Interleukin-1beta Decreases Caveolin-1 Expression in Human Nasal Epithelium / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Caveolin-1 (Cav-1) is the structural protein that is necessary for the formation of caveolae membrane domains. It is known as an inhibitor of various signaling pathways and associated with several diseases such as cancer, atherosclerosis, restrictive lung disease and obesity. However, studies for Cav-1 in nose has been hardly performed. The objectives of our study were to detect Cav-1 expression in human nasal epithelium and to investigate the change of Cav-1 expression in the inflammation of nasal epithelium. SUBJECTS AND METHOD: We obtained nasal polyp specimens from three patients undergoing endoscopic sinus surgery. Cells from specimens were cultured using the air-liquid interface technique and IL-1beta was treated. The expression of Cav-1 mRNA and protein was determined by reverse transcription-polymerase chain reaction (RT-PCR) and western blot analysis, respectively. RESULTS: Both RT-PCR and Western blot analysis demonstrated the presence of Cav-1 mRNA and protein in human nasal epithe-lium. Furthermore, the expression of both Cav-1 mRNA and protein was decreased by IL-1beta stimulation. CONCLUSION: Cav-1 was expressed in human nasal epithelial cells. It is assumed that Cav-1 may play a role in nasal inflammatory disease. However, further studies to confirm the interaction between Cav-1 and signaling molecules in the nasal inflammatory process should be followed.

Usefulness of Sialendoscopy in Unusual Obstructive Salivary Ductal Diseases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Ductal calculi and stenosis are well known causes of salivary ductal obstructive lesions. As a direct view of the ductal systems was not possible for the surgeons, sialendoscopy has been a convenient tool for finding out these obstructive lesions. This study contains some unusual endoscopic findings that we have found during diagnostic and interventional sialendoscopy. SUBJECTS AND METHOD: Retrospective chart reviews were done, and endoscopic findings were reviewed for patients who received sialendoscopy from September 2003 to January 2007. Sixtyfour patients received sialendoscopy for either diagnostic or interventional method. RESULTS: We found unusual findings in 7 cases (10.9%). Three cases of basin malformation were observed. Two cases had spontaneous ductal perforation, and we also observed 2 cases of occult stone. CONCLUSION: The sialendoscopy is an excellent method in evaluating and treating salivary ductal diseases. We found out that the sialendoscopy made it possible to explore ductal systems completely, as well as to detect unusual findings, and to help in the management of some salivary ductal diseases.

The Clinical Significance of Atypia in Thyroid Fine-Needle Aspiration / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Fine-needle aspiration cytology (FNAC) of thyroid nodules has become the primary diagnostic tool in the evaluation of thyroid nodules. However, the diagnostic utility of thyroid cytology may be limited by the presence of atypical cytologic patterns. In patients with atypical cytology in FNAC, the treatment concept is not established. The purpose of this study is to correlate subcategories of atypical cytology with final histologic diagnosis and help determining treatment concept of thyroid nodule. SUBJECTS AND METHOD: Retrospectively, we analysed 143 specimens of patients with atypical cytology in preoperative FNAC, who underwent thyroidectomy from May 1996 to July 2005 at the Department of Otolaryngology and Surgery, Inha University Hospital. We divided atypical cytology into six groups by its cytologic characteristics and correlated those with final histologic diagnosis. RESULTS: Among 143 specimens with atypical cytology, there were 97 cases (67.8%) in follicular neoplasm with nuclear atypia (FNA) group, 2 cases (1.4%) in follicular neoplasm without nuclear atypia (FNS) group, 13 cases (9.1%) in nodular hyperplasia with nuclear atypia (NHA) group, 23 cases (16.1%) in possibility of papillary carcinoma (PP) group and 5 cases (3.5%) in thyroiditis with nuclear atypia (TA) group and 3 cases (2.1%) in atypical cells (AC) group. Of 97 cases in FNA group, 29 cases (29.9%) were malignant. Malignant cases in NHA and PP groups were 11 cases (47.8%) and 3 cases (23.1%), respectively. But, not all groups have a statistically significant high incidences of malignant pathologic result. Of 29 cases diagnosed as malignant in the FNA group, only 1 case (3.4%) had lymph node metastasis in final pathologic result. Also in NHA and PP groups, only 1 case (NHA : 33.3%, PP : 9.1%) had metastatic lymph nodes. Three cases (10.3%) showed recurrence postoperatively of the 29 cases diagnosed malignant in the FNA group. In PP group, one case (9.1%) revealed recurrence postoperatively. No statistical differences existed between all groups for lymph node metastasis and recurrence. CONCLUSION: Surgery should be considered in FNA, NHA and PP groups. The extent of resection should be determined by frozen section intraoperatively.

Repair of Nasal Septal Perforation Using Silastic Sheet / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In general, for surgical treatment of septal perforation, a suture repair method is necessary for at least unilateral intranasal mucosal flap with the interposition of a connective tissue graft. However, autologous graft material is sometimes insufficient when septal perforation repair is combined with other surgery such as rhinoplasty. The aims of this study were to introduce a new repair technique of septal perforation using silastic sheet and to assess the usefulness of the new method. SUBJECTS AND METHOD: Between March 2003 and September 2004, 5 patients underwent septal perforation repair using silastic sheet with open rhinoplasty at the same time. Size and causes of septal perforation, symptoms, and complication were evaluated by endoscopic examination and questionnaires pre- and postoperatively. RESULTS: The causes of septal perforation were previous septoplasty (3 cases), syphilis (1 case) and unknown (1 case). Preoperative symptoms including nasal obstruction, rhinorrhea, epistaxis and dryness were all improved postoperatively. The perforations of all patients were 1.0 cm sized or more in diameter. Four of five patients (80%) achieved complete closure and one patient had an incomplete closure after a mean follow up of 16 months. CONCLUSION: The repair of septal perforation using silastic sheets is a very useful technique when the size of septal perforation is more than 1 cm large in diameter or when the autograft material is insufficient.

