Korean journal of aerospace and environmental medicine
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v.29
no.3
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pp.93-95
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2019
Middle-ear barotrauma is a common problem reported by aircrew members and passengers. Studies have shown that 20~50% of passengers report ear complaints during the flight or after landing. Barotitis media is defined as an acute or chronic inflammation caused by a pressure differential between the tympanic cavity and the surrounding atmosphere. The Problems caused by otitis media or sinusitis of aircrew during landing and take-off can be a threat to aviation safety. Therefore, the aviation medical examiner should know about barotitis media of aircrews. In this paper, we aimed to learn what is barotitis media and how much it could affect aircrews. Also, we aimed to evaluate how barotitis media could make an impact on crews during flight, and how to manage these problems.
Purpose: To investigate the role of radiotherapy for squamous cell carcinomas of the external auditory canal and middle ear. Materials and Methods: A series of 35 patients who were treated at a single institution from 1981 through 2007 were retrospectively analyzed. Thirteen patients were treated by radiotherapy alone; four by surgery only and 18 by a combination of surgery and radiotherapy. The total radiation dose ranged from 39~70 Gy (median, 66 Gy) in 13~35 fractions for radiotherapy alone and 44~70 Gy (median, 61.2 Gy) in 22~37 fractions for the combined therapy. Clinical end-points were the cause of specific survival (CSS) and local relapse-free survival (LRFS). The median follow-up time was 2.8 years (range, 0.2~14.6 years). Results: The 3-year CSS and LRFS rate was 80% and 63%, respectively. Based on a univariate analysis, performance status and residual disease after treatment had a significant impact on CSS; performance status and histologic grade for LRFS. Patients treated by radiotherapy alone had more residual disease following the course of treatment compared to patients treated with the combined therapy; 69% vs. 28%, respectively. Conclusion: Our results suggest that radiation alone was not an inferior treatment modality for CSS compared to the combined therapy for squamous cell carcinoma of the external auditory canal and middle ear. However, local failure after radiotherapy is the main issue that will require further improvement to gain optimal local control.
The present study was aimed to evaluate the incidence, etiological factors, and management of cleft lip and palate. Two hundred and twenty patients with cleft lip and/or cleft palate who were treated at Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital, during the period between January 1994 and December 2003 were reviewed. The ratios of cleft lip : cleft lip with cleft palate : and cleft palate were 0.4:1.1:1. Males were more common than females in cleft lip (1.3:1) and cleft lip and palate (2.5:1), while females were more common than males in cleft palate (1:1.3). In the cleft side, left clefts were more prevalent than right clefts (cleft lip 1.3:1, cleft lip and palate 1.6:1). Unilateral clefts were more common than bilateral clefts in cleft lip (79:21). Cleft lip and cleft palate were more common in those with blood type A (34.5%) than those with other types. There was no significant relationship between birth season and frequency of clefts. The clefts were common in the first-born (48.8%), and in mothers aged between 25 and 29 (51.7%). Medication (24.7%) and stress (16.7%) during the first trimester were noted. Positive familial history was noted in 13 cases (5.9%). Thirty-two cases (15%) were associated with other congenital anomalies, in which tonguetie (40.6%) and congenital heart disease (21.9%) were most common. Among 100 patients with cleft palate, 77 patients had middle ear disease (77%), which occurred predominently in the incomplete cleft palate. Seventy-six among the 77 patients received myringotomy and ventilation tube insertion, and the remaining one received antibiotic medication only. Cleft lips were treated primarily at 3 to 6 months, and cleft palates were at 1 to 2 years. Treatment regimens included modified Millard method mainly in the cleft lip, and Wardill V-Y, Dorrance method, and Furlow method in the cleft palate. The percentage of palatal lengthening as type of cleft palate was greater in the incomplete cleft palate group (11.2%) than in the complete cleft palate group (9.6%). The percentage of palatal lengthening as operating method was no difference between the Furlow method (10.9%) and the push back method (10.7%). As postoperative complications, hypertrophic scar was most frequent in the cleft lip, and oronasal fistula in the cleft palate. In summary, it was shown that medication and stress during the first trimester of pregnancy were frequently associated with cleft lip and cleft palate, adequate timing and selection of method of operation are important factors to obtain morphologically and functionally good results. Furthermore prevention and treatment of middle ear disease are important in cleft palate patients because of its high co-occurrence.
