Long-Term Polysomnographic Findings and Subjective Results in Sleep Apnea Patients Treated with Laser Assisted Uvulopalatoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Laser-assisted uvulopalatoplasty (LAUP) is well established in the treatment of snoring and obstructive sleep apnea syndrome (OSAS), although most reports are based on short-term follow-up results. This study was performed to determine the long-term effects on symptoms and polysomnographic measures in patients with OSAS after 5yrs of LAUP. MATERIALS AND METHOD: Fifty patients with OSAS underwent LAUP, and of these patients, 20 have completed postoperative polysomnographic studies. Questionnaires ranking snoring and apneic symptoms were completed by the patient and bed partner before LAUP. The parameters of measurement were apnea index (AI), respiratory disturbance index (RDI), SaO2, and sleep stages. The statistical analysis was performed using Wilcoxon signed rank test. RESULTS: Subjective questionnaires showed statistically significant improvements in snoring, falling asleep while day work, headache upon wakening. The symptomatic improvement persisted long time. The AI decreased from 15.9 to 10.5, RDI decreased from 23.2 to 14.9, and the mean, lowest O2 saturation increased from 85, 93 to 92, 97 (p<0.05). The RDI was reduced to 10 or less in 40% of patients. CONCLUSION: LAUP is an effective method for the management of mild OSAS. Authors have demonstrated long-term improvement in subjective and polysomnographic measures.

Changes in Resonance Frequency and Length of External Auditory Canal in Relation to Age / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: With the currently available diagnostic procedure, hearing impaired children are diagnosed at an early age and hearing aids are fitted soon thereafter. Thus, appropriateness of using available correction methods for adult ears and ear models for determining and predicting hearing aid characteristics for these children need to be examined. The objectives of this study are to create a database of resonance frequency and length of external auditory canal (EAC) in all age groups and to adjust the peak frequency response of hearing aid system to take account of the changing resonance peak frequency as child gets older. MATERIALS AND METHOD: We studied 437 ears with no age limitation. We measured rear ear unaided response (REUR) with Rastronics frequency response analyzer and external ear canal length using silastic tube under microscopic or otoscopic finding. Statistical analyses were performed to determine age differences. RESULTS: Ear canal length increased with age, and an adult value was achieved by the age of 14 years. Resonance frequency decreased with age, and reached to an adult value by the age of 9 years. There was significant relationship between ear canal length and resonance frequency. CONCLUSION: Alteration in resonance frequency with age may have practical implications by affecting the insertion gain of hearing aid system in children. The data may be used as useful adjustment factors to correct the current hearing aid system in children.

The Effect of Nasal Obstruction on Sleep Apnea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although it is widely accepted that nasal obstruction leads to snoring and sleep apnea, the relationship between these variable factors is not clear. Moreover, while nasal blockage in human is known to produce sleep- disordered breathing, it is controversial whether nasal obstruction itself produces obstructive apnea and whether it causes changes in the sleep stages. The purpose of this study is to measure changes in sleep physiology by nasal blockage alone and to evaluate whether the nasal blockage itself ca>i produce the sleep apnea syndrorm or not. MATERIAL AND METHOD: Normal thirty subjects, 15 males and 15 females, who had sleep apnea episodes <2 by polysomnography during sleep, were evaluated using Alice III polysomnography after both nostrils opened, unilateral nostril blockage, and bilateral nostril blockage. The parameters of measurement were hypopnea and apnea episodes and apnea type, apnea index (AI), respiratory disturbance index (RDI), SO and sleep stages. A statistical analysis was performed using a wicoxon signed rank test. RESULTS: Bilateral nasal blockage induces significantly increased apnea and hypopnea episodes, AI, and RDI but induces significantly decreased mean and lowest O. saturation. Also, bilateral nasal blockage significantly prolonged S,-NREM sleep and decreased REM sleep (p(0.05). However, these changes did not correspond with the criteria of the sleep apnea syndrome. CONCLUSION: Unilateral nasal obstruction does not cause any significant changes in the measured parameters compared to the normal nose of unblocked state. Bilateral nasal obstruction does not induce the obstructive sleep apnea syndrome by itself. However, it causes changes in the sleep stages and increases sleep apnea episodes significantly.

