Kim SJ, et al. J Korean Med Sci. 2020 Jun;35(30):e245. https://doi.org/10.3346/jkms.2020.35.e245

OBJECTIVES: We aimed to assess the clinical significance of the intensity of transcutaneous vagus nerve stimulation (tVNS) in chronic tinnitus. MATERIALS and METHODS: Four sessions of tVNS were performed over a 2-week period for 24 patients with unilateral, non-pulsatile chronic tinnitus. The cavum, cymba, and tragus were sequentially stimulated to the maximal sensory thresholds. One month later, after the four sessions, the level of tinnitus distress and changes in stimulus intensity were assessed. RESULTS: The stimulus intensity did not differ according to sex or laterality. However, a moderate positive correlation between tinnitus distress and the initial stimulus intensity was observed. This correlation was not observed during the subsequent sessions. The stimulus intensity at the cavum changed significantly (p=0.018), and notable differences in tinnitus annoyance were observed between the responders and non-responders (p=0.006). CONCLUSION: The effect of stimulus intensity on the treatment outcome seems to be limited. An increasing trend in the stimulus intensity for tinnitus annoyance at the cavum was observed in the responders. Therefore, the cavum may be an optimal stimulation site for tVNS.

Min JY, et al. Allergy Asthma Immunol Res. 2023 Jul;15(4):437-450. https://doi.org/10.4168/aair.2023.15.4.437

OBJECTIVES: This study aimed at evaluating the clinical significance of hematological findings in patients with acute peripheral facial palsy. MATERIALS and METHODS: For this retrospective case series review, 84 patients who visited our university hospital and were diagnosed with Bell’s palsy (BP) or Ramsay Hunt syndrome (RHS) between March 2017 and March 2019 were enrolled. We documented their epidemiological details, final diagnoses, House-Brackmann (HB) palsy grades, and pretreatment and day 7 post-hospitalization complete blood counts. The outcome was considered favorable if the HB grade at weeks 10–16 was I or II. We analyzed the hematological findings in terms of diagnosis and the final treatment outcomes. RESULTS: A higher pretreatment neutrophil-to-lymphocyte ratio (NLR) and neutrophil count and a lower day-7 lymphocyte count were observed in patients with RHS with unfavorable outcomes. In such patients, moderate positive correlations were observed between the pretreatment white blood cell, neutrophil, and basophil counts; the NLR and basophil-to-lymphocyte ratio; and the initial HB grade. Only the latter was a significant risk factor for a poor treatment outcome. In patients with BP, both the initial HB grade and the pretreatment eosinophil count were included in a regression model predicting prognosis. CONCLUSION: Inflammation plays an important role in RHS pathogenesis. Initial RHS severity and the response to corticosteroids may determine the final treatment outcome. However, inflammatory markers do not predict all BP outcomes; BP may be etiologically heterogeneous. Cite this article as: Kim SJ, Lee HY. Hematological Findings in Patients with Acute Peripheral Facial Palsy. J Int Adv Otol 2020; 16(3): 382-6.

OBJECTIVES: We aimed to evaluate the clinical significance of the somatic modulation test in patients with tinnitus and analyze the treatment outcomes. MATERIALS AND METHODS: Medical records of patients who visited the tinnitus clinic at a local university hospital between October 2018 and April 2019 were retrospectively reviewed. RESULTS: The data of 81 patients were analyzed for this study, of which 61.7% (n=51) showed tinnitus modulation after one or more neck or jaw maneuvers. Patients with narrow-band noise tinnitus tended to show maneuver-induced modulation more frequently than those with pure-tone tinnitus (85.7% vs. 53.3%, p=0.010). Neck maneuvers reduced tinnitus loudness in 29.6% of the patients, while 27.2% of patients (n=22) reported worsening of tinnitus loudness, and 23.5% of patients (n=19) reported tinnitus suppression after jaw maneuvers. None of the patients with noise exposure history reported tinnitus modulation. Backward regression analysis revealed that age was an independent risk factor for improvement (Exp [B]=0.703, p=0.034, 95% CI=0.508-0.974). However, somatic modulation or medical treatments targeting somatic modulation were not related to improvement. CONCLUSION: Patients showing modulation after neck or jaw maneuvers have specific clinical characteristics. However, somatic modulation itself does not affect the final treatment outcome. Cite this article as: Lee HY, Kim SJ, Choi JY. Somatic Modulation in Tinnitus: Clinical Characteristics and Treatment Outcomes. J Int Adv Otol 2020; 16(2): 213-7.