Clinical findings for 95 patients (159 ears) of MEE (middle ear effusion) treated at Wallace Memorial Baptist Hospital (Busan) from July 1979 to August 1981 were observed. A group who was treated with myringotomy and ventilation tube isertion was compared with another group of children treated with adenotonsillectomy at the same time. The following are the results: 1) The sex distribution showed 48 male and 47 female, and the age distribution was most common in the ages from six to ten (34 cases, 35%). 2) MEE of children treated with adenotonsillectomy in the same duration was 18 cases (14%), and it was 19% of all MEE patients. 3) Bilateral effusion (67%) was as twice as unilateral cases (33%). In children, bilateral effusion (42 cases, 88%) was predominant, and MEE in adenotonsillectomized children was bilateral in all cases. 4) The nature of middle ear fluid was 49% serous exudate, 33% mucoid exudate, 5% purulent and 3% bloody fluid. Serous exudate was 59% in adult group, but serous (41%) and mucoid exudate (43%) was similar incidence in children. 5) In the preoperative tympanogram, there were 6% with type A, 91% with type B, and 3% with type C. The incidence of abnormal tympanogram (type B or C) was same in MEE patients of adenotonsillectomized children (95%) and the other children group (95%), and it was 93% in adult group. 6) Treatment by myringotomy and ventilation tube insertion resulted in postoperative improvement in air conduction hearing acuity especially in adenotonsillectomized children.
Concerning the pathogenesis of acquired cholesteatoma in attic, there has been postulated theories by immigration from the Shrapnell's portion of the tympanic membrane, posterosuperior quardrant of the deep meatal skin and invagination of the margin of the central perforation. Otherwise, squamous metaplasia of the epithelium lining the middle ear cleft has been supported as a possible cause of cholesteatoma. Clinically, there has been known of the facts that cholesteatoma is formed in the attic but the pathogenesis concerning the acquired cholesteatoma is not still exactly reported. Recently, authors analyzed 170 cases of cholesteatomatous middle ear performed the operation to the middle ear cleft. On the operation finding, when the primary focus of the cholesteatoma was in the attic, we observed two types of perforation, marginal and central perforation in the Shrapnell's portion, and retraction to the Prussak's space, bony defect on the Rivinus notch. Among 36 cases of the cholesteatoma, the perforation of the Shrapnell's portion are 5 cases. Bony defect on the Rivinus notch and marginal perforation on the posterosuperior quadrant of the Shrapnell's portion are 21 cases. Among these cases, 3 cases are combined with central perforation of the Shrapnell's portion. Conclusively, the reasons that cholesteatoma is favorable site in the attic: 1) Excretion of the inflammatory discharge in the attic is difficult because of the distance of the E-tube. 2) The Shrapnell's portion has less collagen fiber than the pars tensa and it is thin because the elastic fibers are rich in it. It is easy to retract within the Prussak's space to the cases of keratinizing hyperplasia. 3) The epidermis attached at the Rivinus notch of the superior portion on the Shrapnell's portion is invaginated through the destructed bony wall of the Rivinus notch and the margin of the tympanic membrane in the response to the keratinizing hyperplasia.
ACROSS device, which is composed of an implantable microphone, a signal processor, and a vibrating transducer, is a fullyimplantable middle ear hearing device(F-IMEHD) for the recovery of patients with hearing loss. And since a microphone is implanted under skin and tissue at the temporal bones, the amplitude of the sound wave is attenuated by absorption and scattering. And the vibrating transducer attached to the ossicular chain caused also the different displacement from characteristic of the stapes. For the gain control of auditory signals, most of implantable hearing devices with the digital audio signal processor still apply to fitting rules of conventional hearing aid without regard to the effect of the implanted microphone and the vibrating transducer. So it should be taken into account the effect of the implantable microphone and the vibrating transducer to use the conventional audio fitting rule. The aim of this study was to measure gain characteristics caused by the implanted microphone and the vibrating transducer attached to the ossicle chains for the gain compensation of ACROSS device. Differential floating mass transducers (DFMT) of ACROSS device were clipped on four cadaver temporal bones. And after placing the DFMT on them, displacements of the ossicle chain with the DFMT operated by 1 $mA_{peak}$ current was measured using laser Doppler vibrometer. And the sensitivity of microphones under the sampled pig skin and the skin of 3 rat back were measured by stimulus of pure tones in frequency from 0.1 to 8.9 kHz. And we confirmed that the microphone implanted under skin showed poorer frequency response in the acoustic high-frequency band than it in the low- to mid- frequency band, and the resonant frequency of the stapes vibration was changed by attaching the DFMT on the incus, the displacement of the DFMT driven with 1 $mA_{rms}$ was higher by the amount of about 20 dB than that of cadaver's stapes driven by the sound presssure of 94 dB SPL in resonance frequency range.
