A Case of Squamoid Eccrine Ductal Carcinoma of the Auricle Mimicking Perichondritis.

The subtype of eccrine carcinoma known as squamoid eccrine ductal carcinoma (SEDC) is rare; only 38 cases, including only 6 cases in the ear, have been documented in the literature. This may be the first case to focus on the fact that SEDC, located within the dermal and subcutaneous layers, spares the epidermis histopathologically, which can cause clinicians to confuse SEDC with acute perichondritis.

Two Cases of Multiple Ossicular Chain Disruption After Penetrating Injury and Tympanic Membrane Healing.

Ossicular chain disruption is a typical consequence of temporal bone trauma. However, it can also occur as a result of direct trauma to the ossicular chain due to penetrating injuries. Hearing loss, dizziness, and facial nerve damage could also occur after penetrating middle ear injuries. Multiple ossicular chain disruption is a rare traumatic ossicular complication caused by direct penetrating lesions in the external auditory canal. We present two cases of multiple ossicular disruptions (dislocation of the incudostapedial and malleoincudal joints) after ear-pick injuries, both of which resulted in conductive hearing loss. The condition improved after delayed surgical intervention (ossiculoplasty).

Bidirectional Association Between Sudden Sensorineural Hearing Loss and Glaucoma: A Cohort Study.

OBJECTIVES: To investigate the bidirectional association between sudden sensorineural hearing loss (SSNHL) and open-angle glaucoma (OAG) over a 12-year follow-up period using nationwide, population-based data. METHODS: The study was conducted using the National Health Information Database of the National Health Insurance Service (NHIS-NHID), which covered 3.5 million individuals from 2008 to 2019. In Study 1, we evaluated the effect of OAG on SSNHL, and in Study 2, we evaluated the effect of SSNHL on OAG. Participants of the control group were enrolled through "greedy nearest-neighbor" 1:1 propensity score matching. RESULTS: In Study 1, 26,777 people were included in each group. The hazard ratio (HR) for SSNHL of the OAG group was 1.27 (95% confidence interval [CI], 1.15-1.39). In subgroup analysis, there was significant HR value regarding (old age: 1.17, hyperlipidemia: 1.19). In Study 2, 15,433 people were included in each group. The HR for OAG of the SSNHL group was 1.18 (95% CI, 1.07-1.30). In subgroup analysis, the HRs were significant for old age (2.31), hypertension (1.17), diabetes (1.39), and hyperlipidemia (1.26). CONCLUSION: Over the 12-year follow-up, we found a bidirectional association between SSNHL and OAG, suggesting a shared pathogenesis. LEVEL OF EVIDENCE: N/A. Laryngoscope, 133:3169-3177, 2023.

Human Acellular Dermal Allograft Patch on Traumatic Tympanic Membrane Perforation.

BACKGROUND: This study aimed to investigate the outcome of using the human acellular dermal allograft patch compared with the conven- tional paper patch in traumatic tympanic membrane perforation. METHODS: This was a retrospective study including 41 patients (42 ears) treated with 22 human acellular dermal allografts and 20 paper patches for acute traumatic tympanic membrane perforation from April 2013 to June 2020. The procedure was performed by applying human acellular dermal allograft or paper patches after trimming of perforation margins under local anesthesia. Patient's age, sex, cause, duration, side, location, size of perforation, and the result of healing was analyzed. The audiologic or computed tomography data were also investigated when available. RESULTS: There was no significant difference in sex, age, affected side ratio, size and duration of perforation, recovery confirmation time, and audiogram results between the two groups. There was no significant difference in the size or duration of perforation between the success and failure groups. The human acellular dermal allograft and paper-patch groups showed no significant difference in the recovery confirmation time (70.7 ± 42.3 vs. 89.9 ± 119.4 days, P = .486) and recovery rate (95.5% vs. 85.0%, P = .333). However, the patch maintenance time of the human acellular dermal allograft group was statistically longer than the paper-patch group (32.9 ± 14.9 vs. 15.6 ± 19.9 days, P = .001). On multivariable regression analysis, patch material was the only parameter associated with patch maintenance time (P = .002). CONCLUSION: Treatment outcomes of traumatic tympanic membrane perforation using human acellular dermal allograft showed better or similar therapeutic efficacy compared to paper patch. The important advantage of this material is to stay in situ for a sufficient time without being detached until successful healing.

Association of sudden sensorineural hearing loss with increased risk of insomnia: a nationwide population-based cohort study.

