An oval-shaped mass with a smooth surface was found in the ear canal of a 22-month-old male infant. Although the mass appeared to be almost entirely blocking the ear canal, it was successfully removed under a surgical microscope without general anesthesia at the outpatient department. Under an optical microscope with hematoxylin and eosin staining, the specimen was observed to have a cuticle with a serrated surface and a pore canal, as well as parts of the capitulum, salivary glands, muscles, midgut, and the legs. The specimen was identified as a hard tick of the family Ixodidae, based on gross and histological findings. This paper is the first report in Korea on the diagnosis and treatment of a tick bite in the ear canal.
Anesthesia, General ; Diagnosis ; Ear Canal* ; Eosine Yellowish-(YS) ; Female* ; Hematoxylin ; Humans ; Infant* ; Ixodidae* ; Korea ; Leg ; Male ; Muscles ; Outpatients ; Salivary Glands ; Tick Bites ; Ticks

BACKGROUND AND OBJECTIVES: Zinc has antioxidant effect, anti-inflammatory effect and neuromodulative function. The purpose of this study was to investigate whether treatment with zinc can improve the outcome of sudden sensorineural hearing loss (SSNHL). SUBJECTS AND METHOD: The study group consisted of 143 patients diagnosed as SSNHL. Of the patients, 82 were given corticosteroid treatment (group Ct) and 61 were given oral zinc plus corticosteroid treatment (group Zn). In group Zn, serum zinc level was checked before treatment and the patients with normal serum zinc level were included. Hearing was assessed before therapy and at 2 weeks, 1 month and 2 months after the initiation of therapy. RESULTS: A significantly larger hearing gain in pure tone average (group Ct vs. group Zn=26.40 dB HL vs. 34.28 dB HL) and at 2000 Hz (group Ct vs. group Zn=24.93 dB HL vs. 33.60 dB HL) and 8000 Hz (group Ct vs. group Zn=11.64 dB HL vs. 20.66 dB HL) were seen in group Zn compared with the group Ct. CONCLUSION: Oral zinc supplementation may have beneficial effects in the treatment of SSNHL, especially at 2000 and 8000 Hz.
Antioxidants ; Hearing ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Zinc*

Intratympanic membrane congenital cholesteatoma (ITMCC) is extremely rare in patients without previous trauma or surgery of the ear. There are multiple theories to the pathogenesis of middle ear congenital cholesteatoma but none are applicable for ITMCC. When the size of ITMCC is small, there are usually no ear symptoms. However, surgery is needed early, as in any other type of cholesteatoma, because early treatment before middle ear involvement enables enucleation without the need for other procedures such as myringoplasty. We report an incidental finding of a small pearl at the umbo in a 2-year-old boy. The cholesteatoma involved only the outer epidermic layer of the tympanic membrane (TM). A transcanal approach was performed and the cholesteatoma was enucleated from TM.
Cholesteatoma ; Ear ; Ear, Middle ; Humans ; Incidental Findings ; Membranes ; Myringoplasty ; Preschool Child ; Tympanic Membrane

Benign paroxysmal positional vertigo is the most common disease of the peripheral vestibular disorder. A 51-year-old man showed geotropic horizontal nystagmus in the head roll test. After head-bending posture, the nystagmus of the patient was changed to apogeotropic horizontal nystagmus in the head roll test. We concluded that transition of canalolithiasis into cupulolithiasis happened during head-bending posture. The cupulolithiasis was returned to canalolithiasis by using side-lying position with the affected ear downward for approximately 45 minutes.
Ear ; Head ; Humans ; Middle Aged ; Nystagmus, Pathologic ; Posture ; Semicircular Canals ; Vertigo

