BACKGROUND AND OBJECTIVES: Recurrent vestibulopathy is defined a disease characterized by more than a single episode of vertigo of duration characteristic of endolymphatic hydrops but without auditory or clinical neurological symptoms or signs. To investigate the clinical characteristics and the efficacy of combination therapy, we analyzed the clinical records of the patients diagnosed as recurrent vestibulopathy. MATERIALS AND METHOD: Clinical records of sixty four patients diagnosed as recurrent vestibulopathy were retrospectively reviewed. The data on age, sex distribution, natural history, family history of recurrent vestibulopathy, concurrent headache, caloric response was analyzed. The efficacy of combination therapy for vertigo control in the patients with a minimum 24-month follow-up was also evaluated. RESULTS: Mean onset age of recurrent vestibulopathy was 43 years and there was a female preponderance. Concurrent headache and elevated SP/AP ratio in electrocochleogram was frequently observed in these patients. After the combination medical therapy, patients with severe recurrent vestibulopathy showed significant decrease in the number of vertigo spells with 37.5% of complete control of vertigo. CONCLUSION: As a distinctive clinical disorder with unknown cause, recurrent vestibulopathy should be always considered to the patients complaining recurrent episodic vertigo. Combination therapy individualized to the symptoms and signs of the patients with recurrent vestibulopathy might be effective in reducing the frequency of vertigo attacks. Further case-control studies with large population should be necessary.
Age of Onset ; Case-Control Studies ; Endolymphatic Hydrops ; Female ; Follow-Up Studies ; Headache ; Humans ; Natural History ; Retrospective Studies ; Sex Distribution ; Vertigo ; Vestibular Neuronitis*

No abstract available.
Coxiella burnetii* ; Coxiella* ; Korea* ; Milk*

BACKGROUND AND OBJECTIVES: Paper patching for the treatment of traumatic tympanic membrane perforation is a safe, simple, and inexpensive method. This study was designed to evaluate the therapeutic effect of proper paper-patch techniques for traumatic tympanic membrane perforation using more objective measurement of perforated area by image analyzer. SUBJECTS AND METHOD: A prospective study of paper-patch techniques was carried out on 55 patients with traumatic perforations of the tympanic membrane. Objective semiquantitative measurement of the perforated area was performed using computerized image analyzer. Immediate eversion of inverted flaps and single to multiple patching techniques were used in all cases. Treatment results were analyzed according to various variables which may affect the healing rate. RESULTS: The closure rate of tympanic membrane with this paper patching method was 98.2% and the mean healing time was 2.9+/-1.9 weeks. Hearing impairment was correlated with the size of perforation which was measured quantitatively by image analyzer and the healing rate was decreased with infectious signs such as otorrhea. There were no side effects or complications. CONCLUSION: Multiple paper patching with proper technique for traumatic tympanic membrane perforation produced an excellent success rate and could be considered as part of initial therapeutic methods for all cases of large perforation with inverted flap.
Hearing Loss ; Humans ; Prospective Studies ; Tympanic Membrane ; Tympanic Membrane Perforation

Semicircular canal dehiscence is a rare but well-described condition to be induced noise or straining. Patients with Superior semicircular canal dehiscence (SSCD) present with a wide variety of symptoms. Reported case is a 51-year-old woman who presented with intermittent vertigo and left-side aural fullness for one month after traffic accident. To establish the diagnosis, high resolution temporal bone CT scanning has been performed to demonstrate bone defect overlying superior semicircular canal, and vestibular auditory symptoms and signs are evaluated through vestibular function test and auditory examination. Cognitive behavior therapy, vestibular rehabilitation and vestibular suppressants are prescribed. Auditory symptoms and vertigo have been subsided. At the same time, Presented depression and anxiety have been improved after 3 month treatment and the quality of life of patient has been improved.
Accidents, Traffic ; Anxiety ; Cognitive Therapy ; Depression ; Female ; Humans ; Middle Aged ; Noise ; Quality of Life ; Semicircular Canals ; Sprains and Strains ; Temporal Bone ; Vertigo ; Vestibular Function Tests

