Background and Objectives: The purpose of the mastoidectomy and tympanoplasty is to improve the hearing by removing the middle ear lesion and reconstructing the hearing mechanism. The purpose of this study is to verify whether several factors, including the presence of mastoidectomy can affect the hearing outcome of tympanoplasty patients.Subjects and Method From 1989 to 2018, 1260 patients with chronic otitis media who had been followed up for more than 6 months after type 1 tympanoplasty were selected. The each patient group was divided into 2 groups based on the last audiometry; Group A (post operative air-bone gap [ABG] ≤10 dB HL) and Group B (post operative ABG >10 dB HL). We analyzed the various factors including patency of E-tube or mastoid aeration for each group to figure out which factors affect the post operative hearing outcome. Results: In conclusion, even with mastoidectomy, the final hearing after surgery was worse than that of the group who underwent tympanoplasty only (final ABG; tympanoplasty only vs. tympanoplasty with mastoidectomy; 6.59±9.09 vs. 9.71±8.94). In both with and without mastoidectomy group, the size of the perforation and external ear canal diameter before surgery did not affect the final hearing outcome. On the otherhand, in the group with mastoidectomy, mastoid pneumatization and E-tube patency affected the postoperative prognosis, but not in the case without mastoidectomy. Conclusion In this study, the factors affecting postoperative hearing success were analyzed. The results can be used to predict the postoperative hearing prognosis and to help select surgical treatment.

A congenital defect of the anterior wall of the external auditory canal (EAC) is known as foramen of Huschke. The tympanic bone is incompletely developed and has a U shape at birth. The foramen of Huschke closes via continuous bone growth, which occurs before the age of 5 years. A persistent foramen of Huschke is an anatomic variation located in the anteroinferior portion of EAC, which can cause ear discomfort with spontaneous temporomandibular joint (TMJ) herniation into the EAC bony defect. We present a case of 50-year-old man who had a symptomatic TMJ herniation through an osseous defect. The physical examination showed a bulging mass of anterioinferior portion of EAC when the patient closed his mouth, which was retracted when the mouth openned. We report a case of surgical reconstruction of the EAC wall defect, and the foramen of Huschke with titanium mesh via preauricular approach along with literature’s review.

BACKGROUND AND OBJECTIVES: Vestibular schwannoma is a benign neoplasm originating from the vestibular nerve, and the most common symptom caused by the tumor is unilateral hearing loss. This study is aimed to review the clinical outcomes of tumor growth and hearing changes in the natural progress of vestibular schwannoma.SUBJECTS AND METHOD: We retrospectively reviewed 28 patients who were diagnosed with vestibular schwannoma and treated with the ‘wait and scan’ modality for more than a year. We analyzed the patients' audiological changes and tumor growth by reviewing the temporal bone MR images. Patients were classified into an intrameatal group and extrameatal group according to the involvement of the cerebropontine angle. RESULTS: The overall mean follow-up was 45.6±25.8 months. Among the 28 patients, 6 (21.4%) showed tumor growth after ‘wait and scan.’ Hearing thresholds and speech discrimination scores showed deterioration after ‘wait and scan’ in both groups. Among the 12 patients with serviceable hearing at initial diagnosis, 9 (75.0%) preserved serviceable hearing after ‘wait and scan.’ When the pure tone average and speech discrimination scores were applied to the scattergram, most values were positioned near the center of the scattergram, which implied slight changes after ‘wait and scan.’ CONCLUSION The percentage of patients showing tumor growth after the ‘wait and scan’ policy was low. Patients with serviceable hearing at diagnosis would most likely preserve their hearing after ‘wait and scan.’ Considering the limited tumor growth and minimal hearing changes, rather than microsurgery or radiation surgery, the conservative ‘wait and scan’ policy can be an alternative treatment modality in patients with small-sized, non-growing vestibular schwannomas.

