• Journal of Veterinary Clinics
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• v.20 no.1
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• pp.26-32
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• 2003

The clinical results of 10 consecutive total ear canal ablation combined with lateral bulla osteotomy (TECA-LBO) in six dogs with chronic otitis externa and media were evaluated by the postoperative recovery and long-term follow-up. All dogs were selected for TECA-LBO on the basis of following five clinical symptoms. First, medical treatment couldnt improve clinical signs at least for eve. 2 months. Second, tympanic membrane was completely disappeared. Third, radiopacity was increased in tympanic cavity. Forth, petrous temporal bone was sclerosed. Fifth, ear canal calcification was progressed. And all cases were satisfied all five clinical symptoms. At 14. days after operation, the preoperative symptoms of chronic otitis externa and media which were scratching ear, pain, and hardening ear canal were resolved, and postoperative swelling, erythema, head tilt, and exudate from Penrose drainage were not existed In all cases. Loss of eye blink was happened in 4 cases, but these were disappeared between 14 days a(ter operation except one case on 3 months. All dogs were discharged form hospital at 14 days after operation. Between 3.5 and 6.5 months after discharging from hospital, para-aural abscessation was happened only in all Cocker spaniels. But this complication was solved by ventral bulla osteotomy (VBO). The dogs which didn't show para-aural abscessation after TECA-LBO didn't show scratching, pain, hardening of ear and hearing ability was improved, at 7.5 months after TECA-LBO. And the dogs which showed para-aural abscessation after TECA-LBO also didn't show scratching, pain, hardening of ear and hearing ability was also improved, at 7.5 months after VBO. In conclusion, After TECA-LBO, all dogs were recovered well without complication within 2 weeks except Cocker spaniel. And loss of eye blink can be cured naturally within 2 weeks after surgery. And para-aural abscessation can be happened between 4 and 7 months after TECA-LBO, so surgeon must follow-up until 8 months.

• The Korean Journal of Pain
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• v.5 no.2
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• pp.263-268
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• 1992

Involvement of the facial nerve(herpes zoster oticus, Ramsay Hunt Syndrome) is a rather common clinical syndrome. It begins with unilateral ear pain, followed shortly by a peripheral facial palsy. Paresis or paralysis may affect the muscles of facial expression, which also close the eyelids. The levator palpebrae which is innervated by the 5th cranial nerve is spared, so the eye may remain open. The rash is usually confined to the tympanic membrane and the external auditory canal. It may spread to involve the outer surface of the lobe of the ear, anterior pillar or the fauces and mastoid. There also may be a loss of taste in the anterior two thirds of tongue. At time, the auditory nerve involvement produces tinnitus, deafness and vertigo. The 5th, 8th and 10th nerves and even the upper cervical spinal nerve can be involved presumedly on the base of spread of the infective process along anastomotic connections between the facial nerve. The facial paralysis is identical to that of Bells palsy. Frequently the recovery of facial nerve function is incomplete, leaving the patient with some residual facial weak ness. We experienced 2 cases of Ramsay Hunt Syndrome. The first patients, 55 year old male, visited our pain clinic on the day when his left facial nerve start to paralyze. We injected 6 ml of 0.25% bupivacaine into his left stellate ganglion 15 times. TENS was also applicated simultaneously. His facial paralysis was recovered completely 3 weeks after treatment without any complications. Another one, 53 year old male, visited us 7 weeks after onset of facial paralysis. He has been treated conventional oriental method(acupuncture, massage, warm application, etc). But the degree of his left facial paralysis didn't improve at all He has been treating with SGB 50 times and TENS for 2 months. Temporal and zygomatic branch of his left facial nerve recovered nearly completely but buccal and mandibular branch did not recover completely. We are willing to insist on the early treatment is the best choice in managing of Ramsay Hunt Syndrome.

• Journal of Veterinary Clinics
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• v.30 no.4
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• pp.301-304
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• 2013

Otic mass removal was performed in a 19-month-old, castrated domestic shorthair cat. The patient had 1- year history of recurrent otitis externa, and then otic mass in the right ear canal was found. Under general anesthesia, 2.7 mm rigid endoscope was inserted to the right ear canal with the irrigation system. The ovoid-shaped, 4.9 mm in diameter red otic mass located in the right ear canal was removed via traction-avulsion. Then, rupture of the tympanic membrane was revealed and otic flushing was performed with sterile isotonic (0.9%) saline to remove exudates. Histologically, the removed polyp was diagnosed as granulation tissue with severe ulceration. The patient didn't reveal any remarkable abnormality after surgery, and no recurrence were found after 5 months follow up. The video otoscopy seems to offer a useful option for treatment of a feline inflammatory polyp.

