Objectives: . We evaluated changes in income levels in a hearing-impaired population. Methods: . The study subjects were selected from the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 of Koreans ≥40 years old. In total, 5,857 hearing-impaired subjects were matched with 23,428 comparison participants. Differences between the initial income level and income levels at 1, 2, 3, 4, and 5 years post-enrollment were compared between the hearing-impaired and comparison groups. The interaction of time and hearing impairment/comparison was estimated. Results: . Both the hearing-impaired group and the comparison group showed increased income levels over time. In the hearing-impaired group, the income levels at 4 and 5 years post-enrollment were higher than the initial income level (each P<0.001). In the comparison group, the income levels of all the participants after 1–5 years were higher than the initial income level (each P<0.001). The interaction of time and hearing impairment was statistically significant (P=0.021). Conclusion . The increase in income over time was relatively lower in the hearing-impaired adult population; therefore, the income gap widened between this population and the normal-hearing population.

Objectives: . We evaluated changes in income levels in a hearing-impaired population. Methods: . The study subjects were selected from the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 of Koreans ≥40 years old. In total, 5,857 hearing-impaired subjects were matched with 23,428 comparison participants. Differences between the initial income level and income levels at 1, 2, 3, 4, and 5 years post-enrollment were compared between the hearing-impaired and comparison groups. The interaction of time and hearing impairment/comparison was estimated. Results: . Both the hearing-impaired group and the comparison group showed increased income levels over time. In the hearing-impaired group, the income levels at 4 and 5 years post-enrollment were higher than the initial income level (each P<0.001). In the comparison group, the income levels of all the participants after 1–5 years were higher than the initial income level (each P<0.001). The interaction of time and hearing impairment was statistically significant (P=0.021). Conclusion . The increase in income over time was relatively lower in the hearing-impaired adult population; therefore, the income gap widened between this population and the normal-hearing population.

Extracranial carotid artery aneurysm is an uncommon disease that otorhinolaryngologists may encounter only rarely. It usually presents as pulsatile neck mass or as other neurologic symptoms. We report a case of extracranial internal carotid artery aneurysm in an 81-year old female who presented with a fever and nonpulsatile oropharyngeal swelling mimicking a peritonsillar abscess. Incision and drainage of the swelling lesion could have resulted in catastrophic events such as aneurismal rupture or a stroke. We thus recommend radiologic evaluations of peritonsillar abscess before performing any procedure, even if it is clinically highly suspicious.

BACKGROUND AND OBJECTIVES: To investigate epidemiological features of patients with sialolithiasis and to evaluate the difference in outcomes depending on its location.SUBJECTS AND METHOD: We included in the test 472 patients, or 534 cases, who were admitted to the Hallym University Sacred Heart Hospital between February 2006 and May 2017 with the diagnosis of sialolithiasis. The diagnosis of sialolithiasis was established by CT images; all of the cases were classified by the location of stones (orifice to stone/orifice to hilum: 0–0.25, type I; 0.25–0.5, type II; 0.5–0.75, type III; 0.75–1, type IV). RESULTS: The average size of stone was 7.2±4.8 mm and the mean patient age was 36.1±17.4 years old. According to the method described above, 534 cases were classified into the following: type I consisted of 188 cases (35.2%), type II consisted of 55 cases (10.2%), type III consisted of 92 cases (17.2%) and type IV consisted of 199 (37.2%). When comparing these types, stones in Type I were significantly smaller than other groups. There was a significant difference in the surgical method depending on the location of stones. Different complications such as swelling, bleeding, tongue discomfort, ranula, recurrence, etc. have been reported and, together, they statistically show meaningful differences in the distribution depending on types. CONCLUSION The position of stone in Wharton's duct is important factor that can determine the method of surgical procedure or postoperative prognosis. We recommend 4 types classification of sialolithiasis and it can provide more specific diagnosis of disease and facilitate approach for treatment.