The Assessment of Olfactory Function Related to the Age after Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We assessed olfactory function change in patients with chronic sinusitis who received endoscopic sinus surgery. By comparing the olfactory test results of two different age groups, we determined whether age affected postoperative olfactory function. SUBJECTS AND METHOD: Twenty patients with chronic sinusitis (2 age groups, with 10 patients in the forties and 10 patients in the seventies), who underwent endoscopic sinus surgery were selected. We used preoperative OMU CT and nasal endoscopy examination to evaluate the severity of sinusitis and polyp. Preoperative and postoperative nasal symptoms were assessed by questionnaires. The improvement of olfactory function after endoscopic sinus surgery was evaluated by olfactory function tests (T & T olfactometer and CCCRC test) preoperatively and postoperatively. RESULTS: There was no significant difference in the severity of chronic sinusitis in both groups. Significant improvement of olfactory function was seen in both groups. There was no significant differences in the improvement of olfactory function between younger and older groups. CONCLUSION: Though old aged patients with chronic sinusitis have olfactory dysfunction, active surgical treatment is effective in the improvement of olfactory function.

Preoperative Factors in Prediction of Postoperative Pulmonary Complication in Patients with Conservative Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To predict postoperative pulmonary complication in patients with conservative laryngectomy, variable factors such as pulmonary function test (PFT) have been reported. Therefore, we reviewed the relationships between postoperative pulmonary complications and preoperative risk factors including the parameters of PFT. PATIENTS AND METHOD: From 1997 Jun. to 2005 July., conservative laryngectomy was performed under diagnosis of laryngeal cancer in 36 patients. The factors related to age, history of lung diseases, the parameters of PFT (FEV1, FEV1/FVC and FVC), and the types of surgery were analyzed to evaluate the postoperative pulmonary complication. We used a retrospective analysis of medical records and Fisher exact method to verify the relationships between preoperative risk factors and the pulmonary complications. RESULTS: 8 patients had postoperative pulmonary complication. Age, history of lung diseases and PFT parameters had no statistical significance. Among them, 7 patients and 1 patient had takensupracricoid laryngectomy and supraglottic laryngectomy, respectively. Supracricoid laryngectomy cases had more significant postoperative pulmonary complications than vertical partial laryngectomy cases. CONCLUSION: Age, the history of lung diseases, and parameters of PFT had no predictable value for postoperative lung complications. In the comparison between the surgery types, only supracricoid laryngectomy cases had statistical increase of postoperative pulmonary complications.

Video-assisted Endoscopic Thyroidectomy with Cervical Approach / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Endoscopic approach to the neck is more widely used since it was first reported by M.Gagner in 1996, because of its low invasiveness and better cosmetic result. In this article, we introduce a surgical technique of video-assisted endoscopic thyroidectomy via cervical approach and assess its efficacy for patients with thyroid nodule. SUBJECTS AND METHOD: Eleven patients hospitalized in our department from May to September 2004, underwent video-assisted thyroidectomy with cervical approach. The subjects were 9 women and 2 men with ages ranging from 23 to 62 year old (mean 40.9 years). Inclusion criteria for the subjects were having benign solitary tumor that is less than 30 mm in longitudinal diameter, low risk micropapillary carcinoma that is less than 1 cm, confined to one lobe, within the thyroid gland, and without lymph node swelling on ultrasonography or computed tomography, and follicular neoplasm that is without evidence of any malignancy or with suspicious and indeterminate cytology among patients with no prior neck surgery or previous radiotherapy. Most patients (82%) had thyroid mass less than 2 cm. Nodular hyperplasia was 7 cases and papillary carcinoma was 4 cases. RESULTS: Hemithyroidectomy with or without isthmusectomy was performed in 10 patients. Video-assisted thyroidectomy was converted into conventional thyroidectomy in only one case because of the uncontrolled intraoperative superior thyroid artery bleeding and large thyroid volume. The operation time was 80+/-12 minutes. Temporary recurrent laryngeal nerve palsy occurred in one case. The average postoperative hospital stay was 5.0+/-1.8 days. Operative scars were small and most patients were satisfied with the cosmetic result. CONCLUSION: We conclude that the video-assisted endoscopic thyroidectomy with cervical approach is feasible, practical, and has safe procedures, and has greater cosmetic benefits than the conventional one. We hope that video-assisted thyroidectomy will become another surgical option for small nodular thyroid diseases.

Effects of Galvanic Vestibular Stimulation on the Subjective Visual Vertical / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to determine the otolithic effects of galvanic vestibular stimulation on the perception of subjective visual vertical in normal subjects. SUBJECTS AND METHOD: Fifteen normal subjects were selected on the basis of medical history and neurological examination. We measured subjective tilt of a central vertical line during galvanic vestibular stimulation (0, 1.0, 2.5, 4.0 mA). Binaural and monaural electric current was applied to each subject's mastoid and forehead for vestibular stimulation. RESULTS: Anodal stimulation of the right mastoid led to clock-wise subjective visual vertical. Anodal stimualtion of the left mastoid led to counter clock-wise subjective visual vertical. There was a correlation between the amount of the measured parameter and the strength of the applied current. More consistent parameters were obtained from the binaural stimulation than the monaural stimualtion. CONCLUSION: Galvanic vestibular stimulation had effects on the vestibular functions, making changes in the subjective visual vertical. Since the galvanic stimulation had consistency with the direction of the stimulation and was proportionate to the intensity, it is thought to be a useful method for assessing otolith functions.