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.41-47
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• 2002

Objectives: In a number of simulated night shift studies, timed exposure to bright light improves sleep quality and work performance. We evaluated the effect of bright light on adaptation to night shift work with a field study. Methods: Five female nurses working shifts at Korea University Hospital were recruited for participation in this study. We investigated two series of six consecutive shift rotations comprising three day and three night shifts, using wrist Actigraphy, the Stanford Sleepiness Scale, Visual-analogue scales, STIM and tympanic membrane temperature for daytime sleep quality, alertness, subjective feeling, attention performance, and temperature rhythm. The subjects were exposed to bright light (2,500 lux) from 24:00 to 04:00 a.m. on three consecutive night shifts during the second series, whereas they worked under normal lightening (650 lux) conditions during the first series. Results: Actigraphic assessment of daytime sleep showed no significant difference between the first and third night shift in both baseline and light exposure phase. The mean lowest temperature shifted earlier during baseline phase but not during the light exposure phase. Also, the score for subjective feelings of depression, anxiety, physical discomfort and sleepiness was significantly higher in the third night shift than the first during baseline phase but not during the light exposure phase. Attention and attention switching ability was significantly improved in the third night shift compared to the first night during the light exposure phase but there were no significant changes during the baseline phase. Conclusion: This result suggests that there were no significant differences between the two phases in measures of quality of daytime sleep, but subjective feelings, attention and alertness were enhanced during light exposure. Although some placebo effects and learning effects might influence this result, bright light exposure between midnight and 4:00 a.m. may improve adaptation to night shift. In future, further controlled studies with a larger sample size, including melatonin measurement, are needed for real shift workers.

• Journal of Veterinary Clinics
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• v.32 no.3
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• pp.255-258
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• 2015

Gastric dilatation and volvulus (GDV) is an acute and life-threatening disease most commonly affecting large- and giant-breed dogs. However a 17-year-old Shih-tzu (4 kg, spayed female) was hospitalized for acute GDV. Repeated unproductive retching, lethargy, and excessively enlarged abdomen were observed. Physical examination indicated that the patient had suffered from hypothermia ($36.5^{\circ}C$), tachycardia (240 bpm), slowed capillary refill time (> 2 sec.), and pale mucous membrane. Grade III murmur with normal lung sound was auscultated. Abdominal palpation revealed that tympanic regions existed in both the left and right sides. Systolic blood pressure decreased gradually from 220 to 40 mmHg within 4 hours. In blood analysis, slight azotemia was observed by blood urea nitrogen (BUN; 29.1 mg/dl) and creatinine (1.6 mg/dl). Blood lactate concentration (8.13 mmol/l) was severely elevated. Additionally, dilatation and volvulus of the stomach was observed by radiograph. Supportive oxygen, heat, fluid, and drugs were administered with gastric decompressions (e.g., gastrocentesis and nasogastric tube). However the patient entered into comatose status with uncontrollable systolic blood pressure, despite the administration of dobutamine intravenously. The case was closed by euthanasia, considering welfare and age. We finally diagnosed the patient as a GDV, thus this is the first GDV case report in small-breed dog such as Shih-tzu.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.4.4-5
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• 1979

The degree of hearing impairment of chronic otitis media will indicate the nature and severity of middle ear pathology especially condition of ossicular chain, size of ear drum perforation and location of granulation tissue in the middle ear cavity. The subjects were 189 ears of tympanoplasty for chronic otitis media and divided into four groups as follows: Normal ossicular chain with only ear drum perforation (group I), normal ossicular chain with granulation tissue only around the ossicles regardless of any other region (group II), ossicular ankylosis or fixation of handle of malleus to promontory with or without granulation tissue around the ossicle (group III) and ossicular interruption by partial or complete destruction(groupf IV). The results were concluded as follows: 1) The average hearing threshold of chronic otitis media was 44.6 dB and hearing threshold was closely related to the condition of ossicular chain. Hearing threshold became greater in order of normal ossicular chain, ankylosis and interruption. 2) The average hearing threshold of ossicular interrupted group was 49.1 dB and it was greater in the cases of total destruction than that of partial destruction. 3) The hearing loss in the cases of normal ossicular chain with only tympanic membrane perforation was within 45 dB and this level was presumed to represent normal ossicular function. The degree of hearing loss was in proportion to the size of ear drum perforation and when over 45 dB, other middle ear pathology was suggested. 4) In the cases of small ear drum perforation with normal ossicular function, the hearing threshold was within 30 dB. 5) In the type of audiogram, flat type was 30.2% and ascending type 35.4%. Descending type was more frequent in the cases of normal ossicular mobility with granulation tissue around the ossicle and flat type was observed frequently in the cases of ossicular ankylosis. 6) Carhart's notch was seen in 14 cases (7.4%) and observed mainly in ossicular ankylosis. 7) There was no relation between hearing threshold and histopathological type of granulation tissue in chronic otitis media. However the degree of hearing impairment was related to the location of granulation tissue in the middle ear cavity. 8) Authors recognized the granulation tissue compensated the function of interrupted ossicular chain.