BACKGROUND AND OBJECTIVES: To investigate epidemiological features of patients with sialolithiasis and to evaluate the difference in outcomes depending on its location. SUBJECTS AND METHOD: We included in the test 472 patients, or 534 cases, who were admitted to the Hallym University Sacred Heart Hospital between February 2006 and May 2017 with the diagnosis of sialolithiasis. The diagnosis of sialolithiasis was established by CT images; all of the cases were classified by the location of stones (orifice to stone/orifice to hilum: 0–0.25, type I; 0.25–0.5, type II; 0.5–0.75, type III; 0.75–1, type IV). RESULTS: The average size of stone was 7.2±4.8 mm and the mean patient age was 36.1±17.4 years old. According to the method described above, 534 cases were classified into the following: type I consisted of 188 cases (35.2%), type II consisted of 55 cases (10.2%), type III consisted of 92 cases (17.2%) and type IV consisted of 199 (37.2%). When comparing these types, stones in Type I were significantly smaller than other groups. There was a significant difference in the surgical method depending on the location of stones. Different complications such as swelling, bleeding, tongue discomfort, ranula, recurrence, etc. have been reported and, together, they statistically show meaningful differences in the distribution depending on types. CONCLUSION: The position of stone in Wharton's duct is important factor that can determine the method of surgical procedure or postoperative prognosis. We recommend 4 types classification of sialolithiasis and it can provide more specific diagnosis of disease and facilitate approach for treatment.
Classification ; Diagnosis ; Heart ; Hemorrhage ; Humans ; Methods ; Prognosis ; Ranula ; Recurrence ; Retrospective Studies ; Salivary Ducts ; Salivary Gland Calculi ; Submandibular Gland ; Tongue

BACKGROUND AND OBJECTIVES: This study aimed to review the characteristics of microbiology of peritonsillar abscess and to recommend adequate empirical antibiotics. SUBJECTS AND METHOD: Patients (437) who underwent surgical drainage for peritonsillar abscess were reviewed retrospectively. We analyzed correlations between age, gender, obesity and diabetes mellitus and cultured organisms with respect to susceptibility of antibiotics. RESULTS: The leading pathogens were α-hemolytic streptococcus (44.3%), Streptococcus viridians (12.3%), β-hemolytic streptococcus (8.2%) and Streptococcus pyogenes (6.8%). The rates of α-hemolytic streptococcus and Streptococcus pyogenes growth were p=0.002 and p=0.032, respectively; these values were significantly higher in patients under the age of 40 than those over the age of 40. Klebsiella pneumoniae infection was observed more frequently in the diabetic group than in the non-diabetic group. Antibiotics susceptibility test showed that four leading pathogens were susceptible to ampicillin/sulbactam. CONCLUSION: Only ampicillin/sulbactam was sufficient to treat peritonsillar abscess empirically. In conclusion, the use of third generation Cephalosporin or other antibiotics for anaerobes is not considered necessary for the empirical treatments of peritonsillar abscess.
Anti-Bacterial Agents ; Diabetes Mellitus ; Drainage ; Humans ; Klebsiella pneumoniae ; Methods ; Obesity ; Peritonsillar Abscess* ; Retrospective Studies ; Streptococcus ; Streptococcus pyogenes

