Objectives: . This study aimed to compare positive airway pressure (PAP) therapy compliance between patients with comorbid insomnia and sleep apnea (COMISA) and those with obstructive sleep apnea (OSA) alone. It also assessed the influence of insomnia clinic visits on PAP compliance. Methods: . Patients diagnosed with OSA and initiated on PAP therapy between January 2012 and December 2021 were included. The COMISA group (n=43) comprised patients with insomnia, while the control group (n=86) consisted of OSA patients without insomnia, matched 1:2 based on age and sex. COMISA patients were further categorized into group A (n=20), with at least two insomnia clinic visits, and group B (n=23) with one or no visits. PAP compliance in each group was evaluated at 3 and 9 months. Results: . No significant differences were observed in PAP compliance between the COMISA patients and OSA patients without insomnia. Within the COMISA group, the impact of insomnia clinic visits on PAP compliance was not significant. No significant difference was observed in daily PAP usage between the two groups at 3 months (265.5±145.9 minutes in group A vs. 236.3±152.3 minutes in group B, P=0.760) or 9 months (213.4±155.3 minutes in group A vs. 166.3±158.3 minutes in group B, P=0.538). The percentages of PAP users and nights with PAP use exceeding 4 hours also showed no significant differences at either time point. Conclusion . This study demonstrated no significant disparity in PAP compliance between the COMISA and OSA groups at either 3 or 9 months. Furthermore, insomnia clinic visits did not significantly impact PAP compliance in COMISA patients during 3- and 9-month intervals.

Background and Objectives: Epistaxis is one of the most common emergencies in otolaryngology, and the recently developed Rapid Rhino nasal pack, a balloon-type nasal packing device, is widely used in emergency departments. Rebleeding after initial treatment increases patients’ discomfort and medical costs. The aim of this study was to investigate risk factors for rebleeding in patients treated with Rapid Rhino packing. Methods: In this retrospective study, 93 patients with epistaxis treated with Rapid Rhino from January 2020 to November 2022 were divided into the well-controlled group (39 patients) and the rebleeding group (54 patients), and the baseline characteristics, management methods, and complications were compared between these groups. The rebleeding group was divided according to whether patients experienced a single episode of rebleeding (38 patients) or multiple rebleeding episodes (16 patients), and the differences between these two groups were compared. Results: Oral anticoagulation therapy was associated with a higher risk of rebleeding after Rapid Rhino packing (odds ratio [OR]=8.41, p=0.047). A history of nasal surgery was associated with multiple rebleeding (OR=22.55, p=0.009). Age, sex, the management method, complications, and the site of bleeding were not found to be related to rebleeding. Conclusion Patients with rebleeding after Rapid Rhino nasal packing had a higher rate of concurrent oral anticoagulation therapy. A history of nasal surgery was strongly associated with multiple episodes of rebleeding. A detailed medical history can be important for assessing the risk of rebleeding in epistaxis patients treated with Rapid Rhino packing.

BACKGROUND AND OBJECTIVES: We reviewed the selection processes of contralateral routing of signal (CROS) hearing aids (HAs) and bone-conduction (BC) Has, and compared aided and unaided hearing thresholds. SUBJECTS AND METHOD: Twenty-four patients with asymmetrical hearing loss who used BC HAs (n=12) and CROS HAs (n=12) were enrolled. The choice of two different HAs were compared with respect to the degree of hearing loss, the unaided hearing thresholds and functional gains. RESULTS: When the hearing thresholds of the better hearing ears were >30 dB HL, most (92%, 11 of 12) chose CROS rather than BC HAs, with significant difference (p=0.001). Both CROS and BC HAs groups showed significantly improved functional gains (46.6 dB and 53.4 dB, respectively). Aided air-conduction (AC) thresholds (40.2 dB HL) in the CROS group were similar to the AC thresholds (43.1 dB HL) of better hearing ears. However, the hearing threshold of Aided AC thresholds (35.8 dB HL) in BC HAs group were less than the BC thresholds (17.3 dB HL) of better hearing ears by 19 dB (p<0.001). CONCLUSION: Both groups showed significantly increased functional gains. CROS HAs were preferred when hearing thresholds in better hearing ears were >30 dB HL. The CROS group showed aided thresholds similar to the thresholds of better hearing ears, but the BC HAs group showed poorer aided thresholds than the thresholds of better hearing ears. For patients with asymmetric hearing loss, HAs should be selected based on the degree and types of hearing loss and the maximum output level of the selected device.
Bone Conduction ; Deafness ; Ear ; Hearing Aids ; Hearing Loss ; Hearing ; Humans ; Methods

