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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]

Abstract: Objective: To determine the significance of laryngopharyngeal reflux (LPR) in benign vocal mucosal lesions. Study Design and Setting: A case-control study at the tertiary referral medical center. Subjects and Methods: From April 2003 to December 2006, we studied 110 patients with benign vocal mucosal lesions who had undergone 24-hour ambulatory double pH monitoring. The control group included 200 patients who had undergone ambulatory 24-hour double-probe pH monitoring due to laryngopharyngeal reflux–related symptoms without specific findings of benign vocal mucosal lesions. Reflux symptom index and reflux finding score were measured. We compared the prevalence of pathologic laryngopharyngeal reflux and various parameters of the pH monitoring such as total reflux number, fraction time of pH below 4 in various positions, and DeMeester scores. Results: The prevalence of pathologic laryngopharyngeal reflux was 65 percent in the control group, 66 percent in vocal nodule group, 75 percent in the vocal polyp group, and 90 percent in the Reinke''s edema group. Patients with Reinke''s edema had a significantly higher prevalence of pathologic laryngopharyngeal reflux than controls (P = 0.016). LPR was associated with a significantly increased risk of Reinke''s edema (odds ratio: 4.846, 95% confidence interval 1.093∼21.492). Total reflux number and DeMeester scores in the Reinke''s edema group and fraction time of pH below 4 in the supine position in the vocal polyp group were significantly higher than those in the control group. Conclusion: Laryngopharyngeal reflux might play a role as an etiologic factor in Reinke''s edema and vocal polyps. [Copyright &y& Elsevier]

Objectives: To evaluate the necessity of preserving the posterior branch of the great auricular nerve during parotidectomy. Study Design and Setting: Forty-six patients undergoing parotidectomy were prospectively analyzed. Twenty-four patients had preservation of the posterior branch of the great auricular nerve; in the remaining 22 patients the nerve was sacrificed. A sensory index score was defined as the area involved multiplied by the intensity grade of sensory loss. Quality-of-life was evaluated with a questionnaire. Results: The sensory index score was significantly higher in the sacrificed group as compared with the preserved group at both 1 week (41.87 vs 62.11) and 1 month (24.91 vs 46.11) after parotidectomy. The sensory deficit improved over time in both groups, and after 12 months only minimal sensory loss remained. Quality-of-life was not significantly different between the groups. Conclusions: Irrespective of preservation of the posterior branch of the great auricular nerve, sensory deficit improved over time. Therefore, preservation of the posterior branch of the great auricular nerve might not be necessary during parotidectomy. [Copyright &y& Elsevier]

Objective: Intratympanic dexamethasone injection (ITDI) was generally used as salvage treatment for sudden sensorineural hearing loss (SSNHL) patients who failed initial systemic treatment or for patients who considered to have a hazard risk on systemic steroids. We investigated the effectiveness of combination therapy, early ITDI accompanied by systemic therapy on SSNHL. Method: We gathered the data of 151 SSNHL patients who were refractory to systemic treatment for 5 days. The injection group was administered systemic therapy and 4 times of ITDI within 2 weeks after break of SSNHL. The control group only received traditional treatment. We compared the last concrete hearing level and recovery rate. Results: Overall hearing improvement was observed in 47 of 104 (45.2%) control patients and in 30 of 47 (63.8%) injection patients (P =. 034). On the basis of Siegel criteria, 7 of 47 (14.9%) injection patients were recovered in Siegel criteria 1, and 10 of 47 (21.3%) and 13 of 47 (27.7%) injection patients were respectively recovered in Siegel criteria 2 and 3. In the control group, 15.4%, 8.7%, and 21.2% patients were recovered in Siegel criteria 1, 2, and 3, respectively. Depending on the degree of initial hearing loss, patients with severe hearing loss who were treated with ITDI showed significantly higher recovery rates than patients in the control group (83.8% vs 50.0%) (P =. 049). Conclusion: Early combination therapy of intratympanic dexamethasone injection within 2 weeks accompanied by initial systemic treatment is effective for patients with refractory sudden sensorineural hearing loss, especially for patients with severe hearing loss. [ABSTRACT FROM AUTHOR]

Objectives: Investigate the role of cochlear microphonics (CM) that could be simultaneously acquired in auditory brain stem response (ABR) test in neonatal hearing screening. Methods: From April 2013 to January 2014, hearing screening tests were performed on 51 newborns treated in neonate intensive care unit. The subjects underwent transient evoked otoacoustic emission (TEOAE) and auditory brain stem response (ABR). The amplitude of CM was acquired by applying 90 dB‐click sound of condensating and rarefacting polarity. Results: There were 68 ears with normal results in ABR, CM and OAE. Auditory neuropathy was suspected in 2 ears that had presence of CM and OAE with abnormal ABR waveform. Amplitude of CM correlated with reproducibility of OAE (p<.01) inversely correlated with latencies of wave I and III (P =. 016, P =. 010). The subjects with presence of OAE showed higher amplitude of CM than those with absent OAE (P <. 01). Mean CM amplitude of subjects with normal ABR threshold was higher than those with abnormal ABR, but there was no statistical significance. Five subjects who had normal ABR threshold showed no OAE response but CM was measured. Conclusions: Amplitude of CM had correlation with results of OAE and ABR test. CM might provide more stable information about cochlear hair cell than OAE test which could be easily influenced by condition of middle ear or external ear. We suggest CM as a useful supplementary tool for OAE test. [ABSTRACT FROM AUTHOR]

Objective: Robotic thyroidectomy and conventional endoscopic thyroidectomy have not been thoroughly compared. In this study, we compared the potential advantages of robotic versus endoscopic thyroidectomy. Method: We analyzed 218 consecutive patients who underwent endoscopic (105 cases) or robotic (113 cases) thyroidectomy using a gasless unilateral axillo‐breast (GUAB) or axillary (GUA) approach. Results: Because of the dexterity of robotic instruments and the improved surgical view, it was subjectively easier and took less time to perform a complete total thyroidectomy and central compartment neck dissections (CCND) in robotic thyroidectomy. In the case of unilateral lobectomy, endoscopic and robotic thyroidectomy had quite similar surgical outcomes. Cosmetic satisfaction was excellent in both groups. Conclusion: Robotic thyroidectomy is superior to endoscopic thyroidectomy for performing total thyroidectomy and bilateral CCND. However, in terms of cost‐effectiveness, endoscopic thyroidectomy is comparable to robotic thyroidectomy in patients who undergo unilateral lobectomy. [ABSTRACT FROM AUTHOR]

Objective: Nitric oxide (NO) is known to be an important mediator and inflammatory marker of airway. The purpose of this study is to analyze the distribution of nasal NO (nNO) and exhaled NO (eNO) in chronic sinusitis (CRS) with polyp and to predict clinical features of CRS with polyp by NO, which is easy to measure. Method: We used chemiluminescent analyzer to measure nNO and eNO between healthy individuals (32) and CRS with polyp patients (30), CRS with polyp and allergic rhinitis and compared it with a variety of clinical features of chronic sinusitis like sinus CT and symptoms. Results: The nNO were significantly lower in CRS with polyp (88.5 ± 54.7 ppb) compared with controls (241.0 ± 89.5 ppb), CRS with polyp and allergic rhinitis (167.0 ± 47.6 ppb) (pp < 0.009) with a positive relationship with the extent of sinus disease, and it was different from nNO. Conclusion: The nasal NO could be used to predict CRS with polyp, which eventually has to be treated with surgery. The upper airway disease could affect the lower airway inflammation, and it reflects, "One airway, one disease." [ABSTRACT FROM AUTHOR]