An Acoustic and Radiologic Study on Voice Change after Tonsillectomy and Adenotonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Some patients who have undergone tonsillectomy complain of voice change, but few studies for the mechanism of voice change were found. To solve this problem, study of voice change after tonsillectomy and adenotonsillectomy was done. MATERIALS AND METHODS: We analyzed voice change of 22 patients who underwent tonsillectomy and 15 patients who underwent adenotonsillectomy at CSL (computerized speech laboratory), St. Benedict Hospital. With the measured cross sectional area of vocal tract and its length from the glottis on MR images, we presented the change of cross sectional area schematically after tonsillectomy. RESULTS: Acoustically, the frequencies of the second formant of /e/ and /i/ increased and that of the first formant of /u/ decreased significantly after tonsillectomy and the frequency of the second formant of /o/ and those of the second and third formants of /i/ and /u/ increased significantly after adenotonsillectomy. It was also showed acoustically that the formant bandwidths of /a/ and /hana/ after tonsillectomy and those of /e/ and /hana/ after adenotonsillectomy increased due to nasalization. Anatomically, it was showed that the cross sectional area of oropharyngeal cavity increased and coupling effect of vocal tract happened after tonsillectomy. CONCLUSION: This study showed that acoustic characteristics and vocal tract shapes of the patients did change following tonsillectomy and adenotonsillectomy. It is imperative that we explain to patients about the postoperative voice change. Research should also be done to find ways to induce better voice changes following the operations.

Analysis of Influencing Factors on the Olfactory Function of Diabetic Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Diabetes mellitus has been known as a multisystemic disorder that causes chronic complications, and diabetic peripheral and autonomic neuropathy may affect olfaction. The aim of this study was to evaluate the olfactory status of diabetic patients and the influencing factors on olfaction. Materials and Method: The olfactory status was evaluated with the recognition threshold of T and T olfactometery to diabetic group of 37 patients (19 male, 18 female) and control group of 115 healthy adults (56 male, 59 female). To the diabetic group, retrospective analysis of diabetic duration, alcohol and smoking history, and associated chronic complication such as neuropathy, retinopathy and nephropathy was done. And fasting blood sugar and HbA1c level was assessed. The statistical analysis was performed using Students t-test and Spearman methods. RESULTS: The olfactory recognition threshold of the diabetic group was significantly higher than that of the control group according to age, and there was no significant difference of the recognition threshold between male and female in both diabetic and control groups. The recognition threshold was significantly correlated with diabetic duration, associated complications and serum HbA1c level in the diabetic group. However, serum fasting sugar level and smoking history did not affect the recognition threshold in diabetic group. CONCLUSION: The diabetic patients with inappropriate sugar control have decreased olfaction than healthy normal control. We suggest that diabetic duration, associated chronic complications, and serum HbA1c level may be the influencing factors of olfactory dysfuction of diabetes.

The Effects of Adenotonsillectomy on Weight Change in Young Children / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A history of poor weight gain can often be elicited in young children with chronic upper airway obstruction resulting from adenotonsillar hypertrophy. The purpose of this study was to determine the incidence of growth disturbance and what effect, if any tonsillectomy and/or adenoidectomy has on subsequent growth in a group of children. MATERIALS AND METHODS: The subjects consisted of 78 patients with adenotonsillar hypertrophy who had been treated between March 1997 and September 1997 at the department of otolaryngology, Saint Benedict Hospital. Available preoperative data were collected including sex, age at surgery, tonsillar hypertrophy grade, presence of snoring and sleep apnea, preoperative weight, preoperative eating disorder, and URI frequency. RESULT: Many had improvements in growth after adenotonsil-lectomy. The improvement in growth appears to be obvious in chidren with eating disorder, snoring, and sleep apnea resulting from adenotonsillar hypertrophy. CONCLUSION: We can conclude that there exists a relationship beween adenotonsillar hypertrophy children and preoperative eating disorder, growth delay and snoring.