Sungsu Lee

Outcomes of Severe to Profound Idiopathic Sudden Sensorineural Hearing Loss

Objectives While a severe to profound sudden sensorineural hearing loss (SSNHL) may cause serious disability in verbal communication, there have been little studies focusing on this high degree SSNHL. The present study was aimed to investigate the characteristics of hearing recovery in a high degree SSNHL (>70 dB). Methods Three hundred and two SSNHL patients were enrolled. For a long-term follow-up, 46 patients were evaluated. Hearing level was examined by pure tone audiometry on day 1, week 3, month 3, month 6, and year 1 or after. According to the degree of the initial hearing loss, the patients were divided into 4 groups from 70 to ≥100 dB. Results After 3 weeks, the recovery rate and mean hearing gain was 61%, 23.85 dB in the 70 dB group, whereas 10%, 6.61 dB in the ≥100 dB group. There was a significant correlation between 3-week recovery and final hearing outcome. However, there was almost no recovery after 3 months. Conclusion An early recovery can be a prognostic factor for the final recovery in severe to profound SSNHL. Since recovery after 3 months is rare, an early hearing intervention like hearing aid or cochlear implantation should be considered in the high degree SSNHL to restore the patients verbal communication.

Atoh1 as a Coordinator of Sensory Hair Cell Development and Regeneration in the Cochlea

Cochlear sensory hair cells (HCs) are crucial for hearing as mechanoreceptors of the auditory systems. Clarification of transcriptional regulation for the cochlear sensory HC development is crucial for the improvement of cell replacement therapies for hearing loss. Transcription factor Atoh1 is the key player during HC development and regeneration. In this review, we will focus on Atoh1 and its related signaling pathways (Notch, fibroblast growth factor, and Wnt/β-catenin signaling) involved in the development of cochlear sensory HCs. We will also discuss the potential applicability of these signals for the induction of HC regeneration.

Effectiveness of anatomic criteria for predicting parotid tumour location.

We evaluated the accuracy, positive predictive value (PPV), negative predictive value (NPV), specificity and sensitivity of eight anatomic landmarks to differentiate parotid deep lobe tumours from superficial lobe tumours: the lateral margin of the retromandibular vein (RMV), a straight line from the facial nerve trunk (FN trunk) to the mandibular ramus (FN line), a straight line from the FN trunk to the RMV (tRMV), a straight line from the FN trunk to the lateral margin of the masseter (tMasseter), a straight line from the ipsilateral vertebral posterior end to the RMV (U‐line), an arc with a radius of 8.5 mm centred on the mandibular ramus (Conns arc), a straight line from the lateral surface of the masseter muscle to the lateral margin of the RMV (rMasseter) and an angle from the FN line, tumour and the lateral margin of the masseter muscle (FTM angle).

A Case of Cochlear Implantation in Bromate-Induced Bilateral Sudden Deafness

Despite the well-established nature of bromate-induced ototoxicity, cochlear implantation after bromate intoxication has been rarely documented. We hereby present a case of a 51-year-old female deafened completely after bromate ingestion. Her hearing was not restored by systemic steroid treatment and hearing aids were of no use. A cochlear implantation was performed on her right ear 3 months after the bromate ingestion. In bromate intoxication cases, early monitoring of hearing level is necessary and other drugs with potential ototoxicity should be avoided. The outcome of cochlear implantation was excellent in this case of bromate-induced deafness.

A Case of Cochlear Implantation Targeting Preserved Cerebral Cortex in Severe Traumatic Brain Injury

Temporal bone fracture and blunt head trauma was once considered as contraindication for the surgery. Increasing numbers of successful cochlear implantation are being reported. However, the outcome of cochlear implantation in severe damaged brain is unclear. A multichannel cochlear implant was successfully implanted in a 33-year-old man who had both sensorineural deafness, left hemiplegia due to bilateral transverse temporal bone fractures and severe right brain damage after a traffic accident.

Cochlear implantation in a patient with acute myelomonocytic leukemia before allogeneic peripheral blood stem cell transplantation

Bilateral deafness can occur in patients with acute leukemia and it can cause communication problems and depressed mood during the treatment of leukemia. Cochlear implantation (CI) is the choice of hearing rehabilitation; however, there is scarce information about the safety of CI during the treatment of leukemia. A 50-year-old female leukemia patient was successfully implanted with a Nucleus cochlear implant while in complete remission before peripheral blood stem cell transplantation. Until now, with a follow-up of 4 years, the patient has useful hearing perception without any complications. To our knowledge, this is the first reported case of a successful CI in a patient with acute leukemia during the treatment of leukemia.

110. Bickerstaff’s brainstem encephalitis overlapping acute motor axonal neuropathy

ences between the parameters of the control group and the patient group were analysed by using independent t test. Results: Patients had significantly increased CSA (normal group: 7.2 ± 1.3, patient group: 12.3 ± 4.0), compression ratio (normal group: 1.10 ± 0.21, patient group: 1.84 ± 0.79) and swelling ratio (normal group: 2.80 ± 0.58, patient group: 3.39 ± 0.93). The flattening ratio increased only at the pisiform level (normal group: 2.80 ± 0.58, patient group: 3.39 ± 0.93) (p < 0.05). Normal values were obtained from two standard deviations of the control group. The parameters showed sensitivities of 80.3% (maximal CSA), 55.7% (compression ratio), 53.2% (swelling ratio), and 19.7% (flattening ratio). The sensitivity of combining the four parameters was higher (88.5%) than using maximal CSA only (80.3%). Conclusion: These results suggest that combining various US parameters gives a higher sensitivity than using CSA only in the diagnosis of CTS.

85. Correlations among diabetic complications according to severity

Introduction: Diabetes mellitus is a common cause of polyneuropathy (PN). The development and progression of nephropathy, retinopathy, and neuropathy are closely interrelated. Objectives: To investigate the correlations among diabetic complications including polyneuropathy, retinopathy, and nephropathy according to the severity of each complication. Methods: One hundred diabetic polyneuropathy patients (47 males, 53 females; age 67.8 ± 10.6 years; duration of disease 11.8 ± 8.2 years) were recruited. The severity of diabetic polyneuropathy was electrodiagnostically determined by modified Stevens’ criteria, that of retinopathy by the fundoscopic findings, and that of nephropathy by the urine protein level collected for 24 h. Results: (1) Twenty two patients had a retinopathy and 10 patients had a nephropathy combined with PN. Thirty patients had a triopathy. (2) There were significant correlations between polyneuropathy and retinopathy, between polyneuropathy and nephropathy, and between retinopathy and nephropathy (p < 0.05). (3) As the severity of each polyneuropathy and retinopathy became worse, the urine protein level went up significantly (p < 0.05). (4) The severity of retinopathy was significantly correlated with tibial nerve conduction velocity and F-wave onset latency, each (p < 0.05). (5) The urine protein level was significantly correlated with peroneal nerve F-wave onset latency and amplitude, each (p < 0.05). (6) HbA1c was significantly correlated with the severities of polyneuropathy, retinopathy, and nephropathy, respectively (p < 0.05). Conclusions: The severity of diabetic polyneuropathy was correlated with those of retinopathy and nephropathy. We believe that the electrodiagnostic evaluation of diabetic polyneuropathy will be helpful for the early detection of other diabetic complications. Study supported by the Korea Research Foundation Grant funded by the Korean Government (MOEHRD). The Regional Research University’s Program/Biohousing Research Institute.