Jae-Yong Byun

Comparison of steroid administration methods in patients with idiopathic sudden sensorineural hearing loss: a retrospective observational study.

To compare the recovery rates of patients with idiopathic sudden sensorineural hearing loss (ISSHL) treated with oral systemic steroids (PO) or intratympanic steroid injection (IT) or both.

Steroid plus antiviral treatment for Bell's palsy

The effectiveness of antiviral agents for the treatment of Bells palsy is uncertain. We evaluated whether a steroid with an antiviral agent (S + A group) provided better recovery outcomes than a steroid alone (S group) in patients with Bells palsy.

Pseudocolor transformation for visualization of ossicles in CT images

Conclusion. Pseudocolor transformation demonstrated partial efficiency for increasing the visibility of the stapes and the incudostapedial (IS) joint in CT images. Variable color transformation could be examined in the future for increasing detection of otologic lesions. Objectives. Pseudocolor transformation is a technique for artificially assigning colors to a gray scale. This study was undertaken to evaluate the efficiency of the pseudocolor transformation technique for the visualization of ossicles in temporal bone CT images. Subjects and methods. Twenty CT studies of healthy ears were reviewed. CT images were transformed to pseudocolor (rainbow scale) with Image-Pro Plus 4.0. software and compared with plain images using the following rating scale. For each image one of five scores concerning the visibility of the stapes and IS joint was given: 1, not seen; 2, probably not seen; 3, not sure; 4, probably seen; 5, definitely seen. Visualization sensitivity was determined through statistical analysis using a paired t test. Results. The stapes and IS joint were more easily identifiable in pseudocolor-transformed images compared with plain images (p<0.05). The oval window and footplate were both more easily distinguishable in pseudocolor-transformed images compared with plain images (p<0.05).

Pulsatile Tinnitus with a Dural Arterio-Venous Fistula Diagnosed by Computed Tomography-Angiography

A 43 year-old female patient suffered the sudden onset of pulsatile tinnitus in the left ear 2 months ago. The tinnitus did not subside spontaneously and remained unchanged. The patient had no history of head trauma or surgery of the head and neck. The character of the tinnitus was pulsatile, and it was synchronous with the heart beat. Audiologic examinations were performed and all of the results were normal. Computed tomography with angiography was performed and evidence of an arterio-venous fistula (AVF) was found. 4-vessel angiography was performed to confirm the dural AVF between the external carotid artery and sigmoid sinus. Embolization of the feeder-vessels was done under a fluoroscope and 70% of the fistula flow was controlled after embolization and the tinnitus totally subsided during the embolization.

Steroid-Antiviral Treatment Improves the Recovery Rate in Patients with Severe Bell’s Palsy

Objectives: The extent of facial nerve damage is expected to be more severe in higher grades of facial palsy, and the outcome after applying different treatment methods may reveal obvious differences between severe Bell’s palsy and mild to moderate palsy. This study aimed to systematically evaluate the effects of different treatment methods and related prognostic factors in severe to complete Bell’s palsy. Methods: This randomized, prospective study was performed in patients with severe to complete Bell’s palsy. Patients were assigned randomly to treatment with a steroid or a combination of a steroid and an antiviral agent. We collected data about recovery and other prognostic factors. Results: The steroid treatment group (S group) comprised 107 patients, and the combination treatment group (S+A group) comprised 99 patients. There were no significant intergroup differences in age, sex, accompanying disease, period from onset to treatment, or results of an electrophysiology test (P > 0.05). There was a significant difference in complete recovery between the 2 groups. The recovery (grades I and II) of the S group was 66.4% and that of the S+A group was 82.8% (P = 0.010). The S+A group showed a 2.6-times higher possibility of complete recovery than the S group, and patients with favorable electromyography showed a 2.2-times higher possibility of complete recovery. Conclusions: Combined treatment with a steroid and an antiviral agent is more effective in treating severe to complete Bell’s palsy than steroid treatment alone.