No abstract available.

BACKGROUND AND OBJECTIVES: The treatment result of endolymphatic sac decompression (ELSD) is controversial especially after a long term follow-up period. The aims of this study are to review the long term treatment outcome of ELSD and to analyzethe factors associated with the long term prognosis. SUBJECTS AND METHOD: A retrospective review of medical records was performed. Sixteen patients (18 ears) who had been diagnosed with definite Meniere's disease, had undergone ELSD and been followed up for more than 2 years were included in this study. The average follow up period was 88.6 months, with the range spanning from 25.7 to 243.4 months. All results were described according to the 1995 AAO-HNS criteria. RESULTS: After a long term follow-up, vertigo was successfully controlled in 66.6% and hearing was preserved or improved in 58.8%. Tinnitus and aural fullness were relieved in 27.3% and 60.0% respectively. The preoperative hearing threshold (p=0.03) and caloric test (p=0.05) showed a close relationship with the long term vertigo control after ELSD. CONCLUSION: Although vertigo and hearing may deteriorate again after 2 years, ELSD generally seems to be able to control vertigo even after a long term follow up. Preoperative hearing threshold and caloric test may be able to serve as prognostic factors.
Caloric Tests ; Decompression ; Endolymphatic Sac ; Follow-Up Studies ; Hearing ; Humans ; Medical Records ; Meniere Disease ; Retrospective Studies ; Tinnitus ; Treatment Outcome ; Vertigo

Temporal bone trauma can cause hearing loss and in case of prolonged conductive hearing loss, traumatic ossicular injury should be considered. Separation of the incudostapedial joint is the most common lesion, and stapediovestibular dislocation is relatively rare but can easily cause perilymphatic fistula. Here, we report a very rare case of external stapediovestibular dislocation after trauma, ending up with successful surgical outcome. A 27-year-old man with non-progressive hearing loss on the right side since childhood visited the clinic. Audiogram showed a conductive hearing loss with air-bone gap of 55 dB on the right side. Temporal bone CT revealed the disruption of ossicular chain. An exploratory tympanotomy identified multiple ossicular disruptions including external stapediovestibular dislocation with shiny fibrous membrane sealing the oval window. Ossicular chain reconstruction was performed using the total ossicular replacement prosthesis of titanium. A postoperative audiogram showed a recovery of air-bone gap less than 10 dB. To the best of our knowledge, this is the first case of external long-standing stapediovestibular dislocation, with oval window completely sealed with fibrous membrane, ending up with successful hearing recovery by surgery. This case would help dealing with such condition which can be encountered in the clinic.

No abstract available.
Noise* ; Tinnitus*

Aging is one of the most evident biological processes, but its mechanisms are still poorly understood. Studies of cognitive aging suggest that age is associated with cognitive decline; however, there may be individual differences such that not all older adults will experience cognitive decline. That is, cognitive decline is not intrinsic to aging, but there is some heterogeneity. Many researchers have shown that speech recognition declines with increasing age. Some of the age-related decline in speech perception can be accounted for by peripheral sensory problems but cognitive aging can also be a contributing factor. The potential sources of reduced recognition for rapid speech in the aged are reduction in processing time and reduction of the acoustic information in the signal. However, other studies also indicated that speech perception does not decline with age. Cognitive abilities are inherently involved in speech processing. Two cognitive factors that decline with age may influence speech perception performance. The first factor is working memory capacity and the second factor concerns the rate of information processing, defined generally as the speed at which an individual can extract content and construct meaning from a rapid signal. Cognitive function shows the adaptive processes with age which are consistent with the view that the brain itself has potentially a life-long capacity for neural plasticity. Assessing the speech perception difficulty in older adults, cognitive function could be considered in the evaluation and management of speech perception problem.
Acoustics ; Adult ; Aged ; Aging ; Automatic Data Processing ; Biological Processes ; Brain ; Cognition ; Fibrinogen ; Humans ; Individuality ; Memory, Short-Term ; Plastics ; Population Characteristics ; Speech Perception

No abstract available.
Tinnitus* ; Transcranial Direct Current Stimulation*

Congenital sialo-cutaneous fistula arising from the accessory parotid gland is extremely rare. Although the fistula tract can be successfully excised after making a skin incision along the skin tension line around the fistula opening, a facial scar inevitably remains. We here report a case of sialo-cutaneous fistula that was treated with chemocauterization with trichloroacetic acid (TCA). TCA cauterization is an easy and effective option for the treatment of congenital fistula from an accessory parotid gland, especially from the aesthetic point of view.
Cicatrix ; Fistula ; Parotid Gland ; Skin ; Trichloroacetic Acid

