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Objective: The aim of this study was to investigate the clinical implications of diabetes for the management of idiopathic sudden sensorineural hearing loss (ISSNHL).Study Design: Retrospective study.Setting: Tertiary referral center.Subjects and Methods: ISSNHL patients (N = 403) who received inpatient management between January 2015 and December 2018 were analyzed. All were managed by a uniform treatment protocol of high-dose steroid therapy and salvage intratympanic steroid injections. Treatment results were evaluated according to the American Academy of Otolaryngology-Head and Neck Surgery's criteria 3 months after the start of treatment. We compared the clinical parameters and treatment outcomes of ISSNHL with and without diabetes. We also evaluated the influence of diabetes on the prognosis of ISSNHL by propensity score matching.Results: Overall, of the 403 ISSNHL patients, 94 (23.3%) had diabetes, and 11 were newly diagnosed with diabetes. The patients with diabetes were older than those without diabetes (P < .001), and their initial hearing threshold was significantly higher (P < .001). The diabetic patients were hospitalized for a longer period, and their hearing recovery rate was lower. However, when age, sex, and initial hearing level were adjusted by propensity score matching, the diabetic patients and matched controls yielded similar treatment results.Conclusions: ISSNHL with diabetes usually presents with severe hearing loss and requires longer hospitalization. However, diabetes itself may not influence the prognosis of ISSNHL. Proper management must be provided in ISSNHL with diabetes. [ABSTRACT FROM AUTHOR]

Objective: Analyze the outcomes of early surgical exploration in suspected traumatic perilymph fistulas (PLF). Method: Study Design: Retrospective case review. Setting: Tertiary otology referral center. Patients and Intervention: Nine patients (10 cases) that developed sudden sensorineural hearing loss and dizziness following head trauma underwent exploratory tympanotomy and PLF repair with the clinical impression of traumatic PLF. Outcome Measure: Postoperative hearing changes and control of dizziness. Results: All patients had sudden or progressive hearing loss and dizziness following head trauma; a car accident, slap injury, and barotraumas. Surgical exploration was performed 2 to 47 days after the trauma. Possible evidence of PLF was found in 9 cases and included: fibrous web around the oval window (OW) (n = 3), perilymph collection around the round window (RW) (n = 5), and bulging of the RW membrane (n = 1). After surgical repair, the mean hearing gain was 28dB (10~55dB); the hearing improved to serviceable levels in 6 out of 10 cases (60%). All patients had resolution of the vestibular symptoms after the surgery. Conclusion: Sudden or progressive sensorineural hearing loss accompanied by dizziness following head trauma should prompt the consideration of a traumatic PLF. Early surgical exploration is recommended to control dizziness and improve hearing outcomes. [ABSTRACT FROM AUTHOR]

Objective: Assess the efficacy and safety of ultrasound‐powered shears (Harmonic Scalpel) in free flap elevation for head and neck defects. Method: From January to August 2010, there were 15 patients enrolled, who underwent reconstructive surgery with free flap in our institution. Donor sites were radial forearm in 10, anterolateral thigh in 5, and fibula in 2. HS was used in harvesting the perforators and the vascular pedicles. Results: All the free flaps were successfully harvested within 50 to 70 min (from skin incision to pedicle ligation). Bleeding was minimal even without tourniquet application. All vascular pedicle dissections were performed without mechanical or thermal damages, and they were anastomosized to proper, recipient vessels. Conclusion: Based on our experiences, HS is a safe and efficient instrument in harvesting the free flaps, especially because of no increased risk of thermal damage to vascular pedicle. [ABSTRACT FROM AUTHOR]