The Classification and Clinical Importance of the Anterior Attic Bony Plate on Temporal Bone CT / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Anterior attic bony plate (cog) is a coronally oriented bony septum which is suspended from the anterior petrosal tegmen, and the anterior epitympanic recess is partitioned from epitympanum by this bony plate. It is an important pathway for anterior drainage which can cause inflammation in obstructed conditions; therefore, it needs appropriate procedure to eradicate the lesions without recurrence. We aimed to classify types of the anterior attic bony plates on the temporal bone CT and to find correlation between the types of the anterior attic bony plates and the development of chronic otitis media and cholesteatoma. MATERIALS AND METHODS: We reviewed 264 cases of the temporal bone CT of the normal and the chronic otitis media patients, of which 64 cases were excluded as lesions could not be identified due to severe destruction and obscurity of the figure. RESULTS: In normal ears, the incidence of the anterior attic bony plate was 67% in the plate type, 28% in the pyramid type, and 5% in the anterior type. In the diseased ear, the incidences were 40%, 44%, 16%, in the plate type, pyramid type, and anterior type, respectively and in the cholesteatoma ear, 30%, 43%, 27%, respectively. The difference of incidence was statistically significant. CONCLUSION: We assumed that the development of the chronic otitis media is related to the type of the anterior attic bony plate in some degree. Especially, the anterior type was more prominent in cholesteatoma than in noncholesteatoma with a statistical significance. Further studies are needed to figure out the correlation between the type of the anterior attic bony plate and it's clinical importance.

Isolated Sphenoid Sinus Lesion: A Clinical Analysis of 17 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An isolated sphenoid sinus lesion is a rare disorder and is difficult to diagnose for several reasons. This lesion can easily spread to the adjacent structures and lead to severe complications. Thus, early diagnosis and treatments are needed. We experienced 17 cases of isolated sphenoid sinus lesions, including inflammatory, neoplastic, and vascular lesions, and reviewed the clinical findings, radiologic features, treatments and complications of these cases. MATERIALS AND METHOD: Isolated sphenoid sinus lesions were reviewed retrospectively of patients from January 1995 to July 2001. Patients were identified with radiologic findings and intraoperative endoscopic findings excluding other paranasal sinus involvements. RESULTS: The most common symptom was headache, and 13 patients (76%) complained. Nasal symptoms appeared only 4 patients (23%). Pathologic reviews showed 9 cases of acute and chronic sinusitis were 9 cases, 4 fungal sinusitis, 2 neoplastic diseases, 1 polyp, and 1 vascular disease. We carried out medical treatment in 5 cases, and diagnostic biopsy in 3 cases, and therapeutic surgery in 10 cases. In 7 cases, complications including cranial nerve palsy were observed, and 1 patient was expired due to meningitis. CONCLUSION: We can diagnose isolated sphenoid sinus lesions exactly with the use of radiologic findings and endoscopic examinations. With endoscopy, we can operate relatively less invasively and more effectively. It is apparent that early recognition and rapid treatment are essential if complications are to be avoided.

Lemierre's Syndrome Following Acute Tonsillitis / 대한이비인후과학회지

Abstract Postanginal sepsis (Lemierre's syndrome) is a rare disease but potentially life-threatening illness at the present. This disease is a septicemia resulting from an antecedent oropharyngitis that causes deep neck infection, an internal jugular vein thrombophlebitis and septic emboli. Because of the severity of the disease and the difficulty in its diagnosis, familiarity with all aspects of the disease is essential. This syndrome needs immediate diagnosis and treatment. Contrast-enhanced computed tomography is the most useful method for an accurate diagnosis. Treatment of Lemierre's syndrome includes incision & drainage, systemic antibiotics, anticoagulation and other surgical interventions. We report on two cases of Lemierre's syndrome which showed deep neck infection, internal jugular vein thrmobosis and pulmonary septic emboli.