We aimed to estimate the effects of various risk factors on hearing level in Korean adults, using data from the Korea National Health and Nutrition Examination Survey. We examined data from 13,369 participants collected between 2009 and 2011. Average hearing thresholds at low (0.5, 1, and 2 kHz) and high frequencies (3, 4, and 6 kHz), were investigated in accordance with various known risk factors via multiple regression analysis featuring complex sampling. We additionally evaluated data from 4,810 participants who completed a questionnaire concerned with different types of noise exposure. Low body mass index, absence of hyperlipidemia, history of diabetes mellitus, low incomes, low educational status, and smoking were associated with elevated low frequency hearing thresholds. In addition, male sex, low body mass index, absence of hyperlipidemia, low income, low educational status, smoking, and heavy alcohol consumption were associated with elevated high frequency hearing thresholds. Participants with a history of earphone use in noisy circumstances demonstrated hearing thresholds which were 1.024 dB (95% CI: 0.176 to 1.871; P = 0.018) higher, at low-frequencies, compared to participants without a history of earphone use. Our study suggests that low BMI, absence of hyperlipidemia, low household income, and low educational status are related with hearing loss in Korean adults. Male sex, smoking, and heavy alcohol use are related with high frequency hearing loss. A history of earphone use in noisy circumstances is also related with hearing loss.
Adult ; Alcohol Drinking/*epidemiology ; Causality ; Comorbidity ; Diabetes Mellitus ; Disease Susceptibility ; Educational Status ; Employment/statistics & numerical data ; Female ; Hearing Loss/*diagnosis/*epidemiology ; Hearing Tests/statistics & numerical data ; Humans ; Income/statistics & numerical data ; Male ; *Noise ; Occupational Exposure/*statistics & numerical data ; Republic of Korea/epidemiology ; Risk Factors ; Sex Distribution ; Smoking/*epidemiology ; Surveys and Questionnaires

Carcinoma showing thymus-like element (CASTLE) is a very rare malignant neoplasm in the lower portion of the thyroid gland or soft tissue of the neck. Recurrent laryngeal nerve (RLN) is the most frequent site of CASTLE. Non-RLN is also a rare anomaly. Both CASTLE and non-RLN are risk factors for vocal cord paralysis. In this report, the authors describe a 73-year-old patients diagnosed with CASTLE and non-RLN. During total thyroidectomy, one RLN was sacrificed inevitably because of tumor invasion, while the other non-RLN was successfully saved, which was expected based on preoperative computed tomography (CT). If the diagnosis is uncertain, CT should be checked to prevent unexpected risks.
Aged ; Diagnosis ; Humans ; Laryngeal Nerves* ; Neck ; Recurrent Laryngeal Nerve ; Risk Factors ; Thymus Gland ; Thyroid Gland ; Thyroidectomy ; Vocal Cord Paralysis

External jugular vein thrombosis is an infrequent disease that has been associated with altered blood flow, vascular endothelium lesion or a hypercoagulable state. It could be originated from phlebectasia, but very rare. It could be diagnosed with detailed history taking, when patients had no specific previous history of intervention or treatment. The authors report a case of external jugular vein thrombosis originated from phlebectasia without risk factor. This patient was successfully managed by ligation and excision of the vein without any complications.
Endothelium, Vascular ; Humans ; Jugular Veins* ; Ligation ; Risk Factors ; Thrombosis* ; Veins

BACKGROUND AND OBJECTIVES: This study aimed to review the characteristics of microbiology of deep neck abscess and to recommend adequate empirical antibiotics. SUBJECTS AND METHOD: Medical records of the 71 patients who underwent surgical drainage for deep neck abscess were reviewed retrospectively. We analyzed correlations between age, gender, etiology and diabetes mellitus and the cultured organism with respect to susceptibility of antibiotics. RESULTS: The leading pathogens were Streptococcus viridians group (18.3%), Klebsiella pneumonia (K. pneumonia, 15.5%), Staphylococcus aureus (S. aureus, 15.5%) and alpha-hemolytic Streptococcus (12.7%). The most common source of infection had a dental origin. Streptococcus viridians group was associated with infections of dental origin and K. pneumonia infection was over-represented in the diabetic group compared to the non-diabetic group. Antibiotics susceptibility test showed that four leading pathogens were susceptible to ampicillin/sulbactam. The rate of methicillin-resistant S. aureus accounting for S. aureus infections was only 18.2%. CONCLUSION: Only ampicillin/sulbactam without other antibiotics was sufficient to treat deep neck abscess empirically. Thus we suggest that other antibiotics that target anaerobes or 3rd generation cephalosporin are not necessary for the empirical treatments of deep neck abscess.
Abscess* ; Anti-Bacterial Agents ; Diabetes Mellitus ; Drainage ; Humans ; Klebsiella ; Medical Records ; Methicillin Resistance ; Neck* ; Pneumonia ; Retrospective Studies ; Staphylococcus aureus ; Streptococcus