BACKGROUND: A cartilage wedge block and covering flap are standard procedures for firm elevation of the ear in microtia correction. However, using costal cartilage for elevation of the reconstructed auricle can be insufficient, and the fixed cartilage wedge block may be absorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and uses up fascia, a potential source of reconstruction material. Therefore, we propose an innovative method using autologous onlay rib bone graft for auricular elevation of microtia. METHODS: From February 1995 to August 2012, 77 patients received a first stage operation with a rib cartilage framework graft. In the second stage operation, a small full thickness of rib bone was harvested through the previous donor scar. The bihalved rib bone was inserted into the subperiosteal pocket beneath the cartilage framework. RESULTS: The follow-up time ranged from 1 month to 17 years, with a mean of 3 years. All of the patients sustained the elevation of their ears very well during the follow-up period. Donor site problems, except for hypertrophic scars, were not observed. Surgery-related complications, specifically skin necrosis, infection, or hematoma, occurred in 4 cases. CONCLUSIONS: Onlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate material than cartilage, due to the bone-to-bone contact between the bone graft and the temporal bone. Postoperative minor correction of the elevation degree is straightforward and the skin graft survives better. Therefore, reconstructed auricle elevation using onlay rib bone graft is a useful and valuable method.
Bone Transplantation ; Cartilage ; Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Ear ; Ear Auricle ; Fascia ; Follow-Up Studies ; Hematoma ; Humans ; Inlays ; Necrosis ; Ribs ; Skin ; Temporal Bone ; Tissue Donors ; Transplants

This study was conducted to evaluate the ability of plants to purify indoor air by observing the effective reduction rate among pollutant types of particulate matter (PM) and volatile organic compounds (VOCs). PM and four types of VOCs were measured in a new building that is less than three years old and under three different conditions: before applying the plant, after applying the plant, and a room without a plant. The removal rate of each pollutant type due to the plant was also compared and analyzed. In the case of indoor PM, the removal effect was negligible because of outdoor influence. However, 9% of benzene, 75% of ethylbenzene, 72% of xylene, 75% of styrene, 50% of formaldehyde, 36% of acetaldehyde, 35% of acrolein with acetone, and 85% of toluene were reduced. The purification of indoor air by natural ventilation is meaningless because the ambient PM concentration has recently been high. However, contamination by gaseous materials such as VOCs can effectively be removed through the application of plants.
Acetaldehyde ; Acetone ; Acrolein ; Benzene ; Formaldehyde ; Particulate Matter* ; Plants ; Styrene ; Toluene ; Ventilation ; Volatile Organic Compounds* ; Xylenes

Listening effort is defined as a listener's mental exertion required to understand a speaker's auditory message, especially when distracting conditions are present. This review paper analyzed several subjective scaling tools used to measure the listening effort in order to suggest the best tool for use with hearing-impaired listeners who have to expend much effort even in everyday life. We first explained the importance of measuring listening effort and discussed various kinds of measurements. We then analyzed and categorized 15 recently published articles (i.e., from 2014 to 2016) into three topics: performance and listening effort, listening effort and fatigue, and clinical implication of listening effort. We compared the articles in terms of pros and cons and also identified 10 tools for use in the subjective scaling. Although none of these tools were unified or standardized easily, we concluded that 7-point scale would be the most reasonable as a less time-consuming measurement for compartmentalizing the degree of listening effort. If used with objective tools for measuring the listening effort, the subjective scaling could be a powerful tool for clinical use.
Fatigue

This study was conducted to evaluate the ability of plants to purify indoor air by observing the effective reduction rate among pollutant types of particulate matter (PM) and volatile organic compounds (VOCs). PM and four types of VOCs were measured in a new building that is less than three years old and under three different conditions: before applying the plant, after applying the plant, and a room without a plant. The removal rate of each pollutant type due to the plant was also compared and analyzed. In the case of indoor PM, the removal effect was negligible because of outdoor influence. However, 9% of benzene, 75% of ethylbenzene, 72% of xylene, 75% of styrene, 50% of formaldehyde, 36% of acetaldehyde, 35% of acrolein with acetone, and 85% of toluene were reduced. The purification of indoor air by natural ventilation is meaningless because the ambient PM concentration has recently been high. However, contamination by gaseous materials such as VOCs can effectively be removed through the application of plants.
Acetaldehyde ; Acetone ; Acrolein ; Benzene ; Formaldehyde ; Particulate Matter ; Plants ; Styrene ; Toluene ; Ventilation ; Volatile Organic Compounds ; Xylenes

BACKGROUND: The eyelid and canthal areas are common locations for cutaneous tumors. The medial canthus includes, among many other apparatuses, the canthal tendon and lacrimal canaliculi, and its characteristic thin and supple skin is hard to mimic and restore using tissue from other regions. Accordingly, reconstruction of the canthal area can prove challenging for surgeons. Although various methods, such as skin grafts and local flaps from adjacent regions, have been utilized for reconstructive purposes, they present known disadvantages. However, we were able to successfully reconstruct both lateral and medial canthal area defects by using orbicularis oculi myocutaneous island flaps. METHODS: Our study included seven patients who underwent medial or lateral canthal region reconstruction, using orbicularis oculi myocutaneous island flaps, between 2011 and 2014, following either cutaneous tumor excision or traumatic avulsion injury. RESULTS: Five patients had basal cell carcinoma, one had squamous cell carcinoma of the eyelid, and one had sustained a traumatic avulsion injury of the eyelid and canthal area. Entire flap loss was not observed in any patient, but one-a heavy smoker-showed partial flap loss, which healed with secondary intention and yielded acceptable results. Donor site morbidity was not observed, and all patients were satisfied with their surgical outcomes. CONCLUSIONS: The canthal regions can be successfully reconstructed with orbicularis oculi myocutaneous island flaps. These flaps offer several key advantages, including similarity in texture, color, and thickness to the recipient site and a negligible incidence of donor site morbidity.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Eyelids ; Humans ; Incidence ; Intention ; Myocutaneous Flap ; Skin ; Surgical Flaps ; Tendons ; Tissue Donors ; Transplants