BACKGROUND AND OBJECTIVES: ZLow frequency hearing loss is known to be the most common hearing loss form in Meniere's disease (MD) and episodic dizziness with low frequency sensorineural hearing loss is considered a very crucial symptom for the diagnosis of MD. However, flat or high frequency hearing loss is also commonly encountered in the Ear, Nose and Throat clinic. The aim of this study is to investigate the differences in clinical manifestation between episodic dizzy patients with low frequency hearing loss (LFHL) group and non-low frequency hearing loss (non-LFHL) group. SUBJECTS AND METHOD: We reviewed medical records of 78 patients (36 of LFHL group and 42 of non-LFHL group) who had episodic dizziness with unilateral hearing loss and analyzed clinical characteristics according to hearing loss pattern. RESULTS: The clinical features of LFHL include a predominance of female sufferers, high incidence of tinnitus and short duration of dizziness. There was no significant difference in frequency, nature of dizziness, and results of vestibular function test. Although the proportion of patients diagnosed with definite MD was higher in LFHL group at initial and final diagnosis, there were no statistically significant differences between two groups. CONCLUSION: Therefore, when episodic dizziness is accompanied with unilateral hearing loss, not only low frequency but flat or high frequency hearing loss could be considered as a critical sign for possible progression to Meniere's disease and careful observation should be taken.
Diagnosis ; Dizziness* ; Ear ; Female ; Hearing Loss* ; Hearing Loss, Sensorineural ; Hearing Loss, Unilateral* ; Humans ; Incidence ; Medical Records ; Meniere Disease ; Nose ; Pharynx ; Tinnitus ; Vestibular Function Tests

BACKGROUND AND OBJECTIVES: Cervical vestibular evoked myogenic potentials (cVEMP) test has been widely used to assess the function of the saccule and inferior vestibular nerve. Electrode location and stimulating sound are important factors which might affect the test results. Today those parameters are usually selected to maximize the waveform response. In this study, we tried to find the optimal condition to minimize the range of normal value of cVEMP. SUBJECTS AND METHOD: Thirteen normal subjects (26 ears) were included. We placed electrodes at five different locations over the sternocleidomastoid muscle (SCM) and used four different stimulation sounds. Variances of parameters, including interpeak amplitude, interaural difference (IAD) and normal value were analyzed and compared. RESULTS: When using the classical condition (mid point of SCM and 500 Hz) without rectification, IAD ratio was 20.8+/-14.2% and the range of normal value was 39%. When we used 2000 Hz tone burst sound at the classical electrodes site, IAD ratio and normal value were minimized, resulting in 18.7+/-14.3% and 31% respectively. After the rectification, when using the classical condition, IAD ratio was 26.4+/-22.3% and the range of normal value was 49%. The minimum IAD ratio was measured as 17.4+/-13.7% when we used click sound at SCM at the level of mandibular angle. And the minimum normal value of 32% was measured when we used 1000 Hz tone burst sound at SCM at the level of mandibular angle. CONCLUSION: Although the condition was not optimal for maximizing the interpeak amplitude, we could alternatively use the condition to minimize the normal value.
Electrodes ; Reference Values ; Saccule and Utricle ; Vestibular Evoked Myogenic Potentials* ; Vestibular Nerve

BACKGROUND AND OBJECTIVES: Caloric test and rotatory chair test have been adopted in diagnosing bilateral vestibulopathy. However, most of patients who were confirmed by the diagnostic testing not complained typical symptoms of bilateral vestibulopathy such as ossilopsia and ataxia. Patients who do not have typical symptoms of bilateral vestibulopathy, were often diagnosed with bilateral vestibulopathy by caloric test and slow harmonic acceleration test (SHA). The aim of this study is to assess the clinical features between groups classified according to the caloric test and SHA test, and possibly to investigate the representative test in the diagnosis of bilateral vestibulopathy. MATERIALS AND METHODS: Seventy-five patients were divided into three groups: (A) patients diagnosed with the caloric test only, (B) patients diagnosed with SHA test only, (C) patients satisfying the diagnostic criteria of both tests. Clinical characteristics, the results of physical examination, hearing test and vestibular function test (VFT) were compared among three groups. Results: There was no difference in clinical characteristics and results of physical examination among three groups. Regarding VFT results, only in step velocity test, The proportion of patients who showed low gain value on both sides were higher in group C than that of group A and B. No difference was observed in the other VFT results among three groups. RESULTS: There was no difference in clinical characteristics and results of physical examination among three groups. Regarding VFT results, only in step velocity test, The proportion of patients who showed low gain value on both sides were higher in group C than that of group A and B. No difference was observed in the other VFT results among three groups. CONCLUSION: We could not predict the clinical features of bilateral vestibulopathy by the results of VFT, and could not find preferable test in diagnosing bilateral vestibulopathy.
Acceleration ; Ataxia ; Caloric Tests ; Diagnosis ; Diagnostic Tests, Routine ; Hearing Tests ; Humans ; Physical Examination ; Vestibular Function Tests