A Case of Pleomorphic Rhabdomyosarcoma of Maxillary Sinus Accompanied with Inverted Papilloma / 대한이비인후과학회지

Rhabdomyosarcoma is an aggressive malignant tumor rarely developing in the head and neck in adults. In the sinonasal region, rhabdomyosarcoma constitutes a clinically important group because of the difficulty of surgical resection and its generally poor prognosis. Inverted papilloma is a relative rare and benign sinonasal lesionconstituting 0.5% to 4% of all nasal tumors that has a known propensity for recurrence, local aggressiveness, and association with transformation to malignancy. Squamous cell carcinoma is the major malignancy that is associated with inverted papilloma. To our knowledge, this is the first case report of pleomorphic rhabdomyosarcoma accompanied with inverted papilloma, and we represent the case with a review of the related literatures.

Adenomatous Hyperplasia Arising from Dual Ectopic Thyroid

Ectopic thyroid tissue is an uncommon embryologic aberration characterized by the presence of thyroid tissue in a site other than its usual pre-tracheal location. Single ectopic thyroid tissue is the most common variant, and the base of the tongue is the most frequent ectopic location. Dual ectopic thyroid is extremely rare, and only eleven cases have been reported in the English literature. Furthermore, adenomatous hyperplasia has never been reported to arise from dual ectopic thyroid. There has been only one reported case of adenomatous hyperplasia arising from a single intratracheal ectopic thyroid. We report a case of adenomatous hyperplasia arising from dual ectopic thyroid tissue that presented as a sublingual mass in a 37-yr-old woman. The diagnosis was made through pathologic examination after surgical resection. We also discuss the diagnosis and treatment of ectopic thyroid, along with a review of the literature.

A Case of Vestibular Neuronitis Followed by Mumps Parotitis in a Pediatric Patient / 대한이비인후과학회지

Vestibular neuronitis is characterized by sudden onset of vertigo, horizonto-rotatory spontaneous nystagmus, loss of caloric response on the affected side with normal otoscopic findings, normal hearing and no other neurological deficit. The pathogenesis of the disease is still unproven, though the viral origin is strongly considered. Herpes simplex virus-type 1, Mumps virus, Rubella virus, Cytomegalovirus, Ebstein-Barr virus may have a role in the disease. Mumps virus is among the other rare causes, so we introduce a case of 13-year old girl who developed sudden vertigo with spontaneous nystagmus, nausea, and vomiting preceded by mumps in her left parotid one week ago. She was diagnosed as a vestibular neuronitis clinically, and serum IgM Ab of mumps virus was detected positive. This case supports the possible role of mumps virus in the etiology of vestibular neuronitis.

A Case of Esophageal Cavernous Hemangioma Misconceived as a Thyroid Neoplasm / 대한이비인후과학회지

Hemangiomas are benign vascular neoplasms found as a bluish mass in the skin or internal organs. Though hemangiomas are the most common benign neoplasms seen in children, it occurs rarely in adults. Furthermore, hemangiomas of esophagus are very rare and represent less than 3% of benign neoplasms of the esophagus. Recently, we experienced a case of a cavernous hemangioma of the esophagus which was misconceived initially as a thyroid neoplasm. Cavernous hemangioma can occur in the neck region of adults and a differential diagnosis of anterior neck mass should be conducted. We report this case with a review of the literature.

Assessment of Residual Subjective Symptoms after Canalith Repositioning Procedure in Benign Paroxysmal Positional Vertigo / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Canalith repositioning procedure (CRP) provides rapid and long-lasting relief of symptoms in most patients with benign paroxysmal positional vertigo (BPPV). However, some patients express nonspecific symptoms such as anxiety or discomfort after CRP, even after the disappearance of nystagmus and vertigo. The purpose of this study is to assess the residual symptoms after CRP in patients with BPPV using questionnaire. SUBJECTS AND METHOD: CRP was performed in 135 patients until nystagmus and vertigo disappeared, and the patients were asked to complete the Dizziness Handicap Inventory (DHI) before and five to seven days after treatment. For the control group, 135 normal volunteers were selected, and cross matched according to the age and sex with the patient group. The DHI were compared among pre CRP, post CRP and control group. RESULTS: There were statistically significant differences between the pre-CRP and post-CRP DHI scores and also between the post-CRP and control group. Comparison between the pre and post-CRP DHI scores, and post-CRP and control group both showed incomplete improvement with respect to some items. CONCLUSION: Even after the successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms was presented. Thus, additional follow up and management may be needed.

