Myxoma is a rare nonepithelial neoplasm of the larynx frequently misdiagnosed as a large vocal polyp due to its slow-growing nature. Myxoma is a benign but often infiltrating neoplasm of uncertain mesenchymal cell origin, characterized by irregular round, spindle or stellate cells within a matrix containing abundant mucoid material, scant vascularity and a variable meshwork of reticulum and collagen. We report one case of myxoma with life-threatening dyspnea requiring tracheotomy.
Case Report ; Critical Illness ; Human ; Laryngeal Neoplasms/complications* ; Male ; Middle Age ; Myxoma/complications* ; Respiration Disorders/surgery ; Respiration Disorders/etiology* ; Tracheotomy

The external auditory canal is composed of skin, subcutaneous tissue and gland. The mass originated from external auditory canal can produce otorrhea and some obstructive symptoms. Ceruminoma is a broad term expressing the tumor arising from the ceruminous gland. The ceruminous gland tumors is assigned to one of four categories(adenoma, pleomorphic adenoma, adenocystic carcinoma & adenocarcinoma) by Wetli's protype. The wide local excision is a treatment of choice for all benign ceruminous gland tumors except the malignant tumors needed combined treatment modalities as surgery and radiotherapy. We report our recent experience of two ceruminous adenomas causing ear canal obstruction & otorrhea.
Adenoma* ; Adenoma, Pleomorphic ; Carcinoma, Adenoid Cystic ; Ear Canal* ; Radiotherapy ; Skin ; Subcutaneous Tissue

PURPOSE: Early detection and intervention of hearing impairment is believed to improve speech and language development and behavior of children. The aim of this preliminary study was to determine the prevalence of hearing impairments, and to identify the association of risk factors relating to refer response in high risk neonates who were screened using distortion product otoacoustic emissions (DPOAE). METHODS: The subjects included 871 neonates who were admitted to the neonatal intensive care unit of the Pediatric Department in Soonchunhyang University Bucheon Hospital from May, 2001 to December, 2004. They were screened using DPOAE. Based on DPOAE, we divided the neonates in two groups:'Pass' and 'Refer'. The differences in risk factors between the pass group and the refer group were analyzed. RESULTS: The incidence of the refer group was 12.1 percent(106 out of 871). The bilateral refer rate was 5.4 percent(47 out of 871). And the unilateral refer rate was 6.7 percent(59 out of 871). Gender, birth place, family history of hearing loss, small/large for gestational age, obstetrical factor, hyperbilirubinemia and use of gentamicin were not statistically related to the refer rate. Statistically related to refer rate were birth weight, resuscitated neonates, Apgar score, craniofacial anomaly, mechanical ventilator application, sepsis, using of vancomycin(P<0.05). The prevalence of hearing impairment (> or = 60 dB) in this study was 2 percent(18 out of 871). CONCLUSION: This study showed a higher prevalence of hearing impairment in high-risk neonates. Thus neonatal hearing screening should be carried out in high-risk neonates.
Apgar Score ; Birth Weight ; Child ; Gentamicins ; Gestational Age ; Gyeonggi-do ; Hearing Loss ; Hearing* ; Humans ; Hyperbilirubinemia ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal* ; Language Development ; Mass Screening* ; Prevalence ; Residence Characteristics ; Risk Factors ; Sepsis ; Ventilators, Mechanical

