BACKGROUND AND OBJECTIVES: External auditory canal osteoma is an uncommon benign lesion and represents as unilateral solitary pedunculated mass. The aim of this study is to evaluate the clinical symptoms of osteoma and its treatment outcomes over a 10-year period in a tertiary hospital. SUBJECTS AND METHOD: Eight patients underwent operation to remove an external auditory canal osteoma at Chungbuk National University Hospital from 2008 to 2017. The medical records were retrospectively reviewed with regard to clinical characteristics, size and location of osteoma, method of surgery and treatment outcomes. RESULTS: The average age of patients was 41.8 years with the male predominance of 6:2. All of the lesions in the osteoma were unilateral and solitary (average size 5.0 mm). All of the eight cases were pedunculated: in four cases, the stalks of the osteoma were found on the tympanomastoid suture line and in three cases, it was found on the tympanosquamous suture line. Four patients were asymptomatic, where the lesions were found incidentally during unrelated evaluations. No patients were found with conductive hearing loss in the pure tone audiometry. Transcanal and endaural approach were used in five and three cases, respectively. Most of the cases were removed by curettage only, except for the two who needed additional drilling. The average surgery time was 15.6 minutes. There was no postoperative complication or recurrence. CONCLUSION: The external auditory canal osteoma was mostly unilateral and solitary. The removal of osteoma in the early stage was relatively easy with no recurrence or complication.
Audiometry ; Chungcheongbuk-do ; Curettage ; Ear Canal ; Exostoses ; Hearing Loss, Conductive ; Humans ; Male ; Medical Records ; Methods ; Osteoma ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Sutures ; Tertiary Care Centers

BACKGROUND AND OBJECTIVES: External auditory canal osteoma is an uncommon benign lesion and represents as unilateral solitary pedunculated mass. The aim of this study is to evaluate the clinical symptoms of osteoma and its treatment outcomes over a 10-year period in a tertiary hospital.SUBJECTS AND METHOD: Eight patients underwent operation to remove an external auditory canal osteoma at Chungbuk National University Hospital from 2008 to 2017. The medical records were retrospectively reviewed with regard to clinical characteristics, size and location of osteoma, method of surgery and treatment outcomes. RESULTS: The average age of patients was 41.8 years with the male predominance of 6:2. All of the lesions in the osteoma were unilateral and solitary (average size 5.0 mm). All of the eight cases were pedunculated: in four cases, the stalks of the osteoma were found on the tympanomastoid suture line and in three cases, it was found on the tympanosquamous suture line. Four patients were asymptomatic, where the lesions were found incidentally during unrelated evaluations. No patients were found with conductive hearing loss in the pure tone audiometry. Transcanal and endaural approach were used in five and three cases, respectively. Most of the cases were removed by curettage only, except for the two who needed additional drilling. The average surgery time was 15.6 minutes. There was no postoperative complication or recurrence. CONCLUSION The external auditory canal osteoma was mostly unilateral and solitary. The removal of osteoma in the early stage was relatively easy with no recurrence or complication.

BACKGROUND AND OBJECTIVES: The incidence of recurrence after surgery of congenital cholesteatoma is increasing due to the widespread use of otoendoscopy as well as an increased awareness of these lesions among primary care physicians. There is no general consensus on the risk factors affecting recurrence. In this study, analyzing clinical characteristics of recurred cases from a tertiary hospital, we investigated risk factors for the recurrence of congenital cholesteatoma after surgery. SUBJECTS AND METHOD: From 1999 to 2016, data were collected from retrospective chart reviews of patients who have undergone surgeries for congenital cholesteatoma at Hospital. We analyzed data about clinical characteristics and recurrence according to the age at diagnosis, location, stage and type of disease, pneumatization of mastoid, ossicular erosion, and surgical techniques. RESULTS: Sixty-eight patients underwent surgery for congenital cholesteatoma. The average age at operation was 4.8 years. Recurrence was detected in 7 cases of the 68 patients, with the recurrence rate of 10.3%. Sex, age, cholesteatoma type, location, stage, mastoid pneumatization, and operation method did not show significant differences between the recurred group and the non-recurred group in the univariated analysis. CONCLUSION: The recurrence rate of congenital cholesteatoma after primary operation was 10.3%. In this study, there was no statistically significant risk factor for postoperative recurrence of congenital cholesteatoma.
Cholesteatoma* ; Consensus ; Diagnosis ; Humans ; Incidence ; Mastoid ; Methods ; Physicians, Primary Care ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Tertiary Care Centers

