Congenital stapes fixation showing normal finding of external auditory canal and tympanic membrane causes non-progressive conductive hearing loss in the range of 40 to 60 dB since childhood. It is a rare disease, but most commonly found among the isolated ossicular anomalies. Patients with this disease are very suitable candidates for stapes surgery, and successful hearing improvement can be expected by an appropriate surgical procedure. We report 2 cases of congenital stapes fixation which had been operated improperly. One case showed interposed homologous ossicle between the stapes head and the incus, and the other case showed transposed incus between the malleus handle and the stapes head along with the anterior crus fracture. They showed hearing improvements of more than 30 dB after stapedotomy with placement of the Fisch type stapes prosthesis. We are reporting two cases of misdiagnosed congenital stapes fixation with a discussion.
Ear Canal ; Head ; Hearing ; Hearing Loss, Conductive ; Humans ; Incus ; Malleus ; Prostheses and Implants ; Rare Diseases ; Stapes Surgery ; Stapes* ; Tympanic Membrane

Objectives: The purpose of this study was to compare the demographic, clinical, and criminal characteristics and legal judgments of criminal cases, in which psychiatric evaluation was requested, and to identify factors affecting criminal responsibility judgments. Methods: The medical records of 100 subjects that committed crimes and the judgment records of 51 subjects admitted to Yongin Mental Hospital from February 2005 to February 2021 were analyzed retrospectively. Psychiatric disorder groups were compared with respect to demographic, clinical, criminal characteristics, and legal judgments. Factors affecting criminal responsibility judgments were identified by comparing legal judgment groups. Results: Psychiatric history, criminal motivation, and criminal history differed significantly between psychiatric disorder groups. Differences between the opinions of the appraiser and courts regarding criminal responsibility were significantly dependent on psychiatric disorder type, and there was a consistent tendency according to the psychiatric disorders, but there was a difference of opinion between the two groups. Conclusion The findings of the current study suggest psychiatric diagnoses and symptoms such as psychotic symptoms and cognitive impairments that provoke crime can influence criminal responsibility judgments.

BACKGROUND AND OBJECTIVES: Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory abnormal findings. BMS is not an uncommon disease that ENT doctors can encounter in the OPD clinics. However, the causes, pathophysiology, and treatment of BMS are not known yet, and there are just a few reported articles. The aim of this study was to analyze the characteristics of BMS and to evaluate the effects of steroid gargle treatments. SUBJECTS AND METHOD: We reviewed 18 patients with BMS who visited the Department of Otolaryngology, Ajou University Hospital. The patients were analyzed according to the sites, duration of their burning sensations and associated symptoms. Furthermore, the interview included inquiries regarding current diseases, on-going medications, smoking history and psychological factors. The change of symptoms after steroid gargle treatment with/without other drugs was carefully analyzed. RESULTS: The average age of patients with BMS was 56.4 years old, and the male to female ratio was 8:10. The most frequently involved site was tongue (94.4%), followed by lower lip, gingiva, palate, and floor of mouth. We found that the causes of BMS were psychogenic factors for 4 patients, and diabetes mellitus and hypertension for 2 patients each. Approximately 80.0% (8/10 patients) of the women was menopausal. Six (50.0%) of 12 patients treated only with steroid gargle and 3 (75.5%) of 4 patients treated with steroid gargle and other medications showed relieved symptoms. CONCLUSION: Burning mouth syndrome is not an uncommon disease in the ENT field, and has complex etiology. Although the definitive treatment for BMS is not known yet, we think that steroid gargle may be helpful in the treatment of BMS.
Burning Mouth Syndrome* ; Burns* ; Diabetes Mellitus ; Female ; Gingiva ; Humans ; Hypertension ; Lip ; Male ; Mouth Floor ; Otolaryngology ; Palate ; Psychology ; Sensation ; Smoke ; Smoking ; Steroids ; Tongue

No abstract available.

