Sudden sensorineural hearing loss (SSNHL) is a medical emergency, making detailed examination to determine possible causes and early treatment important. However, etiological examinations in SSNHL do not always reveal a cause, and several factors have been found to affect treatment outcomes. Various studies are being performed to determine the prognosis and effects of treatment in patients who experience sudden hearing loss, and to identify biomarkers associated with this condition. Embase, PubMed, and the Cochrane database were searched using the key words SSNHL, prognostic, and biomarker. This search identified 4 articles in Embase, 28 articles in PubMed, and 36 in the Cochrane database. Of these 68 articles, 3 were duplicates and 37 were unrelated to the research topic. After excluding these articles, the remaining 28 articles were reviewed. Factors associated with SSNHL were divided into six categories: metabolic, hemostatic, inflammatory, immunologic, oxidative, and other factors. The associations between these factors with the occurrence of SSNHL and with patient prognosis were analyzed. Low monocyte counts, low neutrophil/lymphocyte ratio (NLR) and monocyte/high-density lipoproteins (HDL) cholesterol ratio (MHR), and low concentrations of fibrinogen, platelet glycoprotein (GP) IIIa, and TNF-α were found to be associated with good prognosis. However, these factors alone could not completely determine the onset of and recovery from SSNHL, suggesting the need for future basic and clinical studies.

BACKGROUND: We evaluated and compared the role of endoplasmic reticulum stress in chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma. METHODS: The messenger ribonucleic acid expression of endoplasmic reticulum stress was measured and compared between chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma according to the presence or absence of bacteria, type of hearing loss, ossicle destruction, and facial canal dehiscence. RESULTS: The expression of immunoglobulin heavy chain-binding protein messenger ribonucleic acid was higher in the chronic otitis media without cholesteatoma group than in the chronic otitis media with cholesteatoma group, and Protein kinase RNA (PKR)-like endoplasmic reticulum kinase and activating transcription factor 6 messenger ribonucleic acid expression were higher in the chronic otitis media with cholesteatoma group than in the chronic otitis media without cholesteatoma group. CONCLUSION: Endoplasmic reticulum stress messenger ribonucleic acids were expressed in both chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma. The levels of expression of endoplasmic reticulum stress messenger ribonucleic acids differed according to clinical features, suggesting that different endoplasmic reticulum stress pathways are involved in the pathophysiology of different types of chronic otitis media. Cite this article as: Woong Kang D, Jun Kim Y, Soo Kim S, et al. Comparison of endoplasmic reticulum stress messenger ribonucleic acid expression between chronic otitis media with and without cholesteatoma. J Int Adv Otol. 2023;19(4):271-276.

Background and Objectives: In June 2018, South Korea expanded insurance coverage for polysomnography (PSG) to improve diagnostic access for obstructive sleep apnea (OSA). This study investigated the impact of this policy by analyzing changes in PSG utilization and diagnostic outcomes.Methods: A multicenter retrospective study was conducted using data from 17 tertiary hospitals across South Korea. Patients aged ≥20 years who visited the hospitals for suspected OSA between 2015 and 2023 were included. The pre-coverage period was defined as 2015–2017, and the post-coverage period as 2019–2023. Demographics, PSG implementation rates, and apnea-hypopnea index (AHI) distributions were compared.Results: A total of 29,055 patients were included (7,800 pre-coverage; 21,255 post-coverage). PSG utilization significantly increased from 51.3% to 74.4% (p<0.001). The proportion of female patients rose from 20.0% to 23.0%, and the mean age increased from 45.8 to 49.8 years (p<0.001). The average AHI increased from 31.2 to 35.3. The proportion of patients with severe OSA (AHI ≥30) rose from 42.8% to 48.8%, while cases with normal AHI (<5) declined from 11.6% to 8.3% (p<0.001).Conclusion: The expansion of insurance coverage significantly improved PSG accessibility, particularly for older adults, women, and high-risk patients. The observed shift toward more severe diagnoses suggests enhanced detection of untreated OSA rather than overdiagnosis of mild or normal cases. These findings support the ongoing implementation of inclusive health policies while emphasizing the importance of appropriate patient selection.

Background and Objectives: Sinonasal fungal balls (FBs) most commonly occur in the maxillary sinus, followed by the sphenoid sinus (SS). Relatively little is known about the predisposing factors and pathogenesis of unilateral sphenoid sinus fungal balls (SSFBs) compared to maxillary sinus FBs. We investigated whether anatomical variations have clinical implications for the location of unilateral SSFBs.Methods: This study included 33 patients who underwent endoscopic sinus surgery for unilateral SSFBs between 2010 and 2021. Preoperative computed tomography scans were used to analyze the presence of anatomical variations, including sphenoid lateral recess, complete accessory septum of the SS, types of SS pneumatization, anterior and posterior nasal septal deviation (NSD), cephalocaudal NSD, concha bullosa (CB), Haller cell (HC), paradoxical middle turbinate (MT), everted uncinated process (UP), and Onodi cell.Results: The presence of HC (33.3% vs. 12.1%, p=0.04), complete accessory septum of the SS (51.6% vs. 25.8%, p=0.04), and the sellar type of the SS (90.9% vs. 50%, p=0.003) differed significantly according to the presence or absence of FBs in the SS. However, other anatomical variations, including NSD, CB, paradoxical MT, everted UP, Onodi cell, and sphenoid lateral recess, were not significantly associated with the presence of unilateral SSFBs (all p>0.05). In the multivariable analysis, only sellar-type pneumatization of the SS showed a statistically significant relationship with SSFB, not the combined conchal and presellar type (adjusted odds ratio, 8.96; 95% confidence interval, 1.27–63.19; p=0.03).Conclusion: We demonstrated that unilateral SSFBs were most strongly associated with the ipsilateral type of SS pneumatization, followed by the presence of HC and a complete accessory septum of the SS. Intranasal anatomical variations may play a significant role in the location of unilateral SSFBs.