Palatal myoclonus is a rare condition in which there are rhythmic jerky movements of the soft palate and sometimes of the other muscles innervated by the brainstem A particularly annoying symptom is a rhythmic clicking sound in the ear due to the opening and closing of the Eustachian tube. Orofacial buccal dystonia is a focal dystonia with sustained spasms of the masticatory, facial or lingual muscles. The frequent symptoms of this disease have mainly been reported to be involuntary and possibly painful jaw opening, closing, deflecting and retruding, or a combination of the above. However, the subtle and unnoticeable involuntary movement of multiple facial muscles, which might be an infrequent symptom of orofacial buccal dystonia, makes this disease hard to diagnose. Understanding the functional orofacial anatomy that is responsible for the clinical signs and symptoms is necessary for making a proper diagnosis. Here we report on a rare case of palatal myoclonus that was associated with orofacial buccal dystonia, and such a case has not been previously reported. We describe the diagnostic approach and excellent treatment results after Botulinum toxin A (Dysport) injection and proper counseling.
Botulinum Toxins ; Brain Stem ; Counseling ; Dyskinesias ; Dystonia ; Dystonic Disorders ; Ear ; Eustachian Tube ; Facial Muscles ; Jaw ; Muscles ; Myoclonus ; Palate, Soft ; Spasm ; Tinnitus

Objective tinnitus due to high jugular bulb is a rare presenting symptom. Annoying pulsatile tinnitus caused by high jugular bulb which may cause sleep disturbance or hearing impairment can be treated by surgical therapy of ligation of internal jugular vein. We present a case of pulsatile tinnitus with high jugular bulb which has been treated by surgical therapy. Otologic examination demonstrated bluish mass in hypotympanic portion behind intact tympanic membrane and temporal bone CT showed the high jugular bulb. Audiological characteristics and the nature of tinnitus was also described. After the angiographic examination, the site for venous ligation was confirmed by compression of internal jugular vein with the probe of doppler sonogram. The patient's pulsatile tinnitus has completely disappeared two weeks after surgery.
Hearing Loss ; Jugular Veins* ; Ligation* ; Temporal Bone ; Tinnitus* ; Tympanic Membrane

Relapsing polychondritis is a relatively rare systemic disease characterized by episodic recurrent inflammation involving cartilaginous structure of auricle, joints, nose, eyes, respiratory tract, heart valve, and skin. The etiology is unknown but autoimmune mechanism has been thought to be its causative factor. Autoantibodies against cartilaginous collagen may play a crucial role in the pathogenesis of relapsing polychondritis. We have recently experienced a case of relapsing polychondritis with recurrent otitis media with effusion, so we report this case with a review of the literature.
Autoantibodies ; Collagen ; Heart Valves ; Inflammation ; Joints ; Nose ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Polychondritis, Relapsing* ; Respiratory System ; Skin

For the purpose of obtaining reference materials for the prevention and management of mental health promoting in industrial workers, this survey was investigated the relationship between subjective fatigue symptoms and its related factors such as demographic, job and health related variables. 442 cases of industrial workers which occurred in 7 factories of machine an4 metal manufacturing industrial in Taejon industrial area surveyed by self-recorded questionnaire. The results were as follows : 1. In the complaint raters of fatigue, "eye strain" was the highest (21.9%) and followed by "feel like tying" (12.4%) and "feel a pain in the low back" (12.4%), "feel drowsy" (12.2%), "yawning a lot"(11.8%) and "whole body feels tired" (11.1%) in the descending order. 2. In the average weighted scores of fatigue complaints, dullness and steepness group (I) was the highest, followed by difficulty in concentration group(II) and bodily projection of fatigue group(III) in the descending order. 3. The average weighted scores of fatigue complaints by general characteristics were significantly higher in the lower age group, lower education group and unmarried divorce group. But there was no significant difference in sex. 4. By the working condition, the fatigue scores were significantly higher in manual worker and shift worker than in clerical worker and day worker. 5. By the life style, the fatigue scores were significantly lower in 7-8 sleeping hour group and every day eating breakfast group than in other groups. But fatigue score of everyday alcohol drinking group and the lower health practice indecies group were significantly higher than that of other groups. 6. By the health status and psychological factors, the fatigue scores were higher in unhealthy group, unsatisfaction income level group, unsatisfaction worker contents group and the group of badly self-control in work. 7. In the stepwised multiple regression, factors affecting the fatigue symptoms scores were depression symptom score, health status, marital status, job satisfaction, job repeatedness and body mass index.
Alcohol Drinking ; Body Mass Index ; Breakfast ; Daejeon ; Depression ; Divorce ; Eating ; Education ; Fatigue* ; Humans ; Job Satisfaction ; Life Style* ; Marital Status ; Mental Health ; Psychology ; Questionnaires ; Single Person