It is uncommon for a palatal fistula to be detected in individuals who have not undergone surgery, and only sporadic cases have been reported. It is even more difficult to find cases of acquired palatal fistula in patients with submucous or incomplete cleft palate. Herein, we present 2 rare cases of this phenomenon. Case 1 was a patient with submucous cleft palate who acquired a palatal fistula after suffering from oral candidiasis at the age of 5 months. Case 2 was a patient with incomplete cleft palate who spontaneously, without trauma or infection, presented with a palatal fistula at the age of 9 months.
Candidiasis, Oral ; Cleft Palate* ; Fistula* ; Humans ; Oral Fistula

Primary malignant melanoma of the breast (PMMB) is a rare tumor with only a few case reports available in the literature. We report two cases of PMMB, one derived from the breast parenchyma and the other from the breast skin. The first case consisted of atypical epithelioid cells without overt melanocytic differentiation like melanin pigments. The tumor cells showed diffuse positivity for S100 protein, tyrosinase, and BRAF V600E. However, the tumor cells were negative for cytokeratin, epithelial membrane antigen, and HMB-45. The second case showed atypical melanocytic proliferation with heavy melanin pigmentation. The tumor cells were positive for S100 protein, HMB-45, tyrosinase, and BRAF V600E. These two cases represent two distinct presentations of PMMB in terms of skin involvement, melanin pigmentation, and HMB-45 positivity. Although PMMB is very rare, the possibility of this entity should be considered in malignant epithelioid neoplasms in the breast parenchyma.
Breast ; Epithelioid Cells ; Keratins ; Melanins ; Melanoma ; Monophenol Monooxygenase ; Mucin-1 ; Pigmentation ; Skin

BACKGROUND AND OBJECTIVES: Many studies have reported no benefit of sound localization, but improved speech understanding in noise after treating patients with single-sided deafness (SSD). Furthermore, their performances provided a large individual difference. The present study aimed to measure the ability of speech perception and gap detection in noise for the SSD patients to better understand their hearing nature.
Deafness ; Hearing ; Hearing Loss ; Hearing Loss, Conductive ; Humans ; Individuality ; Noise ; Plastics ; Sample Size ; Signal-To-Noise Ratio ; Silver Sulfadiazine ; Sound Localization ; Speech Perception ; Young Adult

This study aimed to evaluate the efficacy of music training on the improvement of musical perception among hearing-impaired listeners using a systematic review and meta-analysis. Article search was conducted from five databases, Scopus, ScienceDirect, Web of Knowledge, CINAHL, and PubMed. A total of 186 participants from 10 studies investigating the music training effects on individuals fitted with hearing assistive devices and outcome measurements were included. The meta-analysis showed standardized mean difference as a measure of the effect size, in musical improvement between the preand post-training. Although the funnel plot yielded an asymmetrical graph, the Egger’s regression showed no significant publication bias. Interestingly, subgroup analysis showed that the training effect was greater in children than in adults. With a necessity of longer training period to significantly improve their musical perception, cochlear implant only users had better effect compared to bi-modal users with both cochlear implant and hearing aids. However, the difference in the training effect between the users with and without previous musical experience was nonsignificant. The present study concludes that auditory music training brings hearing-impaired listeners into better musical perception while informing that training effects differ depending on age, duration of the training, and the type of hearing device used.

The present study aimed to compare thresholds of directbone-conduction (BC direct) with those of behaviorally measured BC pure-tone audiometry(PTA) and objectively measured BC auditory brainstem response (ABR) to confirm the clinicalfeasibility of their relationships. Subjects and Methods: Young adults with normal hearingparticipated in the study to determine the thresholds from three measurements at four testingfrequencies. In the BC direct, the vibrator of a bone-anchored hearing aid softband wasplaced on the right mastoid of each subject. In both PTA and ABR, a B71 bone oscillatorwas placed on the subject’s right mastoid. While the subject’s thresholds of BC direct andBC PTA were determined with a clinically routine 5-dB step procedure, BC ABR was conductedto determine the individual’s hearing sensitivity by a peak V of the waveform usingtone-burst and click stimuli. Results: The BC direct showed a different pattern between lowand high frequencies. Precisely, its thresholds were 13.25 and 12.25 dB HL at 0.5 and 1kHz, respectively, but 19 and 19.75 dB HL at 2 and 4 kHz, respectively. A significant positivecorrelation existed between BC direct and PTA at 1 kHz, which was also correlated withABR. Conclusions: Based on the current data, the thresholds of BC direct were similar toBC PTA at low frequencies and BC ABR at high frequencies. The thresholds of BC directmight be predictable at approximately 5 dB higher (or lower) than that in PTA, although alarge data set is required for standardization. J Audiol Otol 2020;24(2):85-90