STUDY OBJECTIVES: To evaluate the risk of insomnia in patients with sudden sensorineural hearing loss (SSNHL). METHODS: A retrospective propensity score-matched cohort study was conducted using a nationwide representative sample from the National Sample Cohort 2002-2013 data from the Korea National Health Insurance Service. The SSNHL group (n = 631) included patients diagnosed with SSNHL between January 2002 and December 2005. The comparison group (4 controls for every patient with SSNHL, n = 2,524) was selected using propensity score matching, according to sociodemographic factors and the year of enrollment. Each patient was monitored until 2013. Survival analysis, log-rank test, and Cox proportional hazards regression models were used to calculate the incidence, survival rate, and hazard ratio (HR) of insomnia for each group. RESULTS: Among the 3,155 individuals included in the study population (male, 48.6%), the overall incidence of insomnia during the 11-year follow-up was 1.4-fold higher in the SSNHL group than in the non-SSNHL group (106.3 vs 138.3 per 10,000 person-years; adjusted HR, 1.38; 95% confidence interval [CI], 1.08-1.78). Moreover, the adjusted HRs for developing insomnia (depression, 3.33 [95% CI, 2.22-5.01]; anxiety, 1.78 [95% CI, 1.27-2.53]; tinnitus, 1.56 [95% CI, 1.2-2.03]; dizziness, 1.76 [95% CI, 1.27-2.44]) were higher in patients with comorbidities. CONCLUSIONS: This observational study suggests that SSNHL is associated with an increased incidence of insomnia. Specifically, findings from this study show that patients with tinnitus, depression, anxiety, and dizziness had a higher risk of developing insomnia than those without tinnitus, depression, anxiety, and dizziness. CITATION: Yeo CD, Yeom SW, You YS, Kim JS, Lee EJ. Association of sudden sensorineural hearing loss with increased risk of insomnia: a nationwide population-based cohort study. J Clin Sleep Med. 2022;18(5):1335-1342.

Association of gastroesophageal reflux disease with increased risk of chronic otitis media with effusion in adults: A nationwide population-based cohort study.

ABSTRACT: This study aimed to evaluate the risk of developing chronic otitis media with effusion (OME) in individuals with gastroesophageal reflux disease (GERD).A retrospective propensity score-matched cohort study was performed using data from the Korea National Health Insurance Service. The GERD group (n = 3532) included certain individuals who had been diagnosed with GERD between January 2002 and December 2005. A comparison control group (n = 14,128) was calculated by 1:4 Propensity Score (PS) matching considering age, sex, and comorbidities and year of enrolment. Each patient was monitored until 2013. Survival analysis, the log-rank test, and Cox proportional hazard regression models were used to calculate the incidence, survival rate, and hazard ratio (HR) of chronic OME for each group.Among the 17,660 individuals included in the study population (53.2% male), the overall incidence of chronic OME during the 11-year follow-up was 1.84-fold higher in the GERD group than in the non-GERD group (1.8 vs 3.0 per 1000 person-year; adjusted HR 1.84; 95% confidence interval [CI], 1.46-2.31). Moreover, the adjusted HRs of developing chronic OME (allergic rhinitis, 1.69 [95% CI, 1.37-2.10]; asthma, 1.29 [95% CI, 1.02-1.64]; chronic rhinosinusitis, 1.61 [95% CI, 1.26-2.05]) were greater in study population with comorbidities.From long-term follow-up, the prevalence of chronic OME in adults was 1.84 times higher in the GERD group compared with the non-GERD group. Specifically, it found that allergic rhinitis, asthma, or chronic rhinosinusitis showed increase the risk of developing chronic OME than those without these conditions.

Association of gastroesophageal reflux disease with increased risk of chronic otitis media with effusion in adults: A nationwide population-based cohort study.

ABSTRACT: This study aimed to evaluate the risk of developing chronic otitis media with effusion (OME) in individuals with gastroesophageal reflux disease (GERD).A retrospective propensity score-matched cohort study was performed using data from the Korea National Health Insurance Service. The GERD group (n = 3532) included certain individuals who had been diagnosed with GERD between January 2002 and December 2005. A comparison control group (n = 14,128) was calculated by 1:4 propensity score matching considering age, sex, and comorbidities and year of enrollment. Each patient was monitored until 2013. Survival analysis, the Log-rank test, and Cox proportional hazard regression models were used to calculate the incidence, survival rate, and hazard ratio (HR) of chronic OME for each group.Among the 17,660 individuals included in the study population (53.2% men), the overall incidence of chronic OME during the 11-year follow-up was 1.84-fold higher in the GERD group than in the non-GERD group (1.8 vs 3.0 per 1000 person-year; adjusted HR 1.84; 95% confidence interval [CI], 1.46-2.31). Moreover, the adjusted HRs of developing chronic OME (allergic rhinitis, 1.69 [95% CI, 1.37-2.10]; asthma, 1.29 [95% CI, 1.02-1.64]; chronic rhinosinusitis, 1.61 [95% CI, 1.26-2.05]) were greater in study population with comorbidities.From long-term follow-up, the prevalence of chronic OME in adults was 1.84 times higher in the GERD group compared with the non-GERD group. Specifically, it found that allergic rhinitis, asthma, or chronic rhinosinusitis showed increase the risk of developing chronic OME than those without these conditions.

Is septal deviation associated with headache?: A nationwide 10-year follow-up cohort study.

