A case of vocal cord gnathostomiasis diagnosed with sectional morphologies in a histopathological specimen from a Chinese woman living in Korea.

This study aimed to describe a rare case of gnathostomiasis in the vocal cord. A 54-year-old Chinese woman living in Korea visited with a chief complaint of voice change at the outpatient department of otorhinolaryngology in Hallym Sacred Heart Hospital, Hallym University on August 2, 2021. She had eaten raw conger a few weeks before the voice change developed, but her medical history and physical examinations demonstrated neither gastrointestinal symptoms nor other health problems. A round and red cystic lesion, recognized in the anterior part of the right vocal cord, was removed using forceps and scissors through laryngeal microsurgery. The histopathological specimen of the cyst revealed 3 cross-sections of a nematode larva in the lumen of the cyst wall composed of inflammatory cells and fibrotic tissues. They differ in diameter, from 190 µm to 235 µm. They showed characteristic cuticular layers with tegumental spines, somatic muscle layers, and gastrointestinal tracts such as the esophagus and intestine. Notably, intestinal sections consisted of 27-28 lining cells containing 0-4 nuclei per cell. We tentatively identified the nematode larva recovered from the vocal cord cystic lesion as the third-stage larva of Gnathostoma, probably G. nipponicum or G. hispidum, based on the sectional morphologies.

Associations Between Chronic Rhinosinusitis and Cancers: A Nationwide Population-Based Cohort Study.

OBJECTIVE: Chronic rhinosinusitis (CRS) is one of the most common chronic inflammatory diseases. The effect of chronic inflammation caused by CRS on the occurrence of various cancers has not been thoroughly evaluated. This study aimed to investigate the increased incidences of 10 types of cancers among CRS patients with/without nasal polyps (NP) using a national population-based database from the Korean Health Insurance Review and Assessment Service. STUDY DESIGN: A case-control cohort study. METHODS: We compared the prevalence of various comorbidities between CRS and control participants from a national cohort dataset of the Korean Health Insurance Review and Assessment Service. METHODS: CRS participants (n = 6,919) and non-CRS (n = 27,676) participants were selected from among the 514,866 participants from 2002 to 2015. A stratified Cox proportional hazards model was utilized to assess the hazard ratio (HR) of CRS for 10 types of cancers. RESULTS: A stratified Cox proportional hazard model demonstrated that the adjusted HR for hematologic malignancy was significantly higher in the CRS patients than in the controls regardless of the presence of NP (2.90 for total CRS; 2.15 for CRS with NP; 4.48 for CRS without NP). The HR for thyroid cancer was significantly higher in the CRS patients without NP but not in those with NP (1.50 for total CRS; 1.78 for CRS without NP). CONCLUSION: This study showed that CRS participants had a significantly higher prevalence of hematologic malignancy and thyroid cancer. LEVEL OF EVIDENCE: 4 Laryngoscope, 133:1044-1051, 2023.

Is the Number of Missing Teeth Associated With Mortality? A Longitudinal Study Using a National Health Screening Cohort.

This study aimed to estimate the risk of mortality related to the number of missing teeth in a South Korean population. The ≥ 40-year-old population of the Korean National Health Insurance Service-Health Screening Cohort 2002-2003 was analyzed. Participants were selected from a total of 220,189 participants and included in groups of 0 teeth lost, 1-2 teeth lost, and ≥ 3 teeth lost. Among the total population, 17,211 participants were included in no missing teeth, 1-2 missing teeth, and ≥ 3 missing teeth and were randomly matched 1:1:1 for age and sex. Mortality from specific causes and all-cause mortality were compared among the groups. The hazard ratio (HR) of the number of missing teeth for all-cause mortality or each cause of mortality was analyzed using Cox proportional hazard models. According to the cause of death, the HRs for metabolic disease, digestive disease, and trauma were greater in the group with ≥ 3 missing teeth than in the no missing teeth group. The group with ≥ 3 missing teeth indicated a 1.19-fold higher HR for all-cause mortality than the no missing teeth group [95% confidence intervals (95% CIs) = 1.12-1.27, P < 0.001]. The group with 1- 2 missing teeth did not show a higher HR for all-cause mortality. In the group with 1-2 missing teeth, the HRs for mortality from mental disease and digestive disease were higher than those in the no missing teeth group. The group with 1-2 missing teeth did not show a higher HR for all-cause mortality. The number of missing teeth was linked with a higher risk of mortality. For specific causes of mortality, mortality from metabolic disease, digestive disease, and trauma was higher in the participants with the number of missing teeth.

