Results of Hearing Outcome According to the Alloplastic Ossicular Prosthesis Materials.

The aim of this study is to compare the functional results and extrusion rates according to the type of ossciular alloplastic prosthesis. In this study, a retrospective analysis was performed. Sixty-one patients were involved in partial ossicular replacement (POR) cases and 70 patients were involved in total osscicular replacement (TOR) cases. In POR cases, Plastipore was used in 21 cases, hydroxyapatite in 20 cases, and titanium in 20 cases. In TOR cases, Plastipore was used in 20 cases, hydroxyapatite (HA) in 25 cases and titanium in 25 cases. We reviewed postoperative ABG (less than 20 dB or more than 20 dB) and the extrusion rate for more than 1 year follow-up period. In POR cases, ABG less than 20 dB were 71.4, 80.0, 85.0 % in plastipore, HA, and titanium prosthesis and in TOR cases, ABG less than 20 dB were 25.0, 28.0, 32.0 % in plastipore, HA, and titanium prostheses, respectively. In POR cases, extrusion rates (ER) were 9.5, 5.0, 5.0 % in plastipore, HA, and titanium prosthesis, respectively. In TOR cases, ER were 15.0, 8.0, 4.0 % in plastipore, HA, and titanium prosthesis, respectively. There were no significant differences in hearing gain results among plastipore, HA, and titanium in both POR and TOR cases, but the ER was significantly low in titanium. Clinically relatively better hearing gain and low-rate of extrusion were found in titanium prosthesis and thus this material is recommended in cases of ossicular alloplastic replacement surgery.

CEACAM6 as detected by the AP11 antibody is a marker notable for mucin-producing adenocarcinomas.

A new monoclonal antibody recognizing CEACAM6, which we named AP11, was generated by immunizing BALB/c mice with phytohemagglutinin-activated human peripheral blood mononuclear cells. This study aims to evaluate whether CEACAM6 can serve as a tumor marker using AP11. We examined the expression of CEACAM6 with AP11 in 11 human carcinoma cell lines by flow cytometry and 439 human tissues including 282 tumor tissues and 157 normal tissues by immunohistochemistry. CEACAM6 epitope recognized by AP11 was well preserved in formalin-fixed and paraffin-embedded tissues. Adenocarcinomas of the stomach (86%), colorectum (95%), pancreas (100%), and lung (83%), urinary bladder (100%), and mucinous ovarian tumors (88%) had a high rate of CEACAM6 immunoreactivity. We observed a variable expression of CEACAM6 in hepatocellular carcinomas (35%), squamous cell carcinomas of the lung (60%), renal cell carcinomas (14%), urothelial carcinomas (13%), serous carcinomas of the ovary (17%), and breast carcinomas (11%). Small-cell carcinomas of the lung, prostatic adenocarcinomas, papillary thyroid carcinomas, malignant melanomas, giant cell tumors, and osteosarcomas were negative for CEACAM6. All normal tissues of various organs were negative for CEACAM6. In conclusion, CEACAM6 as detected by AP11, may serve as a marker for mucin-producing adenocarcinomas of the gastrointestinal tract and ovary as well as non-small cell lung cancer. Thus, AP11 represents a valuable diagnostic tool for detecting CEACMA6-positive cancers.

Clinical characteristics of labyrinthine concussion.

BACKGROUND AND OBJECTIVES: Inner ear symptoms like hearing loss, dizziness or tinnitus are often developed after head trauma, even in cases without inner ear destruction. This is also known as labyrinthine concussion. The purpose of this study is to determine the clinical manifestations, characteristics of audiometry and prognostic factors of these patients. MATERIALS AND METHODS: We reviewed the medical records of the 40 patients that had been diagnosed as labyrinthine concussion from 1996 to 2007. We studied the hearing levels in each frequency and classified them according to type and degree of hearing loss. Rates of hearing improvement were evaluated according to age, sex, hearing loss type, degree and presence of dizziness or tinnitus. To find out any correlation between hearing improvement and these factors, we used χ(2) test or Fisher's exact test. RESULTS: Bilateral hearing loss was observed in 22 patients, and unilateral hearing loss in 18 patients. There were 4 (6.5%) ascending, 34 (54.8%) descending, 24 (38.7%) flat type hearing loss, which indicated hearing loss was greater in high frequencies than low frequencies. Among 62 affected ears, 20 (32.3%) gained improvement, and it was achieved mainly in low frequencies. There were only 2 ears with dizziness in 20 improved ears and among 20 dizziness accompanied ears, also only 2 ears were improved. CONCLUSIONS: High frequencies are more vulnerable to trauma than low frequencies. The hearing gain is obtained mainly in low frequencies, and association with dizziness serves poor prognosis.

The efficacy of an additional cycle of oral steroids in partially recovered sudden sensorineural hearing loss (SSNHL) after initial oral steroid therapy.