Induction of general anesthesia with tracheal intubation may eause hypertension and tachycardia with concomitant increase in plasam catecholamine concentration. These transient stress responses are undesirable, especially in patients with cardiovascular or intracrainal diseases. Many drugs(topical or i.v. lidocaine, inhalation anestheties, opioids, adrenergic blockers, etc) are used in an attempt to blunt these potentially adverse hemodynamic responses. This study was made to examine blunting effect of labetalol and fentanyl for hemodynamic changes after tracheal intubation. Eighty patients, ASA physical status I or II, scheduled for elective surgery were selected randomly. They were divided into four groups. Group l: Control(saline)(n=20) Group 2: Labetalol 0.125 mg/kg(n=20) Group 3: Labetalol 0.25 mg/kg(n=20) Group 4: Fentanyl 3 ug/kg(n=20) Study drugs were injected 3 minutes before induction with thiopental sodium. Patients were induced with thiopental sodium 5 mg/kg and succinylcholine chloride l mg/kg i.v.in all groups. 5 minutes after injection of study drug, laryngoscopy was initiated and performed tracheal in- tubation. After the completion of intubation, 50% nitrous oxide in oxygen and 1.5vol.% halothane was administed. The blood pressure and heart rate were measured using automated noninvasive blood pressure device and E.C.G. monitoring for 10 minutes per 1 minute. Data were analyzed with Stu- dent's t-test within the group and unpaired t-test between the groups. P<0.05 was considered significant. Labetalol or fentanyl pretreatment significantly blunted the increase in heart rate and rate pressure product caused by laryngoscopy and endotracheal intubation. But the increase of arterial blood pressure was blunted significantly in fentanyl 3 ug/kg group. Labetalol and fentanyl may offer an important role in patients in whom an increase in blood pressure, heart rate and/or rate pressure product should be avoided during the endotracheal intubation.
Adrenergic Antagonists ; Analgesics, Opioid ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Fentanyl* ; Halothane ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Inhalation ; Intubation ; Intubation, Intratracheal* ; Labetalol* ; Laryngoscopy ; Lidocaine ; Nitrous Oxide ; Oxygen ; Succinylcholine ; Tachycardia ; Thiopental

In the treatment of spasmodic dysphonia, local injection of botulinum toxin A has been reported to be successful. The treatment of adductor type spasmodic dysphonia using botulinum toxin type A was conducted in 31 patients. These patients were given toxins in the vocal fold(s), unilaterally or bilaterally, under telelaryngoscopic guidance with 23 gauge scalp needle attached by laryngeal forceps. Before the above procedure, laryngeal anesthesia was done with 2% pontocain instillation. Among the 31 patients, 30 patients were given the toxin successfully. Telephone interview were made at 2 weeks and then at 4 weeks post injection. Among the above 30 patients, 90% reported that the injection was of significant benefit. The functional status of the patient's disorder was classified into four grades. The mean pre-injection grade for the patients in this study was 2.10 and it was significantly lowered to 1.13 after the injection(p<0.01). As a self assessment method, the patients were asked to rate their voice on a scale of 100. In this study, the mean pre-injection score was 40 and it was significantly improved to 69.8 after the injection(p<0.01). In conclusion, botulinum toxin injection using telelaryngoscope is a safe and effective method for the treatment of adductor type spasmodic dysphonia.
Anesthesia ; Botulinum Toxins* ; Botulinum Toxins, Type A ; Dysphonia* ; Humans ; Interviews as Topic ; Needles ; Scalp ; Self-Assessment ; Surgical Instruments ; Voice

PURPOSE: The effects of the mobile phone speaker function, which makes it possible to communicate continuously and to allows the free use of two hands, during the early phase of cardiopulmonary resuscitation (CPR) by dispatcher-assisted laypersons were investigated through a mannequin-based simulation study. METHODS: Fifty volunteers were randomly assigned to "non-speaker function CPR" (NSFCPR) (n=25) and "speaker function CPR" (SFCPR) (n=25). Fifty compressions of "Hands-only CPR" were performed according to telephone-instructed CPR by dispatchers with or without the speaker function. The quality of CPR administered and interviews from laypersons on the difficulties of performing CPR were examined. RESULTS: There were no significant differences in compression rate, depth, incomplete chest recoil, and time to first compression between the two groups. However, fourteen participants in the NSFCPR group (56.0%) and five participants in the SFCPR group (20.0%) reported interrupted chest compression (p=0.042). There were twenty-eight events of interruption in the NSFCPR group and twelve in the NSFCPR group (p=0.008). The most common cause of interrupted chest compression were difficulties in hearing the dispatcher's instructions (23, 57.5%). All 13 cases for position correction (32.5%) were observed in the NSFCPR group. There were significant differences between the two groups in causes and counts of compression interruption (p=0.004). CONCLUSION: There was difference in the interruption of compression and there were no differences in CPR performance between two groups. Still, the speaker function may reduce the interruption of chest compression due to phone holding, permitting a clearer hearing of instructions.
Cardiopulmonary Resuscitation* ; Cellular Phone* ; Emergency Medical Services ; Hand ; Hearing ; Out-of-Hospital Cardiac Arrest ; Thorax