Association between Thyroid Cancer and Weight Change: A Longitudinal Follow-Up Study.

BACKGROUND: The purpose of this study was to evaluate body mass index (BMI) and systolic blood pressure (SBP)/diastolic blood pressure (DBP) between Korean adults who underwent thyroidectomy and comparison groups. METHODS: Data were included from the Korean National Health Insurance Service-Health Screening Cohort (2002-2015). BMI and SBP/DBP were measured before thyroidectomy, 1 and 2 years after thyroidectomy (n = 1995 in study I, n = 2162 in study II), comparing 1:4 matched participants (n = 7980 in study I, n = 8648 in study II). The paired t-test and linear mixed model were used to identify the differences between groups. RESULTS: DBP in both thyroid cancer II and comparison II group were significantly lower after thyroidectomy than before thyroidectomy. However, the interaction effect of thyroidectomy in study I and study II did not reach statistical significance. CONCLUSION: BMI, SBP and DBP were not significantly different between the thyroidectomy group and the matched comparison group.

Causes of Mortality in Korean Patients with Neurodegenerative Dementia.

The prevalence of neurodegenerative dementia is increasing owing to the rapid growth of the older population. We investigated risks and causes of mortality in Korean patients with neurodegenerative dementia using data from the Korean Health Insurance Review and Assessment Service-National Sample Cohort with the aim to improve their care. From a pool of 1,125,691 patients, 11,215 patients aged ≥60 years who were diagnosed with dementia between 2002 and 2013 were examined along with 44,860 matched controls. A Cox proportional hazard model was used to calculate crude and adjusted hazard ratios (HRs). During the follow-up period, 34.5% and 18.8% of individuals in the neurodegenerative dementia and control groups, respectively, died (P < 0.001). The adjusted HR for mortality in the neurodegenerative dementia group was 2.11 (2.41 and 1.96 in men and women, respectively). Moreover, the adjusted HRs in patients with neurodegenerative dementia were 3.25, 2.77, and 1.84 for those diagnosed at ages 60-69, 70-79, and ≥80 years, respectively. The highest odds ratio for mortality was noted among patients with neurologic disease (15.93) followed by those with mental disease (4.89). These data show that the risk of mortality increased regardless of age and sex in Korean patients with neurodegenerative dementia.

Increased Risk of Temporomandibular Joint Disorder in Osteoporosis Patients: A Longitudinal Study.

Background: The objective of this study was to investigate the risk of temporomandibular joint disorder (TMD) in patients with osteoporosis. Methods: Data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 were collected. Participants ≥ 40 years old were enrolled, and the history of osteoporosis was evaluated. The 62,328 osteoporosis patients were matched for age, sex, income, and region of residence with 62,328 control participants. The occurrence of TMD was assessed in both the osteoporosis and control groups during the follow-up period. Stratified Cox proportional hazard analyses for TMD were conducted for the osteoporosis and control groups. The hazard ratios (HRs) of osteoporosis for TMD were further analyzed by age and sex subgroups. Results: A total of 1.2% (725/61,320) of the osteoporosis patients and 0.6% (339/61,320) of the control participants had TMD (P<0.001). Osteoporosis was associated with an elevated HR of TMD (adjusted HR=1.96, 95% CI=1.72-2.23, P<0.001). Among the age and sex subgroups, the < 60-year-old mal\e group demonstrated an adjusted HR of osteoporosis for TMD as high as 4.47 (95% CI=1.17-17.12, P=0.029). Other age and sex subgroups also showed a higher HR for TMD associated with osteoporosis (adjusted HR=2.30, 95% CI=1.90-2.78, P<0.001 for the ≥ 60-year-old female group). Conclusion: Osteoporosis was related to a higher risk of TMD in the adult population. A prominent association of osteoporosis with TMD was noted in middle-aged men and older women.

