BACKGROUND: This study was designed to evaluate medical instrument purchases by Korean family practitianers in private practice. We then proposed guidelines for purchasing equipment for new physicians who are just beginning their private practice. METHODS: A questionnaire was sent to 646 family practitioners managing their private clinics. The questiannaire assessed current medical equipment purchases. They were then asked which instruments they would recommend or discourage others from purchasing. We analysed 123 returned questionnaires (19%). RESULTS: The number of instruments they have was between 4 to 26, and the average was 13. The most frequently owned items included in descending order: otoscope (89.9%), electrocardiograph(82.5 %), ophthahnoscope(78.9%), ultrasound(78%), ultraviolet sterihzer(73.2%) and microscope(69.9%). The instruments they recommended avoiding were sigmoidoscope(27.3%), cryo-therapy kit(25%), laser therapy kit(21.1%), thermo-hemorrhoidectomy instrument(20%), and defibrillator (20%). Instruments they recornmended purchasing were otoscope(87.0%), electrocardiograph (83.0%), ultrasound(74.8%), gastrofiberscope(65.9%), ultraviolet sterilizer(63.4%), microscope(57.7%), and plain radiographic unit(<100mA, 56.1%). The most frequent advice given in purchasing medical instruments was "Avoid over (purchasing) at the beginning". Some instruments were different in possession rate according to sex, age, and practice patterns. CONCLUSIONS: This study evaluated medical instrument purchases of Korean family practitianers in private practice. This compiled list may be of benefit to new physicians who are just opening their own clinic.
Defibrillators ; Electrocardiography ; Humans ; Laser Therapy ; Otoscopes ; Physicians, Family ; Private Practice* ; Surveys and Questionnaires

PURPOSE: To examine the effect of unilateral otitis media and unilateral cerumen occlusion of the ear canal on thermometers. METHODS: One hundred eighty six children with unilateral otitis media, fifty children with unilateral cerumen occlusion, and fifty children with neither otitis media nor cerumen were enrolled. Temperature was measured in both ear canals using thermometers. After 15 minutes, second temperature was measured again in both ears. Unilateral otitis media was graded by video otoscope for 7 grades. Differences in temperatures between affected ears and unaffected ears were analyzed. RESULTS: No temperature difference between the normal and cerumen groups was observed. The mean temperature of the otitis media ear canal was 0.13+/-0.20degrees C higher than that of the intact ear canal (36.99+/-0.54degrees C vs 36.86+/-0.52degrees C; P<0.001). There was no statistically significant temperature difference between grades. CONCLUSION: Unilateral otits media can affect estimation of body temperature measured by thermometers.
Body Temperature ; Cerumen ; Child ; Ear ; Ear Canal ; Humans ; Otitis ; Otitis Media ; Otoscopes ; Thermometers

BACKGROUND AND OBJECTIVES: An otoscope is a basic instrument used by otorhinolaryngologists. An inappropriately sterilized otoscope has been reported to be a possible bacterial vector for infection. In this regard, we decided to investigate contaminated otoscopes for possible bacterial contamination and evaluate the efficacy of the otoscope disinfection methods. MATERIALS AND METHOD: We randomly drew 22 otoscope cones from university hospitals and 10 from private hospitals. Cones were divided into three groups accordingly to their sterilization methods: group 1 was wiped with 70% isopropyl alcohol, group 2 was soaked for 20 min in 70% isopropyl alcohol, and group 3 was soaked in CIDEX solution. The samples were cultured twice, first before the disinfection process and then after the disinfection process. Otoscopes were cleaned for a week by employing these techniques. RESULTS: Most of the pre-sterilized otoscopes (20/22) were obtained from the hospitals which demonstrated contamination with microorganisms. Staphylococcus was the most common bacteria found (16/22). After a week of cleansing, no bacteria were seen in group 1 (0%, 0/8), whereas group 2 (14.3%, 1/7), and group 3 (28.6%, 2/7) still showed remaining microorganisms. The three methods were significantly effective on sterilizing microorganisms. CONCLUSION: An otoscope can be a vector for spreading infection. We found that disinfection by alcohol-swabbing alone is sufficient for sterilizing otoscope cones. Clinically, this information may be useful to otorhinolaryngologists. However, further studies are required to establish the most appropriate disinfection protocol to prevent infection from microorganisms.
2-Propanol ; Bacteria ; Disinfection ; Glutaral ; Hospitals, Private ; Hospitals, University ; Methods ; Otoscopes* ; Staphylococcus ; Sterilization

