Search

Background Sudden sensorineural hearing loss (SSNHL) is a relatively common condition that is usually of unknown etiology. A number of individual studies have investigated the association between various serum lipids and SSNHL; however, the findings have been inconsistent. In an attempt to obtain more definitive information on the relationship between serum lipids and SSNHL, we carried out a systematic review and meta-analysis. Methods Medline, the Cochrane Library, and EMBASE were searched using the following key words: lipid, cholesterol, triglyceride, fat, serum, blood, sudden hearing loss, hearing loss, hearing disorders. Randomized controlled trials, prospective cohort studies, and retrospective case-control studies involving patients with SSNHL and healthy controls that examined the relationship (reported as odds ratios [OR]) between lipid profiles and SSNHL were included. Primary outcomes were total cholesterol and low-density lipoprotein cholesterol (LDL-C) concentrations. Secondary outcomes were triglyceride, high-density lipoprotein cholesterol, and lipoprotein(a) concentrations. Results A total of 6 case-control studies were included in this systematic review/meta-analysis. The total number of participants ranged from 30 to 250 in the case group and from 43 to 271 in the control group. Meta-analysis revealed no significant difference in total cholesterol levels between the case and control groups (pooled OR = 1.79, 95% confidence interval [CI] = 0.98 to 3.26, P = 0.057). Likewise, meta-analysis revealed no significant difference in LDL-C concentrations between the case and control groups (pooled OR = 1.15, 95% CI = 0.64 to 2.07, P = 0.639). Since there were an insufficient number of studies reporting data for the secondary outcomes, meta-analysis was not possible. Conclusions Our results do not provide evidence for serum lipids being associated with SSNHL, nor do they definitively rule out such an association. Additional studies are needed to ascertain the relationship, or lack thereof, between serum lipids and SSNHL.

A prospective study with subjective evaluation of shoulder pain and objective evaluation of shoulder muscle strength by isokinetic testing and electromyographic and electroneurographic studies of spinal accessory nerve function was performed on patients who had undergone neck dissection procedures. Twenty-one patients with head and neck cancer were enrolled in this study. Three types of neck dissection were performed: 7 selective neck dissections, 9 modified radical neck dissections, and 5 radical neck dissections. All patients who underwent radical neck dissection had shoulder pain, and 80% of them had shoulder droop after the operation. In the patients who underwent selective neck dissection, the electromyographic findings of the spinal accessory nerve were relatively normal. Their shoulder strength was sometimes decreased at 1 month after operation, but it had returned to preoperative strength by the 6-month follow-up visit. These findings suggested that patients who underwent selective neck dissection had the least damage to spinal accessory nerve function and the least shoulder disability after neck dissection.

Objective: To evaluate the relationship between unilateral renal agenesis and auditory abnormality, and to determine the clinical spectrum of hearing impairment in such patients. Methods: Seventy-five children with unilateral renal agenesis underwent auditory examinations. The subjects comprised 35 males and 40 females. Fourteen females had mullerian abnormalities. Another 75 schoolchildren with the same gender profile were selected for audiometric testing as a control group. Children with sonographically evident urogenital system abnormalities were excluded from the control group. Results: The prevalence of auditory abnormalities in children with unilateral renal agenesis (4/75) (5.3%) was higher than in the control group (0%). The prevalence in children with urogenital anomalies was significantly higher in patients with renal agenesis than in the normal population (28.5%). Audiometric results showed that four of the 75 children manifested ipsilateral sensorineural hearing impairment, particularly in the high-frequency range. All were females with coexisting genital abnormalities. Two were diagnosed with mild sensorineural hearing impairment while the other two had moderate hearing loss. Conclusions: The results of our study suggest that neurosensory hearing loss was found to be associated with renal agenesis. Further audiometric follow-up of children with renal agenesis seems worthwhile.

Although traditional microscopic laryngeal surgery has been well developed, we still may encounter some clinical problems, including exposure difficulty, blind areas during examination, and inadvertent cutting through lesions. These problems may lead to an increased risk of complications or protracted or even repeated operations. We have partially overcome these problems since October 1992 with a new telescopic endolaryngeal surgery technique. This technique was developed by combining and modifying the principles of bronchoscopic surgery and endoscopic sinus surgery. With this technique, it is not necessary to use a very slim laryngoscope or apply overpressure on the larynx when introducing and suspending the laryngoscope. Difficult-to-examine regions can be accessed more easily. We can also get a 3-dimensional impression of lesions and related structures, so it is easier to determine a proper cutting line to avoid cutting through lesions. We consider this telescopic method to be a useful alternative to conventional microscopic laryngeal surgery.