BACKGROUND AND OBJECTIVES: The purpose of this study was 1) to assess differences in categories of olfactory dysfunction according to the pathological classification of chronic rhinosinusitis with nasal polyp (CRSwNP) patients; 2) to identify the degree of olfaction recovery after endoscopic sinus surgery (ESS); and 3) to identify the factors that predict the changes in olfactory status. SUBJECTS AND METHOD: The sample of the study consisted of patients with CRSwNP who underwent ESS with biopsy from January 2012 to September 2014. Seventy five patients were classified into eosinophilic CRS (ECRS) and non-ECRS groups. During an approximately five-month follow-up, the Korean Version of Sniffin' Sticks test II (KVSS II) was conducted on each patient to examine the difference between the preoperative and postoperative states of olfactory function. RESULTS: The ECRS group showed a statistical significant increase in the postoperative KVSS II scores when compared to the preoperative scores, while the non-ECRS group did not show any statistically significant change. For the anosmia category by KVSS II, the ECRS group showed significantly improved olfactory function test scores for the threshold, discrimination, and identification tests. CONCLUSION: ECRS and preoperative olfactory function status (anosmia) could be predictable factors of postoperative olfactory function.
Biopsy ; Classification ; Discrimination (Psychology) ; Eosinophils* ; Follow-Up Studies ; Humans ; Methods ; Nasal Polyps ; Olfaction Disorders ; Polyps* ; Smell

BACKGROUND AND OBJECTIVES: Drug-induced sedation endoscopy (DISE) has recently gained popularity among otolaryngologists because it can provide direct information of upper airway obstruction in patients with obstructive sleep apnea (OSA). In that regard, we examined how DISE examination affected the decision of clinician's treatment plan and the consequent patient's compliance in OSA patients. SUBJECTS AND METHOD: All enrolled patients were classified into two groups according to the method of upper airway evaluation employed: a physical examination only group and a physical examination combined with DISE group. The clinician's treatment plan was categorized into the following four groups: sleep surgery, positive airway pressure, oral appliance, and sleep surgery combined with oral appliance. The change of patient's compliance was also evaluated. RESULTS: There were several differences in how DISE evaluation affected the decision of clinician's treatment plan and patient's compliance between the two groups. The rate for sleep surgery fell from 69.6% to 15.9%; on the other hand, the rate for positive airway pressure, oral appliance and sleep surgery combined with oral appliance all increased from 13.0% to 36.2%, 14.5% to 26.6%, and 2.9% to 21.3%, respectively. The patient's compliance also changed after DISE evaluation: sleep surgery, positive airway pressure, oral appliance and sleep surgery combined with oral appliance all increased from 78.1% to 87.9%, 16.7% to 76.0%, 25.0% to 87.3%, and 50.0% to 91.03%, respectively. CONCLUSION: We found that DISE examination influences the decision of clinician's treatment plan and patient's compliance. We suggest additional cohort studies to confirm these findings.
Airway Obstruction ; Cohort Studies ; Compliance ; Endoscopy* ; Hand ; Humans ; Methods ; Physical Examination ; Sleep Apnea, Obstructive*

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the usefulness of speech mapping based on real ear measurement for routine hearing aid fitting and to compare functional gains for evaluating subjective satisfaction of hearing aid users. SUBJECTS AND METHOD: Twenty two participants with bilateral symmetric (< 10 dB HL difference) sensorineural hearing loss were enrolled in this study. All participants were fitted unilateral hearing aids with speech mapping using the National Acoustic Laboratories-Nonlinear 2 formula. After the initial fitting, patients were followed with the 2nd and 3rd fitting at two weeks and six weeks, respectively, and measured for aided pure tone average (PTA), aided speech discrimination score (SDS), the difference between target gain and real ear insertion gain (REIG) using speech mapping and subjective satisfaction via Korean Adaptation of the International Outcome Inventory for Hearing Aids (K-IOI-HA) questionnaire before further fitting was performed. We analyzed correlation of each parameter at 2nd and 3rd fitting with the K-IOI-HA score. RESULTS: Every sequential aided PTA and SDS at 2nd fitting and 3rd fitting were significantly improved after repeated hearing aid fitting (all p < 0.01). In the correlation analysis between K-IOI-HA and each parameter, the aided PTA and aided SDS did not show significant correlations with subjective satisfaction from the 2nd and 3rd fittings. But the difference between the target gain and R EIG in speech mapping showed significant negative correlations with the satisfaction scores at various speech level (r=–0.609 to –0.709, all p < 0.01). CONCLUSION: Speech mapping using real ear measurement was useful to expect subjective satisfaction of hearing aid users and it would be a valuable tool for fine tuning to achieve individual preferences.
Acoustics ; Auditory Threshold ; Ear ; Hearing Aids* ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing* ; Humans ; Methods ; Speech Perception

