BACKGROUND AND OBJECTIVES: Ginkgo biloba extract (GBE) enhances cell survival in various organs. GBE protects nerve cells in the central nervous system and is clinically applied in Parkinson's and Alzheimer's disease. GBE can protect ototoxicity caused by cisplantin and gentamycin through rescue of hair cells in Organ of Corti and is accepted as one of the therapeutic agents for sudden deafness and tinnitus. The experimental study on GBE for the inner ear is confined to the hair cells, not to the spiral ganglion neurons (SGNs) which is the stimulated part by the electrode of cochlear implant. The aim of this study is to elucidate the effect of GBE on the survival of SGNs after hair cell loss in rats. MATERIALS AND METHOD: Ten Sprague-Dawley rats aged 50 days (P50) were deafened with kanamycin sulfate. GBE (EGb 761) was injected into the right cochlea and artificial perilymph was injected into the left side. The number and size of SGNs were compared after immunohistochemical statin in both groups. The expression of pJun, which is well-known as a proapoptotic transcription factor in the cochlea, was also compared. RESULTS: The number of SGNs was significantly larger in the GBE group than the control. The expression of pJun activity was significantly decreased in GBE group than the control. The size of SGNs in both groups was similar. CONCLUSION: These results suggest that GBE can protect SGNs death by inhibiting the pJun-C-jun N-terminal kinase pathway. GBE might be a potential drug for the patients with total deafness before or after cochlear implantation surgery for better hearing results.
Aged ; Alzheimer Disease ; Animals ; Cell Survival ; Central Nervous System ; Cochlea ; Cochlear Implantation ; Cochlear Implants ; Deafness ; Ear, Inner ; Electrodes ; Gentamicins ; Ginkgo biloba ; Hair ; Hearing ; Hearing Loss, Sudden ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Kanamycin ; Neurons ; Organ of Corti ; Perilymph ; Phosphotransferases ; Rats ; Rats, Sprague-Dawley ; Spiral Ganglion ; Tinnitus ; Transcription Factors

BACKGROUND AND OBJECTIVES: Stapedial reflex (SR) threshold is of considerable diagnostic significance in the evaluation of audiological function, especially under sedation or general anesthesia since anesthetic drugs often act on neurotransmitters or neuromodulators. The aim of this study was to evaluate the changes in the SR threshold according to the depth of anesthesia. SUBJECTS AND METHOD: Sixty patients with normal hearing who were scheduled for operation under general anesthesia were included in this study. Anesthetic agent used was propofol and the depth of anesthesia was monitored by the bispectral index (BIS). SR was measured five times according to depth of anesthesia. RESULTS: Both ipsilateral and contralateral SR thresholds were increased according to the depth of anesthesia using propofol. In particular, ipsilateral SR showed no response at BIS 60 and contralateral SR at BIS 40. However, there were no significant differences between age groups and gender. CONCLUSION: Propofol significantly increased both ipsilateral and contralateral SR threshold according to depth of anesthesia. When it is necessary to measure SR under general anesthesia, we should consider the effect on SR threshold according to the depth of anesthesia.
Anesthesia ; Anesthesia, General ; Anesthetics ; Cellulose ; Hearing ; Humans ; Neurotransmitter Agents ; Propofol ; Reflex ; Reflex, Acoustic

BACKGROUND AND OBJECTIVES: A distortion product otoacoustic emission (DPOAE) is a non-invasive method which is commonly used to assess the hearing function of the cochlea and to reflect objective information of specific frequency in the cochlea. We hypothesize that after applying a broad band noise (BBN), the outer hair cell's function will change and cause reduction in the amplitude of DPOAEs and signal to noise ratio (SNR). SUBJECTS AND METHOD: We performed the examination on 40 subjects (80 ears) who have a normal hearing function. DPOAEs were recorded before and after BBN stimulation (intensity: 90 dB HL, duration: 10 minutes). RESULTS: After the BBN stimulation, the amplitude of DPOAEs and SNR were decreased at all frequencies. The amplitude of DPOAEs and SNR decreased 0.3-1.6 dB SPL, 0.6-1.5 dB SPL, respectively. Decreases in the amplitude had statistical significances after 3 and 6 minutes in 1 kHz, 3 and 6 minutes in 2 kHz, immediately after noise exposure, and after 3 and 6 minutes in 6 kHz. However, the SNR changes had statistical significance only after 3 minutes in 1 kHz. After the stimulation, pure tone threshold at 4 kHz increased 3.2+/-3.9 dB HL. After the BBN exposure, the amplitude of DPOAEs and SNR decreased at all frequencies and most of them recovered within 12 minutes. CONCLUSION: These results suggest that DPOAE could be a clinically useful method for the purpose of screening, managing and assessing the prognosis of acoustic trauma and noise induced sensorineural hearing loss.
Auditory Fatigue ; Cochlea ; Hair ; Hearing ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural ; Mass Screening ; Noise ; Prognosis ; Signal-To-Noise Ratio

