Sudden sensorineural hearing loss (SSNHL) is characterized by abrupt unilateral loss of hearing, sometimes accompanied by tinnitus or vertigo. From the majority of patients with SSNHL, no specific cause can be identified, but numerous conditions including viral infection, vascular compromise and intracochlear membrane break are considered as possible causes of disease. According to these etiologic hypotheses, a combination therapy has been frequently used combining several options among steroids, antiviral agents, vasodilators, volume expanders, stellate ganglion block and carbogen or hyperbaric oxygen. The contents of the combination could vary according to the experience of each clinic, but steroids have been accepted as the mainstay of the treatment for SSNHL since Wilson's landmark study although two recent meta-analysis of steroid treatment suggested there was no benefit. The amount and the length of oral steroid therapy have not been well established. Commonly used regimen of oral steroid therapy is prednisone. A reported success rate with systemic steroid therapy is between 49% and 89%, whereas only 30% to 65% of patients without treatment achieved hearing improvement. Recently there is an obvious trend for an increasing number of positive results of intratympanic steroids injection. It is difficult to evaluate the efficacy of a certain drug or regimen prescribed for SSNHL because of various drugs used as combination therapy, many prognostic factors and different inclusion criteria.
Antiviral Agents ; Carbon Dioxide ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Membranes ; Oxygen ; Prednisone ; Stellate Ganglion ; Steroids ; Tinnitus ; Vasodilator Agents ; Vertigo

An orbital abscess is a serious complication of sinusitis that can lead to blindness and sometimes death. Immediate surgical drainage via an endonasal endoscopic approach or through a traditional Lynch-type incision is required for successful treatment. We describe a case of an orbital abscess with a medial subperiosteal abscess complicating acute sinusitis in a five-month-old infant. The patient was successfully treated with endonasal endoscopic surgery. Following an anterior ethmoidectomy and an antrostomy, the medial subperiosteal abscess was drained by removing the involved lamina papyracea and the orbital abscess was drained by incising the periorbita.
Abscess* ; Blindness ; Drainage ; Humans ; Infant ; Orbit* ; Sinusitis

Nostril stenosis is a rare disease causing cosmetic problem and nasal airway obstruction. Various etiologies including iatrogenic cause the stenosis. Usually the shortage of internal lining of vestibule initiates secondary intention healing where granulation and contracture results in the stenosis. Many surgical techniques have been used to correct the stenosis. The objective of this article is to present a case of iatrogenic unilateral nostril stenosis which was successfully repaired with the use of auricular composite graft.
Constriction, Pathologic* ; Contracture ; Intention ; Nasal Obstruction ; Rare Diseases ; Transplants*

Fibrous dysplasia of temporal bone is a rare disease that may lead to progressive stenosis of external auditory canal. This stenosis leads to trapping of skin and development of cholesteatoma. Most cases with fibrous dysplasia of temporal bone are monostotic, and the polyostotic type is far more rare. We have experienced a recurred polyostotic fibrous dysplasia with cholesteatoma on the external auditory canal and the mastoid. Our purpose of this paper is to discuss properties and management of this rare disease. A twenty-one-year-old woman who had undergone canaloplasty for polyostotic fibrous dysplasia of right temporal bone and occipital bone 5 years ago returned complaining of intermittent right-sided otorrhea for one year. She underwent canal down mastoidectomy with tympanoplasty type 3 for recurred canal obstruction and developing cholesteatoma. The patient has been followed up regularly for one year. There is no evidence of the recurrence of the disease or associated symptoms. We emphasize the need for a long term follow-up of patients with this disease as cholesteatoma or restenosis may develop insidiously.
Cholesteatoma* ; Constriction, Pathologic ; Ear Canal* ; Female ; Fibrous Dysplasia, Polyostotic* ; Follow-Up Studies ; Humans ; Mastoid* ; Occipital Bone ; Rare Diseases ; Recurrence ; Skin ; Temporal Bone ; Tympanoplasty

Noise-induced hearing loss could be caused by mechanical destruction of the delicate membranes of the inner ear, hair cells and supporting structures of the organ of Corti, and by intense metabolic activity, which increases free radical formation in the cochlea. When exposure is continuous, injury is a consequence of the total amount of energy to which cochlear tissues are exposed and a hearing conservation program is essential including hearing protection devices. Several therapeutic trials including antioxidant agents have been shown at least partially effective in prevention of hearing loss and hair cell death.
Cell Death ; Cochlea ; Ear, Inner ; Hair ; Hearing ; Hearing Loss* ; Hearing Loss, Noise-Induced ; Membranes ; Noise* ; Organ of Corti

Otolaryngologists are sometimes confronted with various complications. They may be minor or sometimes they can be major, and rarely fatal. Some complications can be prevented, but some are unavoidable. Five cases of major complications, which occurred during or after routine rhinologic surgery, are presented. Two patients died of toxic shock syndrome: one patient after endoscopic sinus surgery (ESS) and the other patient after closed nasal bone reduction. One patient died of acute myocardial infarction during the recovery of anesthesia after uneventful ESS. One patient had a lidocaine shock, which required treatment in the intensive care unit. One patient had a transient unilateral blindness after intranasal steroid injection. Though the 3rd and 4th cases of complications were unavoidable, the others could have been prevented if precautions had taken place. The presumed pathophysiology, possible prevention measures, and their implications in routine otolaryngologic surgery are discussed.
Anesthesia ; Blindness ; Humans ; Intensive Care Units ; Lidocaine ; Myocardial Infarction ; Nasal Bone ; Shock ; Shock, Septic

