The Clinical Correlation between Anterior Inferior Cerebellar Artery and Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The influence of anterior inferior cerebellar artery (AICA) loop on sudden sensorineural hearing loss (SSHL) remains controversial. The objective of this study was to evaluate the correlation between the anatomical type of AICA loop and SSHL. SUBJECTS AND METHOD: We reviewed the medical records of 69 ears from 60 patients with SSHL between January 2005 and April 2008, retrospectively. AICA loops were classified according to the Chavda classification method by magnetic resonance imaging. According to the extension depth of the loop in the internal auditory canal, it was classified as type I, II and III. The loop was classified as S (small diameter) and L (large diameter) by comparing the thickness of the loop with adjacent facial nerves. RESULTS: The predominant type of AICA loop was type I (68.1%) and type S (78.3%). There was no significant correlation between the pretreatment hearing level, extension depth and diameter. There was also no significant correlation between the rate of hearing recovery by Siegel's criteria and diameter. However, there was significant correlation between the rate of hearing recovery by Siegel's criteria and the types of the extension depth (p< 0.05). The ears with type II and III of AICA loop presented higher rates of hearing recovery by Siegel's criteria than those with type I. CONCLUSION: This study suggests that the type II and III of AICA loop may be considered a good prognostic factor in SSHL.

A Case of Sinogenic Multiple Brain Abscesses / 대한이비인후과학회지

Intracranial complications of sinusitis are known as serious illness, however, they are often neglected because their initial symptoms are not definitively remarkable. Although the incidence is progressively decreasing since the development of antibiotics, these intracranial complications are still very dangerous to death until now. Brain abscess, along with meningitis, is regarded as one of the most common intracranial complication of sinusitis. Brain abscess of sinus origin develops most commonly in the frontal lobe and usually secondary to infection in the frontal or ethmoid sinus either as isolated infection or part of pansinusitis. Both craniotomy and sinus surgery as well as administration of massive intravenous antibiotics are necessary for complete eradication of sinogenic brain abscess. However, little information has been available on the appropriate management of sinogenic multiple brain abscesses. We have experienced a case of multiple brain abscesses secondary to acute pansinusitis in 17 year-old female patient. So we report a case of sinogenic multiple brain abscesses treated by craniotomy and endoscopic sinus surgery with massive intravenous antibiotics.

Long-Term Outcomes of Transnasal Endoscopic and Extranasal Management in Inverted Papilloma of Nasal Cavity and Paranasal Sinuses / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES:Extranasal approach has been emphasized treatment of choice in inverted papilloma of nasal cavity and paranasal sinuses until several years ago. However, nowadays conservative transnasal endoscopic surgery is done in properly selected cases of inverted papilloma. The aim of this study was to compare the long-term outcomes of transnasal endoscopic and extranasal surgical management of inverted papilloma. MATERIALS AND METHODS: Among 33 patients who were pathologically diagnosed as inverted papilloma from January 1990 to August 1997, we reviewed the medical records and CT scans of 25 patients who underwent surgical treatment and were available for the follow up at least more than 2 years, retrospectively. RESULTS: Thirteen patients were treated via transnasal endoscopic approach and twelve patients by extranasal approach. According to Skolnik(1966)'s stage classification, 20 patients showed stage T3. Eleven patients of them were treated via transnasal endoscopically and 9 patients extranasally. Four minor postoperative complications, such as epiphora, septal perforation, vestibular pain and facial parasthesia, were noted in extranasal approach group. One case(7.7%) recurred in conservative transnasal endoscopic surgery group during mean 38 months follow up period. However, no recurrence was found in extranasal approach group during mean 60 months follow up period. CONCLUSION: If endoscopic surgery is performed by experienced surgeons in adequately selected patients, conservative transnasal endoscopic surgery can be considered as an alternative surgical modality in inverted papilloma of nasal cavity and paranasal sinuses.