Association between Gout and Dyslipidemia: A Nested Case-Control Study Using a National Health Screening Cohort.

The association between lipid levels and uric acid disorders remains controversial. We evaluated the association between dyslipidemia and gout in a large cohort from the Korean National Health Insurance Service-Health Screening Cohort. Among the 514,866 participants aged ≥40 years, 16,679 gout participants were selected and matched with 66,716 control participants for income, region of residence, sex, and age. We used the ICD-10 codes to define dyslipidemia (E78) and gout (M10) and diagnosis was confirmed when each was reported ≥2 times. The odds ratios (ORs) of dyslipidemia history were calculated using conditional logistic regression in crude, partial, and fully adjusted models. The days of statin use, systolic and diastolic blood pressure, fasting glucose level, total cholesterol, obesity, Charlson comorbidity index, alcohol consumption, and smoking were used as covariates. Patients with gout had a significantly higher dyslipidemia history than those without gout (33.1% vs. 24.0%, p < 0.001). The association was significant after adjustment (OR in partial adjusted model = 1.50, 95% confidence interval (CI) = 1.44−1.57; OR in fully adjusted model = 1.43, 95% CI = 1.37−1.49). These findings were consistent with the subgroup analysis. Our findings suggest that dyslipidemia history is more likely in patients with gout aged ≥40 years than in healthy controls among Korean population.

Association between chronic rhinosinusitis and pneumonia: a longitudinal follow-up study using a national health screening cohort.

This study was aimed to compare the risk of pneumonia between patients with chronic rhinosinusitis (CRS) and those without CRS (control) in a Korean population. The population aged 40 years or over was included from the Korean National Health Insurance Service-Health Screening Cohort. Participants with CRS (n = 6393) and controls (n = 25,572) were selected by 1:4 matching for age, sex, income, region of residence, and history of pneumonia for the previous 1 year. The index date (ID) of the controls was set as the treatment date of their matched CRS participants. The incidence of pneumonia after the ID was measured from 2003 to 2015. Simple and multiple linear regressions were performed to calculate estimated values (EVs) and 95% confidence intervals (CIs) for 1-y post-ID pneumonia, 2-y post-ID pneumonia, and 3-y post-ID pneumonia in CRS participants compared to controls. Statistical significance was noted in the 3-y post-ID period (EV = 0.017, 95% CI = 0.002-0.031, P = 0.030). In the subgroup analyses according to age and sex, statistical significance was seen in the younger age group (< 60 years old) in the 3-y post-ID period and in the female group in the 1-y and 3-y post-ID periods. This study revealed an increased risk for pneumonia following a diagnosis of CRS.

Association Between Meniere Disease and Migraine.

Importance: A connection between Meniere disease (MD) and migraine has been proposed, but the temporal association remains unknown. Objective: To examine the bidirectional association of MD with migraine. Design, Setting, and Participants: This case-control study included participants 40 years or older from the Korean National Health Insurance Service Health Screening Cohort from 2002 to 2015. Main Outcomes and Measures: A total of 6919 patients with MD were matched with 27 676 control participants without MD for age, sex, income, region of residence, and index date. The incidence of migraine was analyzed in the MD and matched groups using a stratified Cox proportional hazard regression model. In addition, 35 889 patients with migraine were matched with 71 778 control participants without migraine. The incidence of MD was analyzed using a stratified Cox proportional hazard regression model. Results: Of 142 262 total participants, 94 611 (66.5%) were women. Migraine occurred in 695 of 6919 patients with MD (10.0%) and 970 of 27 676 matched control participants (3.5%). The MD group demonstrated a 2.22-fold higher risk of migraine than the matched control group (95% CI, 1.99-2.49). Meniere disease was present in 1098 of 35 889 patients with migraine (3.1%) and 781 of 71 778 matched control participants (1.1%). The migraine group had a 1.95-fold higher risk of MD than the matched control group (95% CI, 1.77-2.15). Conclusions and Relevance: The results of this case-control study suggest that patients with MD had a greater risk of migraine occurrence. Furthermore, patients with migraine had a higher risk of MD. Based on the bidirectional association, therapeutics for migraine could potentially be applied to MD and vice versa.