The Singer's Formant and Speaker's Ring Resonance: A Long-Term Average Spectrum Analysis

OBJECTIVES: We previously showed that a trained tenor's voice has the conventional singer's formant at the region of 3 kHz and another energy peak at 8-9 kHz. Singers in other operatic voice ranges are assumed to have the same peak in their singing and speaking voice. However, to date, no specific measurement of this has been made. METHODS: Tenors, baritones, sopranos and mezzo sopranos were chosen to participate in this study of the singer's formant and the speaker's ring resonance. Untrained males (n=15) and females (n=15) were included in the control group. Each subject was asked to produce successive /a/ vowel sounds in their singing and speaking voice. For singing, the low pitch was produced in the chest register and the high notes in the head register. We collected the data on the long-term average spectra of the speaking and singing voices of the trained singers and the control groups. RESULTS: For the sounds produced from the head register, a significant energy concentration was seen in both 2.2-3.4 kHz and 7.5-8.4 kHz regions (except for the voices of the mezzo sopranos) in the trained singer group when compared to the control groups. Also, the chest register had a significant energy concentration in the 4 trained singer groups at the 2.2-3.1 kHz and 7.8-8.4 kHz. For speaking sound, all trained singers had a significant energy concentration at 2.2-5.3 kHz and sopranos had another energy concentration at 9-10 kHz. CONCLUSION: The results of this study suggest that opera singers have more energy concentration in the singer's formant/speaker's ring region, in both singing and speaking voices. Furthermore, another region of energy concentration was identified in opera singer's singing sound and in sopranos' speaking sound at 8-9 kHz. The authors believe that these energy concentrations may contribute to the rich voice of trained singers.

A Case of Familial Otosclerosis / 대한이비인후과학회지

Otosclerosis is a primary metabolic bone disease of the otic capsule and ossicles. It is one of the causes of acquired hearing loss, with clinical manifestations occurring in approximately 1% of individuals in some populations in the Western countries. Although the cause of otosclerosis is undetermined, the disease has a well established hereditary predisposition, with approximately half of all affected individuals having family members known to be affected. Many genetic studies of otosclerosis support an autosomal dominant mode of inheritance with penetrance in the range of 20-40%. There have been a few reports of the clinically suspicious otosclerosis cases in Korea, but otosclerosis having familial forms have not been reported. We report one case of familial otosclerosis.

Herpes Zoster Oticus with Multiple Cranial Nerve Involvement: 2 Cases / 대한이비인후과학회지

Herpes Zoster Oticus is an infectious cranial polyneuropathy caused by varicella zoster, the herpetic virus that also causes chicken pox and shingles. Its symptoms include facial paralysis, ear pain, and an auricular vesicle. This syndrome can affect any cranial nerve and usually affects multiple nerves, causing central, cervical, and peripheral effects. Most commonly affected cranial nerves are facial nerve (VII) and vestibulocochlear nerve (VIII). With a review of literature, we report two rare cases. First case involves cranial nerve VII, VIII, IX, X and second case involves cranial nerve VIII, IX, X, which characteristically does not involve facial nerve.

A Case of Actinomycosis in Nasal Cavity

Actinomycosis is a rare form of disease which is caused by Actinomyces such as A. israelii and A. bovis. These anaerobic gram-positive organisms may take the form of an acute or a subacute disease progression. Only a few cases of actinomycosis in the nasal cavity have been reported previously. Actinomycosis is difficult to diagnose because of the fastidious nature of the organism in culture and a general lack of familiarity with the disease. In this paper, we report a case of actinomycosis presenting nasal cavity mass without prior mucosal trauma. Our patient had endonasal endoscopic removal of infected tissue and was treated with 2 days of intravenous antibiotics and 3 weeks of oral antibiotics therapy without any evidence of recurrence.

Clinical Manifestations of Headache in Meniere's Disease

BACKGROUND AND OBJECTIVES: A possible link between Meniere's disease (MD) and headache was originally suggested by Prosper Meniere. We aimed to analyze the clinical manifestation of headache in definite MD compared with benign paroxysmal positional vertigo (BPPV) as a control group. MATERIALS AND METHODS:We examined headache in 67 patients with definite MD according to the criteria of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Sex- and age-matched 67 patients with BPPV served as a control group. Information was obtained concerning the prevalence, localization, severity, character, sequence of headache and response to therapy. RESULTS: Altogether 60 MD patients (90%) and 47 BPPV patients (70%) was reply the questionnaire. 46 MD patients (69%) and 15 BPPV patients (22%) reported headache. Headache was moderate to severe in 39 MD patients (85%) and as a whole more severe than that of the BPPV patients (P<0.05). Temporal area was the most frequently involved region in MD group, whereas posterior neck area was most frequent in BPPV group. The sequence of headache and vertigo attack was pre-(23%), intra-(33%), after-(44%). The 39 patients (89%) of headache in MD was response to the vestibular suppressants, diuretics, calcium channel blocker. CONCLUSION: It is concluded that high incidence of headache and migraine in combination with MD seems to common pathophysiology with migraine. Therefore, our results could provide predictive value in the treatment and follow up of MD patients with headache.