Epidemic MRSA Infection after Intranasal Surgery / 대한이비인후과학회지

In recent years, drug-resistant bacterial and nosocomial infections have been increased. The epidemic Methicillin Resistant Staphylococcus aureus (MRSA) infection after intranasal surgery was broken out at Wallace Memorial Baptist Hospital recently. MRSA was identified in 22 patients among 118 patients who underwent intranasal operation from January 23rd, 1996 to February 8th, 1996. Most patients represented symptoms the 7th day after the operation. Among 22 patients, 17 patients were treated with hydration, daily nasal dressing and intravenous antibiotics; Vancomycin or Ciprofloxacin was administrated in 11 patients, and primary antibiotics in five patients. Other five patients were treated with daily nasal dressing and oral antibiotics (Trimethoprim-Sulfamethoxazole or Ciprofloxacin). One of Vancomycin-treated patients developed sepsis. No further MRSA infection occurred after emphasizing thorough hand-washing, sterilization and disinfection of equipment, and control of health care providers, showing that the prevention of MRSA infection is very important.

Post-operative Result of Endoscopic Sinus Surgery in Patients with Chronic Paranasal Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery has recently become a popular and effective treatment method for chronic paranasal sinusitis. Although several papers have been written about the results of ESS, little has appeared about its longterm results. The purpose of this study is therefore to add to the understanding long-terms results of EES by presenting our experience. MATERIAL AND METHODS: We report our experience on 410 patients who underwent endoscopic sinus surgery for chronic paranasal sinusitis from January 1993 to August 1995 and a long term follow-up study from 12 to 36 months. We evaluated their preoperative symptoms, previous nasal surgery history, anatomical variations on the preoperative OMU-CT, pattern of inflammatory sinonasal disease, as well as their postoperative improvement of the symptoms using questionnaires and the endoscopic sinonasal findings. RESULTS: Nasal obstruction was the most improved symptom. Patients without any history of nasal surgery had relatively good results compared to those with previous operation history. Patients with an OMU anatomical variation also had relatively good results compared to those with no OMU variation. Among the different patterns of chronic paranasal sinusitis based on the Babbel classification, the sinonasal polyposis pattern (IV) showed most inferior postoperative improvement of the symptoms. Nevertheless, the overall postoperative improvement of chronic paranasal sinusitis indicates that the endoscopic sinonasal surgery was effective. CONCLUSION: On the whole, 371 (91%) of the 410 patients benefited from this procedure, indicating that endoscopic sinus surgery provides an efficient method for treating chronic sinusitis and that sinonasal polyposis can be managed with a high level of success.

The Contents of Concha Bullosa and Its Origin Site / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Concha bullosa is one of the most common obstructive anatomical variants seen in patients with sinusitis. We wanted to illustrate the relationship of the contents and CT findings of concha bullosa, and of the contents of concha bullosa and the lesion at the origin site of concha bullosa. MATERIAL AND METHODS: We evaluated PNS CT of 1023 patients with sinusitis, and a total of 172 patients with concha bullosa were evaluated to study the contents and origin site of concha bullosa by CT and endoscopic findings and pathologic confirmation of the contents. RESULTS: Contents of the concha bullosa were normal mucosa in 29.2%, mucosal thickening 26.0%, mucopurulent discharge 35.6% and polyp 9.2%. Although CT findings and the origin site of concha bullosa were normal, the diseased concha bullosa were 30.1% and 23.0%. CONCLUSION: Regardless to the presence of disease at the origin site and CT findings of Concha bullosa, we found it necessary to validate concha bullosa.