Comparison of Stress and Suicide-Related Behaviors Among Korean Youths Before and During the COVID-19 Pandemic.

Importance: The COVID-19 pandemic has had a substantial psychological effect on young people. A quantitative assessment of the association between the pandemic and stress and suicidality in youths is needed. Objective: To investigate the association of the COVID-19 pandemic with self-reported stress and suicide-related behaviors in youths. Design, Setting, and Participants: This cross-sectional study used data from the the Korea Youth Risk Behavior Web-based Survey (KYRBWS) conducted in 2019 and 2020 with youths aged 12 to 18 years. Statistical analysis was performed from January to February 2021. Main Outcomes and Measures: The odds ratios (ORs) with 95% CIs for subjective stress level, sadness or despair, suicidal thoughts, suicide planning, and suicide attempts among 2020 participants were compared with those of the 2019 participants using multiple logistic regression analysis with complex sampling using weighted values. Results: The 48 443 youths in the 2019 KYRBWS (24 917 male youths [51.3%]; mean [SD] age, 15.0 [1.7] years) and the 44 216 youths in the 2020 KYRBWS (23 103 male youths [52.5%]; mean [SD] age, 15.1 [1.7] years) were compared. The degree of subjective stress was lower in the 2020 participants than in the 2019 participants (severe stress: adjusted OR [aOR], 0.90 [95% CI, 0.83-0.97]; very severe stress: aOR, 0.65 [95% CI, 0.60-0.72]). Sadness or despair was also lower in the 2020 participants than in the 2019 participants (aOR, 0.81 [95% CI, 0.78-0.84]). There were fewer suicide-related behaviors, including suicidal thoughts, suicide planning, and suicide attempts, among the 2020 participants than among the 2019 participants (suicidal thoughts: aOR, 0.77 [95% CI, 0.73-0.80]; suicide planning: aOR = 0.88 [95% CI, 0.81-0.96]; suicide attempts: aOR, 0.64 [95% CI, 0.58-0.70]). Conclusions and Relevance: This cross-sectional study found that severe stress, sadness or despair and suicide-related behaviors had inverse associations with the early COVID-19 pandemic in Korean youths. These findings suggest that levels of high stress decreased among Korean youths in the early period of the pandemic compared with prepandemic levels.

Analysis of the Association between Female Medical History and Thyroid Cancer in Women: A Cross-Sectional Study Using KoGES HEXA Data.

The purpose of this study was to evaluate the association between female medical history and thyroid cancer. Methods: Data from the Korean Genome and Epidemiology Study were collected from 2004 to 2016. Among a total of 1303 participants with thyroid cancer and 106,602 control (non-thyroid cancer) participants, the odds ratios (ORs) with 95% confidence intervals (CIs) of hysterectomy, oophorectomy, use of oral contraceptives, and number of children were evaluated. Results: The adjusted OR of hysterectomy for thyroid cancer was 1.73 (95% CI = 1.48-2.01, p < 0.001) in the minimally adjusted model. The adjusted ORs for thyroid cancer were 1.89 (95% CI = 1.06-3.37, p = 0.031), 0.89 (95% CI = 0.83-0.94, p < 0.001), and 0.85 (95% CI = 0.73-0.99, p = 0.040) for bilateral oophorectomy, number of children, and use of oral contraceptives, respectively, in the fully adjusted model. In the subgroup analysis, the adjusted ORs of bilateral oophorectomy were significant in the younger age (OR = 3.62, 95% CI = 1.45-9.03, p = 0.006), while the number of children was significant in the older age (OR = 0.86, 95% CI = 0.80-0.93, p < 0.001). Conclusions: The ORs of hysterectomy and bilateral oophorectomy were significantly higher in the thyroid cancer group in the younger age group. The adjusted ORs of the number of children were significantly low in the older age group.