BACKGROUND AND OBJECTIVES: Vestibular evoked myogenic potentials (VEMP) have become a good diagnostic tool to evaluate the integrity of the vestibulocollic reflex. To investigate the standard recording of VEMP response in normal hearing subjects, the authors studied the effects of test positions and different acoustic stimulations on the VEMP. SUBJECTS AND METHOD: We performed VEMP on both ears of thirty normal hearing volunteers. Three acoustic stimulations (clicks and 500 Hz and 1,000 Hz short tone bursts) and four test positions were presented alternately to evoke VEMP. The latencies of peak p13 and n23, p13n23 interpeak latency (IPL) and amplitude were measured by EMG equipment and compared by statistical program. We also made up questions for the compliance of the test positions. RESULTS: The effects of test positions p13 latency had no significant difference on all test positions except between test position 2 and 4, n23 latency and p13n23 IPL had shortest waveform on test position 2, p13n23 amplitude had the largest waveform in test position 4. Acoustic stimulations on all test positions were influenced that clicks had shorter waveform about 2-3 ms than STBs on p13 latency and n23 latency, STBs had larger waveform than clicks on p13n23 amplitude. And the compliance of the test positions exhibited highest comfort in test position 1. CONCLUSION: Test position 1 had higher VEMP response rates and compliance, 500 Hz STB had a largest p13n23 amplitude. Therefore we recommend that the ideal conditions were position 1 and 500 Hz STB for acoustic stimulations to evoke VEMP.
Acoustics* ; Compliance ; Ear ; Hearing ; Reflex ; Vestibular Evoked Myogenic Potentials* ; Volunteers

BACKGROUND AND OBJECTIVES: First bite syndrome is the development of pain in the parotid region after the first bite of each meal and can be seen after surgery of the parapharyngeal space tumor. The purpose of this study is to report the incidence and clinical courses of first bite syndrome after surgery of parapharyngeal space tumor. SUBJECTS AND METHOD: A retrospective review was done on 22 patients diagnosed and surgically treated for tumors of the parapharyngeal space from May 2001 to September 2005. RESULTS: Seven of 22 patients were diagnosed with the first bite syndrome after the operation of the parapharyngeal space tumor. In postoperative pathology, three were pleomorphic adenoma of parotid gland, three were paraganglioma of carotid body, and remaining one was schwannoma originated from sympathetic nerve chain. The first bite syndrome developed in 1 out of 5 patients with Horner's syndrome, 2 out of 4 patients with ligation of external carotid artery above branching point of facial artery, and all three patients with paraganglioma, originated from carotid body. The pain subsided in one patient 3 months after the development of first bite syndrome, although the pain persisted in remaining 6 patients during follow-up period. CONCLUSION: First bite syndrome is a minor complication of surgery involving the parapharyngeal space. But symptoms are often mild but can be severe enough to hinder a patient's quality of life and ability to eat. Therefore, surgeons who operate in the parapharyngeal space should be aware of first bite syndrome and counsel patients regarding this potential complication.
Adenoma, Pleomorphic ; Arteries ; Carotid Artery, External ; Carotid Body ; Follow-Up Studies ; Horner Syndrome ; Humans ; Incidence ; Ligation ; Meals ; Neurilemmoma ; Paraganglioma ; Parotid Gland ; Parotid Region ; Pathology ; Quality of Life ; Retrospective Studies