Labyrinthine fistula refers to a condition caused by an abnormal connection between the inner ear and surrounding structures. Most cases of that occur as a result of a complication brought about by cholesteatoma. It may also be generated by long repeated infections of a mastoid cavity that has been exposed to the outside after canal wall down mastoidectomy (CWDM). The infection is usually repeated for several years or decades after surgery. Therefore, labyrinthine fistula after CWDM is known as a late complication. In this case, labyrinthine fistula occurred in two months after surgery due to postoperative infection. Although cholesteatoma was removed after CWDM and the horizontal semicircular canal (HSCC) was not damaged during the operation, this labyrinthine fistula was thought to develop very early after surgery. Two months after surgery, the patient complained of dizziness, we identified the opened bony labyrinth and damaged endosteum of the HSCC in the patient.
Cholesteatoma ; Dizziness ; Ear, Inner ; Fistula ; Humans ; Mastoid ; Semicircular Canals

BACKGROUND: Otomycosis is a fungal infection that comprises 7~10% of outer ear infections. Although the occurrence is higher in humid climates, relatively few studies have investigated otomycosis occurrences in humid environments. While recurrent chronic otitis media discharge in the ear creates a milieu in which otomycosis is likely to occur, investigations of otomycosis co-occurring with chronic otitis media have been rare. OBJECTIVE: To examine the characteristics of patients with otomycosis co-occurring with chronic otitis media and identify causative fungi. METHODS: The study included 60 patients with chronic otitis media who presented typical otomycosis findings in the outer ear canal and the presence of fungi. Patients were treated in the department of otolaryngology, Daegu Catholic University Medical Center, between July 2011 and June 2018. RESULTS: The mean patient age was 57.77 years, and our study included 20 men and 40 women (p=0.010). The lesion was on the right in 39 patients and on the left in 21 (p=0.020). Ear discharge was the most common chief complaint at diagnosis. Of the 54 patients over age 19, 10 had diabetes (18.5%). Aspergillus was causative in 29 patients and Candida in 31. Aspergillus niger was identified in 15 patients, Aspergillus sp. in 14, Candida parapsilosis in 12, Candida sp. in six, and Candida albicans in five. CONCLUSION Otomycosis and chronic otitis media co-occurrences increase with age. The Aspergillus and Candida genera were similar in proportion. A. niger was the most common Aspergillus species, while C. parapsilosis was the most common Candida.

Vascular leiomyoma (Angiomyoma) is a benign tumor composed of smooth muscle cell and vascular endothelium. Most of them occur at the skin of the lower leg. Cases of vascular leiomyomas developing in the nasal cavity and paranasal sinuses are extremely rare. Most common symptoms are nasal obstruction, epistaxis and nasal pain but none are specific for diagnosis. Complete surgical excision is the treatment of choice and was used in all cases reported. Local recurrence rate is very low. We experienced a case of vascular leiomyoma in the inferior turbinate of a 70-year-old woman who complained of intermittent epistaxis. The tumor was successfully removed via an endoscopic approach. It displayed the characteristic histological findings of abundant thick-walled blood vessels blending with proliferative smooth muscle tissue.
Aged ; Angiomyoma ; Blood Vessels ; Endothelium, Vascular ; Epistaxis ; Female ; Humans ; Leg ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Nasal Cavity ; Nasal Obstruction ; Paranasal Sinuses ; Recurrence ; Skin ; Turbinates

BACKGROUND AND OBJECTIVES: Bee venom (BV) has been used as a traditional medicine to treat a variety of diseases, and the anti-inflammatory, antinociceptive, and anticancer activity of BV has been studied over the past few years. This study was designed to investigate the effects of BV on the production of cytokines by peripheral blood mononuclear cells (PBMCs) and on the proliferation of these cells. In addition, we investigated the potential cytotoxic effects of BV on PBMCs. MATERIALS AND METHODS: PBMCs from healthy human volunteers were stimulated with 5 microg/mL phytohaemagglutinin (PHA) and 10 microg/mL lipopolysaccharide (LPS) in the presence of different concentrations of BV. The cytotoxic effects of BV were measured using an aqueous cell proliferation assay kit and the supernatants were analyzed using an enzyme-linked immunosorbent assay. Tumor necrosis factor-alpha (TNF-alpha), interleukin-5 (IL-5), and interferon-gamma (INF-gamma) levels were measured to determine the activation status of PBMCs. RESULT: Although BV alone did not have a cytotoxic effect on PBMCs, PHA- and LPS-induced cytokine production was significantly inhibited by BV. TNF-alpha and INF-gamma production was inhibited by a lower concentration (0.5-1 microg/mL) of BV than IL-5 (6 microg/mL). CONCLUSION: BV seems to be relatively safe as a modulator of cytokine production by PBMCs. These experimental data suggest that BV could be used to treat immunologic and inflammatory diseases.
Bee Venoms ; Bees ; Cell Proliferation ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Human Experimentation ; Interferon-gamma ; Interleukin-5 ; Medicine, Traditional ; Tumor Necrosis Factor-alpha