Noise-induced hearing loss could be caused by mechanical destruction of the delicate membranes of the inner ear, hair cells and supporting structures of the organ of Corti, and by intense metabolic activity, which increases free radical formation in the cochlea. When exposure is continuous, injury is a consequence of the total amount of energy to which cochlear tissues are exposed and a hearing conservation program is essential including hearing protection devices. Several therapeutic trials including antioxidant agents have been shown at least partially effective in prevention of hearing loss and hair cell death.
Cell Death ; Cochlea ; Ear, Inner ; Hair ; Hearing ; Hearing Loss* ; Hearing Loss, Noise-Induced ; Membranes ; Noise* ; Organ of Corti

BACKGROUND AND OBJECTIVES: The purpose of this study was to determine the prevalence of bilateral chronic otitis media (BCOM) and the ratio of unilateral or bilateral cholesteatoma in BCOM. Pre- and post-operative hearing were analyzed to see if bilateral balanced hearing were achieved. SUBJECTS AND METHOD: A retrospective review was done with a computerized otologic database to identify all patients who underwent surgical treatments for COM between 1998 and 2011, and has a follow up duration for at least 6 months. Comparative analysis between pre- and post-operation hearing was measured by pure tone audiometry and achievement of bilateral balanced hearing was analyzed with 'The Belfast rule of thumb'. RESULTS: Two hundred and eighty-one (14.5%) of 1938 patients suffered from BCOM, and of these, 73 (25.9%) of the patients with BCOM had cholesteatomas in one (12.4%) or both ears (13.5%). When a patient with BCOM is found with cholesteatoma in one ear, the odds of there being cholesteatoma in the other ear was 52.1%. According to 'The Belfast rule of thumb', it is considered difficult to achieve successful bilateral hearing gains sufficient for the patients to perceive subjective hearing improvements in BCOM. CONCLUSION: Approximately 15% of the COM patients were found with the disease in both ears, and the odds of a patient with BCOM having cholesteatoma in one ear also having cholesteatoma in the other ear was 53.4%. It was difficult to achieve subjective, successful and balanced bilateral hearing gain with three-dimensional hearing improvements.
Audiometry ; Cholesteatoma ; Ear ; Ear, Middle ; Follow-Up Studies ; Hearing ; Humans ; Otitis Media* ; Prevalence ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Inner ear symptoms like hearing loss, dizziness or tinnitus are often developed after head trauma, even in cases without inner ear destruction. This is also known as labyrinthine concussion. The purpose of this study is to determine the clinical manifestations, characteristics of audiometry and prognostic factors of these patients. MATERIALS AND METHODS: We reviewed the medical records of the 40 patients that had been diagnosed as labyrinthine concussion from 1996 to 2007. We studied the hearing levels in each frequency and classified them according to type and degree of hearing loss. Rates of hearing improvement were evaluated according to age, sex, hearing loss type, degree and presence of dizziness or tinnitus. To find out any correlation between hearing improvement and these factors, we used chi2 test or Fisher's exact test. RESULTS: Bilateral hearing loss was observed in 22 patients, and unilateral hearing loss in 18 patients. There were 4 (6.5%) ascending, 34 (54.8%) descending, 24 (38.7%) flat type hearing loss, which indicated hearing loss was greater in high frequencies than low frequencies. Among 62 affected ears, 20 (32.3%) gained improvement, and it was achieved mainly in low frequencies. There were only 2 ears with dizziness in 20 improved ears and among 20 dizziness accompanied ears, also only 2 ears were improved. CONCLUSIONS: High frequencies are more vulnerable to trauma than low frequencies. The hearing gain is obtained mainly in low frequencies, and association with dizziness serves poor prognosis.
Audiometry ; Craniocerebral Trauma ; Dizziness ; Ear ; Ear, Inner ; Hearing ; Hearing Loss ; Hearing Loss, Bilateral ; Hearing Loss, Unilateral ; Humans ; Medical Records ; Post-Concussion Syndrome ; Prognosis ; Tinnitus

