Ji Hyun Lim’s research while affiliated with Samsung Medical Center and other places

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Publications (6)


Preoperative House-Brackmann (H-B) grade based on preoperative tumor size and duration of facial nerve paralysis (FNP). The larger the tumor size, the worse the H-B grade before surgery (a). The duration of facial palsy did not reach statistical significance (b)
Postoperative House-Brackmann (H-B) grade based on preoperative tumor size and duration of facial nerve paralysis (FNP). When patients were followed for more than 1 year, preoperative tumor size (a) and the duration of facial palsy (b) did not affect final H-B grade after surgery
Management of facial nerve schwannoma: when is the timing for surgery
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  • Publisher preview available

March 2022

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47 Reads

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12 Citations

European Archives of Oto-Rhino-Laryngology

Young Sang Cho

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Ji Hyun Lim

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PurposeAlthough the estimated prevalence is extremely low, facial nerve schwannoma (FNS) is the most common primary tumor of the facial nerve (FN). In the present study, the outcome of surgical management in 18 patients with FNS was analyzed and an appropriate time for surgery was proposed.Materials and methodsA total of 18 patients with FNS who underwent surgical management by a single surgeon from 1999 to 2018 were retrospectively analyzed.ResultsAmong the 18 patients, five had no facial paralysis before surgery. Near-total removal was performed in three cases, and two cases were managed with decompression. In 13 cases with various degree of preoperative facial palsy, nerve continuity was lost during surgery. FN was reconstructed using cable graft in ten cases, direct anastomosis in one case, and facial-hypoglossal nerve transfer in one case. Facial reanimation surgery without FN reconstruction was performed in one case due to a long-standing facial paralysis before surgery. Preoperative House-Brackmann (H-B) grade in all patients was significantly worse as tumor size increased. The correlation was not observed between the duration and severity of preoperative facial palsy.Analysis of 12 patients who underwent FN reconstruction revealed that all patients with good preoperative facial function (H-B grade II–III) recovered to H-B grade III after surgery (7/7, 100%). However, patients with poor preoperative facial function (H-B grade IV or worse) had only a 40% (2/5) chance of improving to grade III after surgery. Preoperative tumor size and duration of facial palsy did not affect postoperative final facial function.Conclusion We suggest that H-B grade III facial palsy is the best time for surgical intervention, regardless of the tumor size or duration of facial palsy.

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Virtual Reality in Audiology: Feasibility of Virtual Reality Audiological Testing (Preprint)

January 2021

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127 Reads

Hye Yoon Seol

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Ji Hyun Lim

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UNSTRUCTURED It has been noted in literature that, there is a gap between clinical assessment and real-world performance. Real-world conversations entail visual and information and yet there are not any audiological assessment tools that include visual information. Virtual reality (VR) technology has been applied to various areas including audiology. However, the use of VR in speech in noise perception has not been investigated yet. The purpose of this study is to investigate the impact of virtual space on speech performance and its feasibility to be used as a speech test instrument. Thirty individuals with normal hearing and twenty-five individuals with hearing loss completed puretone audiometry and the Korean version of the Hearing in Noise Test (K-HINT) in conventional K-HINT, VS on PC, and VS on head-mounted display at -10, -5, 0 and +5dB signal-to-noise ratios. Participants listened to target speech and repeated back to the tester for all conditions. Hearing aid users in the hearing loss group completed testing in unaided and aided conditions. A questionnaire was administered after testing. Provision of visual information had a significant impact on speech performance between the normal hearing and hearing impairment groups. Hearing aid use led to better integration of audio and visual cues. Statistical significance was observed for some conditions in each group and between hearing aid and non-hearing aid users. Participants reported positive responses across almost all items on the questionnaire except for the weight of the headset. Participants preferred a test method with visual imagery, but the headset was heavy. Findings are in line with previous literature that visual cues are beneficial for communication. This is the first study to include hearing aid users with a more naturalistic stimulus and a relatively “simple” test environment, suggesting the feasibility of virtual reality audiological testing in clinical practice.


