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Evaluation of postoperative hearing acuity and equilibrium was performed in four patients with labyrinthine fistula caused by iatrogenic procedure. Surgical trauma inflicted upon the membranous labyrinth is an uncommon, but often catastrophic, complication of chronic ear surgery. The most vulnerable areas are the oval window and the lateral semicircular canal. Methods of injury include subluxation of the foot plate, fracture of the lateral canal by drill or chisel, and accidental opening of the labyrinth. Three cases of fistula of the lateral and posterior canal during ear surgery are presented. All of three occured while drilling. The other one occured due to iatrogenic stapedectomy. The interrupted semicircular canals were obliterated firmly with autologous materials such as fascia, perichondrium, bone chips, and cartilage. These cases were documented by pre and post operative audiograms, vestibular function tests. One interesting finding was that none of these cases were compromised cochlear function. The dictum that an accidentally opened labyrinth will automatically result in a dead ear is shown to be not necessarily true. These cases indicates that manipulation of the semicircular canal with awareness can be conducted without damaging the cochlear function, and that the treatment of labyrinthine fistulas shoud be performed very carefully but not so conservatively as to lead to future problems.
Cartilage ; Ear ; Ear, Inner ; Fascia ; Fistula* ; Foot ; Hearing* ; Humans ; Semicircular Canals ; Stapes Surgery ; Vestibular Function Tests

BACKGROUND AND OBJECTIVES: The changes in voice that occur after tonsillectomy and adenoidectomy are mainly the nasal sound which can be measured with nasometer. This study was designed to estimate the postoperative changes in the voice, especially the nasal sound. MATERIALS AND METHODS: The subjects of this study included 26 patients who had received tonsillectomy and adenoidectomy. Thirty normal children were also selected as the control group. The nasalance and the each formants of /a/, /i/ of preoperative state were compared with those of postoperative 4 and 8 weeks. RESULTS: The preoperative nasality of the tonsillectomy and adenoidectomy group was significantly lower than that of the control group. Comparing the preoperative and postoperative 1 month state, there was significant increase in the nasalance, whereas it was recovered in the postoperative 2 months to the same level of the preoperatve state. The changes of the formants were not significantly noticed. CONCLUSION: Although the temporary increase in the nasalance does occur immediately after adenoidectomy, the postoperative 2 months state show no significant changes compared to the preoperative state. Therefore, the voice changes that come postoperatively could be considered as no concern for the non-professional voice user.
Adenoidectomy* ; Child ; Humans ; Tonsillectomy* ; Voice

BACKGROUND: Sleep is an essential restorative physiologic phenomenon. Impaired sleep results in significant negative effect to the health. Symptoms like sleep initiation difficulty, frequent awakening, severe snoring have related to poor sleep quality. We studied frequency and compared the characteristics of common sleep disorders at family practice. METHODS: We surveyed patients over 18 years of age and their guardians who visited 16 familial practices for 6 days. We investigated sleep characteristics, frequency of sleep disorder and associated factors by questionnaires and analyzed by frequency analysis, Spearman's correlation coefficient, multiple logistic regression. RESULTS: We enrolled 1,117 participants. Older participants were more likely to report early sleep onset and off time, short sleep duration. Mean number of awakening during a typical night is 1.69. Female complained difficulties in initiation and maintenance of sleep more than male. A total of 32.5% had these insomnia symptoms and related to hypertension, stroke, stress, arthralgia, depression, urological disorder. 31.1% had excessive daytime sleepiness, related to stress, arthralgia, depression. Loud snoring and gasp for breath showed positive correlation between male, high BMI. Disrupted sleep over 3 times was related to old age, female, diabetes, hypertension, stroke, stress, arthralgia, depression. Restless leg syndrome were high in elderly, high BMI, stress, arthralgia and depression. CONCLUSION: About one in three who visit in primary medical practice have sleep disorder symptoms like insomnia, daytime fatigue, snoring. 3% of them have gasp for breath, 8% have restless leg syndrome.
Aged ; Arthralgia ; Depression ; Family Practice ; Fatigue ; Female ; Humans ; Hypertension ; Leg ; Male ; Prevalence ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Snoring ; Stroke