Biomedical subjects

C Y Joseph Chang

Publications and source records attributed to C Y Joseph Chang.

4 recordsLinked to original sources

PubMed2006

Efficacy of steroid injection on idiopathic sudden sensorineural hearing loss.

OBJECTIVE: To evaluate the effectiveness of transtympanic steroid injection on patients with idiopathic sudden sensorineural hearing loss (ISSNHL) compared with patients who receive oral steroids alone. STUDY DESIGN: Retrospective chart review. METHODS: Patients with a history of ISSNHL and failed oral steroid therapy were included. Audiograms were performed and patients were included if SNHL of more than 20 dB occurred over less than 72 hours. Patients who received transtympanic steroid injection were compared with those who received oral steroids alone. RESULTS: Sixty-one patients met inclusion criteria and were included in the study. The number of patients with improvement in pure tone average in the injection group was 9 (30%) compared with 5 (17%) in the oral group. Twelve (38.7%) of the injected patients did have improvement in speech discrimination scores of greater than 15% compared with only 3 (10%) in the oral steroid group. CONCLUSION: Our study revealed that patients with ISSNHL who have failed oral steroid therapy obtain better hearing results with transtympanic steroids in comparison to oral steroids. EBM RATING: B-3b.

Adult↗

PubMed2005

Pressed scar tissue for tympanic membrane grafting in revision tympanoplasty.

OBJECTIVE: Compare the efficacy of pressed scar tissue grafts to standard fascia and areolar tissue grafts for use in tympanoplasty. STUDY DESIGN: A retrospective review of a prospective computerized database of tympanoplasty and mastoid surgeries at an academic, tertiary care practice was performed. Search parameters were set to find all patients who underwent tympanoplasty with or without mastoidectomy with use of various grafting materials for repair of tympanic membrane perforation from 1996 to 2002. All ages were included. Patients with cholesteatoma at the time of surgery were excluded. The short-term graft take rate was evaluated at 30 to 90 days to identify any differences in results using the standard fascia and areolar grafts vs. pressed scar tissue grafts. Other parameters that may have an influence on outcome were analyzed including mastoidectomy, infection, perforation size, perforation location, age of patient, primary vs. revision surgery, number of previous surgeries, postauricular vs. transcanal approaches, and medial vs. lateral grafting techniques. Hearing results were analyzed to see whether the use of scar tissue grafts resulted in equivalent outcomes compared to standard graft materials. RESULTS: There were no statistically significant differences in short-term tympanic membrane closure rates in subjects undergoing surgery using standard fascia/areolar tissue grafts and pressed scar tissue grafts. Hearing results were also statistically equivalent regardless of graft material used. The only parameter that was somewhat associated with successful closure of tympanic perforation was use of the postauricular approach compared to the transcanal approach. CONCLUSIONS: Pressed scar tissue grafts are as efficacious as standard fascia and areolar tissue grafts when used to repair tympanic membrane perforations. Pressed scar tissue graft can be used successfully in cases such as revision tympanoplasty when standard tissue grafts are not available or difficult to obtain. EBM RATING: B-3.

Adolescent↗

PubMed2005

Ossicular chain dislocation with normal hearing.

We report a unique case of an ossicular chain injury in a young man. Despite the fact that the patient's incus was dislocated into the external auditory canal while remaining attached to the stapes, his hearing was not affected and remained nearly normal. We discuss the patient's presenting features and our diagnostic and management strategy in this case.

Accidents, Traffic↗

PubMedDate not supplied

Risk factors for hearing loss in neonates: a prospective study.

OBJECTIVES: To identify potential risk factors for neonatal hearing loss that are not included in the current variables recognized by the Joint Committee on Infant Hearing (JCIH). METHODS: A series of consecutively born neonates with risk factors for hearing loss based on the 1994 JCIH registry were screened prospectively. There were 110 subjects with hearing loss and 636 subjects without hearing loss. Data collected as potential risk factors for infant hearing loss included not only those on the JCIH list but also others that we believed to be possibly significant. The infant hearing screening was performed on each subject using auditory brain stem testing. Statistical analysis of data was performed using the chi-square test. RESULTS: In addition to the variables listed by the JCIH, we identified 11 additional risk factors that were associated with hearing loss in our neonatal population. These are: length of stay in the intensive care unit, respiratory distress syndrome, retrolental fibroplasia, asphyxia, meconium aspiration, neurodegenerative disorders, chromosomal abnormalities, drug and alcohol abuse by the mother, maternal diabetes, multiple births, and lack of prenatal care. CONCLUSION: This study identifies 11 risk factors in addition to those currently on the high-risk registry published by the JCIH for neonatal hearing loss. The inclusion of these additional risk factors in neonatal screening programs may improve the detection rate of neonates with hearing loss. Further study will be needed to determine whether inclusion of these additional risk factors in a hearing screening program can provide an efficacious alternative to the use of universal infant screening.

Age Factors↗