Objective : The purpose of this study was to investigate the existence of any relationship between the initial or total prednisolone dose and the degree of facial nerve recovery in patients with complete idiopathic facial nerve palsy (Bell's palsy).
Materials and methods : This study was carried out on 102 patients with unilateral complete Bell's palsy of no more than 14 days duration. The patients were divided into four study groups : one receiving a single tapering course of steroids after an initial hydrocortisone (HC) dose of 600mg, one receiving a second tapering course of steroids after an initial HC dose of 600mg, one receiving a single tapering course of steroids after an initial HC dose of 1200mg, and one receiving a second tapering course of steroids after an initial HC dose of 1200mg. The following variables were analyzed among the groups : the cure rate, the average time needed to achieve maximum recovery, and the rate of side effects.
Results : The total cure rate of the patients was 77%. No significant differences were detected among the groups in terms of the cure rate, average time to achieve maximum recovery, or the side effects rate (P>0.05).
Conclusion : High-dose steroid therapy was considered to be somewhat effective in curing complete Bell's palsy. However, there were no correlations between the initial or total steroid dose and the prognosis if a prednisolone equivalent dose of more than 150mg initially, or a total dose of more than 880mg was used. These findings show no significant benefits of treating complete Bell's palsy with a second course of steroids.

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We recorded the auditory-evoked fields in five patients with psychogenic hearing impairment and ten healthy controls. The maximum N100m peak amplitude and latency were measured under 1000 and 2000-Hz tone burst stimuli in each ear. The mean N100m amplitude in the patients was smaller than that in the controls. Especially, regardless of the side of stimulation, the mean amplitude in the left-hemisphere was significantly smaller in the patients than in the controls, except for the 2000-Hz stimulus condition in the left ear. There was no significant difference in the latency of the N100m peak between patients and controls.
We attribute the findings of attenuation of the N100m amplitude to the peculiar auditory perception in patients with psychogenic hearing impairment. Concerning the cause of this finding, we suggest two possible mechanisms : inhibitory auditory processing and attention deficit.

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Narrow-band Imaging (NBI) is a novel optical technique in which the diagnostic capability of endoscopes in characterizing tissue is enhanced by the use of narrow-bandwidth filters in the video endoscope system. We report a case of early recurrence of hypopharyngeal cancer after radical radiotherapy which was detected by laryngoscopy using NBI.
A 66-year-old man with right pyriform sinus cancer was treated by radical radiotherapy in March 2004. Twenty months later, laryngoscopy using NBI revealed an abnormal lesion in the right pyriform sinus, visualized as scattered brownish dots, which highly suggestive of a malignant lesion. After obtaining written informed consent from the patient, endoscopic mucosal resection of the lesion was performed. Histological examination of the resected specimen revealed a squamous cell carcinoma in situ. The patient did not need any additional therapy.
Laryngoscopy using NBI appears to have good potential to detect early stage local tumor recurrence after radical radiotherapy.

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