• Journal of Audiology & Otology
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• 제23권1호
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• pp.27-32
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• 2019

Background and Objectives: Detection of auditory signals may be improved when maskers far from the frequency of the target signal are coherently amplitude-modulated. This improvement of signal detection is called comodulation masking release (CMR). In the CMR experiments, flankers have been usually arranged symmetrically. In practice, we will be confronted with a problem by using symmetric flankers due to the limited output of clinical audiometers, especially at high-frequency. We aimed to check whether flanker arrangement has any effect on the amount of CMR, especially when there is no flankers with a frequency higher than the signal. Subjects and Methods: Eighteen normal hearing listeners ranging in age from 20 to 46 years old participated. Symmetric (2-2) and asymmetric (3-1 and 4-0) flankers were used and then the amount of CMR compared among them. Results: Our results showed in the same numbers of flankers, there were no statistically CMR differences between symmetric and asymmetric arrangement. Also when we did not have a flanker at a frequency higher than the signal and all flankers were placed below the signal, there was no statistically difference with the symmetric arrangement. Conclusions: The asymmetry of the flankers and also omitting the flankers with a frequency higher than the signal, have no effect on CMR results. We concluded that CMR can be considered by using clinical audiometer.

• Journal of Audiology & Otology
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• 제23권3호
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• pp.140-144
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• 2019

Background and Objectives: Inlay butterfly cartilage tympanoplasty makes the graft easy, and reduces operating time. The present study aimed to investigate the outcomes of microscopic versus endoscopic inlay butterfly cartilage tympanoplasty. Subjects and Methods: In this retrospective study, the outcomes of 63 patients who underwent inlay butterfly cartilage tympanoplasty with small to medium chronic tympanic membrane perforation were evaluated. Twenty-four patients underwent conventional microscopic tympanoplasty and 39 underwent endoscopic tympanoplasty. The outcomes were analyzed in terms of the hearing gain and graft success rate. Results: The surgical success rate was 95.8% in the patients who underwent conventional microscopic tympanoplasty and 92.3% in those who underwent endoscopic tympanoplasty. In both groups of patients, the postoperative air-bone gap (ABG) was significantly lower than the preoperative ABG. There were no significant differences between the preoperative and postoperative ABG values in either group. Conclusions: Endoscopic inlay tympanoplasty using the butterfly cartilage technique appears to be an effective alternative to microscopic tympanoplasty and results in excellent hearing.

• Journal of Audiology & Otology
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• 제23권4호
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• pp.204-209
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• 2019

For a minimally invasive approach to access the facial nerve, we designed an extended epitympanotomy via a transmastoid approach that has proven useful in cases of traumatic facial nerve palsy and pre-cholesteatoma. To evaluate the surgical exposure through an extended epitympanotomy, six patients with traumatic facial nerve palsy were enrolled in this study. The same surgical technique was used in all patients. Patients were assessed and the degree of facial nerve paralysis was determined prior to surgery, 1-week post-operatively, and 6-months post-operatively using the House-Brackmann grading system. In all cases, surgical exposure was adequate. All patients with traumatic facial nerve palsy were male and the age range was 13 to 83 years. In all cases, the location of the facial nerve damage was limited to the area between the first and second genu. Symptoms of all the patients improved by 6 months post-operation (p=0.024). There were no complications in any of the patients. Extended epitympanotomy is useful for safe, rapid surgical exposure of the attic area, sparing the patient post-operative dimpling, skin incision complications, and lengthy exposure to anesthesia. We suggest that surgery for patients with facial nerve palsy secondary to trauma be performed using this described technique.