Feasibility of Virtual Reality Audiological Testing (Preprint)

January 2021

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48 Reads

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8 Citations

JMIR Serious Games

Background It has been noted in the literature that there is a gap between clinical assessment and real-world performance. Real-world conversations entail visual and audio information, yet there are not any audiological assessment tools that include visual information. Virtual reality (VR) technology has been applied to various areas, including audiology. However, the use of VR in speech-in-noise perception has not yet been investigated. Objective The purpose of this study was to investigate the impact of virtual space (VS) on speech performance and its feasibility to be used as a speech test instrument. We hypothesized that individuals’ ability to recognize speech would improve when visual cues were provided. MethodsA total of 30 individuals with normal hearing and 25 individuals with hearing loss completed pure-tone audiometry and the Korean version of the Hearing in Noise Test (K-HINT) under three conditions—conventional K-HINT (cK-HINT), VS on PC (VSPC), and VS head-mounted display (VSHMD)—at –10 dB, –5 dB, 0 dB, and +5 dB signal-to-noise ratios (SNRs). Participants listened to target speech and repeated it back to the tester for all conditions. Hearing aid users in the hearing loss group completed testing under unaided and aided conditions. A questionnaire was administered after testing to gather subjective opinions on the headset, the VSHMD condition, and test preference. ResultsProvision of visual information had a significant impact on speech performance between the normal hearing and hearing impaired groups. The Mann-Whitney U test showed statistical significance (P


Fig. 1. Average puretone hearing thresholds of all participants.
Effectiveness of Wireless Streaming on Telephone Conversation in Users of Hearing Aids

March 2020

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163 Reads

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1 Citation

Korean Journal of Otorhinolaryngology - Head and Neck Surgery

Background and Objectives The purpose of this study was to figure out the clinical effectiveness of the bluetooth wireless streaming when used with a hearing aid during cell phone conversation for hearing-impaired listeners.Subjects and Method Twenty-four adults with hearing loss participated (mild: 3, moderate: 13, moderately severe: 8) in the study. The following three objective tests and one subjective questionnaire were administered to all participants; 1) consonant and Monosyllabic test in an noisy environment, 2) speech recognition test in quiet and noisy conditions, 3) listening effort test, and 4) questionnaire about sound quality and preference. Each objective test was conducted in three different cell phone conversation environments as follows; 1) unaided condition, 2) aided condition, with the bluetooth function off, and 3) aided condition, with the bluetooth function on.Results In the aided condition with the bluetooth function off, performance on consonant and monosyllabic tests was the lowest ( p <0.05). However, when the bluetooth function was turned on, the result showed statistically significant superior performance ( p <0.05). For the words and sentences test in noisy conditions, using wireless streaming feature with the hearing aids were beneficial compared to not using the feature ( p <0.05). However, no significant difference was found between the bluetooth off and on conditions in quiet conditions. Listening effort was significantly lower in noisy background for aided bluetooth on condition ( p <0.05). There was no significant difference in sound quality according to each condition, but the preference of Bluetooth feature was overwhelmingly high.Conclusion Bluetooth wireless streaming is beneficial during phone conversation in noisy environments for users of hearing aids.


Efficacy of non‐invasive treatment options for single‐sided deafness: A prospective study of 20 patients

January 2020

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67 Reads

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3 Citations

Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

We aimed to ascertain which of the following devices will perform better for individuals with single‐sided deafness (SSD): non‐invasive contralateral routing of signal (CROS) hearing aid (HA) and the new type of bone conduction devices (BCDs) which include ADHEAR and SoundArc. A CROS hearing aid provided some advantage for speech perception in a noisy environment when target speech was directed to the impaired ear side. However, it also showed an adverse effect when the noise was presented to the better ear. Neither of the adhesive‐type BCDs (ADHEAR or SoundArc), showed pseudobinaural benefits in the Hearing in Noise Test (HINT). Sound localization ability was not significantly affected by any device. However, all devices significantly reduced listening effort in noise conditions Although there was little enhancement in speech perception in noise with CROS, and the new type of BCDs, all devices significantly reduced listening effort.


Clinical Performance Evaluation of a Personal Sound Amplification Product vs a Basic Hearing Aid and a Premium Hearing Aid