BACKGROUND AND OBJECTIVES: Conventional studies for the middle ear ossicles destructed by cholesteatoma give relatively limited information on shape, mechanical strength and 3-dimensional relationship. Recently, Micro-CT scanning technology has been applied to analysis of skeletal structure. This study aims to reconstruct the 3-dimensional structure of normal ossicles and destructed ossicles by different cholesteatomas and to compare volume fraction of destructed ossicles with that of normal ossicles. MATERIALS AND METHOD: 13 pathological ossicles obtained during cholesteatoma surgery were used in this study (2 malleuses and 2 incuses from attic cholesteatoma;1 malleus and 2 incuses from sinus cholesteatoma;2 malleuses and 2 incuses from tensa retraction cholesteatoma; 2 incuses from congenital cholesteatoma). As a control, normal ossicles harvested from cadaveric temporal bone specimens were used. The structure of obtained ossicles was analyzed through Micro-CT (SkySan-1072, Belgium) by filming the 2-dimensional cross section image running perpendicular to the long axis of the ossicles. The 3-dimensional images were thereby reconstructed for each, and were analyzed using CT-Analyzer(TM) and ANTTM. Based on the results, the strength of each ossicle were measured. RESULTS: The volume fraction, indicating relative strengths of ossicles, was lower in the portion of destructed surface. The pattern of destructed ossicles by cholesteatoma was different according to pathological status of cholesteatoma. CONCLUSION: Our preliminary data of ossicular structure analyzed by Micro-CT scan will be helpful for elucidation of pathological ossicles in middle ear cholesteatoma and will make a great contribution to research of middle ear cholesteatoma.
Axis, Cervical Vertebra ; Cadaver ; Cholesteatoma* ; Cholesteatoma, Middle Ear ; Ear Ossicles ; Ear, Middle ; Humans* ; Imaging, Three-Dimensional ; Incus ; Malleus ; Microradiography ; Running ; Temporal Bone

Background: The concept of work-life balance (WLB) has become an important issue in workers' health and safety. This study aims to investigate the relationship between WLB and occupational injury and work-related musculoskeletal pain.Method: The study included 27,383 workers who participated in the Fifth Korean Working Conditions Survey. Participants were divided into good WLB and poor WLB groups based on their responses to the five question items which comprised two dimensions: workon-life conflict (items, 1–3) and life-on-work conflict (items 4 and 5). Occupational injury and musculoskeletal pain were also assessed using the question items. The χ 2 test and multivariate logistic regression analyses were performed to examine the relationship of WLB to occupational injury and musculoskeletal pain while considering socio-demographic and occupational characteristics and ergonomic and psychological risk factors. Results: Of the 27,383 participants, 252 (0.9%) had experienced an occupational injury and 6,408 (23.4%) had musculoskeletal pain. The poor WLB group had higher injury rates for both men (1.7%) and women (0.9%) than the good WLB group (1.1% and 0.4%, respectively).Additionally, the prevalence of musculoskeletal pain was higher for both men and women in the poor WLB group (25.2% and 28.0%, respectively) than for men and women in the good WLB group (18.7% and 23.6%, respectively). In the logistic regression analysis, the adjusted odds ratio of WLB for occupational injury was 1.37 (95% confidence interval [CI]: 1.06–1.78), and that for musculoskeletal pain was 1.14 (95% CI: 1.07–1.21), showing positive associations of WLB with both occupational injury and musculoskeletal pain. Conclusions Poor WLB causes an increase in occupational injury and musculoskeletal pain.Therefore, an improvement in WLB may reduce the incidence of occupational injury and musculoskeletal pain among workers. Social and policy-related initiatives are needed to improve workers' WLB to reduce occupational injury and musculoskeletal pain.

Background: The concept of work-life balance (WLB) has become an important issue in workers' health and safety. This study aims to investigate the relationship between WLB and occupational injury and work-related musculoskeletal pain.Method: The study included 27,383 workers who participated in the Fifth Korean Working Conditions Survey. Participants were divided into good WLB and poor WLB groups based on their responses to the five question items which comprised two dimensions: workon-life conflict (items, 1–3) and life-on-work conflict (items 4 and 5). Occupational injury and musculoskeletal pain were also assessed using the question items. The χ 2 test and multivariate logistic regression analyses were performed to examine the relationship of WLB to occupational injury and musculoskeletal pain while considering socio-demographic and occupational characteristics and ergonomic and psychological risk factors. Results: Of the 27,383 participants, 252 (0.9%) had experienced an occupational injury and 6,408 (23.4%) had musculoskeletal pain. The poor WLB group had higher injury rates for both men (1.7%) and women (0.9%) than the good WLB group (1.1% and 0.4%, respectively).Additionally, the prevalence of musculoskeletal pain was higher for both men and women in the poor WLB group (25.2% and 28.0%, respectively) than for men and women in the good WLB group (18.7% and 23.6%, respectively). In the logistic regression analysis, the adjusted odds ratio of WLB for occupational injury was 1.37 (95% confidence interval [CI]: 1.06–1.78), and that for musculoskeletal pain was 1.14 (95% CI: 1.07–1.21), showing positive associations of WLB with both occupational injury and musculoskeletal pain. Conclusions Poor WLB causes an increase in occupational injury and musculoskeletal pain.Therefore, an improvement in WLB may reduce the incidence of occupational injury and musculoskeletal pain among workers. Social and policy-related initiatives are needed to improve workers' WLB to reduce occupational injury and musculoskeletal pain.