BACKGROUND AND OBJECTIVES: This study analyzed short-term clinical outcome and safety of Neuro One® (Oticon Medical) cochlear implantation on postlingually deafened Korean adults. SUBJECTS AND METHOD: A prospective study was performed on five postlingually deafened Korean adults who underwent Neuro One® cochlear implantation between April and June, 2016. All cases were successfully implanted via round window approach. Preoperative pure tone audiometry and speech perception score [phonetically balanced (PB) words, bi-syllable words, Korean version-central institute for the deaf (K-CID)], intraoperative evoked compound action potential (ECAP), postoperative audiometry, aided warble-tone thresholds and speech perception scores after 6 months were evaluated. Residual hearing group was defined as patients with below 40 dB of average audiometric threshold in low frequency (250 and 500 Hz). Preservation of residual hearing and postoperative complication were also evaluated. RESULTS: The mean age of five patients (3 men, 2 women) was 37.6 years. All of the recipients were unsatisfied about the conventional hearing aid. Two patients met the criteria for belonging to a residual hearing group. The audiometric threshold on the implanted side was 102.8 dB, and the opposite side was 89.6 dB. The speech perception score with hearing aid resulted in the PB word score of 35.5%, bi-syllable word score of 50%, and the open set sentence test of 62.5% on the average. The mean operation time was 87 minutes. Three patients showed normal ECAP response throughout the entire electrode intraoperatively, but the other two patients could not detect ECAP response intraoperatively. However, we could eventually identify ECAP responses in all cases postoperatively. All patients of residual hearing group could preserve their residual hearing without deteriorating more than 10 dB on audiometry. At 6 months after implantation, there was significant improvement of speech perception scores (PB word score was 54.1%; bi-syllable word score was 68.1% and K-CID was 86.2%). CONCLUSION: Neuro One® cochlear implant system was able to preserve residual hearing with relative short operation time. Short-term clinical outcome showed no significant difference with other cochlear implant devices. However, intraoperative ECAP measurement was not consistent. Further investigation was necessary.
Action Potentials ; Adult* ; Audiometry ; Cochlear Implantation* ; Cochlear Implants* ; Electrodes ; Hearing ; Hearing Aids ; Humans ; Male ; Methods ; Postoperative Complications ; Prospective Studies ; Speech Perception

The extracellular matrix (ECM) of the vocal folds cannot be replaced after severe injury, but heal as scars. Scarred vocal folds cause voice problems. Many treatments have been attempted for vocal fold scarring, but their effectiveness is limited because the ECM composition does not normalize. Therefore, until now the prevention of scar formation has been important. In the field of regenerative medicine, cell therapies such as stem cell transplantation, and the implantation of several types of growth factors with or without scaffolds have been used. In this article, we reviewed the published research related to vocal fold regeneration and tried to think about the limitations of current studies and the future direction of treatment.
Cicatrix ; Extracellular Matrix ; Intercellular Signaling Peptides and Proteins ; Regeneration* ; Regenerative Medicine ; Stem Cell Transplantation ; Stem Cells ; Tissue Engineering ; Vocal Cords* ; Voice

Myxofibrosarcoma is the most common soft tissue sarcoma that occurs in late adult life, mainly occurring in the lower extremities and trunk. However, head and neck myxofibrosarcoma is extremely rare. The most reliable treatment of adult soft tissue sarcoma is surgical resection with negative margin. A 79-year-old man presented with a left cheek mass first detected six months ago. The pathologic report of the mass showed that it was myxofibrosarcoma and consequently postoperative radiotherapy was done. However, distant and locoregional metastasis occurred postoperatively. We report this case with a brief review of literature.
Adult ; Aged ; Cheek* ; Head ; Histiocytoma, Malignant Fibrous ; Humans ; Lower Extremity ; Myxosarcoma ; Neck ; Neoplasm Metastasis ; Radiotherapy ; Sarcoma

