Publications (34)34.67 Total impact
- [Show abstract] [Hide abstract] ABSTRACT: Even though headache is a common symptom in patients with chronic rhinosinusitis (CRS) or nasal septal deviation (NSD), there are very few recent reports investigating headache characteristics in rhinologic patients. Therefore, we investigated the headache characteristics and differences in CRS and NSD patients who were diagnosed by computerized tomography and endoscopic exams.
- [Show abstract] [Hide abstract] ABSTRACT: Vegetable granuloma or pulse granuloma results from the implantation of food particles of vegetable origin. Pulse granulomas have mainly been reported in association with lung aspirations, the oral cavity with a history of oral procedures and less frequently in gastrointestinal tracks. We report a 31-year-old woman who presented with right nasal obstruction and was found to have a firm mass in the right nasal cavity. Paranasal sinus computerized tomography scans identified a calcified ring lesion in her right nasal cavity. Endoscopic sinus surgery was performed, and pathology examination revealed a lesion consistent with a pulse granuloma that contains starch granules with cellulose envelopes appearing as hyaline rings surrounded by inflammation cells and concentrically arranged delicate connective tissue. Pulse granuloma is a well described entity with distinct histopathology. However, pulse granulomas are rare, and especially extraoral pulse granulomas are extremely rare. We found that pulse granuloma can be occurred in the nasal cavity through regurgitation.
- [Show abstract] [Hide abstract] ABSTRACT: We evaluated the short-term efficacy of Epley, Semont, and sham maneuvers for resolving posterior canal benign paroxysmal positional vertigo (BPPV) in a prospective multicenter randomized double-blind controlled study. Subjects were randomly divided into three groups: Epley (36 patients), Semont (32 patients), and sham (Epley maneuver for the unaffected side, 31 patients). Out of 14 institutes which participated in this study, 5 institutes had previous experience of the Epley but not the Semont maneuver and the other 9 had previous experience of both maneuvers. Each maneuver was repeated twice if there was still positional vertigo or nystagmus on day 0, and the presence of nystagmus and vertigo on positional testing were evaluated immediately, 1 day, and 1 week after treatment. After the first maneuver, the Epley group showed a significantly higher resolution rate of positional nystagmus than the Semont or sham groups (63.9, 37.5, and 38.7%, respectively). After the second maneuver, the resolution rate (83.3%) of the Epley group was significantly higher than that (51.6%) of the sham group. At 1 day and 1 week after treatment, the resolution rate of the Epley group was significantly higher than those of the other groups. Similar results were seen for the resolution of positional vertigo. The Epley maneuver showed persistent resolution rates of positional vertigo and nystagmus without a fatigue phenomenon. The Epley maneuver was significantly more effective per maneuver than Semont or sham maneuvers for the short-term treatment of posterior canal BPPV. The Semont maneuver showed a higher success rate than the sham maneuver, but it was not significantly different. © 2014 S. Karger AG, Basel.
- [Show abstract] [Hide abstract] ABSTRACT: Objectives: Hearing loss can be associated with a decrease in cerebrospinal fluid (CSF) pressure because changes in CSF pressure induce changes in perilymph pressure. Hearing loss after neurosurgical procedures have been reported but clinical information on hearing loss after the placement of ventriculoperitoneal (VP) shunts, the most commonly used CSF shunt for hydrocephalus patients, is limited. This study is aimed to show the relationship between VP shunt and hearing loss. Study Design: Prospective study. Methods: Pure tone threshold and electrocochleography were preoperatively performed in 9 patients (18 ears) undergoing elective VP shunt placement. Five-day and 1-month post-shunt placement hearing thresholds were compared with baseline data. A correlation analysis was conducted between the threshold and summating potential/action potential (SP/AP) ratio changes at 5 days and 1 month after shunt placement. Cochlear aqueduct dimensions measured by high-resolution computed tomography were compared between ears with and without hearing loss. Results: About 40% of subject ears showed hearing loss with a threshold elevation of at least 15 dB in one or more frequencies. After VP shunt placement, the mean threshold of all ears showed a significant increase in most frequencies and the pure tone average. The change in the SP/AP ratios was significantly correlated with the change in the pure tone average at both 5 days and 1 month after shunt placement. Cochlear aqueduct dimensions were not correlated with hearing loss occurrence. Conclusions: Hearing thresholds may increase following VP shunt placement, possibly due to secondary endolymphatic hydrops.