BACKGROUND AND OBJECTIVES: Follicular cells of the thyroid gland has been considered an important factor affecting the thyroid gland regeneration.[(3)H]Thymidine autoradiography and immunohistochemical staining with BrdU have been commonly used and are reliable techniques for examining cell proliferation. However, these methods are not suitable for the routine analysis of cell proliferation kinetics, because they are fraught with problems such as needing fresh tissues and handling radioactive or toxic susbstances used as markers. The purpose of this study is to investigate the utility of immunohistochemical staining with a monoclonal antibody to PCNA during the healing process of a rat thyroid gland. We also compared this method with the immunohistochemical staining using a monoclonal antibody to BrdU. MATERIALS AND METHODS: We investigated the proliferative activity in regeneration of the partially resected rat thyroid tissue by using immunohistochemical stainings of PCNA and 5-bromo-2'-deoxyuridine (BrdU). The two methods were compared. RESULTS: Cell proliferative activity of regenerated follicular cells around the resected margin showed a continuous acceleration for 72 hours, and the PCNA-labeled cells stained the nuclei as clearly discernible as those of the BrdU-labeled cells. In addition, the immunohistochemical staining of PCNA provided reproducible and quantifiable results without the requirement of pretreatment. CONCLUSION: Immunohistochemical staining of PCNA and BrdU may represent as a useful technique for analysis of proliferative activity during regeneration of the thyroid glands in rats.
Acceleration ; Animals ; Autoradiography ; Bromodeoxyuridine* ; Cell Proliferation ; Kinetics* ; Proliferating Cell Nuclear Antigen* ; Rats* ; Regeneration ; Thyroid Gland*

Cryptococcus neoformans is a yeast-like organism causing opportunistic infection in the immunocompromized host. Men-ingitis is the most frequent manifestation and causes serious morbidity and mortality. Other sites are less commonly involved. There have been a few cases presenting hearing loss and vertigo as a result of the extension of meningitis through the internal auditory canal. Authors report a case of cryptococcal infection combined with cholesteatoma that developed in a 54-year-old woman who did not have either evidence of immunocompromised state or pathological signs of cryptococcal infection. Cryptococcus neoformans was incidentally found in the keratinized layer of cholesteatoma.
Cholesteatoma* ; Cryptococcus ; Cryptococcus neoformans ; Female ; Hearing Loss ; Humans ; Meningitis ; Middle Aged ; Mortality ; Opportunistic Infections ; Vertigo

BACKGROUND: The mainstay of treating mandibular fracture is adequate reduction and fixation. Recently, miniplate fixation of mandibular fractures is commonly used due to the rapid bone healing, short duration of maxillomandibular fixation, improved oral intake, and decreased postoperative complications. OBJECTIVE: This study presents the results of treating fractures of the mandible using miniplates. MATERIALS AND METHODS: Among 144 patients treated for fractures of the mandible within a six-year period, 99 patients treated with miniplates were retrospectively studied for etiologies, associated injuries, sites of fractures, postoperative results and complications. RESULTS: All fractures were found to be stable at follow-up and there were no serious postsurgical complications. CONCLUSION: Open reduction and internal fixation with miniplate is a reliable and effective technique for the treatment of mandibular fractures.
Follow-Up Studies ; Humans ; Jaw Fixation Techniques ; Mandible ; Mandibular Fractures* ; Postoperative Complications ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) is an inorganic, gaseous free radical that carries a variety of messages between cells. The histochemical demonstration of neuronal betaNADPH-d is the demonstration of the presence of NOS. The purpose of this study was to identify the existence of NOS and the difference of the expression of betaNADPH-d in mouse and gerbil cochleae. MATERIALS AND METHODS: Each of the eight cochleae of Mongolian gerbil (Meriones unguiculatus) and mice (CJU/A) were fixed by cardiac perfusion with 4% paraformaldehyde in 0.1M phosphate buffer solution. The en-bloc cochleae were incubated after decalcification, and stained with betaNADPH-d and counterstained with acid fuchsin. The relative intensity of staining was decided in the same location of cochlea. RESULTS: Most supporting cells were strongly stained except Claudius cells and Boettcher's cells in gerbil. However, Boettcher's cells were strongly stained in mice. Outer hair cells, inner hair cells, basial membrane and lining cells of spiral limbus were strongly stained. Interdental cells of spiral limbus, inner border cells and intermediate cells of stria vascularis were moderately stained. Tectorial membrane and amorphous layer of basial membrane were not stained. CONCLUSION: Using betaNADPH-d staining, this study documents the presence of nitric oxide synthase in mice and gerbil cochleae and the difference of staining between two species.
Animals ; Cochlea* ; Gerbillinae* ; Hair ; Membranes ; Mice* ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Perfusion ; Rosaniline Dyes ; Stria Vascularis ; Tectorial Membrane