ABSTRACT
Pierre Robin syndrome presents in the neonatal period with upper airway obstruction and feeding difficulties. Infants with pronounced micrognathia may fail to thrive because of chronic airway obstruction, or experience severe respiratory distress and feeding difficulties. This is potentially fatal and surgical intervention in these cases is necessary. We experienced two newborns with pronounced micrognathia who were managed with tongue-lip adhesion and tracheostomy. Herein, we report these two cases with literature reviews.
Subject(s)
Humans , Infant , Infant, Newborn , Airway Obstruction , Pierre Robin Syndrome , TracheostomyABSTRACT
BACKGROUND AND OBJECTIVES: Popular myringoplasty techniques include either an underlay or an onlay approach using tissues such as temporalis fascia or perichondrium as grafting materials. The "cartilage butterfly technique" using a tragal cartilage graft that resembled butterfly wings without incising canal skin was described by Eavey in 1998. This study describes the results of using this technique and analyzes the postoperative hearings. MATERIALS AND METHODS: Cartilage butterfly inlay tympanoplasty was carried out in 28 patients to close small-to-medium tympanic membrane perforations from October 1998 to December 2000. We excluded one patient due to accidental removal of graft at another clinic. We evaluated the success rate and postoperative hearing results. RESULTS: The graft take rate was 96.3% (26/27) at the end of the follow-up period (mean follow-up was 6.0 months). All of successful cases had cartilage grafts that were intact and dry at the last visit. One patient failed due to otorrhea and extruding graft. Two patients were not evaluated, because one had profound preoperative hearing loss and the other was a cerebral palsy patient. Mean air-bone gap (A-B gap) was improved from 16.3 dB to 9.8 dB. Ten patients had an A-B gap average between 0 and 10 dB, 14 patients between 11 and 20 dB, and no patient greater than 20 dB. CONCLUSION: The cartilage butterfly technique was effective to close tympanic membrane perforations in selected patients. It could provide advantages in high success rate, ease, speed and patient comfort.
Subject(s)
Humans , Butterflies , Cartilage , Cerebral Palsy , Fascia , Follow-Up Studies , Hearing , Hearing Loss , Inlays , Myringoplasty , Skin , Transplants , Tympanic Membrane , TympanoplastyABSTRACT
Objective: Injury to the airway, found in 25% to 35% of patients admitted to major burn center, is now the leading cause of death in burn patients. Significant inhalation injury can increase the patient mortality rates by up to 20%. Toxic compounds in smoke can include phosgene, ammonia, sulfur dioxide, and chlorine from plastics and various oxides and aldehydes from burning wood. These compound directly injure airway epithe hal cells, causing an intense inflammatory response with significant edema. After the critical problem is controlled with intensive care in inhalation burn patients, less critical but significant laryngeal function such as protection, phonation and deglutition may often be overlooked. METHOD & RESULT: We have experienced a male patient who was injured by inhalation of toxic compound in ship under cohstruction. He have suffered from pulmonary problem, bronchiohitis obhiterans. Voice disorder was assessed and managed by otolaryngologists after resolving the pulmonary lesion. CONCLUSION: Evaluation and treatment of patients suspected of inhalation injury should include anatomical and functional aspects of the larynx as well as critical problem of the airway.
Subject(s)
Humans , Male , Aldehydes , Ammonia , Burn Units , Burns , Burns, Inhalation , Cause of Death , Chlorine , Deglutition , Edema , Inhalation , Critical Care , Larynx , Mortality , Oxides , Phonation , Phosgene , Plastics , Ships , Smoke , Sulfur Dioxide , Voice Disorders , Voice , WoodABSTRACT
BACKGROUND AND OBJECTIVES: As a society develops, olfactory disturbance increases with the increased industrial disaster, traffic accidents, upper respiratory tract infection, chronic sinusitis and allergic rhinitis from air pollution, Parkinson's disease and Alzheimer's disease from aging process. Nevertheless, there is no practical clinical test of olfactory function in Korea. Authors decided to develop the "Korean olfactory test" using the odorants which are familiar to Koreans. MATERIALS AND METHODS: KVSS Test (Korean Version of Sniffin' Sticks Test) is composed of KVSS Test I (screening test) and KVSS Test II (comprehensive test). KVSS Test I was performed on 120 controls with normosmia, 39 patients with hyposmia, and 24 patients with anosmia. KVSS Test II was performed on 117 controls with normosmia, 29 patients with hyposmia, and 22 patients with anosmia. The subjects ranged in ages from 20 to 69 years. RESULTS: In KVSS Test I, the range of scores (smell test) was 5.36-7.34 in normosmia, 3.41-6.73 in hyposmia, and 1.14-3.16 in anosmia. In KVSS Test II, the range of T.D.I. score (the sum of olfactory threshold score, odor discrimination score, and odor identification score) was 25.98-35.48 in normosmia, 17.01-30.63 in hyposmia, and 7.32-14.06 in anosmia (p<0.001). CONCLUSION: It is concluded that KVSS Test I and II are suitable for the routine clinical assessment of olfactory performance in Koreans.