Effects of short- and long-term exposure to air pollution and meteorological factors on Meniere's disease.

The association between air pollutants and Meniere's disease has not been explored. The present study investigated the relationship between meteorological factors and air pollutants on Meniere's disease. Participants, aged ≥ 40 years, of the Korean National Health Insurance Service-Health Screening Cohort were included in this study. The 7725 patients with Meniere's disease were matched with 30,900 control participants. The moving average meteorological and air pollution data of the previous 7 days, 1 month, 3 months, and 6 months before the onset of Meniere's disease were compared between the Meniere's disease and control groups using conditional logistic regression analyses. Additional analyses were conducted according to age, sex, income, and residential area. Temperature range; ambient atmospheric pressure; sunshine duration; and levels of SO2, NO2, O3, CO, and PM10 for 1 month and 6 months were associated with Meniere's disease. Adjusted ORs (odds ratios with 95% confidence interval [CI]) for 1 and 6 months of O3 concentration were 1.29 (95% CI 1.23-1.35) and 1.31 (95% CI 1.22-1.42), respectively; that for the 1 and 6 months of CO concentration were 3.34 (95% CI 2.39-4.68) and 4.19 (95% CI 2.79-6.30), respectively. Subgroup analyses indicated a steady relationship of O3 and CO concentrations with Meniere's disease. Meteorological factors and air pollutants were associated with the rate of Meniere's disease. In particular, CO and O3 concentrations were positively related to the occurrence of Meniere's disease.

Analyses of the Association between Thyroid Cancer and Osteoporosis/Fracture Histories: A Cross-Sectional Study Using KoGES HEXA Data.

(1) Background: The purpose of this study was to determine the association among thyroid cancer, osteoporosis and fracture history. (2) Methods: The data collected from 2004 through 2016 for the Korean Genome and Epidemiology Study were retrieved. For a total of 1349 participants with thyroid cancer and 163,629 control participants, the odds ratios (ORs) with 95% confidence intervals (CIs) of osteoporosis and fracture history were evaluated using a logistic regression model. (3) Results: The adjusted ORs of osteoporosis comparing thyroid cancer with the control group were 1.41 (95% CI = 1.18-1.70, p < 0.001) for all participants and 1.43 (95% CI = 1.19-1.71, p < 0.001) for women. The adjusted ORs of fracture history comparing these two groups were not significantly associated within the entire group of participants, men only or women only. (4) Conclusions: The adjusted OR of osteoporosis was significantly higher than 1, comparing thyroid cancer with the control group, especially in women. The adjusted OR of fractures was not significantly higher than 1, comparing the thyroid cancer group with the control group.

Negative Prognostic Implication of TERT Promoter Mutations in Human Papillomavirus-Negative Tonsillar Squamous Cell Carcinoma Under the New 8th AJCC Staging System.

Telomerase reverse transcriptase gene promoter (TERTp) mutation is a potential candidate for pathogenesis and therapeutic target of tonsillar squamous cell carcinomas (TSCCs) in association with human papillomavirus (HPV). Their clinical relevance has not been validated under the new 8th American Joint Committee on Cancer (AJCC) staging system. We analyzed real-time peptide nucleic acid-mediated PCR and sequencing methods (TERTp mutation) and real-time PCR-based assay (HPV) in 80 surgically resected TSCCs. The 8th edition staging system improved the stratification of the early and advanced stages and between T or N categories for overall survival over the 7th edition. TERTp mutation was found in 7.5%, and HPV in 80.0% of the patients. The majority (83.3%) of TERTp mutation cases were HPV-positive TSCCs. Applying the 8th edition staging system, TERTp mutation was an independent factor of poor prognosis for disease-free survival (DFS) in TSCC patients, supporting the clinical significance of TERTp mutation in tonsil cancer. TERTp mutations were also negatively correlated with overall survival and DFS in HPV-negative TSCCs. Conclusively, TERTp mutation provides negative prognostic impact on survival of surgically managed tonsil cancers staged with the AJCC 8th edition.