- [Show abstract] [Hide abstract] ABSTRACT: We undertook an animal study to investigate the functional and histological changes that occur in the normal hearing ear of following acoustic trauma. As an animal model of unilateral hearing loss, the right ears of CBA mice were deafened by cochlear destruction at 6 weeks of age (SSD group). The control groups included mice that underwent a sham surgery, and mice that were exposed to noise binaurally and monaurally (by plugging the right ear completely). At 10 weeks of age, all mice were exposed to acoustic trauma (110 dB sound pressure level for 1 hour) that induced a transient threshold shift (TTS). Changes in the hearing thresholds of the left ear were assessed over the next 4 weeks by measuring the auditory brainstem responses (ABRs) and distortion product otoacoustic emissions (DPOAEs). Following the noise exposure, the SSD group showed a permanent threshold shift (PTS) of about 10 dB, whereas the other groups showed full recovery from the TTS. The threshold of the DPOAEs of the left ears were increased after noise exposure but returned to normal in all groups, with no significant differences among the groups. Histological evaluation showed no apparent cellular loss or apoptosis in the left ears of all groups, including the SSD group. These results suggest that normal hearing ears are more vulnerable to acoustic trauma following contralateral unilateral cochlear ablation. This increased vulnerability may be due to damaged neural structures.
- [Show abstract] [Hide abstract] ABSTRACT: The purpose of this study was to estimate the rates of functional recovery of the facial nerve and of total tumor resection in patients who undergo short anterior rerouting and long anterior rerouting of the facial nerve in removal of skull base tumors. We retrospectively collected data on 37 patients with skull base tumors who underwent facial nerve rerouting during the procedure for tumor removal. Information on the rerouting technique, the completeness of tumor resection, and changes in facial nerve function were obtained from the medical records. Rerouting techniques were classified as short anterior rerouting or long anterior rerouting. Ten of 16 patients (62.5%) in the group with short anterior rerouting showed postoperative facial palsy, and all completely recovered within 1 year. In the group with long anterior rerouting, 18 of 21 patients (85.7%) showed postoperative facial palsy, and recovery to a preoperative level of facial function was found in 10 patients at 1 year of follow-up. Total tumor resection was possible in 94% and 81% of patients with short rerouting and long rerouting, respectively. The mean operation time was not significantly related to the postoperative recovery of facial function. Short rerouting techniques, when appropriately chosen on the basis of tumor and patient characteristics, offer excellent preservation of facial function and tumor resection, comparable to those of long rerouting techniques.
- [Show abstract] [Hide abstract] ABSTRACT: Epistaxis may be related to changes in weather, but this relationship has not been well-defined. We investigated the effects of climate fluctuations (temperature, humidity, and barometric pressure) on the number of emergency department (ED) visits for epistaxis.
- [Show abstract] [Hide abstract] ABSTRACT: Matrix metalloproteinases (MMPs) 2 and 9 are a group of Zn2+-dependent endopeptidases to remodel the extracellular matrix. The association of these 2 endopeptidases with the development of morphologic changes in nasal polyps was previously described. To determine whether MMP-2, MMP-9, and tissue inhibitor of MMP-1 (TIMP-1) play a role in the recurrence of nasal polyps. To compare MMP-2, MMP-9, and TIMP-1 expression in recurrent vs nonrecurrent polyps, nasal polyps (NPs) and recurrent nasal polyps (RNPs) were obtained from 15 NP patients with chronic rhinosinusitis (CRS) undergoing endoscopic sinus surgery (ESS) and 15 RNP patients with CRS undergoing revision ESS. Fifteen specimens of inferior turbinate mucosa from patients undergoing nasal septal surgery were used as control. Through real-time polymerase chain reaction and immunohistochemistry, MMP-2, MMP-9, and TIMP-1 expressions were measured among controls, NP patients, and RNP patients. Expression of MMP-9 messenger RNA in the NP patients was significantly higher than in the controls. In addition, expression of MMP-9 messenger RNA in the RNP patents was significantly increased compared with NP patients. With immunohistochemistry, a more increased expression of MMP-9 was observed in NP patients than controls. Expression of MMP-9 in RNP patients was also significantly high compared with NP patients, particularly in stroma. Expression of MMP-9 is increased in NP patients, and it is so more in the mucosa of RNP patients. Increased expression of MMP-9 is particularly found in the stoma of RNP patients, and it may contribute to the recurrence of NP.