PURPOSE. The purpose of this study was to determine accurately the part of the tragus to be used to form the Ala-Tragal line or Camper's line in orthognathic profile patients. MATERIALS AND METHODS. 150 dentate subjects with age of 18-40 years with orthognathic profile were sampled. Life-size lateral digital photographs of the face with fox plane were taken in natural head position. Different angles between Eye-Ear plane and occlusal plane ($OT_1$-OP), Eye-Ear plane and ala-superior border of tragus ($OT_1-AT_1$), Eye-Ear plane and ala-middle border of tragus ($OT_1-AT_2$) and Eye-Ear plane and ala-inferior border of tragus ($OT_1-AT_3$) were calculated using computer software package, AutoCAD 2004. From the three angles formed by the Eye-ear plane ($OT_1$ or FH plane) and the ala-tragal lines, the one closest to the angle formed between Eye-Ear plane ($OT_1$) and occlusal plane (OP) was used to determine the occlusal plane of orientation. The obtained results were subjected to ANOVA F test, Tukey's Honestly significant difference test, followed by Karl Pearson coefficient of correlation test. P values of less than 0.05 were taken as statistically significant. RESULTS. The mean of base line angle i.e. $OT_1$-OP angle ($11.96{\pm}4.36$) was found to be close to $OT_1-AT_2$ angle ($13.67{\pm}1.93$) and $OT_1-AT_3$ angle ($10.31{\pm}2.03$), but $OT_1$-OP angle was found to be more closer to $OT_1-AT_3$ angle. Comparison of mean angles showed that $OT_1$-OP angle in both males (11.68) and females (12.51) is close to $OT_1-AT_3$ angle (males- 11.01, females- 11.95). CONCLUSION. The line joining from ala to the lower border of the tragus was parallel to the occlusal plane in 53.3% of the subjects. There was no influence of the sex on the level of occlusal plane.
Journal of the Institute of Electronics Engineers of Korea SC
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v.41
no.5
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pp.71-78
/
2004
An infrared remote control-type transcutaneous control device using a $\mu$-processor is design for the totally implantable middle ear system. An infrared light transmission model for the tissue of skin was introduced and then a radiant intensity and the required current of the infrared light emitting diode(IR LED) driving circuit at transmission part were calculated for the external control device. And the transmission part generates IR signal by the system's own data protocol which prevents interferences from other infrared remote controls of the household appliances. The control part of the implanted device was designed to analyze functions of the received infrared(IR) signal that indicate the power ON/OFF and volume UP/DOWN. After the system is implemented, a data transmission experiments using 4 mm thickness of porcine skin were carried out. From the experiment, it was verified that the infrared control signal was transmitted to receiving module of the implemented system without any error.
Otitis media with effusion is known to be very common among children with cleft palate and is the common cause of acquired hearing loss in childhood. The purpose of the present study was to examine the anatomic variances, incidence and treatment of middle ear disease in children with cleft palate. In Korea, before 4-year-old age, the prevalence of otitis media was as high as 91.7%. Common treatments for otitis media were conservative or surgical treatment. The medical treatment options include the use of decongestants, antihistamines, antibiotics and mucolytics. Surgical treatment options include grommet insertion, myringotomy. Unlike the case for children without clefts, cleft patient has a higher incidence of recurrence, so surgical treatment between the age of 3 month and 6 month was recommended. The effect of palatoplasty on middle ear disease has remained controversial. Early and periodic evaluation on the symptomatic infection or significant of hearing loss was recommended.
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