Expression of Cytokines in Nasal Polyps with Chronic Sinusitis and Asthma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Rhinosinusitis has been closely related to asthma. However, the mechanistic roles of the cytokines in rhinosinusitis with asthma have not been well understood. We investigated the pattern of cytokine production in chronic sinusitis in asthmatic patients and compare the findings in asthmatic vs. non-asthmatic patients. MATERIALS AND METHOD: We analyzed cytokine levels in nasal polyps from 20 patients with sinusitis&asthma and from 25 patients with sinusitis alone. Evaluated parameters are the levels of the following cytokines: IL-3, IL-4, TGF-beta1, IFN-gamma, and GM-CSF. We also compared preoperative disease extent evaluated by degree of polyposis. RESULTS: There was no statistically significant difference between two groups on cytokine levels and preoperative polyposis. CONCLUSION: This study shows that there was no significant change in cytokine levels of sinusitis according to the presence of asthma. These findings would suggest the existence of other mechanisms shared by sinusitis and asthma.

The Significance of Serum Eosinophil Count in Chronic Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We previously reported that the more eosinophils infiltrate in the mucosa, the poorer the prognosis gets after an endoscopic sinus surgery for the chronic sinusitis patients. But, there have not been any reports until now about correlation between serum eosinophils and tissue eosinophil infiltrations. The aim of this study is to investigate the relevance of serum and tissue eosinophils, and significance of serum eosinophils in chronic sinusitis. MATERIALS AND METHOD: A retrospective review of medical records was carried out on 158 patients who had undergone endoscopic sinus surgery from January, 1995 through July, 2001 at our institution. We divided them into two groups: good and poor outcome groups, then reviewed serum eosinophil counts and tissue eosinophil infiltrations, and investigated their relationship. RESULTS: There were significant statistical differences of serum eosinophils between the two groups, and significant correlation between serum eosinophil counts and tissue eosinophil infiltrations. CONCLUSION: We assume that the serum eosinophil counts is a one of the prognostic factors after endoscopic sinus surgery.

Prognostic Factors of Pediatric Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Pediatric endoscopic sinus surgery (ESS) is performed for refractory cases of sinusitis that do not respond to medical management. However, studies evaluating the prognostic factors affecting outcomes of pediatric ESS have not been reported much. The aim of this study is to investigate the prognostic factors affecting the outcomes of pediatric ESS. MATERIALS AND METHOD: A retrospective review of medical records was carried out on 71 patients, 15 years or younger, who had undergone ESS from February, 1995 through January, 2002 at our institution. We classified them into two groups, one with good outcome, and the other with poor outcome, according to the postoperative endoscopic findings. We compared the following 8 parameters between the two groups: presence of allergy, bronchial asthma, adenotonsillar hypertrophy, previous sinus surgery, degree of polyposis, preoperative disease extent scored with OMC CT finding, blood eosinophil count, and eosinophil infiltration in nasal mucosa. RESULT: There were no statistical differences between the two groups on the presence of allergy, bronchial asthma, adenotonsillar hypertrophy, previous sinus surgery, degree of polyposis, preoperative disease extent scored with OMC CT finding, blood eosinophil count, and eosinophil infiltration in nasal mucosa. CONCLUSION: Prognostic factors affecting the outcome of pediatric ESS are not clear. We assume that postoperative care, including appropriate postoperative medication, debridement and irrigation, etc., is more important in pediatric ESS.

The Histopathologic Findings as a Prognostic Indicator after Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There have been many studies concerning prognosis after endoscopic sinus surgery showing that the prognosis showing that chronic sinusitis patients with asthma is poorer than those without asthma. But, there are only a few reports about histopathology of chronic sinusitis with asthma and correlation between prognosis. The aim of this study is to investigate histopathology of chronic sinusitis and relevance of prognosis after surgery. MATERIALS AND METHOD: A retrospective review of medical records was carried out on 83 chronic sinusitis patients who had undergone endoscopic sinus surgery from 1995 through 1997 at our institution. We compared 7 parameters of sinus mucosal histophathology, allergy and OMC CT between grups with good and poor outcomes. RESULTS: The study revealed no statistical differences on the presence of allergy, OMC CT. However, the poor outcome group showed significant lymphocytes and eosinophils infiltrations with univariant analysis, whereas asthma was proved to be statistically different with multivariant analysis. CONCLUSION: The more lymphocytes and eosinophils infiltrate the mucosa, the poorer the prognosis after endoscopic sinus surgery in the chronic sinusitis patients get. We assume that there will be a good prognostic factor after surgery, and that adequate management and careful follow-up should be taken of patients showing such histopathologic findings.