BACKGROUND AND OBJECTIVES: Acute low-tone sensorineural hearing loss refers to a condition wherein thresholds increase only at low frequencies in pure-tone audiometry. Systemic steroid treatment is commonly used for acute low-tone sensorineural hearing loss without vertigo, but there has been no established treatment in most clinical researches. The purpose of this study is to compare and analyze the short-term effects of high- and half-dose oral steroid therapy on patients suffering from acute low-tone sensorineural hearing loss without vertigo. SUBJECTS AND METHOD: Forty-six patients diagnosed with acute low-tone sensorineural hearing loss were divided into two groups and treated with high-dose (24 patients) and half-dose (22 patients) steroids, respectively. A retrospective analysis was conducted on their medical records. RESULTS: There were no significant differences between the two groups in any of the following: age, sex ratio, duration of symptoms before treatment, pure-tone hearing thresholds, low frequency hearing thresholds and speech intelligibility. However, both groups showed significant differences in hearing thresholds before and after treatment. In addition, no significant difference was noted in the recovery and recurrence rate between the two groups. CONCLUSION: According to the results of this study, there is no difference in treatment effect between the high- and half-dose groups. Therefore, half-dose steroids may be used as a treatment option for acute low tone sensorineural hearing loss.
Audiometry, Pure-Tone ; Hearing ; Hearing Loss, Sensorineural* ; Humans ; Medical Records ; Methods ; Recurrence ; Retrospective Studies ; Sex Ratio ; Speech Intelligibility ; Steroids ; Therapeutic Uses* ; Vertigo

BACKGROUND: Significant clinical heterogeneity within contemporary risk group is well known, particularly for those with intermediate-risk prostate cancer (IRPCa). Our study aimed to analyze the ability of the Cancer of the Prostate Risk Assessment (CAPRA) score to discern between favorable and non-favorable risk in patients with IRPCa. METHODS: We retrospectively reviewed the data of 203 IRPCa patients who underwent extraperitoneal robot-assisted radical prostatectomy (RARP) performed by a single surgeon. Pathologic favorable IRPCa was defined as a Gleason score ≤ 6 and organ-confined stage at surgical pathology. The CAPRA score was compared with two established criteria for the within-group discrimination ability. RESULTS: Overall, 38 patients (18.7% of the IRPCa cohort) had favorable pathologic features after RARP. The CAPRA score significantly correlated with established criteria I and II and was inversely associated with favorable pathology (all P < 0.001). The area under the receiver operating characteristic curve for the discriminative ability between favorable and non-favorable pathology was 0.679 for the CAPRA score and 0.610 and 0.661 for established criteria I and II, respectively. During a median 37.8 (interquartile range, 24.6–60.2) months of follow-up, 66 patients (32.5%) experienced biochemical recurrence (BCR). Cox regression analysis revealed that the CAPRA score, as a continuous sum score model or 3-group risk model, was an independent predictor of BCR after RARP. CONCLUSION: The within-group discrimination ability of preoperative CAPRA score might help in patient counseling and selecting optimal treatments for those with IRPCa.
Counseling ; Discrimination (Psychology) ; Follow-Up Studies ; Goats ; Humans ; Male ; Neoplasm Grading ; Pathology ; Pathology, Surgical ; Population Characteristics ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Retrospective Studies ; Risk Assessment ; ROC Curve

BACKGROUND: Various systemic agents have been assessed for the treatment of alopecia areata (AA); however, there is a paucity of comparative studies. OBJECTIVE: To assess and compare cyclosporine and betamethasone minipulse therapy as treatments for AA with regard to effectiveness and safety. METHODS: Data were collected from 88 patients who received at least 3 months of oral cyclosporine (n=51) or betamethasone minipulse therapy (n=37) for AA. Patients with ≥50% of terminal hair regrowth in the alopecic area were considered responders. RESULTS: The responder of the cyclosporine group was 54.9% and that of the betamethasone minipulse group was 37.8%. In the cyclosporine group, patients with mild AA were found to respond better to the treatment. Based on the patient self-assessments, 70.6% of patients in the cyclosporine group and 43.2% of patients in the betamethasone minipulse group rated their hair regrowth as excellent or good. Side effects were less frequent in the cyclosporine group. CONCLUSION: Oral cyclosporine appeared to be superior to betamethasone minipulse therapy in terms of treatment effectiveness and safety.
Alopecia Areata* ; Alopecia* ; Betamethasone* ; Cyclosporine* ; Hair ; Humans ; Pulse Therapy, Drug ; Self-Assessment ; Treatment Outcome