BACKGROUND AND OBJECTIVES: To study the incidence of nasal septal deformities (NSD) in neonates and to identify pregnancy conditions related with NSD occurrence. MATERIALS AND METHODS: Prospective study of 131 women and their newborns. Incidences of neonatal NSD were looked for with a cotton wool test and through direct visual examination of the neonatal nasal cavity with an otoscope. Under study were arbitrary but possibly related factors of neonatal NSD : the mother's age, parity, medical history, the duration of total labor, the duration of second-stage labor, the delivery type, neonatal birth weight and gestational age. The contributions of these factors were analyzed statistically. RESULTS: The incidence of neonatal NSD as identified through otoscopic examination was 11.5%. All studied factors indicated no statistically significant relationship with neonatal NSD. CONCLUSION: Probable nasal trauma during pregnancy and delivery is likely not a factor in the occurrence of NSD in neonates.
Birth Weight ; Congenital Abnormalities* ; Female ; Gestational Age ; Humans ; Incidence* ; Infant, Newborn* ; Nasal Cavity ; Otoscopes ; Parity ; Pregnancy* ; Prospective Studies ; Wool

BACKGROUND AND OBJECTIVES: Nasal septal deformities have been reported at all ages and in all races. Many factors have been reported as being causative factors in nasal septal deformities. Among the factors, birth trauma was first reported by Metzenbaum as being a causative factor in nasal septal deformities, and has since been reported by many other authors. The aim of this study was to find if birth trauma is a cause of nasal septal deformities and to assess the frequency of neonatal septal deformities in Korean neonates. MATERIAL AND METHOD: The experiment was performed in a randomized group of neonates. A number of 602 neonates aged 1- 2 days have been examined in a two-month period. A number of 278 neonates were born by natural vaginal delivery (group A), 264 by elective cesarean section (group B) and 60 by emergency cesarean section (group C). The nasal septa of neonates were examined by otoscope, cotton wool test and strut test. RESULT: The septal deformities have been found in 66 neonates of group A (23.74%), in 32 of group B (12.12%) and in 11 of group C (18.33%). The Frequency of septal deformities was higher in group A compared to group B and C (p<0.05). In the group A neonates with septal deformity, however, the correlations between parity and septal deformity and between birth weight and septal deformity were not statistically significant (p <0.05). The overall incidence of septal deformities in the investigated neonates was 18.1% in this study. CONCLUSION: Birth trauma is a causative factor of neo natal septal deformities.
Birth Weight ; Cesarean Section ; Congenital Abnormalities* ; Continental Population Groups ; Emergencies ; Female ; Humans ; Incidence ; Infant, Newborn ; Otoscopes ; Parity ; Parturition ; Pregnancy ; Wool

The prevalence and related diseases of otitis media with effusion(OME) which is a very common disease in infants and young children were investigated in a group of 3 to 6 year old children. The study population includes 374 children with 185 boys and 189 girls enrolled in 7 kindergartens in Puchun city. The middle ear status was assessed by combination of findings of otomicroscope, pneumatic otoscope, impedence audiometry. The related diseases were evaluated by radiologic findings and questionnare with statistic analysis. Fifty-nine children were considered to have OME(prevalence: 15.8%) with peak at 3 years of age(30.6%). Of the 59 children with OME, fifty-four percent had bilateral involvement and all the remainder had unilateral involvement. The risk for otitis media with effusion increased in children with adenoid enlargement, tonsillar enlargement, and paranasal sinusitis, and this was confirmed to be statistically significant(p<0.01).
Adenoids ; Audiometry ; Child* ; Cross-Sectional Studies* ; Ear, Middle ; Female ; Gyeonggi-do* ; Humans ; Infant ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Otoscopes ; Prevalence* ; Sinusitis

