1.Removal and Repositioning of a Piston Wire Prosthesis That Entered the Vestibule Secondary to Trauma in a Patient Who Underwent Stapedotomy
Sung Min KOH ; Younghac KIM ; Joo Hyun PARK ; Young Sang CHO
Journal of Audiology & Otology 2022;26(4):223-226
Otosclerosis is a common cause of adult-onset hearing impairment, and stapedotomy is often performed as surgical treatment. Several studies have reported the complications of stapedotomy surgery; piston wire prosthesis (PWP) disruption or dislocation secondary to indirect force attributable to head trauma is described in many patients. Most PWPs that get displaced are slanted or are completely dislodged from the stapedotomy site and lodged within the middle ear. PWP dislocation into the vestibule is extremely rare. A 65-year-old woman who was involved in a traffic accident underwent computed tomography, which revealed a right-sided PWP in the vestibule. Two weeks after the accident, we observed conductive hearing loss associated with a large air-bone gap (ABG, 47 dB) accompanied by spontaneous nystagmus directed to the right without any change in nystagmus following changes in head or body position. She underwent endoscopic exploratory tympanotomy under general anesthesia, 23 days after the injury. We gently pulled the PWP from the vestibule and repositioned it at its original site with a length of 5.2 mm on the long process of the incus. Pure tone audiometry performed 8 months postoperatively showed a decrease in the ABG from 47 to 10 dB without any complications.
2.Differences in Nasal Shapes and the Degree of Changes Over a Decade or More: A Paired Analysis
Younghac KIM ; Joo Hyun PARK ; Minhae PARK ; Eunkyu LEE ; Sang Duk HONG ; Yong Gi JUNG ; Gwanghui RYU ; Hyo Yeol KIM
Clinical and Experimental Otorhinolaryngology 2024;17(1):56-63
Objectives:
. This study investigated age-related differences in nasal morphometry and the degree of changes within an individual over at least a 10-year period by pairing previous and recent three-dimensional reconstructed computed tomography (CT) images.
Methods:
. Forty-eight adult Korean patients who underwent at least two CT scans of the nasal region with an interval of at least 10 years were selected. Patients were categorized into six subgroups according to sex and age (20–39 years, 40–49 years, and ≥50 years) at the time of initial imaging. Eight nasal parameters were measured on the initial and recent images, and paired comparisons between the two images were performed based on the data. The differences in the degree of change by age were also analyzed.
Results:
. Over an average image interval of 12 years, men exhibited an increase in the nasofrontal angle (3.2°±5.4°, P=0.041), profile nasal length (1.7±1.7 mm, P=0.002), and nasal bridge height (1.2±1.6 mm, P=0.002). Conversely, they showed a decrease in the nasofacial angle (–2.3°±2.9°, P=0.010). Women also demonstrated an increase in the nasofrontal angle (2.5°±5.2°, P=0.010), profile nasal length (1.4±1.9 mm, P<0.001), and nasal bridge height (1.3±1.6 mm, P<0.001). However, they exhibited a decrease in the nasofacial angle (–2.0°±2.1°, P<0.001), glabella angle (–9.1°±9.8°, P<0.001), and pyriform angle (–8.5°±10.1°, P<0.001). With the exception of the nasal bridge height (P=0.036) and pyriform angle (P=0.022), the degree of changes in most parameters did not show significant differences across age groups.
Conclusion
. Our findings indicate that the aging nose exhibits a greater nasal length with inferior angulation of the nasal tip, with an increase in the nasofrontal angle, profile nasal length, and nasal bridge height, along with a decrease in the nasofacial angle. The degree of most nasal morphologic changes demonstrated no significant differences by specific age group.