BACKGROUND AND OBJECTIVES: To determine the clinical application of otoacoustic emissions (OAE) in screening of cochlear function, author studied changes of OAE in Meniere's disease patients. MATERIALS AND METHODS: The author has measured several parameters of OAE with 34 meniere's patients and 15 normal persons. Pass rate, response amplitude, reproducibility were recorded at TEOAE. Amplitude of DP-gram were measured at 2 F2 frequencies-1000, 2000 Hz. The input/output functions of DPOAE were recorded at 2 F2 frequencies -1001, 2002 Hz (respectively DP-1000, DP-2000). Input/output function were determined based on 2 parameters- maximal level and Detection threshold of DPOAE. RESULTS: 1) TEOAE: Significant lower rate of positive finding was recorded at involved ears (55.8%, 19/34) than normal ears (100%, 30/30). 2) DP-gram: At frequency was 2000 Hz, amplitude of involved ears (n=28, 6.3+/-.5 dB/SPL) was significant smaller than normal ears (n=30, 6.3+/-.5 dB/SPL). 3) DP-input/output function: At maximum DP level of DP-2000, response of involved ears (n=11, 51.6+/-.9 dB/SPL) was significant larger than normal ears (n=22, 48.5+/-.0 dB/SPL). CONCLUSION: Parameters of OAE, such as pass rate of TEOAE, amplitude of DP-gram at 2000 Hz, and maximum DP level of DP-2000 was considered to good indicators for monitoring cochlear function of Meniere's disease. Furthermore, evaluation by changes in the TEOAE & DPOAE combined parameters, appeared to be very useful for detection of subtle change in cochlear function of Meniere's disease.
Ear ; Humans ; Mass Screening ; Meniere Disease*

BACKGROUND AND OBJECTIVES: To determine the clinical application of otoacoustic emissions (OAE) in screening of cochlear function, author studied changes of OAE in Meniere's disease patients. MATERIALS AND METHODS: The author has measured several parameters of OAE with 34 meniere's patients and 15 normal persons. Pass rate, response amplitude, reproducibility were recorded at TEOAE. Amplitude of DP-gram were measured at 2 F2 frequencies-1000, 2000 Hz. The input/output functions of DPOAE were recorded at 2 F2 frequencies -1001, 2002 Hz (respectively DP-1000, DP-2000). Input/output function were determined based on 2 parameters- maximal level and Detection threshold of DPOAE. RESULTS: 1) TEOAE: Significant lower rate of positive finding was recorded at involved ears (55.8%, 19/34) than normal ears (100%, 30/30). 2) DP-gram: At frequency was 2000 Hz, amplitude of involved ears (n=28, 6.3+/-.5 dB/SPL) was significant smaller than normal ears (n=30, 6.3+/-.5 dB/SPL). 3) DP-input/output function: At maximum DP level of DP-2000, response of involved ears (n=11, 51.6+/-.9 dB/SPL) was significant larger than normal ears (n=22, 48.5+/-.0 dB/SPL). CONCLUSION: Parameters of OAE, such as pass rate of TEOAE, amplitude of DP-gram at 2000 Hz, and maximum DP level of DP-2000 was considered to good indicators for monitoring cochlear function of Meniere's disease. Furthermore, evaluation by changes in the TEOAE & DPOAE combined parameters, appeared to be very useful for detection of subtle change in cochlear function of Meniere's disease.
Ear ; Humans ; Mass Screening ; Meniere Disease*

BACKGROUND AND OBJECTIVES: The basic principle of microdialysis is to mimic the function of a capillary blood vessel by perfusing physiologic liquid implanted into the target tissue. Amino acids are supposed to have functions for controlling the homeostasis of normal nasal mucosa and a role in the pathogenesis of allergic rhinitis. However, no studies have been conducted about the existence of amino acids in the nasal cavity. This study measures the concentration of 19 amino acids found in the nasal cavity of normal control and experimentally allergy-induced animal model in order to evaluate the difference in the concentration of amino acids between normal and allergic nasal mucosa. MATERIALS AND METHOD: An experimentally induced nasal allergy model was developed by intraperitoneal and intranasal sensitization with ovalbumin in Dunkin-Hartely guinea pigs according to a programmed protocol. A microdialysis probe was designed to be suitable to nasal mucosa using a Cuprophan hollow fiber (200 micrometer inner diameter, 300 micrometer outer diameter, 45 kDa molecular weight cut-off, Fitral, AN 69-HF). After verification of the probe, microdialysis was performed in the inferior turbinate submucosa of normal control (N=8) and experimental (N=8) groups. The concentration of 19 amino acids was analyzed using high performance liquid chromatography. Statistical analysis was performed using a student t-test. RESULTS: All 19 amino acids were validated at various concentrations in the nasal cavity. Glutamate (p=0.036) and GABA (p<0.001) concentrations were significantly higher in the experimental group than in the control group. CONCLUSION: The 19 amino acids measured existed in the nasal cavity at various concentrations, and the concentrations of glutamate and GABA were significantly higher in the allergy group than in the control group. The microdialysis technique is a powerful tool not only to measure endogenous substances for target organ chemistry but also to pharmacokinetically evaluate exogenous drug delivery processes in the nasal cavity.
Amino Acids ; Animals ; Blood Vessels ; Capillaries ; Chemistry ; Chromatography, Liquid ; gamma-Aminobutyric Acid ; Glutamic Acid ; Guinea Pigs ; Homeostasis ; Humans ; Hypersensitivity* ; Microdialysis* ; Models, Animal ; Molecular Weight ; Nasal Cavity ; Nasal Mucosa ; Ovalbumin ; Rhinitis ; Turbinates