BACKGROUND AND OBJECTIVES: The purpose of this study is to determine the prevalence of abnormalities in the mastoid cavity and middle ear in a non-ENT population, and to correlate with clinical data. SUBJECTIVES AND METHOD: Cross-sectional study. We prospectively evaluated a total of 100 adults and 30 children undergoing MRI scan for suspected intracranial pathology from May to July 2003. Patients who had previous history of mastoid/middle ear surgery and were suffering otitis media were excluded. The T2-weighted images were reviewed. The abnormalities found on MRI were divided into 1) mastoid cavity abnormality, and 2) middle ear abnormality. All patients were asked to complete a questionnaire pertaining to symptoms of mastoid/middle ear pathology and history of previous otitis media. Also, their ears were examined carefully by otoscope or otomicroscope. RESULTS: In both groups, most of abnormalities were found in the mastoid cavity. Analysis of the clinical data revealed that abnormal MRI findings of the mastoid cavity were significantly correlated to clinically significant mastoid/middle ear diseases in adults. CONCLUSION: Incidental MRI abnormalities in mastoid cavity and middle ear detected in a non-ENT population were relatively uncommon, compared to incidental paranasal sinus abnormalities. However, clinicians should remember the possibility of the pathologies that demand active treatment among these abnormalities, especially when high signal abnormality is found in the mastoid cavity of adults.
Adult* ; Child ; Cross-Sectional Studies ; Ear ; Ear Diseases ; Ear, Middle* ; Humans ; Incidental Findings ; Magnetic Resonance Imaging* ; Mastoid* ; Otitis Media ; Otoscopes ; Pathology ; Prevalence* ; Prospective Studies ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: Spectral gradient acoustic reflectometry (SGAR) determines the probability of middle ear fluid by measuring the response of the tympanic membrane to a sound. To assess the sensitivity and specificity of SGAR for the diagnosis of otitis media with effusion (OME) in the Korean population, we compared accurate diagnostic rates of OME obtained from SGAR and tympanometry. Pneumatic otoscope was used for diagnostic standard of OME. SUBJECTS AND METHOD: SGAR and tympanometry were performed on 488 ears from May 27th, 2008 to July 30th, 2008. Exclusion criteria were the presence of tympanic membrane perforation, and/or pressure equalization tubes, noncompliance, otorrhea, external auditory canal stenosis and signs of acute inflammation such as fever or otalgia. In all cases, pneumatic otoscopic examination was conducted and diagnostic accurate rates of OME were calculated in SGAR and tympanogram. RESULTS: Using spectral gradients of 3 or higher as breakpoints for indicating OME, in the case of pediatrics under 2 years old, with the sensitivity of 58.3%, specificity of 94.7%, positive predictive value (PPV) of 77.8% and negative predictive value (NPV) of 87.8%. In the case of the pediatrics between 2 and 12 years old, it showed the sensitivity of 67.2%, specificity of 90.3%, PPV of 74.5% and NPV of 86.8%. In the case of the pediatrics over 12 years old, they showed sensitivity of 87.3%, specificity of 88.8%, PPV of 67.6% and NPV of 96.3%. CONCLUSION: SGAR has the higher tendency of specificity and NPV, and will be a useful screeningtest with good portability and economical efficiency.
Acoustic Impedance Tests ; Acoustics ; Constriction, Pathologic ; Ear ; Ear Canal ; Ear, Middle ; Earache ; Fever ; Inflammation ; Otitis Media with Effusion ; Otoscopes ; Pediatrics ; Sensitivity and Specificity ; Tympanic Membrane ; Tympanic Membrane Perforation