Histopathologic Characteristics of Chronic Sinusitis with Asthma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Chronic sinusitis has been closely related to bronchial asthma. Patients with both sinusitis and asthma have showed somewhat different mucosal appearance and pathology, compared to those without asthma. We investigated histopathological features of these patients. SUBJECTS AND METHOD: 19 sinusitis patients with asthma who had undergone endoscopic sinus surgery from April, 1995 through September, 1997, and 53 patients without asthma who had undergone surgery from January, 1997 through July, 1997 were evaluated. We compared the following 7 parameters of sinus mucosal histopathology between the asthma and non-asthma group by reviewing histopathological slides: basement membrane thickening, goblet cell hyperplasia, subepithelial edema, submucous gland formation, eosinophilic infiltration, lymphocyte infiltration, polymorphonuclear leukocyte infiltration. We also compared preoperative disease extent, evaluated by degree of polyposis and OMC CT findings, and presence of allergy, which might affect the sinus mucosal pathology. RESULTS: There revealed no statistical difference between two groups on presence of allergy, preoperative polyposis, and OMC CT scores. However, the asthma group showed significant basement membrane thickening, goblet cell hyperplasia, and eosinophilic infiltration, which was statistically significant. No difference was found between subepithelial edema, submucous gland formation, lymphocyte infiltration, and polymorphonuclear leukocyte infiltration. CONCLUSION: Significant histopathological features such as basement membrane thickening, goblet cell hyperplasia, and eosinophil infiltration characterized chronic sinusitis with asthma; however, there were no differences owing to the presence of allergy or the extent of preoperative disease. Adequate preoperative management, close attention during surgery and careful follow-up would be necessary.

Improvement of Speech Intelligibility in Patients with Sensorineural Hearing Loss Using Noise Reduction Algorithms / 대한이비인후과학회지

BACKGROUND & OBJECTIVES: Speech intelligibility is significantly decreased in noisy environments in patients with sensorineural hearing loss (SNHL) compared to those without hearing loss. It is caused by increased hearing threshold, recruitment, and decreased frequency selectivity. The hearing threshold and recruitment could be grossly controlled by the hearing aid with a compression circuit. It has been well established that various techniques can be used to trigger the signal to increase the noise ratio (SNR), such as noise reduction algorithms, in order to compensate for decreased speech intelligibility in noisy environments. These algorithms are incorporated into some of the commercially available digital hearing aids. This study was designed to measure the effect of noise in speech intelligibility of patients with sensorineural hearing loss and the effect of reducing the background noise with a noise reduction algorithm. MATERIALS AND METHODS: Twenty-one ears with sensorineural hearing loss were selected for this study. Speech reception thresholds (SRTs) and speech discrimination scores (SDSs) were checked with or without noise, and after removal of noise using a noise reduction algorithm. RESULTS: SRTs were increased in noise compared with a quiet environment. By reducing noise using the algorithm we prepared, SRTs were decreased by 4.6 dB, 4.2 dB, and 4.9 dB at +6, 0, -6 dB SNRs, respectively, in comparison with those who didn't use the algorithm in noise. It was observed that SDSs were decreased by 24-50% in noise and patients partially recovered hearing loss when noise was reduced. CONCLUSION: Speech intelligibility deteriorated in noise but partially improved with a noise reduction algorithm. A further study on the development of the noise reduction algorithm is needed to improve SNRs.

Characteristics of waveforms of facial electroneurography (ENoG) according to different electrode placement in normal persons / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Electroneurography (ENoG) is regarded as a useful test for evaluating the degree of facial nerve degeneration and predicting the prognosis of the patients with facial nerve palsy. The test results could be changed by many factors, such as electrode position, skin resistance and stimulus magnitude, etc. In this study, the waveforms of ENoG in normal persons were evaluated according to different electrode placement in the nasal alae and in the nasolabial fold, respectively. MATERIALS AND METHODS: Twenty volunteers with normal facial function were included in this study. ENoG was recorded with the recording electrode placed in two different locations, one in the nasolabial fold and the other in the nasal alae, in each person. The recording waves were compared according to their amplitude, sharpness and types of waveform. Interside variability was compared. RESULTS: The amplitude was not significantly different at two locations, but the sharpness was significantly increased when recorded at the nasal alae. Biphasic waveform was more common when recorded at the nasal alae than at the nasolabial fold. This meant that the masseter artifacts were present more commonly at the nasolabial fold. The average of interside variability was 22.77% (17.62) at the nasolabial fold and 23.71% (15.35) at the nasal alae (p>0.05). CONCLUSION: Different electrode placement resulted in different waveforms. By placing the recording electrode at the nasal alae, more biphasic and sharpened waveforms were recorded and less masseter artifacts were observed.