Lateral neck metastasis is an independent risk factor of the loco-regional recurrence in papillary thyroid carcinoma (PTC). Ultrasonography (US) and computed tomography are frequently performed to diagnose the lymph node (LN) metastasis. However, some metastatic LNs can remain after initial treatment and can present as regional recurrences. A 19-year-old woman was diagnosed as having 1.99 cm PTC. No abnormal LNs was detected on preoperative CT and US. She underwent operation and radioactive iodine (RAI) therapy: seven months after RAI therapy, thyroglobulin level was elevated. However, no metastatic LNs were detected on neck CT, US and positron emission tomography-CT. Neck exploration was performed and metastatic PTC was diagnosed in bilateral level III and IV. A radiologist retrospectively reviewed the neck CTs taken before the first surgery and the second surgery. There was no significant difference in the LN appearances of two CTs. On both CT scans, all LNs were very small, homogenously enhanced, without calcification or cystic changes.
Electrons ; Female ; Humans ; Iodine ; Lymph Nodes* ; Neck ; Neck Dissection ; Neoplasm Metastasis* ; Radiotherapy, Adjuvant ; Recurrence* ; Retrospective Studies ; Risk Factors ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult

Hemophilia is an X-linked recessive disorder, which is classified into hemophilia A, defined by factor VIII deficiency and hemophilia B, defined by factor IX deficiency. The usual clinical presentation is spontaneous bleeding and prolonged activated partial thromboplastin time in a person without history of a coagulation disorder. The severity of hemophilia describes how serious a problem is and has been defined by a traditional classification into three forms: severe, moderate, mild. Hemophilia has never been reported after a rhinosinus surgery in otorhinolaryngology in Korea, but we encountered a 37-year-old man with hemophilia B who had undergone a rhinosinus surgery. He had no bleeding tendency in the past nor a family history for bleeding. But the patient presented with continuous nasal bleeding for a few days after surgery. We report this case of hemophilia B diagnosed after rhinosinus surgery that was cured with Factor IX replacement therapy with a review of the relevant literature.
Adult ; Classification ; Endoscopy ; Epistaxis ; Factor IX ; Hemophilia A* ; Hemophilia B* ; Hemorrhage ; Humans ; Korea ; Otolaryngology ; Partial Thromboplastin Time

Epidermal cysts are generally benign tumors that usually originate from the skin caused by inflammation of hair cortex and proliferation of epidermal cells within the dermis; however, for these cysts to occur in the bony external auditory canal (EAC) is rare. They are often present as a solitary, painless lesion and usually asymptomatic and the diagnosis depends on the results of the histological examination. In treatment, the cyst wall must be completely removed surgically. We recently encountered a 82-year-old male with a mass in the right EAC. An otoscopic examination showed a polypoid mass on the bony EAC, which was finally diagnosed as epidermal cyst after an initial misdiagnosis as EAC carcinoma. We report the rare, unique case with literature review.
Aged, 80 and over ; Dermis ; Diagnosis ; Diagnostic Errors ; Ear Canal* ; Epidermal Cyst* ; Hair ; Humans ; Inflammation ; Male ; Skin

A congenital cholesteatoma is a benign mass formed from the keratinizing stratified squamous epithelium. It usually occurs in young children's anterosuperior part of the middle ear. A congenital cholesteatoma which originates from mastoid temporal bone or expands to posterior cranial fossa is rare. Standard treatment of an intracranial cholesteatoma is surgical removal with craniotomy. A 69-year-old woman was diagnosed with a congenital cholesteatoma of mastoid temporal bone that expanded to the posterior cranial fossa, which was successfully treated with transmastoid marsupialization without craniotomy. This is a first documented case of a congenital cholesteatoma of mastoid temporal bone that expanded to posterior cranial fossa, which was successfully treated with transmastoid marsupialization without craniotomy.
Aged ; Cholesteatoma* ; Cranial Fossa, Posterior* ; Craniotomy ; Ear, Middle ; Epithelium ; Female ; Humans ; Mastoid* ; Occipital Bone ; Temporal Bone*