Physical assessment constitutes a medico-legal procedure through which physicians evaluate impairments and disabilities arising from injury or disease, thereby assisting judicial decisions. In Korea, principal assessment standards include National Compensation Act, Industrial Accident Compensation Insurance Act, the McBride Disability Evaluation, the American Medical Association (AMA) guides, and the Korean Academy of Medical Sciences (KAMS) guides. The McBride criteria are now considered outdated, and the AMA guides focus exclusively on physical impairment without incorporating disability. To overcome these limitations, KAMS developed its own guidelines in 2011 and revised them in 2016, thereby enabling the evaluation of both impairment and loss of earning capacity. In 2020, the judiciary endorsed the KAMS guides as the unified national reference.However, dental disabilities were excluded from that framework. To address this gap, the Korean Academy of Dental Sciences introduced criteria in 2018 subdividing impairments into masticatory, facial and speech functions; yet their adoption remain limited due to methodological constraints. This review surveys existing medico-legal assessment standards, analyses their application in dentistry and argues for the development of a unified, clinically valid system for dental physical assessment.

Objectives: . Balloon dilation of the Eustachian tube (BDET) is widely recognized as a minimally invasive treatment for obstructive Eustachian tube dysfunction (ETD). We employed a Delphi consensus methodology to develop recommendations for the clinical management of BDET in cases of obstructive ETD. Methods: . A Delphi panel consisting of 26 expert physicians specializing in otology participated in two rounds of anonymous, iterative questionnaires. Consensus was defined as agreement from ≥70% of the panelists on a recommendation, while disagreement was defined as <70% agreement. The responses from the Delphi study were analyzed using both the content validity ratio and Kendall’s coefficient of concordance. Results: . The panel finally evaluated 26 topics, reaching agreement on 9 and failing to reach consensus on 17 after two rounds. While consensus was not achieved regarding the postoperative follow-up period, a duration of 12 months was most commonly adopted. The Valsalva maneuver and questionnaire responses were identified as the most agreed-upon postoperative assessment tools following BDET. Conclusion . Consensus was reached on several recommendations for managing BEDT in obstructive ETD. This agreement will guide future research aimed at defining standard postoperative management for BEDT.

Objectives: . Balloon dilation of the Eustachian tube (BDET) is widely recognized as a minimally invasive treatment for obstructive Eustachian tube dysfunction (ETD). We employed a Delphi consensus methodology to develop recommendations for the clinical management of BDET in cases of obstructive ETD. Methods: . A Delphi panel consisting of 26 expert physicians specializing in otology participated in two rounds of anonymous, iterative questionnaires. Consensus was defined as agreement from ≥70% of the panelists on a recommendation, while disagreement was defined as <70% agreement. The responses from the Delphi study were analyzed using both the content validity ratio and Kendall’s coefficient of concordance. Results: . The panel finally evaluated 26 topics, reaching agreement on 9 and failing to reach consensus on 17 after two rounds. While consensus was not achieved regarding the postoperative follow-up period, a duration of 12 months was most commonly adopted. The Valsalva maneuver and questionnaire responses were identified as the most agreed-upon postoperative assessment tools following BDET. Conclusion . Consensus was reached on several recommendations for managing BEDT in obstructive ETD. This agreement will guide future research aimed at defining standard postoperative management for BEDT.

Objectives: . Balloon dilation of the Eustachian tube (BDET) is widely recognized as a minimally invasive treatment for obstructive Eustachian tube dysfunction (ETD). We employed a Delphi consensus methodology to develop recommendations for the clinical management of BDET in cases of obstructive ETD. Methods: . A Delphi panel consisting of 26 expert physicians specializing in otology participated in two rounds of anonymous, iterative questionnaires. Consensus was defined as agreement from ≥70% of the panelists on a recommendation, while disagreement was defined as <70% agreement. The responses from the Delphi study were analyzed using both the content validity ratio and Kendall’s coefficient of concordance. Results: . The panel finally evaluated 26 topics, reaching agreement on 9 and failing to reach consensus on 17 after two rounds. While consensus was not achieved regarding the postoperative follow-up period, a duration of 12 months was most commonly adopted. The Valsalva maneuver and questionnaire responses were identified as the most agreed-upon postoperative assessment tools following BDET. Conclusion . Consensus was reached on several recommendations for managing BEDT in obstructive ETD. This agreement will guide future research aimed at defining standard postoperative management for BEDT.

BACKGROUND AND OBJECTIVES: A rotation chair test has been used to evaluate the function of the horizontal semicircular canals. Currently, two chair systems according to the presence of cylindrical darkroom are used in a clinic setting. However, it has not been thoroughly investigated whether one system is superior to the other system or not. In this study, we aimed to compare test outcomes and subject convenience between two systems. SUBJECTS AND METHODS: Twenty subjects with no history of otologic disease were enrolled. Subjects were tested with two systems: system [A] with a cylindrical chamber and system [B] with no chamber. The results of sinusoidal harmonic acceleration (SHA), step velocity (SV), and visual fixation (VFX) tests were compared between the systems. Subject convenience was assessed with a questionnaire survey and results were compared between the systems. RESULTS: There were no significant differences in gain or asymmetry in SHA test between the systems. However, the phase of system [A] was significantly lower than that of system [B] at 0.16 Hz. There was no significant difference between the systems in directional preponderance (DP) gain or DP time constant. Regarding the VFX test, gain was higher in system [A] than system [B]. Subjects reported less stuffiness and less anxiety with system [B] than system [A], while preferring the system [A] goggles. CONCLUSIONS: A rotation chair system without a darkroom can provide a more comfortable experience for subjects in terms of stuffiness and anxiety, while showing comparable results in SHA and SV tests with a darkroom system.
Acceleration ; Anxiety ; Ear Diseases ; Eye Protective Devices ; Semicircular Canals