CONCLUSION: There was no beneficial effect of an additional cycle of oral steroid therapy in partially recovered patients with sudden sensorineural hearing loss after initial oral steroid therapy. OBJECTIVES: Partial recovery of hearing after one cycle of steroids might be the result of a relatively short duration of medication. We evaluated the efficacy of an additional cycle of steroids in those patients. SUBJECTS AND METHODS: With strict inclusion criteria, we selected the patients with hearing gain more than 10 dB, but still worse than 30 dB with hearing level, at the end of one cycle of steroid therapy. They were divided into a control group with no further treatment and a study group treated with an additional cycle of steroids. We compared their hearing outcomes, recovery rates and the mean duration of hearing improvement. RESULTS: We could not find any significant difference in either hearing outcomes, recovery rates or the mean duration of hearing improvement between the one-cycled group and the two-cycled group.

Endoscopic versus external repair of orbital blowout fractures.

OBJECTIVES: This study evaluates the usefulness of endoscopic repair compared to external repair in the treatment of blowout fracture (BOF) of the orbit. STUDY DESIGN AND SETTING: This retrospective study comprised 100 patients who had had surgical repair of orbital BOF since 1992. Forty-eight of the 100 had undergone endoscopic repair, 48 patients had had external repair, and four patients underwent surgery that combined the two approaches. The two basic approaches were evaluated and compared with respect to technique, results and complications. RESULTS: Endoscopically, transnasal and transantral approaches had been used for reduction and support of fractured medial and inferior walls, respectively. In the external approach, various transorbital incisions were made and the fractured wall was repaired with alloplastic or autologous materials. Complete or partial resolution of preoperative diplopia was achieved in 94% of the endoscopic group and 83% of the external group (NS). Enophthalmos was improved in 89% of the endoscopic group and 76% of the external group (NS). Though the endoscopic group had no significant complications, the external group had ectropions, significant facial scars, extrusion of inserted Medpor, and intra-orbital hematoma. CONCLUSIONS: Endoscopic repair appears to be a safe and effective technique for the treatment of BOF of the orbit.

Key maneuvers for successful correction of a deviated nose in Asians.

BACKGROUND: The authors present surgical results of 64 Asian patients with deviated nose and introduce important key maneuvers used in the surgery. METHODS: Sixty-four consecutive patients who underwent corrective rhinoplasty because of a deviated nose were analyzed retrospectively. Approaches and techniques used for the surgery, surgical results, and complications were evaluated. A questionnaire was used to evaluate each patient's functional and esthetic satisfaction. Preoperative and postoperative standardized photographs of the face were evaluated to judge objectively the esthetic outcomes of the surgery. RESULTS: An endonasal approach was used in 44 patients and an open approach was used in 20 patients. Five important key maneuvers to correct the deviation were noted, in the order of frequency: septoplasty, osteotomy, spreader graft, turbinoplasty, and camouflage graft. Additional procedures included augmentation of the dorsum, tip surgery, and hump removal. On a 5-point box scale of 0-4, the patients scored their satisfaction on functional improvements as 3.2+/-0.79 and their esthetic satisfaction as 3.0+/-0.8. The objective evaluation of the appearance showed complete correction in 84.4%, a minimally visible deviation in 10.9%, and a residual deviation but less than before surgery in 4.7%. Aside from residual deviations, complications included a slight depression of the middorsum after spreader graft and a malpositioning of the dorsal cartilage graft. CONCLUSION: Deviated nose in Asians can be managed successfully by combining key maneuvers that correct specific anatomic abnormalities. Many of these key maneuvers require modifications that take into account the race-specific characteristics of the Asian nose.

Primary facial skin cancer: clinical characteristics and surgical outcome in Chungbuk Province, Korea.

Clinical features of facial skin cancer in Asian population including Korean are not readily available. In the present study, we analyzed the clinical characteristics and the surgical results of primary facial skin cancer in Chungbuk Province, Korea. Eighty-six cases of primary facial skin cancer collected during a 10-yr period (1994-2003) were retrospectively reviewed about the clinical characteristics including age, sex, annual diagnostic rate, types of tumor, specific sites of occurrence, and the surgical results. The average age at the diagnosis was 67 and male to female ratio was 1 to 1.05. The average annual diagnostic rate was 0.73% and the rate surged during the period 2001-2003 compared with the period 1994 to 2000. Basal cell carcinoma was the most common tumor and the nose was the most frequent site. Traditional surgical excision with immediate reconstruction was performed in 81 cases. During the 23 months of average follow-up, three patients had recurrences (3.7%) and three patients had secondary skin cancers. Facial skin cancer is increasing in the province and basal cell carcinoma is most frequent. Traditional surgical excision and immediate reconstruction with local flap are a good therapeutic modality with an acceptable recurrence rate.

Diagnostic criteria of internal jugular phlebectasia in Korean children.

Internal jugular phlebectasia (IJP) is a fusiform dilatation of the internal jugular vein (IJV), usually presented as a neck mass in children. Accurate diagnosis from carefully directed history, physical examination, and radiological study could result in lifesaving therapy. We performed our study to suggest possible clinical diagnostic criteria for IJP in Korean children. We reviewed three cases of IJP (patients group) and compared the diameter of the internal jugular phlebectasias with diameters of IJVs in ten normal children (control group) using ultrasonography (USG). There were no significant differences in the range of diameters in the resting state between the two groups. The diameters on the right side, compared with those on the left side, showed no statistical significance (p > 0.05). The range of expanding diameter and average expanding ratios (resting state to Valsalva maneuver x 100%) showed a statistical difference between the two groups (p < 0.05).