May 2019

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110 Reads

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26 Citations

JAMA Otolaryngology - Head and Neck Surgery

Importance Hearing loss is a highly prevalent condition with multiple negative associated outcomes, yet few persons with hearing loss have hearing aids (HAs). Personal sound amplification products (PSAPs) could be an alternative low-cost solution to HAs, but data are lacking on the performance of PSAPs. Objective To evaluate the clinical efficacy of a PSAP by comparing its performance with that of a basic HA and a premium HA in participants with mild, moderate, and moderately severe hearing impairment. Design, Setting, and Participants A prospective, single-institution cohort study was performed with a total of 56 participants, including 19 with mild hearing loss, 20 with moderate hearing loss, and 17 with moderately severe hearing loss. All participants underwent 4 clinical hearing tests with each of the PSAP, basic HA, and premium HA, and all completed an evaluative questionnaire. Interventions All hearing devices (PSAP, basic HA, and premium HA) were applied by a clinician to prevent bias and order effects; participants were blinded to the device in use, and sequence of devices was randomized. Main Outcomes and Measures The study used the Korean version of the hearing in noise test, the speech intelligibility in noise test, listening effort measurement using a dual-task paradigm, pupillometry, and a self-rating questionnaire regarding sound quality and preference. These tests were administered under the following 4 hearing conditions: unaided hearing, use of PSAP, use of basic HA, and use of premium HA. Results The study included 56 participants with a mean age of 56 years (interquartile range, 48-59 years); 29 (52%) were women. In the mild and moderate hearing loss groups, there was no meaningful difference between PSAP, basic HA, and premium HA for speech perception (Cohen d = 0.06-1.05), sound quality (Cohen d = 0.06-0.71), listening effort (Cohen d = 0.10-0.92), and user preference (PSAP, 41%; basic HA, 28%; premium HA, 31%). However, for the patients with moderately severe hearing loss, the premium HA had better performance across most tests (Cohen d = 0.60-1.59), and 70% of participants preferred to use the premium HA. Conclusions and Relevance The results indicate that basic and premium HAs were not superior to the PSAP in patients with mild to moderate hearing impairment, which suggests that PSAPs might be used as an alternative to HAs in these patient populations. However, if hearing loss is more severe, then HAs, especially premium HAs, should be considered as an option to manage hearing loss.

Citations (5)


... Previous investigators have noted that using a VR test environment reduces visual distractors that are inconsistent with the auditory stimuli, such as booth walls and desktop computers, and even replacing the sound booth with a simple virtual screen provides better consistency between auditory and visual systems (Stecker, 2019). In further support of VR test environments, research suggests that participants who are hard of hearing have favorable opinions of assessments using VR (Seol et al., 2021;Sun et al., 2022). Sun et al. (2022) tested SIN for 20 hard of hearing adults using a HMD and speaker array arranged in 360 o . ...

Reference:

Localization and Speech-in-Noise Performance in a Virtual Reality Test Environment: A Pilot Study of Adults With Single-Sided Deafness Using a Cochlear Implant
Feasibility of Virtual Reality Audiological Testing (Preprint)

JMIR Serious Games

... 13 Abstention with close supervision is only recommended in case of neuromas with normal facial function or minimal paresis H-B less than III. 14 Radiation is an emerging treatment modality for facial schwannomas. Its aim is to avoid further tumour growth and to preserve residual facial function. ...

Management of facial nerve schwannoma: when is the timing for surgery

European Archives of Oto-Rhino-Laryngology

... Despite advancements in feedback reduction algorithms, feedback continues to be a challenge, particularly for individuals who need substantial amplification [4]. Consequently, the current focus of hearing aid technology development is on enhancing speech recognition in noisy listening conditions and optimizing the signal-to-noise ratio (SNR) in scenarios where distance, noise, and reverberation may pose challenges [2] [5]. Individuals with SNHL require a higher signal-to-noise ratio (SNR) compared to those with normal hearing in order to effectively communicate, even with sufficient amplification provided by hearing aids. ...

Effectiveness of Wireless Streaming on Telephone Conversation in Users of Hearing Aids

Korean Journal of Otorhinolaryngology - Head and Neck Surgery

... Although this method is helpful for sound transmission, the percutaneous abutment connection system has cosmetic issues and regular surgical site care is necessary. 3 These factors often cause inflammation and skin infections which can be problematic. 4 Recently, a magnetic transcutaneous bone conduction implant system with intact skin interposed between two magnets have been introduced and widely used. ...

Efficacy of non‐invasive treatment options for single‐sided deafness: A prospective study of 20 patients
  • Citing Article
  • January 2020

Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

... The number of participants for this study was determined using G*Power (version 3.1.9.4) software (Institute for Experimental Psychology). The estimated sample size was based on the findings of a previous study [11]. The calculated total sample size was 56 participants, considering an effect size (Cohen d) of 0.9, an error probability of .05, ...

Clinical Performance Evaluation of a Personal Sound Amplification Product vs a Basic Hearing Aid and a Premium Hearing Aid
  • Citing Article
  • May 2019

JAMA Otolaryngology - Head and Neck Surgery