Ju Hyoung Lee

Clinical use of subjective visual horizontal and vertical in patients of unilateral vestibular neuritis.

Objectives: Subjective visual horizontal (SVH) and subjective visual vertical (SVV) used to assess otolith dysfunction and ipsilesional deviation of SVV and SVH in unilateral vestibular dysfunction is well known. The goal of this study was to investigate the clinical use of SVH/SVV and a dizziness scale in the clinical setting of acute unilateral vestibular neuritis. Methods: Thirty-five patients with unilateral vestibular neuritis were investigated. Every patient was diagnosed by physical examination and electronystagmography. Subjective visual horizontal and SVV were assessed during the acute or subacute period; the Dizziness Handicap Inventory (DHI) and Vestibular Disorder Activities of Daily Living Scale (VADL) were used for a self-dizziness scale at the same time. All patients underwent rehabilitation therapy. Subjective visual horizontal/SVV and DHI/VADL were assessed again approximately 4 weeks later. Postrehabilitation SVH/SVV and DHI/VADL data were compared with initial data. Results: Dizziness Handicap Inventory and VADL were improved after 4 weeks of rehabilitation, and the deviation toward ipsilesional side SVH and SVV was also improved. Conclusion: These results demonstrate that SVH and SVV correlated with clinical dizziness symptoms in patients with acute unilateral vestibular neuritis. Therefore, SVH and SVV would be useful tools for the evaluation of clinical manifestations of unilateral vestibular neuritis.

Comparison of tonsillar biofilms between patients with recurrent tonsillitis and a control group

Abstract Conclusion: The results of the study suggest that biofilms play a causative role in recurrent tonsillitis. Objective: To analyze the association between tonsillar biofilms and recurrent tonsillitis. Methods: The recurrent tonsillitis group comprised patients with a history of at least five episodes of tonsillitis per year over the previous 2 years. The control group comprised volunteers scheduled for laryngeal microsurgery with no history of tonsillitis over the previous 2 years. Between October 2009 and August 2010, specimens were obtained from 20 patients with recurrent tonsillitis and 20 volunteers (controls). Scanning electron microscopy (SEM) was used to confirm the presence of biofilms. Biofilms were graded at a magnification of ×500 by SEM and classified into five grades. The percentages of subjects affected and biofilm grades were compared between the recurrent tonsillitis and control groups. Results: The two groups were matched for age and sex. SEM revealed that biofilms were significantly more prevalent in the recurrent tonsillitis group than in the control group. Furthermore, the biofilms in the recurrent tonsillitis group were of significantly higher grade than those in the control group.

Clinical features and management of facial nerve paralysis in children: analysis of 24 cases

OBJECTIVES To evaluate the causes, treatment modalities and recovery rate of paediatric facial nerve paralysis. MATERIALS AND METHODS We analysed 24 cases of paediatric facial nerve paralysis diagnosed in the otolaryngology department of Gachon University Gil Medical Center between January 2001 and June 2006. RESULTS The most common cause was idiopathic palsy (16 cases, 66.7 per cent). The most common degree of facial nerve paralysis on first presentation was House-Brackmann grade IV (15 of 24 cases). All cases were treated with steroids. One of the 24 cases was also treated surgically with facial nerve decompression. Twenty-two cases (91.6 per cent) recovered to House-Brackmann grade I or II over the six-month follow-up period. CONCLUSION Facial nerve paralysis in children can generally be successfully treated with conservative measures. However, in cases associated with trauma, radiological investigation is required for further evaluation and treatment.

Efficacy of Posterior Canal Wall Reconstruction Using Autologous Auricular Cartilage and Bone Pâté in Chronic Otitis Media with Cholesteatoma

OBJECTIVE This study was designed to investigate the long-term results using the technique of canal wall up mastoidectomy and reconstruction of the posterior canal wall using bone pâté and auricular cartilage in the treatment of chronic otitis media with cholesteatoma. MATERIALS AND METHODS A retrospective review was performed on 42 patients who underwent canal wall up mastoidectomy and posterior canal wall reconstruction at a single institution between November 2005 and November 2012. RESULTS Of the 42 patients, postoperative tympanic membranes were normal in 38 (90.5%), perforated in 1 (2.4%), and retracted in 3 (7.1%). Mean preoperative and postoperative values of the air-bone gap (ABG) were 29.4±12.8 and 23.4±11.7 dB, respectively, which represented a significant average improvement. For patients with ossiculoplasty (n=24), the mean preoperative and postoperative ABG values were 34.7±6.0 and 27.5±8.0 dB, respectively, which also represented a significant average improvement. Thirty-one (73.8%) of the patients were followed up without any complication, but 5 had otorrhea (11.9%), 4 had dizziness (9.5%), and 2 had facial palsy (4.8%). CONCLUSION A canal wall up mastoidectomy with reconstruction of the posterior canal wall using auricular cartilage and bone pâté provides successful preservation of the anatomic structure and a significant improvement in hearing without the long-term disadvantages of a canal wall down mastoidectomy.

Evaluation of Patients Treated by Facial Nerve Decompression via Transmastoid Approach for Traumatic Facial Paralysis

Objectives: Evaluate outcomes and prognosis of patients operated on for traumatic facial paralysis. Methods: The authors retrospectively reviewed 20 patients with temporal bone fractures resulting in facial paralysis, who were treated by surgical facial nerve decompression with transmastoid approach from 2004 to 2012. Results: In 14 patients, HB grade improved as 1, 2, 3. Facial paralysis degree improved from preoperative average HB grade 4.95 to postoperative average HB grade 3.15. Statistically significant improvements were found in both groups where the operation was performed within 3 weeks and after 3 weeks. Conclusions: Postoperative results of facial nerve decompression in traumatic temporal bone fracture can be excellent. And as surgeons can expect better outcomes with early diagnosis and lesser nerve damage, early surgical decompression should be carried out.

P099: Analysis of the Prognostic Factors in Sudden Hearing Loss

crease in osteoclast formation when exposed to PA LPS. This osteoclastogenic effect was even more pronounced in MyD88-/BMMs exposed to PA LPS. CONCLUSIONS: These results demonstrated that PA LPS is able to activate both MyD88-dependent as well as MyD88independent pathways. However, the effect of PA LPS stimulation on osteoclast precursors (BMMs) is based on the integrity of the TLR signaling pathway.