No abstract available.
Noise* ; Tinnitus*

OBJECTIVES: The purpose of this study was to evaluate the therapeutic effect of three different types of sounds on tinnitus patients undergoing tinnitus retraining therapy (TRT). METHODS: This is a single-institution retrospective study, performed in one tertiary otological referral center. Thirty-eight adults with subjective idiopathic tinnitus who were followed for at least 9 weeks were enrolled. Sound therapy was delivered in 3 different ways: narrowband noise TRT (nTRT); mixed band noise TRT (mTRT); broadband noise TRT (bTRT). Treatment response was measured through validated psychometric questionnaires: Tinnitus Handicap Inventory (THI), visual analog scale (VAS) on annoyance, and numerical description of hours of tinnitus perception (awareness hours). RESULTS: A total of 38 patients were followed for at least 9 weeks. In nTRT group, all outcome measures including THI, VAS, and the awareness hours, decreased over 9 weeks with no statistical significance. In mTRT group, all outcome measures except for awareness hours significantly improved 9 weeks after the beginning of the treatment. In bTRT group, all outcome measures decreased significantly in 9 weeks. When therapeutic success is defined as improvement in THI 7 or more, bTRT group (77.8%) showed a higher success rate than other groups for 38 patients with the minimum follow-up of 9 weeks. CONCLUSION: All three sounds can provide relief in patients with annoying tinnitus after TRT. However, there is difference in the therapeutic effect according to sound types. Broadband sound seems to be better than narrowband sound or mixed sound in relieving the patients from tinnitus. Therefore, sound therapy with broadband noise may be more appropriate during TRT, but further evidence is needed for precise conclusion.
Adult ; Follow-Up Studies ; Humans ; Noise ; Outcome Assessment (Health Care) ; Psychometrics ; Referral and Consultation ; Retrospective Studies ; Tinnitus* ; Treatment Outcome* ; Visual Analog Scale ; Surveys and Questionnaires

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

BACKGROUND AND OBJECTIVES: The treatment result of endolymphatic sac decompression (ELSD) is controversial especially after a long term follow-up period. The aims of this study are to review the long term treatment outcome of ELSD and to analyzethe factors associated with the long term prognosis. SUBJECTS AND METHOD: A retrospective review of medical records was performed. Sixteen patients (18 ears) who had been diagnosed with definite Meniere's disease, had undergone ELSD and been followed up for more than 2 years were included in this study. The average follow up period was 88.6 months, with the range spanning from 25.7 to 243.4 months. All results were described according to the 1995 AAO-HNS criteria. RESULTS: After a long term follow-up, vertigo was successfully controlled in 66.6% and hearing was preserved or improved in 58.8%. Tinnitus and aural fullness were relieved in 27.3% and 60.0% respectively. The preoperative hearing threshold (p=0.03) and caloric test (p=0.05) showed a close relationship with the long term vertigo control after ELSD. CONCLUSION: Although vertigo and hearing may deteriorate again after 2 years, ELSD generally seems to be able to control vertigo even after a long term follow up. Preoperative hearing threshold and caloric test may be able to serve as prognostic factors.
Caloric Tests ; Decompression ; Endolymphatic Sac ; Follow-Up Studies ; Hearing ; Humans ; Medical Records ; Meniere Disease ; Retrospective Studies ; Tinnitus ; Treatment Outcome ; Vertigo

OBJECTIVE: This study was to estimate the prevalence of and identify the predisposing risk factors of delirium and to determine the effect of delirium on the prognosis, especially death in burn patients. METHOD: The study was completed by thorough examination of medical records, with additional confirmation, of the 245 patients who were admitted to the Burn ICU in Burn treatment center of Hangang Sacred Heart Hospital during last one year (Jan. 1. 1998-Dec. 31. 1998). Delirium was retrospectively diagnosed according to DSM-IV. Only when disturbance of consciousness and attention, cognitive dysfunction especially disorientation, or perceptual disturbance were observed, diagnosis of delirium were given. Final outcome such as death was discriminated through examination of medical records or question to those who knew the patient. RESULTS: One year prevalence of delirium in burn patients is 34.4%. Statistically significant predisposing risk factors of delirium were five;Age 65 and over (OR=45.51, 95% CI:6.07-341.11), burn size over 60% of total body surface (OR=6.48, 95% CI:3.16-13.28), current psychiatric disorder (OR=6.81, 95% CI:1.42-32.57), current medical disease (OR=3.00, 95% CI:1.40-6.45), alcohol abuse (OR=3.17, 95% CI:1.07-9.43) Statistically significant deathrelated risk factors were three;burn size over 60% of total body surface (OR=4.58, 95% CI:2.00-10.46), delirium (OR=2.94, 95% CI:1.25-6.94), current psychiatric disorder (OR=4.09, 95% CI:1.05-15.87). Aging is not the death-related factor in this study. CONCLUSION: Three factors, such as delirium, organic brain damage, and burn size over 60% of total body surface may predict higher risk of death in burn patients.
Aging ; Alcoholism ; Brain ; Burns* ; Consciousness ; Delirium* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Heart ; Humans ; Critical Care* ; Medical Records ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Factors