BACKGROUND: Laser/light-based devices may provide an alternative to conventional acne therapeutics in some patients with nonresponsive acne. OBJECTIVE: We investigated the efficacy of red or infrared light-emitting diode (LED) devices in a mouse model of Propionibacterium acnes-induced inflammation through clinical examination and histopathological and immunohistochemical studies. METHODS: A human-derived Propionibacterium acnes suspension (10(9) colony-forming units /µl) was injected into the back of an HR-1 mouse. Then, a 28.9 J/cm2 650-nm red LED or 9.3 J/cm2 830-nm infrared LED was applied to the mouse with P. acnes-induced inflammation once daily for 2 weeks. Two weeks after treatment, histological findings with hematoxylin and eosin staining and expression levels of inflammatory biomarkers (integrin α6, neutrophils, interleukin [IL]-1β, and matrix metalloproteinase [MMP]-2/9) were evaluated in tissue specimens using immunohistochemical staining. RESULTS: Mice treated with red and infrared LED showed clinical improvement in inflammatory nodules compared to mice in the control group. Red LED was much more effective than infrared LED. Epidermal hyperplasia, comedone-like cysts, and integrin α6 expression improved to a similar extent in the red and infrared LED treatment groups and control group. Neutrophil, IL-1β, MMP-2, and MMP-9 expression after treatment with red and infrared LED decreased considerably compared to expression in the control group. CONCLUSION: In a mouse model of P. acnes-induced inflammatory nodules, red and infrared LED devices may be an alternative to conventional acne therapies. In addition, a mouse model of P. acnes-induced inflammatory nodules is helpful for laboratory research of acne.
Acne Vulgaris ; Animals ; Biomarkers ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Hyperplasia ; Inflammation* ; Interleukins ; Mice* ; Neutrophils ; Propionibacterium acnes ; Propionibacterium* ; Stem Cells

Amelanotic melanoma comprises only 1.8~8.1% of malignant melanomas, and is difficult to diagnose clinically due to the lack of the diagnostic evidence of clinical pigmentation. To our knowledge, it is rarely reported, and only 10 cases have been reported in the Korean dermatological literature. It presents rather conflicting features such as a pink or red macule, papule, plaque, or nodule mimicking various benign and malignant conditions; therefore, it is difficult to diagnose. We performed a review of six patients with amelanotic melanoma focusing on differential diagnosis, particularly at the time of the initial visit. Clinical impressions included pyogenic granuloma, dermatofibrosarcoma protuberans, eccrine poroma, epidermal cyst, keloid, pilomatricoma, and squamous cell carcinoma in addition to malignant melanoma. The biopsy specimens were consistent with malignant melanoma with little or no melanin pigment on hematoxylin and eosin and Fontana-Masson stains. Four of the six patients were positive for S-100 and HMB-45, but two patients were positive for S-100 only. We report these cases to remind clinicians of the necessity of including malignant melanoma in the differential diagnosis process when patients show poor and unpredictable responses to treatment after a clinical diagnosis of other benign and malignant conditions.
Biopsy ; Carcinoma, Squamous Cell ; Coloring Agents ; Dermatofibrosarcoma ; Diagnosis ; Diagnosis, Differential* ; Eosine Yellowish-(YS) ; Epidermal Cyst ; Granuloma, Pyogenic ; Hematoxylin ; Humans ; Keloid ; Melanins ; Melanoma ; Melanoma, Amelanotic* ; Pigmentation ; Pilomatrixoma ; Poroma

No abstract available.
Arthrodermataceae* ; Epidemiology* ; Korea*

No abstract available.
Biomarkers* ; Magnesium* ; Propionibacterium acnes* ; Propionibacterium*