Short-Term Exposure to Air Pollution and Epiglottitis: A Nested Case-Control Study.

OBJECTIVES/HYPOTHESIS: This study investigated the impacts of air pollution and meteorological factors on the occurrence of epiglottitis. STUDY DESIGN: A nested case-control study. METHODS: Participants ≥40 years old in the Korean National Health Insurance Service-Health Screening Cohort were analyzed. A total of 2,615 epiglottitis patients and 10,460 matched control participants were analyzed. The odds ratios (ORs) for epiglottitis associated with meteorological and air pollution factors, including sulfur dioxide (SO2 , ppb), nitrogen dioxide (NO2 , ppb), ozone (O3 , ppb), and carbon monoxide (CO, ppm), after 3, 7, 15, and 30 days of exposure were analyzed using conditional logistic regression adjusted for total cholesterol, blood pressure, fasting blood glucose, obesity, smoking, alcohol consumption, prior upper respiratory infection, tonsillectomy, immunocompromise, autoimmune disease, and the Charlson comorbidity index. RESULTS: The daily temperature range and NO2 exposure after 3 days were associated with increased rates of epiglottitis (OR = 1.03, 95% confidence interval [CI] = 1.02-1.05 for temperature range and OR = 1.78, 95% CI = 1.14-2.77 for NO2 , respectively). These results were generally consistent at 7, 15, and 30 days. CONCLUSIONS: The temperature range and NO2 exposure for 3, 7, 15, and 30 days were positively related to the occurrence of adult epiglottitis. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:2483-2489, 2021.

Evaluation of the relationship between previous statin use and thyroid cancer using Korean National Health Insurance Service-Health Screening Cohort data.

The association of thyroid cancer with statin use is controversial. This study aimed to investigate the association of previous statin use with thyroid cancer in the ≥ 40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort. The 5501 patients in the thyroid cancer group were matched with the 22,004 patients in the non-thyroid cancer group for age, sex, income, and region of residence. Previous statin use during the 2 years before the diagnosis of thyroid cancer was examined. The odds ratios (ORs) with 95% confidence intervals (CIs) of previous statin use for thyroid cancer were estimated using conditional logistic regression analyses. Additionally, subgroup analyses were conducted. The thyroid cancer group showed more days of previous statin use than the non-thyroid cancer group (72.3, standard deviation [SD] = 181.2 days vs. 64.3, SD = 174.4 days, P = 0.003). Although the odds of previous statin use for thyroid cancer were high in the crude model (OR = 1.10, 95% CI 1.04-1.17, P = 0.002), they were low in the fully adjusted model (OR = 0.89, 95% CI 0.82-0.95, P = 0.001). According to age and sex subgroups, the younger (< 60 years old) male group showed lower odds for thyroid cancer according to previous statin use (adjusted OR = 0.70, 95% CI 0.55-0.88, P = 0.003), but this finding was not observed in other subgroups of older men or in any groups of women. Thyroid cancer was negatively associated with statin use in the previous 2 years in the adjusted model.

Analyses of Weight/Blood Pressure Changes before and after Tonsillectomy in Adults: A Longitudinal Follow-Up Study.

This study aimed to evaluate the changes in weight and blood pressure in Korean adults who underwent tonsillectomy compared to controls. A nested case-control study used data from the Korean National Health Insurance Service-Health Screening Cohort (2002-2015). Tonsillectomy was defined using claim code Q2300. The changes in weight and systolic/diastolic blood pressure (SBP/DBP) were measured before tonsillectomy and 1 year after tonsillectomy (study I) in some participants and during the second year after tonsillectomy (study II) in other participants. Patients who underwent tonsillectomy (n = 569 in study I; n = 556 in study II) were 1:4 matched with control participants (n = 2276 in study I; n = 2224 in study II). The paired t-test and linear mixed model were used to test the differences between groups at each time point. There were no changes in body mass index (p = 0.732 in study I; p = 0.128 in study II), SBP (p = 0.344 in study I; p = 0.559 in study II), or DBP (p = 0.826 in study I; p = 0.524 in study II) between the tonsillectomy patients and controls in the first or second year postoperatively. Subgroup analyses by age, sex, and degree of obesity showed consistent results. Tonsillectomy does not lead to a change in weight or blood pressure in Korean adults.