We report, with a review of literature, an unusual case of ossifying fibroma of temporal bone. A 34-year-old female with history of left craniectomy for hemifacial spasm visited our department in 1998 because of an incidentally found temporal bone mass. Magnetic resonance imaging showed a well-circumscribed, lobulated 3x3x3 cm sized tumor mass which was localized in the temporal bone but did not invade the middle and inner ear with high signal intensity at T2 weighted image. The patient did not have the spasm until 2000, when she manifested intermittent right otalgia. A computed tomography scan showed the 3x3x3 cm sized right temporal bone tumor with bony erosion including tegmen mastoid and partial bony destruction. After retroauricular incision, tumor and granulation tissue were removed through simple mastoidectomy. The permanent pathologic report confirmed the diagnosis of ossifying fibroma. The patient returned in August of 2004 with recurrent right otalgia that had been there for 3 months. A computed tomography scan showed lobulated, multiseptated, osteolytic, low density tumor which located in the upper portion of mastoid pyramidal base. She underwent a simple mastoidectomy with removal of the recurred ossifying fibroma with destruction in tegmen mastoid. Ossifying fibroma are rare lesions of the temporal bone. Because tumors progress and can become clinically massive, early complete resection is advised whenever feasible to prevent clinically evident recurrences and potentially life-threatening complication.
Adult ; Diagnosis ; Ear, Inner ; Earache ; Female ; Fibroma, Ossifying* ; Granulation Tissue ; Hemifacial Spasm ; Humans ; Magnetic Resonance Imaging ; Mastoid ; Recurrence ; Spasm ; Temporal Bone*

BACKGROUND AND OBJECTIVES: Raman spectroscopy is a vibrational spectroscopic technique capable of providing details on the chemical composition, molecular structure and molecular interactions in cells and tissues. Its application of distinguishing normal and cancer tissue has been studied in a variety of sites, such as the cervix, lung, larynx and skin. The purpose was to explore spectral changes between normal and cancer tissue in the larynx using Raman spectroscopy to assess the feasibility of using Raman spectroscopy for the early diagnosis of laryngeal cancer. MATERIALS AND METHOD: Laryngeal tissue specimens (13 adjacent normal and 13 cancer tissues) were obtained from patients who underwent total laryngetomy or supracricoid laryngectomy with squamous cell carcinoma of the larynx. The specimens were stored -70 degrees C until use. These specimens were defrosted at room temperature. The Raman spectra from laryngeal tissue specimens could be obtained at 300 mW and 250 scan during 15 minutes of the signal acquisition time using FT-Raman spectroscopy (Bruker Co., Karsruhe, Germany). RESULTS: Raman spectra were different significantly between cancer and adjacent normal tissues of the larynx at 1446 cm-1, 1240 cm-1, 1335 cm-1, and 1655 cm-1 (p=0.007, 0.2, 0.2, 0.3, respectively). The difference of 1446 cm-1 means the change of CH2 bending mode in protein and lipid of malignant tissue. The change of 1335 cm-1 means a decrease in CH3CH2 to a wagging mode of collagen and polynucleotide chain of malignant tissue. The difference of 1240 and 1655 means a decrease in the alpha-helix conformation of collagen. CONCLUSION: This study demonstrates the differences of Raman units between laryngeal cancer and adjacent normal tissue using Raman spectroscopy. In future, Raman spectroscopy may become a useful tool of guided biopsy for accurate pathologic diagnosis and assessment of the adequacy of resection margins.
Biopsy ; Carcinoma, Squamous Cell ; Cervix Uteri ; Collagen ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Laryngeal Neoplasms ; Laryngectomy ; Larynx* ; Lung ; Molecular Structure ; Skin ; Spectrum Analysis ; Spectrum Analysis, Raman*