Sinusitis due to the Huge Natural Dehiscence of Lamina Papyracea: A Case Report

Natural dehiscence of the lamina papyracea is usually found in ostiomeatal unit CT images and during functional endoscopic sinus surgery. The surgery should be performed on the basis of clinical findings and ostiomeatal unit CT scans to determine the extent of disease and the structural anomalies. Preoperative awareness of dehiscence in the lamina papyracea is essential for avoiding orbital complications during surgery. Sinusitis arising from the natural dehiscence of the lamina papyracea is extremely rare. We report, with a review of the literature, a case of sinusitis due to the natural dehiscence of the lamina papyracea in a 46-year-old female, treated by endoscopic sinus surgery. The CT finding presented a huge natural dehiscence of the lamina papyracea and chronic sinusitis of the maxillary ethmoid sinus. Most of the patient's symptoms resolved without recurrence after endoscopic sinus surgery.

A Case of Verrucous Carcinoma of the Hard Palate and the Nasal Floor / 대한이비인후과학회지

Verrucous carcinoma is a distinct morphologic variant of well differentiated squamous cell carcinoma that is most often seen in the oral cavity & larynx but extremely rare in the nasal cavity. This neoplasm has been characterized as a slow growing lesion in elderly smokers with poor oral hygiene. It is histologically and locally invasive but metastasis is rare. We report a case of verrucous carcinoma found in the hard palate & the nasal floor and treated by surgical excision with a review of the literature.

Contemporary Augmentation Rhinoplasty with Autogenous Cartilage Grafts after Removal of Nasal Paraffinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nasal paraffinoma originating from the liquid paraffin injected for the purpose of augmentation rhinoplasty has many complications such as itching sensation, pain and tenderness, hardness, erythema and telangiectasia, protrusion of lump and even psychologic problems. The only method of improvement is surgical removal of paraffinoma and reconstructive rhinoplasty. The aim of this study is to investigate patients' satisfaction about symptoms and signs in aesthetic aspects through analyzing survey papers following surgery. MATERIALS AND METHOD: We have treated 11 cases of nasal paraffinoma by contemporary augmentation rhinoplasty with autogenous cartilage grafts after removal of nasal paraffinoma from October, 1996 to May, 2000. The patients' ages ranged from 36 to 62 years and all were women. Patients' satisfaction about symptoms and signs in aesthetic aspects was investigated through analyzing survey papers at 6 months after surgery. We also have observed changes after surgery by conducting serial photographic documentation. RESULTS: All patients were satisfied with the results about symptoms and signs in aesthetic aspects. Serial photographic documentation showed the subsided skin lesion and nasal dorsum narrowing. CONCLUSION: Our results indicated that contemporary augmentation rhinoplasty with autogenous cartilage grafts after removal of nasal paraffinoma is one of the effective treatment for nasal paraffinoma.

Results of Endoscopic Dacryocystorhinostomy for the Nasolacrimal Duct Obstruction / 대한이비인후과학회지

BACKGROUND: Improved intranasal visualization with endoscope allowed easy identification and opening of the lacrimal sac, without need for skin incision. OBJECTIVES: We studied and described the endoscopic dacryocystorhinostomy which has success rates comparable to those obtained by external approach. MATERIALS AND METHODS: Endoscopic dacrycystorhinostomy has been used for the treatment of nasolacrimal duct obstruction in 17 patients. The nasolacrimal apparatus related to the lateral nasal wall was approached using endoscopic technique. And bicanalicular nasal silicone tubes were placed during surgery in all cases. RESULTS: In our cases, it appears that lacrimal obstruction is related with congenital, idiopathic, facial trauma and other nasal or paranasal sinus diseases. Epiphora was relieved in 15 patients (88.2%), with a followup of 6 to 9 months. The causes of failure were granulation formation and obstruction of opening of lacrimal sac in 2 patients. CONCLUSION: Endoscopic dacryocystorhinostomy appear to be a safe and effective procedure which should be considered as an alternative to external dacryocystorhinostomy for the surgical treatment of nasolacrimal duct obstruction.

Mandibulotomy for The Approach to The Oral Cavity, Oropharynx and Skull Base / 대한이비인후과학회지

BACKGROUND: Adequate exposure of skull base lesion and intraoral lesion occupying the posterior oral cavity, base of tongue, tonsil, superior hypopharynx, anterior skull base, and infratemporal space for wide-field primary surgical resection is critical to tumor ablation. The division of mandible for resection of tumor was first undertaken by Roux in 1836, and many studies renewed the interest of mandible sparing procedure for surgical treatment of oropharyngeal carcinoma. OBJECTIVES: Mandibular swing approach for gaining access to oral cavity, oropharynx, and skull base for excision of tumor, provides excellent exposure with low complication rate when there is intervening grossly normal tissue between the tumor and bone. We studied mandibular swing approach with our surgical experience, with special emphasis on its subtypes related to osteotomy sites and forms. MATERIALS AND METHOD: The records of 20 patients underwent mandibular swing approach at Hanyang University Hospital, were studied by chart review. The patients were retrospectively reviewed to assess age, sex, tumor site origin, stage of disease, types of neck dissection and methods of the reconstruction, types of the mandibular osteotomies, and difference of complication rates between symphyseal and parasymphyseal osteotomy. RESULTS: Post-operative complications occured in 6 patients(30%). But osteotomy related complication rate was 15%. Complications of osteotomy site occurred at a rate of 20% in the symphyseal osteotomy group, but no complications arose in parasymphyseal osteotomy group. CONCLUSIONS: We believe that, if the mandible is clinically and radiologically clear of malignant involvement, midline mandibulotomy is more feasible surgical approach method for treatment of oral cavity, oropharyngeal, skull base lesion.