Hearing Impairment Increases Economic Inequality.

OBJECTIVES: We evaluated changes in income levels in a hearing-impaired population. METHODS: The study subjects were selected from the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 of Koreans ≥40 years old. In total, 5,857 hearing-impaired subjects were matched with 23,428 comparison participants. Differences between the initial income level and income levels at 1, 2, 3, 4, and 5 years post-enrollment were compared between the hearing-impaired and comparison groups. The interaction of time and hearing impairment/comparison was estimated. RESULTS: Both the hearing-impaired group and the comparison group showed increased income levels over time. In the hearing-impaired group, the income levels at 4 and 5 years post-enrollment were higher than the initial income level (each P<0.001). In the comparison group, the income levels of all the participants after 1-5 years were higher than the initial income level (each P<0.001). The interaction of time and hearing impairment was statistically significant (P=0.021). CONCLUSION: The increase in income over time was relatively lower in the hearing-impaired adult population; therefore, the income gap widened between this population and the normal-hearing population.

Mood Disorders are Associated With Increased Risk of BPPV: A National Sample Cohort.

OBJECTIVES: Few studies have reported that mood disorders increase the risk of benign paroxysmal positional vertigo (BPPV). The purpose of our study was to demonstrate whether the incidence of BPPV in those with mood disorders differs from that in a matched control group. STUDY DESIGN: Nationwide cohort observational study. METHODS: Korean Health Insurance Review and Assessment Service-National Patient Samples were collected from 2002 to 2013. A 1:4 matched mood disorder group (n = 59,340) and control group (n = 237,720) were selected. The crude and adjusted (cerebral stroke, ischemic heart disease, anxiety disorder, and osteoporosis histories) hazard ratios (HRs) for depression and BPPV were analyzed using a stratified Cox proportional hazard model. The results were stratified by age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia in these analyses. RESULTS: The incidence of BPPV was significantly higher in the mood disorder group than in the control group (3.2% vs. 2.1%, P < .001). Mood disorder increased the risk of BPPV (adjusted HR = 1.31, 95% confidence interval [CI] = 1.23-1.39, P < .001). In subgroup analyses, the incidence of BPPV in all age groups and in both sexes was significantly higher in the mood disorder group than in the control group. CONCLUSION: This population-based cohort study demonstrates that mood disorder was significantly associated with BPPV. LEVEL OF EVIDENCE: N/A. Laryngoscope, 131:380-385, 2021.

Mortality and cause of death in patients with tracheostomy: Longitudinal follow-up study using a national sample cohort.

BACKGROUND: The purpose of this study was to evaluate the long-term mortality and cause of death in patients with tracheostomy. METHODS: Data from the Korean National Health Insurance Service-Health Screening Cohort were collected from 2002 to 2013. A total of 2394 tracheostomy participants and 9536 control participants were included in this study. The crude and adjusted hazard ratios (HRs) for tracheostomy-associated mortality were analyzed. Subgroup analysis according to age and cause of death was analyzed. RESULTS: The tracheostomy group showed a significantly higher rate of death (69.1%) than the nontracheostomy group (13.3%). The adjusted HR for mortality was 13.5 in the tracheostomy group. The most common cause of death after tracheostomy was a circulatory disease, followed by neoplasm, respiratory disease, and trauma. CONCLUSIONS: Patients with tracheostomy had a significantly increased long-term mortality rate compared with patients with nontracheostomy. The circulatory disease was the most common cause of death following tracheostomy.