No abstract

Background and ObjectivesZZIn aging society, interest in idiopathic sudden sensorineural hearing loss (ISSNHL) in elderly have been increased. However, as there has been little discussion about prognostic factors of ISSNHL in old age, this study aims to investigate clinical factors related with prognosis of ISSNHL in elderly and compare with that in adults. Subjects and MethodZZA retrospective medical chart review was performed in patients over 19 years old who diagnosed with ISSNHL from Jan. 2010 to Dec. 2012. Patients were categorized into the old age group (over 65 years old, n=62) and the control group (aged 19 to 64 years old, n=218). Clinical findings, audiological result and treatment outcomes were compared between two groups. And possible prognostic factors of SSNHL in elderly were also investigated. ResultsZZSignificant difference of hearing recovery was identified between the old age group (33.9%, 21/62) and control group (50.9%, 111/218) according to Siegel's criteria (p=0.021). Multivariate analysis concluded that delayed treatment and low speech discrimination score (SDS) might lead to poor prognosis in elderly. The presence of tinnitus or dizziness, audiometric configurations, hypertension and diabetes mellitus did not affect the treatment results of ISSNHL in the old age group. ConclusionZZOnset of treatment and initial SDS could be possible prognostic factors of ISSNHL in elderly. Early diagnosis and urgent treatment are more important in old age.

Background and Objectives Benign paroxysmal positional vertigo (BPPV) is treated with appropriate canalith repositioning procedures, which are very effective for the treatment of BPPV. Nevertheless, the recurrence of BPPV may occur after the initial successful treatment. The purpose of this study was to investigate the risk factors and clinical features of recurrent BPPV. Subjects and Method The retrospective study was performed for 227 patients who were diagnosed with BPPV and treated with appropriate canalith repositioning procedures from March 2013 to December 2014. We analyzed various clinical characteristics, locations and types of canalith for the whole BPPV patients, and the interval and frequency of recurrence in the patients of recurrent BPPV. Results Of the total of 227 BPPV patients, 47 patients were recurrent BPPV (21%). The patients of recurrent BPPV were significantly older than those of non-recurrent BPPV (p=0.034). BPPV patients recurred more with increased age, with the significantly increased frequency of recurrence (p=0.010). Twenty two patients were posterior semicircular canal canalolithiasis (PSCC) (46.8%) and 25 patients were lateral semicircular canal canalolithiasis (LSCC) (53.2%). The number of canalith repositioning procedures was significantly higher in LSCC patients than in PSCC patients (p=0.041). The location change of affected canal were identified for 23 patients and the type change of LSCC to ipsilateral PSCC was the most common. Conclusion Age is an important prognostic factor to be considered in BPPV recurrence. Also, the affected semicircular canals were frequently changed in the recurrent BPPV.

When parathyroid carcinoma occurs in the thyroid gland, it is very difficult to diagnose before surgery because imaging studies and aspiration cytology cannot distinguish parathyroid carcinoma from thyroid nodule or benign parathyroid disease. A 53-year-old male was referred to our hospital for assessment of hypercalcemia. He had suffered from chronic kidney disease for 13 years. A 2.5×1.5 cm hypoechoic nodule was noted in the left thyroid gland on ultrasonography, and it showed increased uptake on the sestamibi scan. Fine needle aspiration biopsy revealed it to be a parathyroid lesion, which was confirmed by surgery as parathyroid carcinoma completely surrounded by normal thyroid parenchyme. Because ultrasonography and aspiration cytology have only a limited role in distinguishing parathyroid carcinoma from thyroid neoplasm, suspicion of parathyroid carcinoma before or during surgery through careful examination can lead to complete resection at the initial surgery. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background and Objectives Several studies have assessed the impact of laryngopharyngeal reflux disease (LPRD) on the health-related quality of life (HR-QoL), showing significant impairment of HR-QoL. This study aims to assess the impact of proton pump inhibitor (PPI) treatment of LPRDs to enhance HR-QoL. Subjects and Method We prospectively collected data from LPRD patients from April 2017 to July 2019. Patients who have reflux symptom index (RSI) of ≥13 or reflux finding score (RFS) of ≥7 were enrolled in this study. We assessed HR-QoL using a questionnaire with EORTC QLQ-H&N35,-C30 on the first visit. Patients were treated with PPI (Ilaprazole 20 mg/day) on their visits at 4, 8, and 12 weeks. RSI and RFS were measured at each visit and HR-QoL was reevaluated on the last visit. Results Ninety-five patients completed the 3-months follow-up and were enrolled in this study. Female : male ratio was 71:24 and the mean age was 57.0±11.9 (27-80). The initial RSI and RFS were 16.3±8.8 and 12.6±2.9, respectively, but were changed to 11.1±9.7 and 9.7±2.6 (p<0.001 in both) at 12 weeks after the treatment. Global health status/QoL, speech problem, dry mouth, and coughing were significantly improved. Conclusion PPI administration is effective in treating LPRD, where effects begin to appear at 4 weeks after treatment. HR-QoL was also improved in patients who have RSI improvement.