BACKGROUND AND OBJECTIVES:The guidelines for Meniere's disease recommended from the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) in 1995, provided a basis for reporting results of the treatment used in Meniere's disease. However, these guidelines are sometimes not all inclusive and appropriate for management and reporting for some patients clinically considered having Meniere's disease. The objectives of this study is to review and analyze the symptoms, vertiginous episodes, audiometry, vestibular function test and results of the treatment in Meniere's disease and to evaluate the significance of AAO-HNS guidelines. MATERIALS AND METHOD:This study consisted of the patients with Meniere symptoms who visited the Dizziness Clinic of Ajou University Hospital between 1994 and 2001 were included in this study. The characteristics of dizziness (duration, frequency, and episodes), pure tone audiometry, vestibular function tests, and treatment results were carefully analyzed according to AAO-HNS guidelines. RESULTS:Of 550 patients with Meniere symptoms, 198 patients were in the criteria for Meniere's disease. They were classified to 75 (37.9%) of the "definite", 120 (60.6%) of the "possible", and only 3 (1.5%) of the "probable". In the "definite" group, the pure tone average (PTA) was 54.3 dB and canal paresis (CP) was showed in 33 patients (44%) with a mean CP of 53.6%, and the peak and descending types of the pure tone audiogram were dominant (62%). In the "possible" group, the PTA was 19.4dB and CP was found in 30 patients (25%) with mean CP of 50.1%. CONCLUSION:Even though AAO-HNS guidelines for Meniere's disease are helpful for communication between doctors, they should be considered to have limitations for the diagnosis and treatment in clinical practices.
Audiometry ; Diagnosis ; Dizziness ; Hearing ; Humans ; Meniere Disease* ; Neck ; Paresis ; Vestibular Function Tests

BACKGROUND: The surgical treatment of secondary spontaneous pneumothorax (SSP) can be complicated by fragile lung parenchyma. The preoperative prediction of air leakage could help prevent intraoperative lung injury during manipulation of the lung. Common sites of bulla development and ruptured bullae were investigated based on computed tomography (CT) and intraoperative findings. METHODS: The study enrolled 208 patients with SSP who underwent air leak control through video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the sites of bulla development on preoperative CT and the rupture sites during VATS. RESULTS: Of the 135 cases of right-sided SSP, the most common rupture site was the apical segment (31.9%), followed by the azygoesophageal recess (27.4%). Of the 75 cases on the left side, the most common rupture site was the apical segment (24.0%), followed by the anterior basal segment (17.3%). CONCLUSION: The azygoesophageal recess and parenchyma along the cardiac border were common sites of bulla development and rupture. Studies of respiratory lung motion to measure the pleural pressure at the lung surface could help to determine the relationship between cardiogenic and diaphragmatic movement and bulla formation or rupture.
Humans ; Lung ; Lung Injury ; Pneumothorax* ; Retrospective Studies ; Rupture ; Thoracic Surgery, Video-Assisted

BACKGROUND AND OBJECTIVES: Benign paroxysmal vertigo of childhood (BPVC) and migraine related vertigo (MRV) are most common causes of vertigo in children. Some authors suggested that BPVC may be an early manifestation of migraine. However there is few articles about relationship between BPVC and MRV. The purpose of this study is to compare the clinical characteristics, audiological and vestibular findings, treatment and prognosis of BPVC and MRV and to provide the helpful information for relationship between BPVC and MRV. MATERIALS AND METHOD: The twenty four children (less than 16 years old) with BPVC and 23 children with MRV, who visited the Dizziness Clinic in the Department of Otolaryngology, Ajou University Hospital, Suwon, Korea between January 2001 and August 2003 were selected for this study. These excluded the patients with abnormal eardrums/tympanograms or those that did not perform questionnaires, audiological, or vestibular evaluations. They were retrospectively analyzed for clinical symptoms, audiograms, vestibular functions, and treatment results. RESULTS: BPVC was frequently detected in younger children than MRV. Spinning sensation was frequently associated with BPVC. Aural symptoms, headache, photophobia, phonophobia, and visual symptoms were frequently associated with MRV. Abnormalities in vestibular function tests were 14 (58%) in BPVC and 15 (62%) in MRV. BPVC & MRV had good prognosis. But medication was sometimes more needed in MRV than in BPVC. CONCLUSIONS: BPVC and MRV show some different features in the age of onset, clinical features, treatment and prognosis, but also have some features of MRV. Further studies are needed to find their relationship between them.
Age of Onset ; Child* ; Dizziness ; Gyeonggi-do ; Headache ; Humans ; Hyperacusis ; Korea ; Migraine Disorders* ; Otolaryngology ; Photophobia ; Prognosis ; Surveys and Questionnaires ; Retrospective Studies ; Vertigo* ; Vestibular Function Tests