- [Show abstract] [Hide abstract] ABSTRACT: Objective: The aim of this study was to characterize the various bony anomalies of the inner ear in patients with unilateral sensorineural hearing loss using high-resolution temporal bone computed tomography and establish the relationship between hearing and the diameter of the bony cochlear nerve canal. Methods: We performed a retrospective review of 51 patients (mean age 11 years, range 0-20 years, 27 boys, 24 girls) who were diagnosed with unilateral sensorineural hearing loss with an audiogram. Coronal and axial diameter of the inner ear structures, including the internal auditory canal, bony cochlear nerve canal, and each turn of the cochlea and semicircular canals, were measured with high-resolution temporal bone computed tomography. The mean values (± 2 standard deviations) were calculated and compared between sensorineural hearing loss and normal ears, and between narrow bony cochlear nerve canal and normal bony cochlear nerve canal ears. Bony cochlear nerve canal atresia/stenosis was defined as a value less than 1.4mm in axial images. Results: The diameter of the bony cochlear nerve canal was significantly smaller in sensorineural hearing loss ears than in normal ears (p<.05). Associated inner ear anomalies, such as IAC stenosis (24%), cochlear hypoplasia (7-17%), and narrow semicircular canal bony island (8%) were only observed in the narrow bony cochlear nerve canal group. This group also showed statistically significant, severe to profound hearing loss compared to the normal bony cochlear nerve canal group (p<.05, R(2)=12.8%). Conclusions: Most (57%) of the unilateral sensorineural hearing loss ears had bony cochlear nerve canal stenosis/atresia and this group showed associated inner ear anomalies. When the diameter of the bony cochlear nerve canal was less than 1.4mm, pure tone audio averages were more than 70 dB HL in most ears.
- [Show abstract] [Hide abstract] ABSTRACT: Overexposure to intense sound can cause temporary or permanent hearing loss. Post-exposure recovery of thresholds has been assumed to indicate reversal of damage to the inner ear without persistent consequences for auditory function. However, there was a report that acoustic overexposures causing moderate temporary threshold shift caused acute loss of afferent nerve terminals and delayed degeneration of the cochlear ganglion cells while cochlear sensory cells were intact. The purpose of the study was to evaluate the numerical changes of ribbon synapses and efferents to the outer hair cells in ears with temporary noise-induced threshold shifts.
- [Show abstract] [Hide abstract] ABSTRACT: A microarray-based immunoassay requires only small volume of the sample in each array spot, which leads to faster completion of the immunoreactions than with an ELISA (enzyme-linked immunosorbent assay) [. However, this method still has some technical limitations such as poor signal sensitivity, poor detection limit, large sample consumption, high evaporation rate, coffee stain effect, low signal/noise ratio (SNR) and poor quality images. Recently, SAM (Self-Assembled Monolayer) method was extensively researched for control the surface wettability [. Especially, hydrophobic SAM functionalizations which has low surface energy are possible to prevent sample evaporation [ and to achieve anti-biofouling on them. Therefore, an introduction of hydrophobic SAM would enhance the detection sensitivity on bio array chip . In this work, we fabricated a highly selective and sensitive pre-patterned microarray structure by using MEMS (Micro-Electro-Mechanical-System) process and hydrophilic/hydrophobic SAMs with various precursors.
- [Show abstract] [Hide abstract] ABSTRACT: Objective We aimed to determine whether abnormalities in outer hair cell (OHC) function were related to tinnitus through interaural comparison of distortion product otoacoustic emissions (DPOAEs).Study DesignCross-sectional study.SettingTertiary care university teaching hospital.ParticipantsTwenty-seven patients with unilateral tinnitus and pure-tone average of both ears ≤25 dB hearing loss (HL) at 500, 1000, 2000, and 4000 Hz were included.Subjects and Methods Pure-tone thresholds observed at 500 to 16,000 Hz and DPOAE amplitudes at f2 frequencies of 1001 to 6348 Hz were compared between the tinnitus ears and nontinnitus ears in patients with unilateral tinnitus.ResultsThe pure-tone averages (13 ± 6 dB HL) in the nontinnitus ears were similar to those (15 ± 6 dB HL) in the tinnitus ears. There were no differences in pure-tone averages at all frequencies tested. While the DPOAE amplitudes measured at f2 frequencies of 1001 to 3174 Hz in tinnitus ears were not different from those in the nontinnitus ears, the tinnitus ears showed significantly reduced DPOAE amplitudes when compared with the nontinnitus ears at frequencies of 4004 to 6348 Hz.ConclusionOHC dysfunction was correlated with tinnitus at high frequencies, and DPOAE amplitudes can provide additional information about cochlear dysfunction, which is complementary to pure-tone audiometry.