Objective: To explore the feasibility and short-term effect of tensor tympani muscle Tenotomy in the treatment of Meniere's disease under otoscope. The possible pathogenesis was discussed and our views were put forward. Methods: The clinical data of 9 cases of Meniere's disease treated by otoscopic Tenotomy were analyzed retrospectively, including 2 males, 7 females, 5 right ones, 2 left ones and 2 bilateral ones. The average age was (56.33± 10.56) years, ranging from 38 to 75 years. We evaluated intraoperative findings and short-term postoperative efficacy, respectively evaluated postoperative aural fullness, tinnitus and hearing recovery, and evaluated postoperative vertigo attack in a short time. Results: Nine patients were completed the operation under general anaesthesia and otoscopy, and no serious complications occurred. We found new pathological changes in tympanic cavity in some cases during operation. There were rupture of round window membrane in 1 case, severe fibrous hyperplasia near the round window membrane and vestibular window and adhesion with ossicular chain in 1 case, fibrous cord and membranous hyperplasia near vestibular window and round window membrane in 1 case, fibrous hyperplasia and adhesion near the round window membrane in 2 cases, membranous hyperplasia and adhesion around vestibular window in 1 case. No fibrous hyperplasia was found in 3 cases in the tympanic cavity. The round window membrane can be exposed in 4 cases and failed in 5 cases. After 3 months of follow-up, we found that we found that 5/5 cases of aural fullness disappeared, 2/2 cases of earache disappeared, 3/8 cases of tinnitus improved, 5/8 cases presented with improvement and no aggravation, 3/3 cases of hearing allergy improved, 4/9 cases of hearing improved, and 5/9 cases showed no improvement or decrease. 9 patients were followed up for 3 months, of whom 8 patients had no vertigo, one patient suffered from vertigo twice within 3 months after operation, and the patient suffered from rupture of round window membrane. Conclusions: Endoscopic Tenotomy for Meniere's disease has obvious curative effect and quick recovery after operation. During the operation, we find that most of Meniere's patients have fibrous cord hyperplasia near the inner ear window membrane, which may be the pathological manifestation after repeated rupture and repair of the inner ear window membrane. The vertigo of Meniere's disease may be related to the destruction and repair of inner ear membrane structure caused by improper contraction or spasm of tympanic tensor muscle.
Aged ; Female ; Humans ; Hyperplasia/pathology* ; Male ; Meniere Disease/surgery* ; Middle Aged ; Otoscopes/adverse effects* ; Retrospective Studies ; Tenotomy/adverse effects* ; Tensor Tympani/surgery* ; Tinnitus/complications* ; Vertigo/etiology*

PURPOSE: Acute otitis media(AOM) has variable clinical symptoms and is diagnosed with injection, bulging, and decreased mobility of tympanic membrane. There are many misdiagnoses because children who are suspected of having acute otitis media are uncooperative during diagnosis with an otoscope. An inaccurate diagnosis of acute otitis media when using an otoscope results in wasted of medical resourses and increased tolerance to antibiotics. Therefore, this study was conducted to evaluate the usefulness of a video otoscope as a tool of diagnosis of acute otitis media. METHODS: Among 416 patients who visited Pundang Jesaeng Hospital Emergency Medical Center with a complaint of otalgia from 1 October 2002 to 30 September 2003, we studied 51 patients who were followed up at the otorhinolaryngology depatment. Emergency Medicine residents recorded the findings for tympanic membrane by using an otoscope and by using a video otoscope. we used kappastatistics to carry out a prospective study in which the accuracy of diagnosis of AOM was analyzed by comparison with the confirmed diagnosis by an otolaryngologic specialist. RESULTS: In this study, the number of males was 24 (47%) and that of females was 27 (53%). Of the 51 Patients, 22 (43%) presented with rhinorrhea, 15 (29%) with cough, 11 (22%) with sputum, 10 (20%) with fever, 8 (16%) with a sore throat, 7 (14%) with otorrhea, 4 (8%) with hearing difficulty, 3 (6%) with irritability, 3 (6%) with tinnitus, 3 (6%) with vomiting and 2 (4%) with dizziness. A comparison of the diagnostic accuracy of AOM between otolaryngologic specialist and residents in emergency department, when was undertaken by using kappa statistics, and a diagnostic agreement of 65% (kappa=0.28) for the otoscope, and 76 %( kappa=0.45) for the video otoscope. The diagnostic sensitivity of acute otitis media by video otoscope was 75%, and specificity was 82%. CONCLUSION: When the tympanic membrane of the patient suspected of a having AOM is examined in an emergency medical center, video otoscopy should be a useful diagnostic tool for AOM owing to its high diagnostic accuracy.
Anti-Bacterial Agents ; Child ; Cough ; Diagnosis* ; Diagnostic Errors ; Dizziness ; Earache ; Emergencies ; Emergency Medicine ; Emergency Service, Hospital ; Female ; Fever ; Hearing ; Humans ; Male ; Otitis Media* ; Otitis* ; Otolaryngology ; Otoscopes* ; Otoscopy ; Pharyngitis ; Prospective Studies ; Sensitivity and Specificity ; Specialization ; Sputum ; Tinnitus ; Tympanic Membrane ; Vomiting