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1.
Otol Neurotol ; 42(1): 10-17, 2021 01.
Article in English | MEDLINE | ID: mdl-33177407

ABSTRACT

OBJECTIVE: To evaluate whether cochlear synaptopathy is a common pathophysiologic cause of tinnitus in individuals with normal audiograms. STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. METHODS: We enrolled 27 subjects with unilateral tinnitus and normal symmetric hearing thresholds, and 27 age- and sex-matched control subjects with normal symmetric hearing thresholds. We measured 1) the amplitudes of waves I and V with 90 dB nHL click stimuli in quiet conditions; 2) the latency shift of wave V with 80 dB nHL click stimuli in background noise, varying from 40 dB HL to 70 dB HL; and 3) uncomfortable loudness levels (UCLs) at 500 Hz and 3000 Hz pure tones. RESULTS: There were no significant differences in the wave V/I amplitude ratio or the latency shift in wave V with increasing noise levels among the tinnitus ears (TEs), nontinnitus ears (NTEs), and control ears. There were no significant differences in UCLs at 500 Hz or 3000 Hz between TEs and NTEs, but the UCLs were lower in TEs (mean 111.3 dB or 104.1 dB) and NTEs (mean 109.4 dB or 100.6 dB) than in control ears (mean 117.9 dB or 114.1 dB, p < 0.017). No subject met our criteria for cochlear synaptopathy or increased central gain in terms of all three parameters. CONCLUSION: Based on these results for UCL, increased central gain is a major mechanism of tinnitus in humans with normal audiograms. However, this compensatory mechanism for reduced auditory input may originate from other pathophysiologic factors rather than from cochlear synaptopathy.


Subject(s)
Evoked Potentials, Auditory, Brain Stem , Tinnitus , Audiometry, Pure-Tone , Auditory Threshold , Humans , Prospective Studies
2.
J Int Adv Otol ; 16(3): 338-345, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33136013

ABSTRACT

OBJECTIVES: The purpose of this study was to determine the factors predicting the success or failure of intratympanic dexamethasone (ITD) injection in the treatment of acute subjective tinnitus (AST). MATERIALS AND METHODS: We enrolled patients who were treated with ITD within 3 months of the onset of tinnitus, between 2013 and 2017. We compared the clinical characteristics and audiological data of the patients in the cured group (n=38, 45.6±13.3 years old) and the nonresponder group (n=40, 48.9±18.6 years old). RESULTS: The cured group was predominantly female (p=0.002). The mean duration of tinnitus before ITD was shorter in the cured group than the nonresponder group (p=0.002). The pure-tone averages in both sides were lower in the cured group than in the nonresponder group (p=0.018). The time of tinnitus awareness was shorter in the cured group than in the nonresponder group (p=0.014). Multivariable analysis showed that the duration of tinnitus (odds ratio [OR]=1.045), a history of exposure to noise just before tinnitus development (OR=7.766), and distortion product otoacoustic emissions results (OR=4.580) predicted the outcome of ITD treatment in AST. CONCLUSION: A short duration of tinnitus, no history of immediate noise exposure, and normal distortion product otoacoustic emissions could be favorable prognostic factors for AST treated with ITD injection.


Subject(s)
Dexamethasone/therapeutic use , Tinnitus/drug therapy , Adult , Aged , Audiometry, Pure-Tone , Female , Humans , Injection, Intratympanic , Male , Middle Aged , Noise , Otoacoustic Emissions, Spontaneous , Treatment Outcome
3.
J Int Adv Otol ; 14(3): 501-503, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30541710

ABSTRACT

Verruca vulgaris is commonly seen on the hands, feet, and face, but rarely in the external auditory canal. We report the case of a 57-year-old woman with a huge papillary mass filling the entire external auditory canal, with destruction of the posterior canal wall and excavation into the mastoid bone. We performed en bloc resection of the whole region affected by verruca vulgaris, including the external auditory canal, mastoid skin, and tympanic membrane using canal wall-down mastoidectomy plus meatoplasty. There was no evidence of recurrence 12 months postoperatively. Complete surgical removal by mastoidectomy is a promising option for wide-spread verruca vulgaris in the external auditory canal.


Subject(s)
Ear Canal/surgery , Ear Diseases/surgery , Mastoid/surgery , Mastoidectomy/methods , Warts/surgery , Ear Canal/virology , Ear Diseases/virology , Female , Humans , Mastoid/virology , Middle Aged
4.
Tuberc Respir Dis (Seoul) ; 76(1): 38-41, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24523817

ABSTRACT

Immunoglobulin G4 (IgG4)-related disease is a newly recognized condition characterized by fibroinflammatory lesions with dense lymphoplasmacytic infiltration, storiform-type fibrosis and obliterative phlebitis. The pathogenesis is not fully understood but multiple immune-mediated mechanisms are believed to contribute. This rare disease can involve various organs and pleural involvement is even rarer. We report a case of IgG4-related disease involving pleura. A 66-year-old man presented with cough and sputum production for a week. Chest radiography revealed consolidation and a pleural mass at right hemithorax. Treatment with antibiotics resolved the consolidation and respiratory symptoms disappeared, but the pleural mass was unchanged. Video-assisted thoracoscopic surgery was performed. Histopathology revealed dense lymphoplasmacytic infiltration and storiform fibrosis with numerous IgG4-bearing plasma cells. The serum IgG4 level was also elevated. Further examination ruled out the involvement of any other organ. The patient was discharged without further treatment and there is no evidence of recurrence to date.

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