Sudden sensorineural hearing loss (SSNHL) is characterized by abrupt unilateral loss of hearing, sometimes accompanied by tinnitus or vertigo. From the majority of patients with SSNHL, no specific cause can be identified, but numerous conditions including viral infection, vascular compromise and intracochlear membrane break are considered as possible causes of disease. According to these etiologic hypotheses, a combination therapy has been frequently used combining several options among steroids, antiviral agents, vasodilators, volume expanders, stellate ganglion block and carbogen or hyperbaric oxygen. The contents of the combination could vary according to the experience of each clinic, but steroids have been accepted as the mainstay of the treatment for SSNHL since Wilson's landmark study although two recent meta-analysis of steroid treatment suggested there was no benefit. The amount and the length of oral steroid therapy have not been well established. Commonly used regimen of oral steroid therapy is prednisone. A reported success rate with systemic steroid therapy is between 49% and 89%, whereas only 30% to 65% of patients without treatment achieved hearing improvement. Recently there is an obvious trend for an increasing number of positive results of intratympanic steroids injection. It is difficult to evaluate the efficacy of a certain drug or regimen prescribed for SSNHL because of various drugs used as combination therapy, many prognostic factors and different inclusion criteria.
Antiviral Agents ; Carbon Dioxide ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Membranes ; Oxygen ; Prednisone ; Stellate Ganglion ; Steroids ; Tinnitus ; Vasodilator Agents ; Vertigo

BACKGROUND AND OBJECTIVES: Sudden deafness, an important disease characterized by abrupt sensorineural hearing loss, is rare in children and the prognosis in children is accepted to be worse than that in adults. However, clinical studies are not sufficient to define the clinical characteristics and prognosis of sudden deafness in children. The author analyzed clinical manifestation of sudden deafness in children and compared the treatment results of children with those of adults. SUBJECTS AND METHOD: A retrospective analysis was performed in 25 patients (29 ears) who were treated for sudden deafness from January 1993 to May 2008. RESULTS: 1) The overall hearing recovery rate (79%) was significantly higher in adults (53.7%). The prognosis in children less than 10 years old (73%) was also higher than that in adults. 2) The rate of complete recovery (61%) was higher in children than in adults (38.5%). CONCLUSION: The sudden deafness in children has unique clinical characteristics and the recovery rate is more favorable than in adults.
Adult ; Child ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Prognosis ; Retrospective Studies

Cholesterol granuloma is a histological term used for the description of a tissue response to a foreign body such as cholesterol crystals. The pathogenesis of cholesterol granuloma is controversial. But three factors are thought to have an important role in its development: obstruction of ventilation, impaired drainage, and hemorrhage. It may arise from any portion of the pneumatized temporal bone. But huge cholesterol granuloma with intracranial and extradural extension has been rarely reported. Recently, we experienced a case of huge cholesterol granuloma with intracranial and extradural extension. The patient has never experienced chronic otitis media before. The cholesterol granuloma was successfully removed by transmastoid approach. So we report this case along with a literature review.
Cholesterol ; Drainage ; Foreign Bodies ; Granuloma ; Hemorrhage ; Humans ; Otitis Media ; Temporal Bone ; Ventilation

Vascular tinnitus, a sort of pulsatile tinnitus, should be differentiated with other sensorineural tinnitus because it is possible to be cured by correction of underlying systemic disease or surgery. The dehiscent high jugular bulb, a common cause of venous pulsatile tinnitus, can be cured by reconstruction of hypotympanum. We present a case of pulsatile tinnitus with dehiscent high jugular bulb which has been treated by surgery. Preoperative microscopic finding showed dark bluish pulsating mass in posteroinferior portion of tympanic membrane. Temporal bone CT showed high jugular bulb with bone defect of hypotympanum. The hypotympanum was reconstructed and high jugular bulb lowered using the harvested bony fragment from mastoid cortical bone. The pulsatile tinnitus disappeared immediately after surgery.
Mastoid ; Temporal Bone ; Tinnitus ; Tympanic Membrane