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Long Term Outcomes of Early Cochlear Implantation in Korea.

Myung Whan SUH ; Eung Kyung CHO ; Bong Jik KIM ; Sun O CHANG ; Chong Sun KIM ; Seung Ha OH

Clinical and Experimental Otorhinolaryngology.2009;2(3):120-125.

OBJECTIVES: The objective of this study was to compare the long-term auditory performance and language skill depending on the age of cochlear implantation in the Korean population. We especially tried to separate the effect of maturation/development from that of the age at implantation. METHODS: Eighty-six pre-lingual children with profound hearing loss who underwent a cochlear implantation before the age of six and had been followed for more than 3 yr were included in this study prospectively. Categories of Auditory Performance (CAP) and Korean Picture Vocabulary Test (K-PVT) were serially followed up. In order to separate the age at implantation effect, K-PVT results were readjusted to the child's chronological age in the normal hearing population. RESULTS: When the CAP and K-PVT scores were directly compared without chronological readjustment, we failed to show a significant difference for improvements according to the age at implantation. Early cochlear implantation was associated with better language development, only when the K-PVT scores were readjusted to percentile scores of their chronological age. CONCLUSION: Early cochlear implantation was associated with better language development even within the critical period. This advantage may be recognized only when the effect of the age at implantation is separated from the effect of maturation/development.
Child ; Cochlear Implantation ; Cochlear Implants ; Critical Period (Psychology) ; Hearing ; Hearing Loss ; Humans ; Imidazoles ; Korea ; Language Development ; Language Tests ; Nitro Compounds ; Prospective Studies

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Chondroradionecrosis of the Larynx: Diagnostic and Therapeutic Measures for Saving the Organ from Radiotherapy Sequelae.

Jong Lyel ROH

Clinical and Experimental Otorhinolaryngology.2009;2(3):115-119.

OBJECTIVES: Chondroradionecrosis (CRN) of the larynx is a rare but fatal complication of radiotherapy. We determined the optimal diagnostic methodology and management of laryngeal CRN in six patients. METHODS: We retrospectively reviewed the records of six patients with Chandler grade IV laryngeal CRN who had received prior radiotherapy (mean total radiation dose, 66.7+/-4.5 Gy) at a tertiary care hospital. Two patients underwent transoral laser microresection of their laryngeal carcinoma plus postoperative radiotherapy. All patients underwent endoscopy, computed tomography (CT), positron emission tomography (PET), removal of necrotic tissue, biopsy under suspension laryngoscopy, administration of antibiotics, and hyperbaric oxygen therapy (HBO). Their diagnostic and therapeutic results were assessed. RESULTS: CT showed CRN of the anterior larynx in three patients and CRN of the posterior larynx in three patients, with one patient having a false-positive result on PET. HBO consisted of a mean of 36+/-6 dives. After early debridement and HBO, five patients showed CRN improvement, but one had aggravation and subsequently underwent total laryngectomy. None of these patients showed local tumor recurrence on pathologic examination or during a mean follow-up of 24 months. CONCLUSION: Although CRN of the larynx may be detected by endoscopic and imaging work-ups, detection may require pathologic examination. Early debridement and HBO may effectively treat CRN, saving the functional larynx.
Anti-Bacterial Agents ; Biopsy ; Debridement ; Endoscopy ; Follow-Up Studies ; Humans ; Hyperbaric Oxygenation ; Laryngectomy ; Laryngoscopy ; Larynx ; Positron-Emission Tomography ; Recurrence ; Retrospective Studies ; Tertiary Healthcare

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Contemporary Surgery for Obstructive Sleep Apnea Syndrome.

Nelson B POWELL

Clinical and Experimental Otorhinolaryngology.2009;2(3):107-114.

Surgical treatment of obstructive sleep apnea syndrome (OSAS) has been available in some form for greater than three decades. Early management for airway obstruction during sleep relied on tracheotomy which although life saving was not well accepted by patients. In the early eighties two new forms of treatment for OSAS were developed. Surgically a technique described as a uvulopalatopharyngoplasty (UPPP) was used to treat the retropalatal region for snoring and sleep apnea. Concurrently sleep medicine developed a nasal continuous positive airway pressure (CPAP) device to manage nocturnal airway obstruction. Both of these measures were used to expand and stabilize the pharyngeal airway space during sleep. The goal for each technique was to limit or alleviate OSAS. Almost 30 yr later these two treatment modalities continue to be the mainstay of contemporary treatment. As expected, CPAP device technology improved over time along with durable goods. Surgery followed suit and additional techniques were developed to treat soft and bony structures of the entire upper airway (nose, palate and tongue base). This review will only focus on the contemporary surgical methods that have demonstrated relatively consistent positive clinical outcomes. Not all surgical and medical treatment modalities are successful or even partially successful for every patient. Advances in the treatment of OSAS are hindered by the fact that the primary etiology is still unknown. However, both medicine and surgery continue to improve diagnostic and treatment methods. Methods of diagnosis as well as treatment regimens should always include both medical and surgical collaborations so the health and quality of life of our patients can best be served.
Airway Obstruction ; Continuous Positive Airway Pressure ; Cooperative Behavior ; Humans ; Palate ; Quality of Life ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring ; Tongue ; Tracheotomy

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Erratum: Correction for incorrectly displaying several words.

