Background and ObjectivesSome patients experiencing dizziness also report psychological distress. However, the association between vestibular deficits and psychological symptoms remains controversial. Thus, the aim of this paper is to report the proportion of patients who complained of dizziness who also had high depression and anxiety indices. Also we investigated the severity of their dizziness and the distribution of the diseases underlying this symptom.Subjects and MethodsWe assessed the dizziness and psychological distress of 544 patients experiencing dizziness using the Korean versions of the Dizziness Handicap Inventory (DHI), the Beck Depression Inventory (BDI), and the Spielberger State-Trait Anxiety Inventory (STAI). We also reviewed the audio-vestibular symtoms of patients with high levels of depression and anxiety.ResultsThe incidences of high depression and anxiety scores were 11% (60/544) and 18% (98/544), respectively. Patients with vestibular migraine were most likely to have high depression and anxiety indices. Patients in the high-BDI or high-STAI groups (117/544) obtained significantly higher DHI scores than those in neither the high-BDI nor the high-STAI group (427/544). We noticed that about 20% of the patients experiencing dizziness had high levels of psychological distress in this study; this group also suffered from various vestibular diseases and more symptoms of dizziness.ConclusionsThe results of the study suggest that psychological evaluation should be considered when assessing patients with vertigo.

Objective/Hypothesis: Adenotonsillar problems might affect the voices of patients with pediatric dysphonia, which is very common. This study aimed to evaluate the prevalence of dysphonia in patients with adenotonsillar problems and to demonstrate the impact of tonsillectomy and adenoidectomy (T & A) on their voice postoperatively.Study Design: Single-institution retrospective study. Methods: Subjects were recruited from those children admitted for the purpose of T & A, and all underwent the auditory-perceptual assessment by speech therapists preoperatively. If children demonstrated scores >2 in the G parameter, we performed subjective (pediatric voice handicap index [pVHI], severity, talkativeness scale) and objective (Multi-Dimensional Voice Program) voice analyses preoperatively and 1 and 3 months postoperatively.Results: Among the 1,197 patients, 91 (7.6%) patients showed dysphonia with a score >2 in the G parameter preoperatively. The follow-up voice analysis was completed in 51 and 22 patients after 1 and 3 months, respectively. Although there were no significant differences in the amount of speech preoperatively and postoperatively, the average visual analog scale score for dysphonia severity was significantly decreased at postoperative 1 month and postoperative 3 months. The average total pVHI score, jitter, shimmer, noise-to-harmonic ratio, and soft phonation index were significantly decreased at 1 and 3 months postoperatively. Subjective scores given by parents did not correlate with the acoustic parameters; however, the postoperative subjective parameters were significantly correlated with objective parameters.Conclusions: Voice problems were significantly improved after T & A in the short term and long term. In those with pediatric dysphonia, decreased mouth breathing and compliance with vocal hygiene would be helpful for voice improvement.

Metastatic temporal bone tumors are rare diseases and they are usually clinically asymptomatic, so it is difficult to diagnose them. Breasts are the most common sites of temporal bone metastasis. Tumors of lung, kidney, gastrointestinal tract, prostate gland, larynx and thyroid gland are the other sites. The pathogenesis of the temporal bone is most commonly related to the hematogenous route. We present the case of a 78-year-old man with facial paralysis combined with severe otalgia. This patient was initially diagnosed with Bell's palsy. However, based on the radiologic findings, the patient was diagnosed with lung cancer with temporal bone metastasis.

BackgroundPseudo-spontaneous nystagmus has been reported in patients with direction-changing positional nystagmus (DCPN). Recently, the concept of a “light cupula” has been introduced as a pathophysiology that can exhibit persistent geotropic DCPN. Patients with persistent DCPN could have different characteristics of nystagmus. Therefore, we investigated the pseudo-spontaneous nystagmus in patients with transient (canalolithiasis) and persistent (belong to light cupula theory) geotropic DCPN.MethodsIn this study, prospectively, 49 patients with persistent geotropic DCPN and 67 patients with transient geotropic DCPN were enrolled. We compared the incidence of pseudo-spontaneous nystagmus between persistent and transient DCPN patients and characteristics of pseudo-spontaneous nystagmus and positional nystagmus by the head roll test in these patients. A prospective study was conducted at a dizziness clinic.ResultsPatients with persistent geotropic DCPN exhibited significantly higher incidence of pseudo-spontaneous nystagmus than patients with transient geotropic DCPN. Patients with transient DCPN showed a significantly higher mean SPV value during the head roll test than patients with persistent DCPN. All patients exhibiting pseudo-spontaneous nystagmus in patients with persistent DCPN had a null plane, and all patients had nystagmus beats to the opposite side of the null plane or the lesion side.ConclusionOur results support the possibility that the mechanism between persistent and transient geotropic DCPN may be different. However, more studies are needed on the pathogenesis and mechanism of the two diseases, including the occurrence of pseudo-spontaneous nystagmus in the disease entity.

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