Middle Ear Implant / 한양의대학술지

Patients with hearing loss have been increasing according to the extension of lifespan. Recently, new technology which solves the limitation of conventional hearing aids has been developed. For example, the active middle ear implantation which can directly transfer the vibration energy to the ossicles and inner ear fluid can avoid the feedback and occlusion effect, because this device uses the electromagnetic transducer, not a microphone. Active middle ear implants give more clear sounds and more gain in high frequency area. This device can apply to the patients with ski-sloping hearing loss and severe mixed hearing loss. In the paper, we reviewed the benefits and ideal candidates of the middle ear implant.

A Cervical Vagal Schwannoma Mimicking a Parathyroid Cyst

Cervical vagal schwannomas with cystic degeneration changes are extremely rare. These tumors are typically benign and slow growing. A 44-year-old woman underwent complete resection of a tumor measuring 4x3.5 cm in the right neck using the endoscopic approach, instead of the conventional transcervical approach. We applied the new scarless neck surgery technique with an endoscopic unilateral axillo-breast approach. The tumor originated from the right vagus nerve, and was confirmed to be a vagal schwannoma pathologically. The patient has been followed up for 18 months postoperatively with no evidence of tumor recurrence or neurological deficit. We report an extremely rare vagal schwannoma with cystic degeneration that was removed by an endoscopic approach, along with a review of the relevant literature.

A Case of Selective Inferior Vestibular Neuritis Showing Normal Caloric Test / 대한평형의학회지

Vestibular neuritis is commonly diagnosed by demonstrating of peripheral vestibular failure as a unilateral loss of the caloric response. It is a sudden, spontaneous, unilateral loss of vestibular function without simultaneous hearing loss or brainstem signs. In most patients with vestibular neuritis, the process is thought to involve the superior vestibular nerve. Very rarely, vestibular neuritis involves only the inferior vestibular nerve. We experienced a 56-year-old male with inferior vestibular neuritis. The patient had vertigo and spontaneous nystagmus, but a normal caloric test. Brain magnetic resonance imaging was normal, while vestibular evoked myogenic potentials had absent amplitudes on the lesion side. The patient was thought to suffer from pure inferior nerve vestibular neuritis.

Cochlear Implantation in a Deaf Patient with Bilateral Temporal Bone Fractures / 대한이비인후과학회지

Transverse temporal bone fracture can make a profound sensorineural hearing loss. This temporal bone fracture usually happens in the single side; however, the bilateral temporal bone fracture can make the postlingual deafness. Therefore, the deafness from bilateral temporal bone fractures can be one of the indications for the cochlear implantation. We report on the experience of the cochlear implantation in a deaf patient after bilateral temporal bone fractures.

A Case of Retropharyngeal Liposarcoma Causing Obstructive Sleep Apnea / 대한이비인후과학회지

Although liposarcomas are second most frequently encountered sarcomas that occur in soft tissue, liposarcomas of the head and neck are very uncommon. Liposarcomas of the retropharyngeal space are rare and do not cause symptoms until they reach a large size to cause mass effect. Depending on the location of the pharyngeal tumor, patients may present with foreign body sensation on throat, swallowing difficulty, respiratory difficulty, a painless neck mass, or obstructive sleep apnea. Recently we have experienced a case of retropharyngeal liposarcoma causing obstructive sleep apnea, so we report our clinical experiences with a brief review of literature.

Endoscopic Hemithyroidectomy via a Unilateral Axillo-Breast Approach without Gas Insufflation in Unilateral Benign Thyroid Lesions: Preliminary Results of a Novel Approach / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although the usefulness of various endoscopic thyroid surgery techniques has been reviewed, little specific information is available regarding ENT surgeons who maybe unfamiliar with laparoscopic surgery and must performing endoscopic thyroidectomy. We examined the feasibility and safety of endoscopic thyroid surgery via a novel approach without gas insufflation. SUBJECTS AND METHOD: Forty-one patients undergoing endoscopic hemithyroidectomy via a unilateral axillo-breast approach without gas insufflation were enrolled in this study. Our indications for endoscopic thyroid surgery were as follows: 1) benign nodules less than 6 cm in diameter, 2) follicular neoplasm less than 6 cm in diameter, and 3) only unilateral thyroid lesions. The following variables were examined: perioperative complications, operation time, diameter of resected thyroid nodule, permanent pathology, time of hospital discharge after operation, duration of drain placement, and total amount of drainage. RESULTS: Postoperative pathology revealed 8 follicular adenomas, 31 nodular hyperplasias, and 2 lymphocytic thyroiditis. The operating time in the first 10 hemithyroidectomies was 154.0+/-64.88 min, which was 38.07 min longer than in the last 31 hemithyroidectomies (115.93+/-32.64 min; p=0.1426). The amount and duration of postoperative drainage were 249.34+/-118.47 mL in 4.01+/-1.31 days, respectively. The postoperative hospital stay was 6.12+/-1.99 days. Overall, perioperative complications occurred in seven patients (7/41, 17.1%), including one transient recurrent laryngeal nerve palsies (2.4%), five seromas (12.2%), and one hematoma (2.4%), which arose from a subplatysmal skin flap. CONCLUSION: These results suggest that endoscopic hemithyroidectomy via a unilateral axillo-breast approach without gas insufflation is safe and effective in selective unilateral benign thyroid lesions and appears to provide better cosmetic results and a shorter operation time than other endoscopic thyroidectomy methods. However, more invasiveness due to significant dissection aimed at obtaining an adequate working space and longer operation time needed than with either traditional open surgery or the minimally invasive video assisted technique should be overcome through accumulation of experience.