BACKGROUND AND OBJECTIVES: Honey has various biological and pharmacological activities and has been used as treatment against various inflammatory diseases. The aim of this study was to compare the anti-inflammatory characteristics of manuka, kanuka, and black locust honey. MATERIALS AND METHOD: Peripheral blood mononuclear cells (PBMCs) from healthy human volunteers were isolated and then stimulated with lipopolysaccharide (LPS) with or without pre-treatment of various concentrations of honey for 72 hours. The cytotoxic effects of honeys were measured using an aqueous cell proliferation kit, and the supernatants were analyzed for interleukin-5 (IL-5), IL-10, interferon-γ (INF-γ), and tumor necrosis factor-α (TNF-α) using an enzyme-linked immunosorbent assay. RESULTS: Samples of 1% manuka and kanuka honey were found to have cytotoxic effects on PBMCs. Honey itself enhanced the production of IL-10 and TNF-α production. Manuka and kanuka honeys suppressed LPS-induced IL-10 and INF-γ production, while black locust honey only suppressed IL-10 production from PBMCs. CONCLUSION: Honeys had immunomodulatory properties of both immunostimulatory and immunosuppressive effects on PBMCs. Different honeys might have different immune modulatory functions due to their different components.
Cell Proliferation ; Enzyme-Linked Immunosorbent Assay ; Healthy Volunteers ; Honey* ; Interleukin-10 ; Interleukin-5 ; Kunzea* ; Methods ; Necrosis ; Robinia*

BACKGROUND AND OBJECTIVES: Corticosteroids have been used for therapeutic management of sudden sensorineural hearing loss (SSNHL). Because of the complications associated with systemic steroid therapy and low levels of steroid in the inner ear after systemic administration, intratympanic steroid injection (ITSI) is currently used. The purpose of this study was to compare the efficacy of systemic steroid therapy with systemic combined high frequency ITSI therapy. SUBJECTS AND METHODS: Forty-six SSNHL patients were divided into the only systemic dexamethasone therapy group (systemic steroid IV group, 27 patients) and the systemic with frequent intratympanic dexamethasone injection group (combined ITSI group, 19 patients). In the systemic steroid IV group, dexamethasone was administered intravenously for 5 days followed by oral tapered doses for 10 days. In the combined ITSI group, intratympanic dexamethasone was administered 5 times per day for 5 consecutive days in addition to intravenous administration of dexamethasone. Hearing was assessed both before therapy and at 15 days, 4 weeks, and 8 weeks after the initiation of therapy. RESULTS: The recovery rate and hearing gain were 74% (20 out of 27 patients) and 33 dB mean improvement in the systemic steroid IV group and 73.6% (14 out of 19 patients) and 41.5 dB mean improvement in the combined ITSI group. There was no statistically significant difference in hearing gain and the recovery rate between the two groups. CONCLUSIONS: The therapeutic effect of a combination of highly frequently administered intratympanic dexamethasone and systemic steroid therapy was not superior to only systemic steroid injection therapy.
Administration, Intravenous ; Adrenal Cortex Hormones ; Dexamethasone ; Ear, Inner ; Hearing ; Hearing Loss, Sensorineural ; Humans