To investigate the potential relationship between septal deviation (SD) and headache using nationwide representative cohort sample data.This study used a nationwide cohort sample from the Korean National Health Insurance Service database. The cohort sample was composed of 1 million patients, which is obtained by propensity score matching from 2002 to 2013. There were 9171 individuals in the SD group and 28243 in the control or no SD group. The Kaplan-Meier survival analysis, the log-rank test, and Cox proportional hazard regression analysis were used to calculate the incidence, survival curve, and hazard ratio of headache for each group.There were no statistically significant differences in sex (P = .7708), age (P = .991), residential area (P = .9626), or socioeconomic status (P = .9982) between the 2 groups. The survival curve between SD and control or no SD showed a statistically significant difference. The adjusted hazard ratio for headache incidence during the 10-year follow-up period of the SD group was 1.37 (95% CI: 1.31-1.43).This cohort study suggests that SD is associated with headache. Therefore, these findings suggest that septoplasty can be considered as 1 of the treatment option in SD patients with headache.

A Case of Fungal Ball with Cholesterol Granuloma in the Middle Ear Cavity.

Fungal balls consist of rounded conglomerates of fungal mycelia, which can form within a preexisting cavity. They are mostly found in the paranasal sinuses in the head and neck regions. Cholesterol granuloma is a fibrotic lesion that develops as a tissue response to a foreign body such as cholesterol crystals or hemosiderin and is often associated with chronic otitis media. We present the unusual case of a 62-year-old male who was treated for chronic otitis media, which was histologically confirmed as a fungal ball and cholesterol granuloma in the middle ear cavity following tympanomastoidectomy. This is the first reported case of synchronous fungal ball and cholesterol granuloma in the middle ear cavity.

What Affects Postoperative Sinusitis and Implant Failure after Dental Implant: A Meta-analysis.

OBJECTIVE: The dental implant is an innovative instrument that enables the edentulous patient to chew. Many factors have a bearing on the success of dental implantation. There are also many complications after dental implantation. In this meta-analysis, we investigated which factors increase the risk of postoperative sinusitis and implant failure after dental implant for the first time. DATA SOURCES: Included data were searched through the PubMed, EMBASE, and Cochrane library databases. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and 2 authors (J.S.K., S.H.K.) independently extracted data by multiple observers. REVIEW METHODS: We used a random-effects model considering the variation between and within the included studies. RESULTS: Twenty-seven studies were included in our final meta-analysis. The proportion of postoperative sinusitis, perforation of the sinus membrane, and implant failure was 0.05 (95% confidence interval [CI], 0.04-0.07), 0.17 (95% CI, 0.13-0.22), and 0.05 (95% CI, 0.04-0.07), respectively, using the single proportion test. The only factors that affected postoperative sinusitis were preoperative sinusitis and intraoperative perforation of the Schneiderian membrane ( P < .01 and P < .01, respectively). The only factors that affected dental implant failure were smoking and residual bone height of the maxilla ( P < .05 and P < .01, respectively). CONCLUSIONS: Two factors affect postoperative sinusitis after implant surgery: preoperative sinusitis and Schneiderian membrane rupture. It should also be noted that the factors affecting implant failure are residual bone height and smoking. These findings will have a significant impact on the counseling and treatment policy of patients who receive dental implants.

Rhinocerebral mucormycosis after functional endoscopic sinus surgery: A case report.

RATIONALE: Mucormycosis is a rare fungal infection which mainly develops in compromised hosts and the associated mortality rate is high. PATIENT CONCERNS: We report a case of mucormycosis in a 59-year-old woman following routine endoscopic sinus surgery. The patient had a history of diabetes mellitus (DM) and bronchial asthma. DIAGNOSES: On follow-up 4 weeks after the first functional endoscopic sinus surgery (FESS), she complained of a severe headache and was readmitted for a second period. Endoscopic examination revealed bony erosion and a whitish discharge on the left middle turbinate, which was confirmed as mucormycosis by endoscopic biopsy. INTERVENTIONS: Endoscopic debridement of the necrotic tissue and middle turbinectomy were performed and the patient was treated with intravenous amphotericin B for 3 months (3.5 mg/kg/day). OUTCOMES: About 1 month into the second period of hospitalization, left Bell's palsy had occurred. The facial palsy improved naturally after 2 months of hospitalization. One year after endoscopic debridement, follow-up endoscopy showed that there was no residual lesion. CONCLUSION: This is the first report of mucormycosis after routine endoscopic sinus surgery. We did not miss headache symptom after FESS surgery, and diagnosed mucormycosis through early endoscopic biopsy, which played an important role in curing the patient. In addition to the importance of medical therapy such as DM control for patients, emotional support and psychiatric treatment are also important factors as these patients require hospitalization for a long period, 3 months in the case of this patient.

Endoscopic-Assisted Palatal Surgery Via Transoral and Intranasal Approach.

Palate carcinoma often challenges to the treatment options. It depends on the histologic type, local invasion, and nodal or distant metastasis. Hard palate tumors that invade the nasal cavity can be operated by midfacial degloving approach, lateral rhinotomy approach, and lip splitting incision with infrastructure maxillectomy. These approaches inevitably coincide with facial scars, nerve injuries, facial swelling, and long hospital stay. Transoral robotic assisted surgery can be applied; however, this needs high price and has a weakness of accurate handling about intranasal lesion. The authors have performed transoral and intranasal endoscopic-assisted palatal removal of recurrent palatal carcinoma for a patient and herein report their technique and result.