- [Show abstract] [Hide abstract] ABSTRACT: OBJECTIVE: To verify that tinnitus itself could disturb speech perception and to evaluate the effects of masking noise on speech perception ability in the patients with normal hearing but unilateral chronic tinnitus using the hearing in noise test. STUDY DESIGN: Prospective, nonrandomized study. MATERIALS AND METHODS: Between June 2009 and May 2011, we enrolled 20 patients with normal hearing and subjective unilateral tinnitus that had persisted for more than 12 months, along with 20 healthy controls of the same age. All subjects were evaluated using audiologic examinations, the tinnitus handicap inventory, and the Korean version of the Hearing in Noise Test (K-HINT) to assess characteristics of tinnitus and speech perception ability in various noisy situations. RESULTS: Reception threshold for speech (RTS) in a quiet environment and signal-to-noise ratio (SNR) in various conditions of noise were significantly higher in the tinnitus than in the control group, regardless of whether noise came from the front, right, or left (p < 0.05). When the tinnitus group was subdivided according to the site of noise exposure, the mean SNR of the contralateral noise group was -7.9 ± 1.4 dB, which was significantly higher than the ipsilateral noise (-9.1 ± 1.8 dB) or control group (right, -10.0 ± 0.6 dB; left, -10.1 ± 0.5 dB) (p < 0.05). In addition, there was no significant difference between ipsilateral noise and control groups. CONCLUSION: From this study, we showed that tinnitus itself could adversely affect speech perception ability by increasing both RTS and SNR in the tinnitus patients in comparison with healthy controls. In addition, we suggest that proper level of noise on the site of tinnitus might be helpful to increase speech perception in the patients who experience chronic subjective tinnitus.
- [Show abstract] [Hide abstract] ABSTRACT: Objective: 1) To compare the characteristics of congenital and acquired pediatric cholesteatoma. 2) To investigate the risk factors influencing recidivism after initial surgery to propose a guided therapeutic approach. Method: Retrospective analysis was made on pediatric cholesteatoma cases under the age of 18 years. A total of 163 patients (92 of congenital and 71 of acquired cholesteatoma) were operated by the same surgeon from 1993 to 2011. We analyzed the symptoms, physical findings, computed tomography, operative findings, hearing, and recurrence. Results: The ages at diagnosis and operation in congenital cholesteatoma were significantly younger than acquired. The chief complaint of congenital was mainly the incidental mass (74%), whereas the otorrhea (66%) in acquired. Mass shadow behind the intact tympanic membrane was observed in 95% of congenital cholesteatoma. The main tympanic membrane abnormalities of acquired cholesteatoma were attic retraction and pars tensa perforation (56% and 56%). Invasion of epitympanum and ossicular erosion were more frequently found in the acquired cholesteatoma (P < .05). There was no difference in recurrence rate between congenital and acquired cholesteatoma. Statistically significant factors at high risk of recurrence were pars tensa perforation, diploic pneumatization, incus erosion. On the other hand, lowering risk factors were sclerotic mastoid on CT and no mastoidectomy. Conclusion: The congenital and acquired cholesteatoma showed very different clinical features. Careful eradication and continued follow-up is recommended in the children with high risk of recurrence. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2012.
- [Show abstract] [Hide abstract] ABSTRACT: To investigate the validity of newborn hearing screening protocol using automated auditory brainstem response (AABR) with a confirmation method using click auditory brainstem response (ABR) and to evaluate changes in hearing status of infants with confirmed congenital hearing loss. Neonates in the well-baby nursery were screened by staged AABR. Subjects whose final AABR result was "refer" were tested by diagnostic click ABR and 226 Hz tympanometry within 3 months of age. Changes in hearing status of subjects with confirmed hearing loss were analyzed by follow-up ABR at 3-6 month intervals. Of the 12,193 healthy babies born during this period, 10,879 (89.22%) were screened by AABR. Of 10,879 neonates screened by AABR, 148 (1.36%) were "referred"; of these, 45 subjects showed ABR thresholds over 30 dB nHL in at least one ear. Thirty-four subjects underwent serial follow-up ABR tests, with 11 (32.4%) found to have normal ABR thresholds. Most subjects with mild to moderate hearing loss were found to be normal before 1 year of age, whereas all infants with severe or profound hearing loss were identified as having congenital hearing loss. The referral rate and the positive predictive value of our protocol were acceptable. We have also found here that substantial temporary hearing loss can be included in the first confirmative diagnosis. Temporary hearing loss of our study on follow-up give emphasis to need of further differentiation using the testing for bone conduction and middle ear status.
