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Skin Flap Necrosis by Bone Marking with Methylene Blue in Cochlear Implantation.

Journal of Audiology & Otology.2015;19(2):108-110. doi:10.7874/jao.2015.19.2.108

One of surgical complications in cochlear implantation is the necrosis of the skin flap above the receiver-stimulator coil. We present a case of 55-year-old woman who underwent cochlear implantation and developed a bluish skin necrosis due to bone marking. The planned position for the receiver-stimulator was marked using methylene blue through skin to bone. She did not undergo skin flap thinning and underwent successful implantation with complete electrode insertion. Few weeks postoperatively, the patient developed bluish discoloration with progressive thick, blue eschar formation and skin flap necrosis. She subsequently underwent wound debridement and skin flap closure. Cochlear explantation was not necessary. Timely diagnosis and management about this complication is necessary to prevent further skin breakdown and subsequent device extrusion. This report identifies the marking using methylene blue as another possible source of skin flap necrosis in cochlear implantation, and surgeons should be aware of this potential complication.
Cochlear Implantation* ; Cochlear Implants* ; Debridement ; Diagnosis ; Electrodes ; Female ; Humans ; Methylene Blue* ; Middle Aged ; Necrosis* ; Postoperative Complications ; Skin* ; Wounds and Injuries

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Persistent Positional Vertigo in a Patient with Sudden Sensorineural Hearing Loss: A Case Report.

Yong Won KIM ; Jung Eun SHIN ; Yong Sik LEE ; Chang Hee KIM

Journal of Audiology & Otology.2015;19(2):104-107. doi:10.7874/jao.2015.19.2.104

Because inner ear organs are interconnected through the endolymph and surrounding endolymphatic membrane, the patients with sudden sensorineural hearing loss (SSNHL) often complain of vertigo. In this study, we report a patient with SSNHL accompanied by persistent positional vertigo, and serial findings of head-roll tests are described. At acute stage, head-roll test showed persistent geotropic direction-changing positional nystagmus (DCPN), which led to a diagnosis of SSNHL and ipsilateral light cupula. Although vertigo symptom gradually improved, positional vertigo lasted for more than 3 weeks. At this chronic stage, persistent apogeotropic DCPN was observed in a head roll test, which led to a diagnosis of the heavy cupula. Although the mechanism for the conversion of nystagmus direction from geotropic to apogeotropic persistent DCPN is unclear, the change of specific gravity of the endolymph might be one of the plausible hypothetical explanations.
Diagnosis ; Ear, Inner ; Endolymph ; Head ; Hearing Loss, Sensorineural* ; Humans ; Membranes ; Nystagmus, Physiologic ; Specific Gravity ; Vertigo*

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Objective Tinnitus Concomitant with Eye Blinking: A Case Report.

Tae Hwan KIM ; Ho Joon JANG ; Soon Hyung PARK ; Sung Il NAM

Journal of Audiology & Otology.2015;19(2):101-103. doi:10.7874/jao.2015.19.2.101

Tinnitus is a common auditory phenomenon associated with many otological diseases, and is usually subjective. Objective tinnitus can be generated by para-auditory structures, usually derived from vascular or myogenic sources, or the eustachian tube. We present a rare case of intermittent unilateral tinnitus associated with eye blinking. Otoendoscopic examination showed that the external auditory canals and tympanic membranes were normal; however, rhythmic movements of both tympanic membranes, concomitant with the tinnitus, were evident whenever the patient blinked. The tympanometry and stapedial reflexes measured via impedance audiometry exhibited saw-tooth patterns; movement of the tympanic membrane was associated with eyelid blinking. The patient was managed conservatively, with reassurance and medication, and the condition became well-controlled. Here, we present this educational case and review the literature.
Acoustic Impedance Tests ; Blinking* ; Ear Canal ; Ear Diseases ; Eustachian Tube ; Eyelids ; Humans ; Reflex ; Tinnitus* ; Tympanic Membrane

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The Dynamic Range for Korean Standard Sentence Material: A Gender Comparison in a Male and a Female Speakers.

Kyeong Yeon PARK ; In Ki JIN

Journal of Audiology & Otology.2015;19(2):97-100. doi:10.7874/jao.2015.19.2.97

BACKGROUND AND OBJECTIVES: The purpose of this study was to identify differences between the dynamic ranges (DRs) of male and female speakers using Korean standard sentence material. Consideration was especially given to effects within the predefined segmentalized frequency-bands. MATERIALS AND METHODS: We used Korean standard sentence lists for adults as stimuli. Each sentence was normalized to a root-mean-square of 65 dB sound pressure level. The sentences were then modified to ensure there were no pauses, and the modified sentences were passed through a filter bank in order to perform the frequency analysis. Finally, the DR was quantified using a histogram that showed the cumulative envelope distribution levels of the speech in each frequency band. RESULTS: In DRs that were averaged across all frequency bands, there were no significant differences between the male and the female speakers. However, when considering effects within the predefined frequency bands, there were significant differences in several frequency bands between the DRs of male speech and those of female speech. CONCLUSIONS: This study shows that the DR of speech for the male speaker differed from the female speaker in nine frequency bands among 21 frequency bands. These observed differences suggest that a standardized DR of male speech in the band-audibility function of the speech intelligibility index may differ from that of female speech derived in the same way. Further studies are required to derive standardized DRs for Korean speakers.
Adult ; Female* ; Humans ; Male* ; Speech Intelligibility

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Hearing Thresholds for a Geriatric Population Composed of Korean Males and Females.

