Objective: Nasal septal perforation (NSP) repair is challenging surgery considered in patients with symptomatic NSP intractable to conservative treatments. This study aimed to assess the success rate and identify factors affecting the surgical outcome of NSP by analyzing consecutive series of NSP repairs by a single surgeon. Methods: We enrolled 84 patients diagnosed with NSP and who underwent surgical repair of NSP by a single surgeon (Y.J.J.) between November 2007 and July 2022. Medical records were retrospectively reviewed regarding variables involving preoperative symptoms, rhinologic history, etiology, surgical techniques, and the outcome of surgery. In addition, features of NSP were objectively evaluated using computed tomography scans. Results: The overall success rate of NSP repair was 64.3% (54 of 84). Nasal obstruction (79.8%), crusting (34.5%), and epistaxis (27.4%) were frequent preoperative symptoms. Iatrogenic injury from previous nasal surgery (70.2%) was the most common cause. The average size of NSP on preoperative CT was 9.53 ± 6.68 mm. Patients with incomplete NSP closure had significantly larger perforations (12.21 ± 7.92 mm) than those with successful closure (8.04 ± 5.41 mm) preoperatively ( P = .005). Patients with smoking history (OR = 2.971, 95% CI 1.170-7.548, P = .020) and NSP repair with combined rhinoplasty (OR = 3.811, 95% CI 1.401-10.370, P = .007) were more likely to experience incomplete closure. Patients whose perforations were reinforced with interposition graft were more likely to result in successful repair (OR = 6.752, 95% CI 2.496-18.262, P < .001). The bilaterality of mucosal flap coverage, surgical approach, types of mucosal flap and interposition graft, perforation shape, mucosal thickness around perforation, and distance from the nasal floor were not significantly related to the surgical outcome. Conclusions: Significant factors affecting the outcome of NSP repair were patient’s smoking status, combined rhinoplasty, application of interposition graft, and perforation size.

Objectives. Balloon eustachian tuboplasty (BET) is an emerging treatment for dilatory eustachian tube (ET) dysfunction, yet its efficacy in patients with chronic suppurative otitis media (COM) combined with ET dysfunction remains unclear. This trial aimed to evaluate the efficacy and safety of BET versus medical management (MM) alone in adult patients with COM and chronic dilatory ET dysfunction, as defined by a failed Valsalva maneuver.Methods. This prospective, multicenter, randomized controlled trial enrolled 116 participants (121 ears) between January 2021 and June 2023. Participants were randomly assigned (1:1) to receive either BET combined with MM or MM alone (fluticasone furoate nasal steroid spray). The primary short-term outcome was the normalization of the Valsalva maneuver at 8 weeks, while secondary outcomes included improvements in Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) scores and reductions in the air-bone gap (ABG) measured at 8 weeks. Adverse events were monitored in both groups throughout the follow-up period.Results. Of the 116 participants (121 ears), 60 participants (62 ears) received BET and 56 participants (59 ears) received MM alone. There were no significant differences in demographics, baseline characteristics, ETDQ-7 scores, bone conduction thresholds, or ABG between the groups. In the BET group, 46.8% of ears (29/62) achieved a successful Valsalva maneuver compared with 15.3% of ears (9/59) in the MM-only group (P<0.001). The BET group exhibited greater subjective symptom improvement, with an average ETDQ-7 score reduction of –6.2±9.4 compared to –2.6±8.6 in the MM-only group (P=0.028). Additionally, the ABG decreased more significantly in the BET group (–5.8±11.4 dB HL) than in the MM-only group (–1.2±10.5 dB HL) (P=0.023). No serious procedure- or device-related adverse events were observed during the 8-week follow-up.Conclusion. This trial demonstrates that BET combined with MM is superior to MM alone in treating dilatory ET dysfunction in patients with COM, while also maintaining a favorable safety profile.

Background and Objectives: We aimed to assess the efficacy of various treatments for patients experiencing sudden sensorineural hearing loss (SSNHL), with a focus on hyperbaric oxygen therapy (HBOT) and the effect of HBOT administration timing on hearing recovery.Subjects and Methods: In keeping with guideline recommendations, patients with SSNHL enrolled in this study received systemic corticosteroids, intratympanic dexamethasone, or HBOT in combination or as monotherapy. Hearing thresholds were determined using pure-tone audiometry (dB HL), and recovery was categorized as complete recovery (CR), partial recovery (PR), slight recovery (SR), or no recovery (NR). Post-treatment thresholds were assessed 2-3 months after symptom onset.Results: After treatment, we observed CR in 16 patients (15.2%), PR in 22 patients (21.0%), SR in 44 patients (42.0%), and NR in 23 patients (22.0%). Notably, among the 79 patients with severe hearing loss (>70 dB), those who received treatment within 2 weeks of onset showed better hearing outcomes than those who started treatment after 2 weeks. In the HBOT group, a shorter interval between symptom onset and HBOT initiation was associated with a higher likelihood of hearing improvement. Importantly, in patients with an initial hearing threshold of <70 dB, initiating HBOT within 2 weeks was associated with statistically significantly higher hearing recovery rates.Conclusions: The findings of our study support the premise that early initiation of HBOT within 2 weeks of symptom onset results in better hearing recovery in patients with SSNHL.

Intralabyrinthine schwannomas are rare benign tumors, which arise from neural portions within the labyrinth. These are subclassified into seven groups according to the affected inner ear structures. Intracochlear schwannomas (ICS) are tumors confined to the cochlea, and these can cause progressive unilateral sensorineural hearing loss, tinnitus, vertigo and aural fullness. Here, we report a 49-year-old female patient with left sudden sensorineural hearing loss. There was no improvement of hearing despite steroid and hyperbaric oxygen therapy. Space occupying lesion in the basal turn of the left cochlea was identified in MRI with enhancement. She underwent tumor removal through an extended round window approach, and cochlear implantation was performed successfully. This is the first case report of cochlear implantation after tumor removal in a patient with ICS in Korea, and we discuss management options with a review of the literature.

Coronavirus disease 2019 (COVID-19) changed the practice of medicine, and various anti-contagion restrictions were implemented worldwide. This study aimed to evaluate the annual trend in the incidence of otologic diseases during the COVID-19 pandemic and determine the influence of social restrictions on these diseases. We retrospectively reviewed the number of patients treated for otologic diseases, particularly those associated with infectious pathophysiology, and the total number of patients in the otolaryngology departments at three tertiary referral centers in South Korea. The number of patients who underwent ventilation tube insertion due to persistent otitis media with effusion (OME) significantly decreased (raw number: -37.1%, incidence: -2.04‰) after the onset of the COVID-19 pandemic. However, a sharp increase was observed in 2023 (raw number: +42.9%, incidence: +1.63‰) when the pandemic officially ended. The number of patients newly diagnosed with sudden sensorineural hearing loss (SSNHL) gradually increased during the pandemic period. Restrictive measures to control COVID-19 spread positively influenced the reduction in the incidence of OME. Whether COVID-19 is a direct risk factor for SSNHL remains uncertain, but the potential impact of the virus itself or the COVID-19 vaccine on the auditory system appears to exist.