- [Show abstract] [Hide abstract] ABSTRACT: Peroxisome proliferator activated receptor-γ (PPAR-γ), a member of the nuclear hormone receptor superfamily, plays an important role in the regulation of mucosal inflammation. The aim of this study was to investigate the anti-inflammatory effect of a PPAR-γ agonist, ciglitazone, on cigarette smoke solution (CSS)-induced inflammation in human middle ear epithelial cell lines (HMEECs). HMEECs with or without ciglitazone pre-treatment were exposed to CSS in order to induce the inflammatory response. The suppressive effect of inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α) and cyclooxygenase-2(COX-2), were evaluated using real-time polymerase chain reaction and Western blotting. Stimulation with CSS at 40 μg/ml for 6 h resulted in a 4.1-fold increase in the expression of TNF-α mRNA in the HMEECs. CSS-induced up-regulation of TNF-α mRNA was decreased by more than 2.8-fold in cells pre-treated with ciglitazone. The up-regulation of COX-2 mRNA and increased COX-2 protein expression induced by CSS were also inhibited by more than 3.7-fold with ciglitazone pre-treatment. These findings suggest that the inflammatory response induced by CSS could be inhibited by ciglitazone, a PPAR-γ agonist, in HMEECs. As such, PPAR-γ agonists may have therapeutic potential for the treatment of otitis media.
- [Show abstract] [Hide abstract] ABSTRACT: To evaluate the anti-adhesive and anti-inflammatory effects of sodium hyaluronate-carboxymethylcellulose (HA-CMC) on postoperative hearing improvement and complications during tympanomastoid surgery. Prospective controlled clinical trial. We evaluated 287 patients who underwent type I tympanoplasty, with or without canal wall up mastoidectomy, between January 2007 and June 2010. Postoperative hearing and complications were compared in the 143 patients who received Gelfoam soaked with HA-CMC during myringoplasty and the 144 patients who received Gelfoam only. There were no significant between-group differences in sex, age, and preoperative hearing status. However, average postoperative air-bone gap (13.7 ± 8.5 dB vs. 17.2 ± 9.9 dB) and the number of air-bone gaps smaller than 10 dB (40.6% vs. 24.3%) were significantly improved in the HA-CMC compared with the control group. In addition, the rates of re-otorrhea, reperforation of the tympanic membrane (TM), postoperative TM adhesion, and reoperation were lower in the HA-CMC than in the control group without significances. These findings suggest that combined application of Gelfoam with HA-CMC may be beneficial in patients undergoing tympanomastoid surgery.
- [Show abstract] [Hide abstract] ABSTRACT: Acute otitis media (OM) is a common pediatric disease. Recent research into the pathogenesis of OM has focused on oxidative damage, induced by oxygen free radicals, to the middle ear mucosa along with inflammation. Caffeic acid phenethyl ester (CAPE) is a biologically active ingredient of propolis honey bees, with antioxidative and anti-inflammatory activities. The effect of CAPE on hydrogen peroxide (H2O2)-induced inflammatory and oxidative reactions in the middle ear is still not known. The aim of this study was to evaluate the anti-inflammatory and antioxidative effects of CAPE on cultured human middle ear epithelial cells (HMEECs).
- [Show abstract] [Hide abstract] ABSTRACT: The clinical features and patterns of growth, relative to age, were examined in patients with congenital cholesteatoma to investigate disease progression and site of origin. We retrospectively reviewed 72 children younger than 15 years with intraoperatively confirmed congenital cholesteatoma diagnosed using the inclusion criteria of Levenson et al. Patient demographics, history, and otoscopic and operative findings were evaluated. Correlation between mass volumetric and operation age was analyzed in patients with closed-type masses. Parameters of disease extent of middle ear quadrant, ossicular erosion, attic involvement, invasion of the mastoid cavity, and type of mass were assessed relative to age at operation. Mean patient age was 63.1 months (range, 20-179 months), with 51 patients (70.8%) being asymptomatic and diagnosed incidentally. Nineteen patients (26.4%) had closed-type cystic masses, and 53 (73.6%) had open-type lesions. The volume of closed-type masses was linearly correlated with age at operation. Logistic regression showed that increased age at operation was associated with a lower proportion of anterosuperior quadrant lesions, resulting in uncertainty about the site of origin. The possibility of open-type masses also increased according to age at operation. Congenital cholesteatoma shows growth and extension over time. Early detection and intervention are necessary to avoid advanced disease.
University of UlsanUrusan, Ulsan, South Korea
Sŏul, Seoul, South Korea
- College of Medicine
Sŏul, Seoul, South Korea
- Department of Materials & Chemical Engineering