Clinical analysis of hearing levels in vitiligo patients.

Vitiligo is a common, often inherited disorder resulting from a loss of functional melanocytes. The mechanism by which skin melanocytes disappear can also affect other melanocytic organs. Although melanocyte-associated diseases have racial differences, there have been no studies of hearing loss associated with vitiligo in Asian populations, and no analysis of any relationship between hearing loss and severity of vitiligo. So we tried to assess the hearing differences between Korean vitiligo patients and normal subjects. Pure tone audiometry, auditory brainstem response, and electrocochleography results from 89 vitiligo patients, 47 with active disease and 42 with stable disease, and 89 healthy subjects, were compared. Pure tone thresholds in both vitiligo subgroups were significantly lower than in the control group at 1,000, 4,000, 6,000 and 8,000 Hz (p < 0.05). Pure tone thresholds in the active disease group were significantly lower than in the stable disease group at 1,000, 2,000, 4,000, 6,000 and 8,000 Hz (p < 0.05). Vitiligo patients had a significant decrease in peak I latency and significant increases in peak III and interpeak I-III latencies compared with controls. Compared with the stable disease group, the active disease group had a significant decrease in peak I latency and significant increases in interpeak I-III and interpeak I-V latencies (p < 0.05). Electrocochleography showed that vitiligo patients had significant increases in summation potential (SP) amplitude, action potential (AP) amplitude in the left ear, and SP/AP ratios in both ears, compared with controls (p < 0.05). In conclusion Korean patients with vitiligo show hearing loss compared with controls, which may be caused by functional disorders of intermediate cells (melanocytes) of the stria vascularis.

Comparison of facial nerve paralysis in adults and children.

PURPOSE: Facial nerve injury can occur in the regions ranging from the cerebral cortex to the motor end plate in the face, and from many causes including trauma, viral infection, and idiopathic factors. Facial nerve paralysis in children, however, may differ from that in adults. We, therefore, evaluated its etiology and recovery rate in children and adults. MATERIALS AND METHODS: We retrospectively evaluated the records of 975 patients, ranging in age from 0 to 88 years, who displayed facial palsy at Kyung Hee Medical Center between January 1986 and July 2005. RESULTS: The most frequent causes of facial palsy in adults were Bell's palsy (54.9%), infection (26.8%), trauma (5.9%), iatrogenic (2.0%), and tumors (1.8%), whereas the most frequent causes of facial palsy in children were Bell's palsy (66.2%), infection (14.6%), trauma (13.4%), birth trauma (3.2%), and leukemia (1.3%). Recovery rates in adults were 91.4% for Bell's palsy, 89.0% for infection, and 64.3% for trauma, whereas recovery rates in children were 93.1% for Bell's palsy, 90.9% for infection, and 42.9% for trauma. CONCLUSION: These results show that causes of facial palsy are similar in adults and children, and recovery rates in adults and children are not significantly different.

Effect of paranasal sinusitis on the development of otitis media with effusion: influence of eustachian tube function and adenoid immunity.

OBJECTIVES: Concordance between sinusitis and otitis media with effusion (OME) has been reported in 5-60% of patients. Since nasal diseases induce edema and lymphoid tissue hyperplasia in the nasopharyngeal mucosa, especially the adenoids, chronic infection of the adenoids has been reported to induce otitis media. In addition, deterioration in the mucosal barrier of the adenoids makes the latter vulnerable to bacterial infections, resulting in OME or sinusitis. We therefore evaluated adenoid local immunity and Eustachian tube function by sinusitis and the concordance between sinusitis and OME. MATERIALS AND METHODS: We examined PNS series and tympanometry of 520 patients who had undergone adenotonsillectomies. In addition, local adenoidal immunity was evaluated in 10 children with OME and sinusitis, 11 with only sinusitis, 10 with only OME and 12 with no history of OME or sinusitis. Adenoid size, squamous metaplasia, IgA, BCL-6, and mucosal barrier were also determined. RESULTS: Of 520 patients, 80 (15.4%) had both OME and sinusitis. The incidence of Eustachian tube dysfunction differed significantly between patients with and without sinusitis (p=0.03). The incidence of squamous metaplasia differed significantly between patients with sinusitis plus OME and patients with sinusitis alone (p=0.01), and between patients with OME alone and those without both conditions (p=0.005). Patients with both sinusitis and OME differed significantly in IgA secretion (p=0.01) and Bcl-6 expression (p=0.02) from those with sinusitis alone, as did patients with OME alone and those without both conditions (p=0.02 and p=0.03, respectively). CONCLUSIONS: Sinusitis plus OME were present in 15.4% of patients. Eustachian tube dysfunction was present in 37.9% of sinusitis patients and in 28.4% of those without sinusitis. IgA, BCL-6 and squamous metaplasia were important in local adenoidal immunity.