BACKGROUND: A recent advancement in microsurgery, the free flap is widely used in the reconstruction of the lower leg and foot. The simple and effective methods of local flaps, including transposition and advancement flaps, have been considered for patients with chronic debilitation who are unable to endure long surgical procedures or general anesthesia. However, the location and size of the wound may restrict the clinical application of a local flap. Under these circumstances, a sural flap can be an excellent alternative, rendering satisfying clinical outcomes in chronically debilitated patients. METHODS: Between 2008 and 2012, 39 patients underwent soft tissue defect treatment by sural artery flap as a final method. All of the patients had at least one chronic disease or more (diabetes, hypertension, vascular disease, etc.). Also, all of the patients had a history of chronic lower extremity ulceration, which revealed no response to several months of conservative treatment. RESULTS: The results of the 39 cases had a success rate of 100% with 39 complete recoveries. Nine cases suffered complications: partial necrosis (n=4), wound dehiscence without necrosis (n=3), hematoma (n=1), and infection (n=1). CONCLUSIONS: The sural artery flap is not only useful for the lower leg but also for the heel, and other various parts. Furthermore, it is a relatively simple surgical technique for reconstructing the defect area for patients with various chronic conditions with a high surgical risk or contraindications to surgery.
Anesthesia, General ; Arteries ; Chronic Disease ; Foot ; Free Tissue Flaps ; Heel ; Hematoma ; Humans ; Hypertension ; Leg ; Lower Extremity ; Microsurgery ; Necrosis ; Organic Chemicals ; Soft Tissue Injuries ; Surgical Flaps ; Ulcer ; Vascular Diseases

OBJECTIVES: Morphological studies on presbycusis, or age-related hearing loss, have been performed in several different strains of mice that demonstrate hearing loss with auditory pathology. The C57BL/6 (C57) mouse is a known model of early onset presbycusis, while the CBA mouse is characterized by relatively late onset hearing loss. We performed this study to further understand how early onset hearing loss is related with the aging process of the cochlea. METHODS: We compared C57 cochlear pathology and its accompanying apoptotic processes to those in CBA mice. Hearing thresholds and outer hair cell functions have been evaluated by auditory brainstem response (ABR) recordings and distortion product otoacoustic emission (DPOAE). RESULTS: ABR recordings and DPOAE studies demonstrated high frequency hearing loss in C57 mice at P3mo of age. Cochlear morphologic studies of P1mo C57 and CBA mice did not show differences in the organ of Corti, spiral ganglion, or stria vascularis. However, from P3mo and onwards, a predominant early outer hair cell degeneration at the basal turn of the cochlea in C57 mice without definitive degeneration of spiral ganglion cells and stria vascularis/spiral ligament, compared with CBA mice, was observed. Additionally, apoptotic processes in the C57 mice also demonstrated an earlier progression. CONCLUSION: These data suggest that the C57 mouse could be an excellent animal model for early onset 'sensory' presbycusis in their young age until P6mo. Further studies to investigate the intrinsic or extrinsic etiologic factors that lead to the early degeneration of organ of Corti, especially in the high frequency region, in C57 mice may provide a possible pathological mechanism of early onset hearing loss.
Aging ; Animals ; Apoptosis ; Cochlea ; Evoked Potentials, Auditory, Brain Stem ; Hair ; Hearing ; Hearing Loss ; Ligaments ; Mice ; Mice, Inbred CBA ; Models, Animal ; Organ of Corti ; Presbycusis ; Spiral Ganglion ; Stria Vascularis