Kyung Tae PARK ; Dong Yeop CHANG ; Myung Whun SUNG

Clinical and Experimental Otorhinolaryngology.2010;3(3):176-176.

The publisher wishes to apologize for incorrectly displaying several words. We correct the words from inclu-des (page 104, line 11, right column) to includes, from eventualry (page 105, line 24, left column) to eventually, from approprlate (page 105, line 28, left column) to appropriate, and from Early (page 105, 6 line, right column) to early.

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Benign Pleomorphic Adenoma of the Soft Palate Metastasizing to the Sphenoid Sinus.

Chang Hoon BAE ; Yong Dae KIM ; Si Youn SONG

Clinical and Experimental Otorhinolaryngology.2010;3(3):172-175.

A benign pleomorphic adenoma is the most common tumor of the salivary glands. This tumor has the potential to metastasize to bone, the head and neck region, visceral organs and skin. Although there a few reports about a benign pleomorphic adenoma metastasizing to the maxillary sinus in the paranasal sinuses, there are no reports about a metastatic benign pleomorphic adenoma in the sphenoid sinus. We report here on a case of a benign pleomorphic adenoma of the soft palate that metastasized to the sphenoid sinus, and we briefly review the relevant clinical literature.
Adenoma, Pleomorphic ; Head ; Maxillary Sinus ; Neck ; Neoplasm Metastasis ; Palate, Soft ; Paranasal Sinuses ; Salivary Glands ; Skin ; Sphenoid Sinus

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Schwannoma Mimicking Laryngocele.

Kyung Tae PARK ; Youngjin AHN ; Kwang Hyun KIM ; Tack Kyun KWON

Clinical and Experimental Otorhinolaryngology.2010;3(3):166-171.

A schwannoma of the larynx is a rare benign tumor that usually presents as a submucosal mass in the pyriform sinus and the aryepiglottic space, and this type of schwannoma constitutes a diagnostic and therapeutic challenge for otolaryngologists. We present here two cases of supraglottic schwannomas that were misdiagnosed as laryngoceles. Both were excised through a lateral thyrotomy approach without a tracheostomy, and the laryngeal function was successfully maintained. We discuss the clinical and imaging findings and the management of this rare neoplasm with focusing on the differential diagnosis of laryngeal schwannoma and laryngocele. We also review the relevant medical literature.
Diagnosis, Differential ; Laryngocele ; Larynx ; Neurilemmoma ; Pyriform Sinus ; Tracheostomy

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Clinical Outcome of Squamous Cell Carcinoma of the Tongue in Young Patients: A Stage-Matched Comparative Analysis.

Jun Ook PARK ; Dong Il SUN ; Kwang Jae CHO ; Young Hoon JOO ; Hwa Jong YOO ; Min Sik KIM

Clinical and Experimental Otorhinolaryngology.2010;3(3):161-165.

OBJECTIVES: The reported incidence of tongue cancer in young patients has recently increased. The aim of this study was to analyze the clinical characteristics of tongue cancer in a young group of patients, and to compare them with those of an older group of tongue cancer patients. METHODS: We retrospectively reviewed the records of 85 patients who were diagnosed with squamous cell carcinoma of the tongue. They were divided into two age groups: over 45 years of age and under 45 years. To compare the prognosis of similarly staged patients in the group, each age group was divided into the early (stage I, II) and advanced stage groups (stage III, IV), and then they were compared. The young group consisted of 23 patients and the older group had 62 patients. RESULTS: At the early stage, the clinical prognosis of the patients in both age groups was good, and no significant difference was observed. However, at the advanced stage, the overall and regional recurrence rates were significantly higher in the younger age group as compared to that in the old age group (P=0.007, P=0.001, respectively). The disease-specific survival rate of the patients in the young group was significantly lower than that in the old age group (P=0.025). CONCLUSION: Tongue cancer in young subjects has significantly different clinical outcomes according to the stage. The clinical outcome of the advanced-stage tongue cancer in young subjects was poorer than that in the older subjects. Regional recurrence seemed to be the main cause of the poor prognosis.
Carcinoma, Squamous Cell ; Humans ; Incidence ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate ; Tongue ; Tongue Neoplasms ; Young Adult

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Treatment Outcomes and Quality of Life in Oropharyngeal Cancer after Surgery-based versus Radiation-based Treatment.