OBJECTIVES: We aimed to compare clinical outcomes including hearing improvement and cholesteatoma recurrence between endoscopic and conventional microscopic surgeries in patients with attic cholesteatoma. METHODS: We collected data from patients with attic cholesteatoma who were treated using endoscopic (10 patients) and microscopic (10 patients) approaches by a single surgeon. The data were retrospectively reviewed for patient characteristics, intraoperative findings, hearing levels, and follow-up clinical status. Recurrence of the cholesteatoma, improvement of hearing, and operation time were evaluated. RESULTS: Ossiculoplasty was performed in four patients in the endoscopic group and two patients in the microscopic group. Lempert endaural incision II was used in all the patients in the microscopic group, whereas Lempert I incision was used in all the patients in the endoscopic approach group. There were no significant differences between the two groups regarding hearing improvement and operating time. And, there were no recurrences during the follow-up period in both groups. CONCLUSION: The endoscopic approach for the management of attic cholesteatoma is as useful as the microscopic approach.
Cholesteatoma ; Ear ; Endoscopy ; Follow-Up Studies ; Hearing ; Humans ; Otitis Media ; Recurrence ; Retrospective Studies

BACKGROUND AND OBJECTIVES: We reviewed the selection processes of contralateral routing of signal (CROS) hearing aids (HAs) and bone-conduction (BC) Has, and compared aided and unaided hearing thresholds.SUBJECTS AND METHOD: Twenty-four patients with asymmetrical hearing loss who used BC HAs (n=12) and CROS HAs (n=12) were enrolled. The choice of two different HAs were compared with respect to the degree of hearing loss, the unaided hearing thresholds and functional gains. RESULTS: When the hearing thresholds of the better hearing ears were >30 dB HL, most (92%, 11 of 12) chose CROS rather than BC HAs, with significant difference (p=0.001). Both CROS and BC HAs groups showed significantly improved functional gains (46.6 dB and 53.4 dB, respectively). Aided air-conduction (AC) thresholds (40.2 dB HL) in the CROS group were similar to the AC thresholds (43.1 dB HL) of better hearing ears. However, the hearing threshold of Aided AC thresholds (35.8 dB HL) in BC HAs group were less than the BC thresholds (17.3 dB HL) of better hearing ears by 19 dB (p<0.001). CONCLUSION Both groups showed significantly increased functional gains. CROS HAs were preferred when hearing thresholds in better hearing ears were >30 dB HL. The CROS group showed aided thresholds similar to the thresholds of better hearing ears, but the BC HAs group showed poorer aided thresholds than the thresholds of better hearing ears. For patients with asymmetric hearing loss, HAs should be selected based on the degree and types of hearing loss and the maximum output level of the selected device.

PURPOSE: In order to investigate the survival rate, causes of death, and the predictors of death in hemodialysis patients with chronic renal failure. METHODS: Among the 3,462 patients who started hemodialysis in Asan Medical Center between May 1989 and December 1999, we selected 674 patients who were closely observed at least for 3 months since they began hemodialysis as an initial replacement therapy for chronic renal failure. Demographic and clinical characteristics, including diabetes mellitus, hepatitis viral marker, and laboratory findings at the beginning of hemodialysis were retrospectively analyzed RESULTS: The mean age of the patients was 51.0+/-14.8 years, and their sex ratio was 1.4:1(M:F). The proportion of patients with diabetic nephropathy was 34.4%. The mean follow-up period was 34.2+/-28.1 months and 117 patients died(17%). The greatest number of patients were found to have died of cardiac problems(23%), followed by cerebrovascular disease(16.2%), infection(13.7%) and malignant disease(11.1%). The survival rate of the 674 patients was found to range from 1 to 10 years:96% at 1 year, 88% at 2, 73% at 5, and 54% at 10 years. In order to determine the independent predictors of death, we used Cox proportional hazards model. The predictors of death in hemodialysis patients were found to be (i) male(Relative risk(RR)=1.46, p=0.06), (ii) people over 60 years of age(RR=1.54, p=0.03), diabetes mellitus(RR=1.45, p=0.06), and (iii) low level of serum creatinine(RR=0.65, p < 0.001). CONCLUSION: Cardiovascular disease and infectious diseases were important causes of death in hemodialysis patients. Old age and low serum creatinine at the beginning of hemodialysis were significant predictors of death.
Biomarkers ; Cardiovascular Diseases ; Cause of Death ; Chungcheongnam-do ; Communicable Diseases ; Creatinine ; Diabetes Mellitus ; Diabetic Nephropathies ; Follow-Up Studies ; Hepatitis ; Humans ; Kidney Failure, Chronic ; Proportional Hazards Models ; Renal Dialysis* ; Retrospective Studies ; Sex Ratio ; Survival Analysis* ; Survival Rate