• Journal of Audiology & Otology
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• 제23권2호
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• pp.89-95
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• 2019

Background and Objectives: Knowing the ototoxic potential of the agents used in medical treatments is important for the protection of hearing. Although we have knowledge regarding some effects of dexmedetomidine, which is an anesthetic-sparing drug, its influence over the hearing system has never been studied and is obscure yet. The aim of this study is to determine the effects of intravenous dexmedetomidine application during sevoflurane anesthesia on otoacoustic emissions (OAEs). Subjects and Methods: This prospective randomized study was performed on 60 patients (34 male, 26 female, mean age: 30.6±9.2 years) who were scheduled for an elective surgery under general anesthesia and the patients were enrolled and randomly divided into 2 groups. They received dexmedetomidine (Group D) or Saline (Group S) infusion during a standardized Sevoflurane anesthesia. Transient and distortion product OAEs were measured preoperatively and postoperatively (24th hour). OAE results were compared within and between groups. Results: In group D postoperative OAEs were lower than preoperative OAEs and postoperative levels of group S, especially at low frequencies (p<0.05). Conclusions: Dexmedetomidine infusion affects the micromechanical function of cochlea especially in the low-frequency region. Dexmedetomidine should be carefully used during general anesthesia to avoid its probable harmful effects on cochlear micromechanics.

• Journal of Audiology & Otology
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• 제23권1호
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• pp.33-38
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• 2019

Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

• 대한한의학회지
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• 제30권4호
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• pp.169-178
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• 2009

Objectives: Sudden sensorineural hearing loss (SSHL) is considered an ENT emergency. Despite being a well-recognized condition, SSHL remains one of the most controversial issues in otology. Nowadays, more and more patients have an interest in Oriental medicine for treatment of SSHL. So, to ascertain the therapeutic effect of Oriental Medicine on SSHL, nineteen cases of SSHL patients who had taken Oriental medical therapy in Kyung Hee Oriental Medical Hospital were examined and analyzed. Methods: Nineteen patients who received over 10 times acupuncture therapy and a minimum 2 weeks of herbal medicine from Sep. 1, 2007 to Aug. 31, 2008 were examined and analyzed. The patients who were in the categories below were excluded: - within 7 days after onset - didn't fulfill 10 times acupuncture therapy - failed to recheck hearing outcome after treatment - less than 30dB at mean dB from 250Hz${\sim}$4000Hz. Results: The patients consisted of 12 men and 7 women with a mean age of 45.63 years (19${\sim}$76). Before treatment, 17 patients had tinnitus, 16 patients had pressure in the ear and 6 patients had dizziness, and mean dB of all patients was 66.89 dB. After treatment, 9 patients still had tinnitus, 4 patients felt pressure in the ear and 2 patents felt dizziness, and mean dB of all patients was 54.57dB. After treatment, 9 patients showed effectiveness in improving both hearing level and speech discrimination, 6 patients showed effectiveness only on speech discrimination and 4 patients showed no therapeutic effect. Conclusion: Oriental medical therapy had some therapeutic effects on SSHL even it was started 7 days after onset of the disease.

• 한국실내디자인학회논문집
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• 제21권5호
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• pp.217-226
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• 2012

The purpose of this study had started from trying to look for a new standard in new media era and sounding out possibility of perspective of digital poetry, and had been extracting interpretational elements based on characteristics of otology in digital poetics research in technical method. Through examination of many documentary records, we suggested interpretive elements of medial space based on meaning and the theory of digital poetics. We deduced three perspectives based on relationship between the basic thesis in poetics and interpretive elements of medial space. We used them as tool for analysis of example. We chose as an example that change of program in space is clear through connection of media and space in where new form of creation happens through digital instruments and chose article as subject to which digital technology is applied and had been since 2000, The result of this study is as following: First, epistemological analysis about a space of digital media in new media era requires poetical approach unlike aesthetic approach. We can endow creative action and creation process with significance and pay attention to technical method of manufacturing, stating appropriateness of perspective in digital poetics. Second, the justice of digital poetics and its basic thesis help derive analytic elements from medial space and study purpose of production, technical method, ontological characteristics, which are three perspectives of digital poetics. Third, it analyzed characteristics of example according to three perspectives above and we can analyze characteristics of spacial expression in space of digital media into potential, trans-active, and semiosis space. It would be possible through analyzing examples in digital poetic perspective to overlook new methods of design in 21th and various perspectives and possibilities of medial space design.

