Simultaneous Endoscopic Sinus Surgery and Rhinoplasty: A Pilot Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Plastic surgeons have generally avoided performing rhinoplasty in the presence of rhinosinusitis due to potential infection. For the otolaryngologist, concurrent rhinoplasty can produce increased periorbital swelling and ecchymosis, which can obscure the parameters used to monitor complications of the sinus procedure. But recent advances of endoscopic sinus surgery have made the simultaneous procedures safe in appropriately selected patient. The purpose of this report is to identify the indications and limitations of the simultaneous procedures. MATERIALS AND METHOD: Seven patients were treated by this combined modality and all were available for follow-up. There were 3 women and 4 men with a mean age of 35 years who underwent the combined procedure by the otolaryngologist. RESULTS: Recurrence of sinusitis occurred in one patient, and another patient wanted revision rhinoplasty for cosmetic dissatisfaction. There were no other complications. CONCLUSION: Combined rhinoplasty and endoscopic sinus surgery can be performed safely and with good results in selected patients.

Particle Image Velocimetry Measurements for the Study of Nasal Airflow / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Several studies have utilized physical models or casts of the nasal cavity in an effort to understand the relationship between nasal anatomy and the distribution of inspired or expired airflow. This paper deals with the evaluation of nasal airflow characteristics during physiologic breathing in normal conditions. MATERIALS AND METHOD: The choana of a nasal model casting by a combination of rapid prototyping and solidification of clear silicone was connected to a pump that simulated physiological pressure in the upper airway system. Glycerin-water mixture was used as medium. The airstream was marked with polyvinyl spherical particles, and was observed through an solidificated clear silicone and analyzed with particle image velocimetry. RESULTS: Turbulence is clearly visible at the level of the head of the middle turbinate. The maximal velocity was recorded at the superior meatus. The flow rate was highest at the middle meatus. CONCLUSION: This model allows the investigation of airflow distribution and velocity under physiologic conditions. The main flow stream passes through the middle meatus.

Gene Expression of Nitric Oxide Synthases in Thyroid Papillary Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) is an important bioactive signalling molecule mediating several actions. Increased NO production may contribute in the pathogenesis of variety of disorders including cancer. Until now, the role of NO in cancer biology is unclear. The expressions of nitric oxide synthase (NOS) in thyroid carcinoma had not been fully determined yet and its role in that kind of tumor is still poorly understood. The aim of this study was to determine the expression and production of NOS in thyroid papillary carcinoma. MATERIALS AND METHOD: We investigated expressions of each NOS mRNA in 2 cases of surgical specimen of human thyroid papillary carcinoma by reverse transcriptase-polymerase chain reaction (RT-PCR). Western blot analysis using a polyclonal antibody directed against each NOS recognized immunoreactive NOS specific protein. Using the same antibody, the distribution of each NOS was examined in 10 formalin-fixed paraffin embedded samples by immunohistochemistry. RESULTS: RT-PCR analysis showed that the NOS mRNA expression in carcinoma tissues is elevated significantly in comparison with that in noncarcinoma tissue. The nNOS and eNOS specific proteins were found in papillary carcinoma but not in normal tissue. The iNOS specific protein was not detected in either carcinoma or normal tissues. Interestingly, the nNOS specific protein, which was analyzed by N-terminal antibody, was detected with several seperated bands. nNOS and eNOS were localized in papillary carcinoma cells but not in the normal thyroid tissue. iNOS was weakly stained in papillary carcinoma in comparison with nNOS and eNOS. CONCLUSION: All isoforms of NOS mRNA were expressed in papillary carcinoma but their specific proteins were only identified by the specific antibodies of nNOS and eNOS. Some low molecular weight protein bands detected in carcinoma seems to be a manifestation of possible structural diversity. Further DNA sequencing and activity study are needed for understanding its role in thyroid cancer.

Treatment of Thoracic Tracheal Stenosis by Sternotomy Approach / 대한이비인후과학회지

BACKGROUND: The treatment for thoracic tracheal stenosis is somewhat different from cervical tracheal stenosis, because it needs approach to the thoracic cavity which contains vital organs such as heart and great vessels. The classic surgical approach to thoracic trachea has been either the posterolateral thoracotomy or through the median sternotomy approach, with the former being preferred to the latter. The purpose of this study is to determine the results of the sternotomy method to approach the thoracic cavity in the management of thoracic tracheal stenosis. MATERIALS AND METHODS: From 1996 to 1998, 4 patients with thoracic tracheal stenosis had surgical treatment through various sternotomy approach. A retrospective study was done about various postoperative values. RESULTS: There has been no operative mortality. Hospital stay ranged from 24 to 55 days (mean 38.5+/-12.9 days). No pulmonary complication occurred postoperatively. There were three cases of postoperative wound infection and mediastinitis. But all of them could be treated with early open drainage, debridement, and greater omentum free flap. And there was no postoperative mortality. CONCLUSIONS: In order to reduce postoperative infection, the strategy of median sternotomy can be used for thoracic tracheal stenosis, because it is simple, easy to perform, provides more physiological ventilation-perfusion condition during the operation and has short operation time, good operation field, low postoperative pulmonary complication rate, and short hospital stay.

Treatment of the Nasal Valve Stenosis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nasal obstruction is most often caused by the problems in the nasal valves which are located in the anterior part of the nose. Without careful evaluation of this part of the nose, the effort to improve nasal breathing may be fruitless. However, relatively little attention has been paid to the nasal valve problems. In the present study, we investigated the causes that underlie various problems in the nasal valve and looked for treatment procedures. MATERIALS AND METHODS: A total of 20 patients who had nasal obstruction due to valve problems were studied retrospectively. Various surgical procedures such as spreader graft, alar batten graft, auricular composite graft and Z-plasty were performed for the patients. RESULTS: All patients have experienced reduction in the nasal obstruction. Also, the widening of the valve area was observed. CONCLUSION: Surgery of the internal or external nasal valve is a key factor in functional rhinoplasty. It can significantly improve the nasal breathing of patients with nasal dysfunction leading to obstruction, insufficiency, and nasal valve collapse. With proper diagnosis of the problem, various surgical maneuvers can be used to repair a damaged valve and to correct breathing problems.

Immunohistochemical Localization of Choline Acetyltransferase in External Branch of Superior Laryngeal Nerve in Cat / 대한이비인후과학회지

Existence of the external branch of the superior laryngeal nerve containing afferent fibers is much of concern. In this study, it is the aim to identify the component of fibers by immunohistochemistry using choline acetyltransferase, the specific marker of the cholinergic motor neuron. Both side of external branch of superior laryngeal nerve were excised from 4 adult cats, and also obtained the great auricular nerve and the hypoglossal nerve for sensory control and motor control specimen, respectively. There were no fibers with immune reaction in the great auricular nerve while all of the fibers in the hypoglossal nerve were strongly stained with rabbit anti-choline acetyltransferase antibody. In the external branch of the superior laryngeal nerve, 12.7% of the fibers were not stained with immune reaction product. They are smaller than stained nerve fibers in cross sectioned diameter and peripherally located in the same fascicle. The identification of unstained fiber group in the external branch of the superior laryngeal nerve suggest that it is a mixed nerve and not purely motor, possibly containing the sensory nerve fiber.