Clinical Characteristics of Chronic Sinusitis with Asthma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Chronic sinusitis has been closely related to bronchial asthma. We investigated clinical characteristics of chronic sinusitis including the extent of disease, radiographic findings, subjective sinusitis symptoms, and postoperative outcome in sinusitis patients with asthma, and compared them with those without asthma. MATERIALS AND METHODS: 24 sinusitis patients with asthma and 103 patients without asthma who underwent endoscopic sinus surgery were evaluated. We compared the following 7 parameters between asthma and non-asthma group : presence of allergy, previous sinus surgery, degree of preoperative polyposis, preoperative disease extent scored with OMU CT findings, severity of sinusitis symptoms, patients' sinusitis symptom changes, and postoperative outcome. Postoperative outcome was evaluated by examining the endoscopic findings in 99 patients (asthma group '. 21, non-asthma group 78) who were followed up for more than 6 months. Patients sinusitis symptom changes were also compared before and after surgery in each group. RESULTS: Patients of both groups showed improvement of sinusitis symptoms after surgery. There were no statistical differences between the two groups on the presence of allergy, previous sinus surgery, preoperative polyposis, preoperative OMU CT scores, and severity of sinusitis symptoms. However, asthma group showed poorer postoperative outcome, which was statistically significant, compared with those without asthma. CONCLUSION: Chronic sinusitis with asthma is characterized by poorer postoperative outcome, but there were no differences in the extent of preoperative diseases, allergy, or previous sinus surgery between the two groups. Adequate preoperative management, close attention during surgery and careful endoscopic postsurgical follow-ups would be necessary for patients with chronic sinusitis with asthma.

CT Findings in Revision Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: When performing a revision endoscopic sinus surgery, operators should pay close attention due to the altered sinonasal anatomy or defects of anatomical landmarks. Careful preoperative evaluation of altered anatomy is important, however, little has been reported on its structural changes. We investigated status of anatomical structures and mucosal pathology by reviewing OMU CT in revision sinus surgeries. MATERIALS AND METHODS: A total of 117 operated sides (right: 59, left: 58) from 62 patients who received revision endoscopic sinus surgeries were evaluated. They had history of previous sinus surgeries such as Caldwell-Luc operation, polypectomy, or endoscopic sinus surgery. We investigated the following 5 parameters by reviewing preoperative OMU CT; Sinus mucosal pathology, bony thickening, absence of superior or middle turbinate, structural changes of superior or middle turbinate, and defects of anatomical landmarks. RESULTS: Sinus mucosal pathology was most commonly found in the maxillary sinuses, and was followed by the anterior ethmoid, the posterior ethmoid, the frontal, and the sphenoid sinuses. Out of 117 sides, 47 showed bony thickening and 7 showed absence of superior or middle turbinate. Eleven revealed structural changes in the superior or middle turbinate, and three showed defects in the lamina papyracea. However, there was no complete absence of the middle or superior turbinates, all of which were partially preserved. CONCLUSION: Significant bony thickening, defects or changes of anatomical structures and associated mucosal pathology were frequently found in revision endoscopic sinus surgeries. Preoperative review of OMU CT, identification of structural changes, and close attention during surgery would be necessary.

The Use of Statistical Analysis - In the Korean Journal of Otolaryngology-Head and Neck Surgery - / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The statistical analysis is an essential procedure with the aim of ensuring that the results of researches are based on evidences rather than opinions. We evaluated the frequency, adequacy, and validity of the statistical methods used in the otolaryngology journals, identified types of errors in statistical analysis, and suggested the proper usage of the statistical methods. MATERIALS AND METHODS: 265 articles published in the Korean Journal of Otolaryngology-Head and Neck Surgery in 1997 were reviewed and evaluated. Each article was evaluated in terms of the adequacy, validity and frequency of statistical usage according to the preformed category. RESULTS: 104 out of 265 articles used analytical statistics, and the commonest statistical methods used in the articles were t-test. ANOVA and x(2)-test were the second and third commonest methods, respectively. In only 36.6% of articles, proper statistical methods were used for their data. Misuse of statistical methods (31.4%) was the most frequent errors found in the articles. 64.6% of the misuses was the adoption of a statistical test inconsistent with data characteristics, 18.8% of them was inappropriate use of parametric methods, and 10.4% of them was the use of x(2)-test when an exact test was needed (3.3%). CONCLUSION: Most of statistical errors found in the journals were misuses of statistical methods related to basic statistics. Closer communication between researchers and statistical analysts, and closer editorial attention to statistical methodology in the review process would improve the validity of articles.