Although vestibular neuritis is defined as acute peripheral vestibulopathy without associated hearing loss, a handful of cases reported sudden hearing loss without concurrent vertigo during follow-up of vestibular neuritis. In addition, some patients show benign paroxysmal postional vertigo(BPPV) ipsilateral to the lesion side with various interval after vestibular neuritis, and they are considered to be "secondary" BPPV. Viral and vascular etiologies have been assumed for the vestibular neuritis but, both of those failed to explain exact pathomechanism so far. Authors experienced a case of sudden hearing loss with simultaneous ipsilateral BPPV after vestibular neuritis. There has been no report of concurrent of BPPV and sudden hearing loss after vestibular neuritis. Sequential viral activations are considered to be responsible for this case.
Follow-Up Studies ; Hand ; Hearing Loss ; Hearing Loss, Sudden* ; Humans ; Vertigo* ; Vestibular Neuronitis* ; Virus Activation

BACKGROUND AND OBJECTIVES: The advent of magnetic resonance imaging has enabled surgeons to detect small intracanalicular tumors. Therefore, many patients with acoustic tumors can be candidates for hearing preservation. This study was designed to analyze hearing results following acoustic tumor removal through the extended middle cranial fossa approach (EMCFA) and to determine the prognostic factors associated with successful hearing preservation. MATERIALS & METHODS: We retrospectively reviewed 11 patients whose tumor was removed via EMCFA (10:acoustic tumor, 1:lymphangioma). RESULTS: In 9 patients, the tumors were completely removed with EMCFA and in one patient, the suboccipital approach was combined with EMCFA. However, the approach was transformed to the translabyrinthine approach in one patient, because the tumor adhered to the cochlear nerve. The overall success rate of hearing preservation was 60% (6 of 10). In 20% of patients, the hearing was worse and other 20% of patients lost their hearing. Preoperative hearing level, location of tumor and origin of tumor affect the postoperative hearing. But tumor size did not relate to hearing preservation. CONCLUSION: In most cases, we could preserve the patient's hearing with EMCFA. However, the patients with poor preoperative hearing and tumor originated from the superior vestibular nerve were at risk for hearing loss.
Cochlear Nerve ; Cranial Fossa, Middle* ; Hearing Loss ; Hearing* ; Humans ; Magnetic Resonance Imaging ; Neuroma, Acoustic ; Retrospective Studies ; Vestibular Nerve

Chondroblastoma is an uncommon primary benign bone tumor that usually arises in the epiphyses of the long bones. Chondroblastoma of temporal bone is extremely rare. Its biological nature is often benign but is sometimes aggressive because of the local invasion. Recently, the authors have experienced two cases of chondroblastoma of temporal bone which were completely excised. We report these cases of chondroblastoma of the temporal bone with a review of literature.
Chondroblastoma* ; Epiphyses ; Temporal Bone*

Transverse temporal bone fracture can make a profound sensorineural hearing loss. This temporal bone fracture usually happens in the single side; however, the bilateral temporal bone fracture can make the postlingual deafness. Therefore, the deafness from bilateral temporal bone fractures can be one of the indications for the cochlear implantation. We report on the experience of the cochlear implantation in a deaf patient after bilateral temporal bone fractures.
Cochlear Implantation ; Cochlear Implants ; Deafness ; Hearing Loss, Sensorineural ; Humans ; Temporal Bone