaches were determined according to the age, site and size of the tumor, preoperative facial nerve function and hearing. When the preoperative facial nerve functions were better than House-Brackmann grade III, the results of the surgical treatments were favorable, but when worse than House-Brackmann grade IV, the results were unfavorable. CONCLUSION: For the treatment of the facial nerve schwannoma, the site and size of the tumor, age of the patient, preoperative hearing level and facial nerve function are considered as the decisionmaking factors. We proposed the flow-sheet of the management of the facial nerve schwannoma. Patients with no or mild facial palsy preoperatively can be managed by enucleation only. Patients with more than moderate degree facial palsy or large tumor can be managed by total resection with reconstruction of the facial nerve, which results in somewhat unfavorable results in respect to the facial nerve function.