Tae Wook KIM ; Hye Youn YOUM ; Hayoung BYUN ; Young Ik SON ; Chung Hwan BAEK

Clinical and Experimental Otorhinolaryngology.2010;3(3):153-160.

OBJECTIVES: Advances in reconstruction and conservative surgery and the importance of quality of life (QOL) encouraged this reevaluation of surgery-based treatments for oropharyngeal cancer. We tried to compare treatment outcome and QOL after surgery-based versus radiation-based treatment in oropharyngeal cancer. METHODS: The 133 eligible patients were divided into surgery-based and radiotherapy (RT)-based treatment groups. Medical records were reviewed, and EORTC QLQ-C30 and HN65 questionnaires were completed for survivors. Three-year overall survivals, disease-free survivals, locoregional control rates, and QOL scores were compared between the two groups. RESULTS: Demographic data and overall stages were not significantly different between the two groups, and all survival rates were non-significantly different, either. The scores for most QOL items were equivalent, however, for a few items, scores were significantly better in surgery-based group. CONCLUSION: The surgery-based group achieved equivalent treatment outcomes and slightly better QOL scores than the RT-based group. The results of this study suggest that surgery could still be considered as a first-line therapy for oropharyngeal cancer.
Disease-Free Survival ; Humans ; Medical Records ; Oropharyngeal Neoplasms ; Quality of Life ; Survival Rate ; Survivors ; Treatment Outcome ; Surveys and Questionnaires

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Differences of Upper Airway Morphology According to Obesity: Study with Cephalometry and Dynamic MD-CT.

Tae Hoon KIM ; Bum Soo CHUN ; Ho Won LEE ; Jung Soo KIM

Clinical and Experimental Otorhinolaryngology.2010;3(3):147-152.

OBJECTIVES: We investigated difference of parameters of polysomnography, cephalometry and dynamic multi-detector computerized tomography (MD-CT) in wake and sleep states according to obesity. METHODS: We evaluated 93 patients who underwent polysomnography and cephalometry. MD-CT was performed in 68 of these 93 patients. Fifty-nine and 34 patients were classified as obese and non-obese, with obesity defined as BMI > or =25. Cephalometry results were analyzed for 12 variables. Using the MD-CT, we evaluated dynamic upper airway morphology in wake and sleep states and divided the upper airway into four parts named as high retropalatal (HRP), low retropalatal (LRP), high retroglossal (HRG), and low retroglossal (LRG). A minimal cross sectional area (mCSA) and collapsibility index (CI) were calculated for each airway level. RESULTS: Diastolic blood pressure (P=0.0005), neck circumference (P<0.0001), and apnea-hypopnea index (P<0.0001) were statistically significantly different between the obese and non-obese group. Among 12 cephalometric variables, there was a significant difference in only the distance from mandibular plane to hyoid bone (P=0.003). There was statistical difference in CI of HRG and LRG in sleep state (P=0.0449, 0.0281) but no difference in mCSA in wake and sleep states. CONCLUSION: The obese group had more severe sleep apnea than the non-obese group. We believe that the increased severity of apnea in the obese group may be have been due to increased collapsibility of the upper airway rather than decreased size of the upper airway.
Apnea ; Blood Pressure ; Cephalometry ; Humans ; Hyoid Bone ; Neck ; Obesity ; Polysomnography ; Sleep Apnea Syndromes ; Snoring

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Congenital Epidermoid Cyst of the Oral Cavity: Prenatal Diagnosis by Sonography.

Seung Wan PARK ; Jung Ju LEE ; Soo Ahn CHAE ; Byoung Hoon YOO ; Gwang Jun KIM ; Sei Young LEE

Clinical and Experimental Otorhinolaryngology.2013;6(3):191-193.

Epidermoid cysts are benign developmental anomalies that are rarely observed in the oral cavity of neonate. If large in size, especially in the developing fetus or newborn infant, they can cause swallowing difficulty and occasionally respiratory difficulty. We report a case of epidermoid cyst in the oral cavity detected prenatal sonography. The sonographic finding was large cystic mass, measuring 30x25 mm. In this case, supplies and equipment for an emergency tracheostomy were made available prior to the delivery. However, the infant did not require intervention to secure the airway. The lesion was surgically excised, and histologic diagnosis was epidermoid cyst. After 6 months of follow up, the cyst had not recurred. This case illustrates the value of accurate prenatal diagnosis and planned perinatal management using a team approach.
Deglutition ; Emergencies ; Epidermal Cyst ; Equipment and Supplies ; Fetus ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Mouth ; Prenatal Diagnosis ; Tracheostomy

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