Junghwa BAHNG ; Junghak LEE

Journal of Audiology & Otology.2015;19(2):91-96. doi:10.7874/jao.2015.19.2.91

BACKGROUND AND OBJECTIVES: The purpose of the present study was to provide the hearing threshold levels in the elderly Korean population, and to compare Korean data with that in the International Organization for Standardization (ISO) 7029 (2000). SUBJECTS AND METHODS: Data were collected from a total of 526 ears from 112 males and 151 females aged 60-84 years. All participants were screened otologically by the procedure given in ISO 8253-1 (2010). RESULTS: Results showed that the pure-tone average was gradually elevated with increasing age. The amount of hearing loss was greater in males than in females, and the high frequency hearing thresholds were worse than the low frequency hearing thresholds in males and females. The hearing threshold levels were higher at low frequencies in males and at all frequencies in females than the norms of ISO 7029 (2000). CONCLUSIONS: Results from this study will be partly used for standardization of hearing thresholds as a function of age in Korea and for updating the ISO 7029.
Aged ; Aging ; Audiometry, Pure-Tone ; Ear ; Female* ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing* ; Humans ; Korea ; Male* ; Presbycusis

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The Effect of Korean Red Ginseng on Symptoms and Quality of Life in Chronic Tinnitus: A Randomized, Open-Label Pilot Study.

Tae Su KIM ; Hwan Seo LEE ; Jong Woo CHUNG

Journal of Audiology & Otology.2015;19(2):85-90. doi:10.7874/jao.2015.19.2.85

BACKGROUND AND OBJECTIVES: The major mechanism of inner ear cell damage is the production of reactive oxygen species (ROS). Korean red ginseng (KRG) has an anti-ROS effect; thus we hypothesized that KRG may be of use for the treatment of chronic idiopathic tinnitus. The aim of the study is to investigate clinical outcomes and health-related quality of life (QoL) in chronic tinnitus patients after taking KRG. SUBJECTS AND METHODS: This study was an open-label randomized controlled trial. Sixty-one patients with chronic tinnitus were enrolled and randomized to three groups. The control group was treated for 4 weeks with 160 mg/day Ginkgo biloba extract, and two other groups receiving 1500 mg/day or 3000 mg/day KRG for 4 weeks. Clinical assessments were performed using the tinnitus handicap inventory (THI), Visual Analogue Scale (VAS) and QoL was assessed by Short Form-36 Health Survey (SF-36) questionnaire. RESULTS: Fifty-nine patients completed the planned protocol. Significant improvements were observed between initial and post-treatment THI scores in patients receiving 3000 mg/day KRG. There was no statistically significant difference between initial and post-treatment VAS scores in all groups. Treatment with 3000 mg/day KRG for 4 weeks significantly improved role emotional and mental health scores in the SF-36 survey. CONCLUSIONS: These results suggest that KRG may improve tinnitus symptoms and mental wellbeing in chronic tinnitus patients.
Ear, Inner ; Ginkgo biloba ; Health Surveys ; Humans ; Mental Health ; Panax* ; Pilot Projects* ; Quality of Life* ; Reactive Oxygen Species ; Tinnitus*

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Measurement of Acceptable Noise Level with Background Music.

Hyun Jung AHN ; Junghwa BAHNG ; Jae Hee LEE

Journal of Audiology & Otology.2015;19(2):79-84. doi:10.7874/jao.2015.19.2.79

BACKGROUND AND OBJECTIVES: Acceptable noise level (ANL) is a measure of the maximum background noise level (BNL) that a person is willing to tolerate while following a target story. Although researchers have used various sources of target sound in ANL measures, a limited type of background noise has been used. Extending the previous study of Gordon-Hickey & Moore (2007), the current study determined the effect of music genre and tempo on ANLs as possible factors affecting ANLs. We also investigated the relationships between individual ANLs and the familiarity of music samples and between music ANLs and subjective preference. SUBJECTS AND METHODS: Forty-one participants were seperated into two groups according to their ANLs, 29 low-ANL listeners and 12 high-ANL listeners. Using Korean ANL material, the individual ANLs were measured based on the listeners' most comfortable listening level and BNL. The ANLs were measured in six conditions, with different music tempo (fast, slow) and genre (K-pop, pop, classical) in a counterbalanced order. RESULTS: Overall, ANLs did not differ by the tempo of background music, but music genre significantly affected individual ANLs. We observed relatively higher ANLs with K-pop music and relatively lower ANLs with classical music. This tendency was similar in both low-ANL and high-ANL groups. However, the subjective ratings of music familiarity and preference affected ANLs differently for low-ANL and high-ANL groups. In contrast to the low-ANL listeners, the ANLs of the high-ANL listeners were significantly affected by music familiarity and preference. CONCLUSIONS: The genre of background music affected ANLs obtained using background music. The degree of music familiarity and preference appears to be associated with individual susceptibility to background music only for listeners who are greatly annoyed by background noise (high-ANL listeners).
Humans ; Music* ; Noise* ; Recognition (Psychology)

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Long-Term Outcomes of Acute Low-Tone Hearing Loss.