Subject(s)
Humans , Accidents, Traffic , Aging , Air Pollution , Alzheimer Disease , Disasters , Discrimination, Psychological , Korea , Odorants , Olfaction Disorders , Parkinson Disease , Respiratory Tract Infections , Rhinitis , SinusitisABSTRACT
Kimura's disease is a chronic inflammatory disease which commonly affects the head and neck regions in young oriental men. It is a rare disease and is found as tumor-like painless swelling with or without lymphadenopathy. However, it's treatment method is not clearly defined. The purpose of this article is to report a very unusual case which is often mistaken for a malignant tumor. A 15-year old male was seen with diffuse epiglottic swelling and cervical lymphadenopathy. CT and MRI showed diffusely enlarged epiglottis with homogenous ensity and bilateral multiple lymphadenopathy in internal jugular and spinal accessory chains. Biopsy of epiglottic mass was performed under the impression of malignant lymphoma. The histology revealed marked lymphoid follicular hyperplasia and massive interfollicular eosinophilic cell infiltration, which was compatible with Kimura's disease. The mass was partially excised especially in laryngeal surface area because the mass was not separated from epiglottis itself. After surgical removal, oral prednisolone was taken. The epiglottis was nearly returned to its normal figure after subsequent excision and vaporization with CO2 laser and neck nodes enlargements were spontaneously resolved. The etiology of this disease is still unknown. It is essential to differentiate it with malignant tumor through biopsy. When Kimura's disease is confirmed, combination of surgical excision and oral steroid appear to be effective therapeutic modality.
Subject(s)
Adolescent , Humans , Male , Biopsy , Eosinophils , Epiglottis , Head , Hyperplasia , Lasers, Gas , Lymphatic Diseases , Lymphoma , Magnetic Resonance Imaging , Neck , Prednisolone , Rare Diseases , VolatilizationABSTRACT
Successful regeneration of a cartilage framework using perichondrium has been reported by several authors but there are some arguments surrounding mucosal regeneration. Some authors report that regeneration of mucosa is completed by ingrowth from neighboring tissue but others insist that it occurs via metaplasia from the squamous epithelium. This study was designed to investigate the differences in regeneration between nonvascularized and vascularized flaps. A 5 X 15mm sized vascularized composite flap composed of vascularized perichondrium pedicled on the central auricular artery and free buccal mucosa which was harvested from the oral cavity and sutured on the vascularized perichondrium was fabricated in a rabbit ear. It was transferred to a pre-created 4 X 12mm tracheal defect. A morphologic study was carried out to determine the outcome of the grafted mucosa at regular intervals under light microscopy after H and E staining. A nonvascularized perichondrial-mucosal composite flap with the same dimension was transferred in the control group. The results are as follows;1) The control group showed necrosis of the grafted mucosa and defective area was covered by ingrowth of the neighboring normal mucosa. The periphery of the defective area regenerated earlier than the central area and immature epithelia were still found 6 weeks after the graft. Regeneration of cilia was rather inconsistently observed 8 weeks after the transfer. 2) In the experimental group, the grafted mucosa survived on the vascularized perichondrium which was thought to act as a vascularizing bed. Two weeks after reconstruction, the covering epithelium appeared almost as normal as the tracheal columnar epithelium. At 4 weeks, the regenerated mucosa could hardly be distinguished from the normal mucosa. Regeneration of cilia was consistent at 6 weeks in the experimental group. Mucosal regeneration in the experimental group was superior to the control group in terms of degree and quality. Mucosal coverage of the control group occurred by ingrowth from the neighboring mucosa. In the experimental group, survival of the grafted mucosa relied upon revascularization through the vascular pedicle. It can be conceived that metaplasia of the grafted mucosa occurs in a vascularized composite flap transferred group. In conclusion, maintenance of vascularization is essential to successful regeneration of grafted mucosa with good quality.
Subject(s)
Arteries , Cartilage , Cilia , Ear , Epithelium , Metaplasia , Microscopy , Mouth , Mouth Mucosa , Mucous Membrane , Necrosis , Regeneration , TransplantsABSTRACT
Lipoma is a common tumor throughout the body, but occurrence in the deep neck space is very rare, and only some cases have been reported by otolaryngologist and pathologist for the last century. In head and neck area, as elsewhere, the lipoma is mainly originated from the subcutaneum. But in deeper tissues, its characteristics are different from those of other sites of lipoma. Submucosal lipoma in the head and neck area usually occur in oral cavity and hypopharynx. Recently we hae experienced 3 cases of deep neck space lipoma, so we report our clinical experiences with brief review of literature.
Subject(s)
Head , Hypopharynx , Lipoma , Mouth , NeckABSTRACT
Vibrio alginolyticus is a microorganism of marine environment that occasionally occurs as a human pathogen. We isolated V. alginolyticus from a patient with otitis media. A 37-year-old man had been exposed to seawater one month before admission. The isolate showed typical biochemical and characteristics of this organism such as positive Voges-Proskauer reaction, fermentation of sucrose, growth on 10% sodium chloride media. In vitro susceptibility test shows the isolate was resistant to ampicillin and carbenicillin, but was susceptible to other antimicrobial agents. The patient improved with ciprofloxacin and ofloxacin therapy.