• Journal of Audiology & Otology
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• 제24권2호
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• pp.85-90
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• 2020

Background and Objectives: The present study aimed to compare thresholds of direct bone-conduction (BC direct) with those of behaviorally measured BC pure-tone audiometry (PTA) and objectively measured BC auditory brainstem response (ABR) to confirm the clinical feasibility of their relationships. Subjects and Methods: Young adults with normal hearing participated in the study to determine the thresholds from three measurements at four testing frequencies. In the BC direct, the vibrator of a bone-anchored hearing aid softband was placed on the right mastoid of each subject. In both PTA and ABR, a B71 bone oscillator was placed on the subject's right mastoid. While the subject's thresholds of BC direct and BC PTA were determined with a clinically routine 5-dB step procedure, BC ABR was conducted to determine the individual's hearing sensitivity by a peak V of the waveform using tone-burst and click stimuli. Results: The BC direct showed a different pattern between low and high frequencies. Precisely, its thresholds were 13.25 and 12.25 dB HL at 0.5 and 1 kHz, respectively, but 19 and 19.75 dB HL at 2 and 4 kHz, respectively. A significant positive correlation existed between BC direct and PTA at 1 kHz, which was also correlated with ABR. Conclusions: Based on the current data, the thresholds of BC direct were similar to BC PTA at low frequencies and BC ABR at high frequencies. The thresholds of BC direct might be predictable at approximately 5 dB higher (or lower) than that in PTA, although a large data set is required for standardization.

• Journal of Audiology & Otology
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• 제24권4호
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• pp.167-173
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• 2020

Background and Objectives: Top-down restoration of distorted speech, tapped as phonemic restoration of speech in noise, maybe a useful tool to understand robustness of perception in adverse listening situations. However, the relationship between phonemic restoration and speech perception in noise is not empirically clear. Subjects and Methods: 20 adults (40-55 years) with normal audiometric findings were part of the study. Sentence perception in noise performance was studied with various signal-to-noise ratios (SNRs) to estimate the SNR with 50% score. Performance was also measured for sentences interrupted with silence and for those interrupted by speech noise at -10, -5, 0, and 5 dB SNRs. The performance score in the noise interruption condition was subtracted by quiet interruption condition to determine the phonemic restoration magnitude. Results: Fairly robust improvements in speech intelligibility was found when the sentences were interrupted with speech noise instead of silence. Improvement with increasing noise levels was non-monotonic and reached a maximum at -10 dB SNR. Significant correlation between speech perception in noise performance and phonemic restoration of sentences interrupted with -10 dB SNR speech noise was found. Conclusions: It is possible that perception of speech in noise is associated with top-down processing of speech, tapped as phonemic restoration of interrupted speech. More research with a larger sample size is indicated since the restoration is affected by the type of speech material and noise used, age, working memory, and linguistic proficiency, and has a large individual variability.

• Journal of Audiology & Otology
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• 제24권1호
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• pp.17-23
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• 2020

Background and Objectives: We aimed to measure the head dimensions on computed tomography (CT) images, to compare them to directly measured head dimensions, and to predict a new parameter of bone thickness for aiding bone conduction implant (BCI) placement. Subjects and Methods: We reviewed the facial and mandibular bone CT images of 406 patients. Their head sizes were analyzed using five parameters included in the 6th Size Korea project, and they were divided into age groups (ranging from the 10s to the 80s). We compared the head length, head width, sagittal arc, bitragion arc, and head circumference in the CT and Size Korea groups. We also added the parameter bone thickness for aiding BCI placement. Results: All the head size parameters measured using CT were significantly smaller than those measured directly, with head length showing the smallest difference at 7.85 mm. The differences in the other four parameters between the two groups according to patient age were not statistically significantly different. Bone thickness had the highest value of 4.89±0.93 mm in the 70s and the lowest value of 4.10±0.99 mm in the 10s. Bone thickness also significantly correlated with head width (p=0.038). Conclusions: Our findings suggested that the CT and direct measurements yielded consistent data. Moreover, CT enabled the measurement of bone sizes, including bone thickness, that are impossible to measure directly. CT measurements may complement direct measurements in the Size Korea data when used for developing bone conduction hearing devices (BCIs and headsets) for the Korean population.