Kyung Jin ROH ; Eun Jung LEE ; Ah Young PARK ; Byeong Il CHOI ; Eun Jin SON

Journal of Audiology & Otology.2015;19(2):74-78. doi:10.7874/jao.2015.19.2.74

BACKGROUND AND OBJECTIVES: Although acute low-tone hearing loss has been associated with cochlear hydrops or early stage Meniere's disease, its prognosis in the short-term has been reported to be better than sudden hearing loss. However, recurrence of hearing loss and possible progression to Meniere's disease remain important concerns in the clinical setting. This study aims to investigate the long-term audiological outcomes of acute low-tone hearing loss. SUBJECTS AND METHODS: A retrospective review of patients presenting with a first attack of acute low-tone hearing loss was performed. Of the 77 patients, 33 were followed up for more than 3 months. Progression, recovery of hearing loss and recurrence of hearing loss were examined. Also, correlation between long-term outcomes and associated clinical factors were analyzed. RESULTS: Twenty-five patients (75.7%) had complete hearing recovery, five patients (15.1%) had partial recovery, two patients (6.0%) had no recovery, and one patient (3.0%) had progression of hearing loss 1 month after initial treatment. Thirty-three patients were followed up for more than 3 months (mean 22 months, range 3-79 months). Recurrences of acute low-tone hearing loss were observed in five patients (15.2%). All of the recurrences occurred during the first 12 months of follow-up. Long-term prognosis correlated with the initial therapy results (R2=0.693). CONCLUSIONS: Recurrences of hearing loss were documented in five patients (15.2%), and all of these cases occurred within one year of the first attack. Audiological outcomes after initial therapy may predict the recurrence of acute low-tone hearing loss.
Edema ; Follow-Up Studies ; Hearing Loss* ; Hearing Loss, Sudden ; Hearing* ; Humans ; Meniere Disease ; Prognosis ; Recurrence ; Retrospective Studies

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Test-Retest Reliability of Word Recognition Score Using Korean Standard Monosyllabic Word Lists for Adults as a Function of the Number of Test Words.

Jinsook KIM ; Junghak LEE ; Kyoung Won LEE ; Junghwa BAHNG ; Jae Hee LEE ; Chul Hee CHOI ; Soo Jin CHO ; Eun Yeong SHIN ; Jeonghye PARK

Journal of Audiology & Otology.2015;19(2):68-73. doi:10.7874/jao.2015.19.2.68

BACKGROUND AND OBJECTIVES: The purpose was to establish the test-retest reliability of word recognition score (WRS) using Korean standard monosyllabic word lists for adults (KS-MWL-A) recently developed based on the international standard for speech audiometry (ISO 8253-3:2012). SUBJECTS AND METHODS: Subjects consisted of 159 adults aged to 18 to 25 years with normal hearing sensitivity. WRSs were obtained in 2 dB steps from the level of speech recognition thresholds to the level of 86% correct responses or greater. After one or two weeks, retest was performed. Correlation, confidence interval (CI) and prediction interval (PI) were calculated for the reliability. RESULTS: Correlation coefficients were 0.88 for 50 test words, 0.76 for 25 and 0.61 for 10 words. Results also showed that 95% CIs and PIs were narrower for 25 and 50 test words than those for 10 test words. CONCLUSIONS: Korean WRS using the KS-MWL-A has high reliability for 25 and 50 test words, but relatively low for 10 words. It suggested that 95% CIs for each test words would be criteria for significant differences in WRS for groups and 95% PIs at each score of WRS could be utilized for a considerable difference for each individual at retest.
Adult* ; Audiometry, Speech ; Hearing ; Humans

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Stem Cell Therapy for Sensorineural Hearing Loss, Still Alive?.

Yong Ho PARK

Journal of Audiology & Otology.2015;19(2):63-67. doi:10.7874/jao.2015.19.2.63

In mammals, the auditory system, which includes the cochlea, has a very complex structure harboring many types of cells performing different functions. Among these cells are the auditory hair cells (HCs), which are terminally and well differentiated unique cells which have lost their regenerative potential after development. The auditory HCs are easily damaged by aging as well as during episodes of ototoxicity and acoustic trauma. HCs damages typically occur in the early stage of injury and can result a permanent hearing loss. Recently, there have been tremendous developments from stem cells (SCs) research involving sensorineural hearing loss, but several limitations and obstacles persist in allowing these developments from continuing onto clinical applications. This review discusses the recent advances in SC research in sensorineural hearing loss with the subsequent sections discussing the possible hurdles and limitations that currently preclude their clinical application.
Aging ; Cochlea ; Hair Cells, Auditory ; Hearing Loss ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural* ; Mammals ; Stem Cells*

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