Multicenter Evaluation on the Safety of Gore-Tex as an Implant in Rhinoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study was done to evaluate the safety of Gore-Tex as a nasal implant. Materials and METHOD: A retrospective multicenter study was carried out on 15 surgeons from 11 general hospitals and 4 private practice clinics regarding the safety of the Gore-Tex as a nasal implant. The study involved 853 patients, of whom 656 received primary surgery and 197 revision surgery. Gore-Tex was mainly used as a dorsal implant in a form of sheet or as a reinforced nasal implant. RESULTS: The overall complication rate associated with Gore-Tex was 2.5% (21 cases). Infection was the most common complication (18 cases ; 2.1%) followed by 2 cases of seroma and 1 case of persistent nasal swelling. In 19 out of 21 complication cases, the graft needed removal to control the infection or seroma (91% removal rate). Nine cases of infection developed in both primary cases (1.37%) and in revision cases (4.57%), which suggests a higher association rate between infection and revision cases (p=0.0062). Infection developed within 1 month in 5 cases while 9 cases developed infection after 6 months of operation. Other complications such as aesthetic problems (malpositioning of the implant or dorsal irregularities) were found in 15 cases (1.8%) and hematoma in 1 case. CONCLUSION: The infection rate of Gore-Tex used in rhinoplasty was about 2% and it rose significantly in the revision cases. If infected, almost all of the implanted Gore-Tex needs removal; therefore, we suggest judicious use of Gore-Tex in rhinoplasty.

Cytokeratin Expressions in Normal Nasal Mucosa, Nasal Polyps, Inverted Papilloma, and Squamous Cell Carcinoma Tissues / 대한이비인후과학회지

All epithelial cells express more than 2 cytokeratins, and their tissue distribution is determined by cellular types, location, and degree of differentiation. It is known that changes in cytokeratin expression accompany squamous metaplasia of the human nasal epithelium. We analysed cytokeratin expression patterns and their significance in normal nasal mucosae, nasal polyps, inverted papillomas, and maxillary squamous cell carcinomas using immunohistochemical staining with anti-CK4, CK8, CK10, CK13, CK17, CK18, and CK19. Nasal polyp showed the same pattern of cytokeratin expression as that of nasal mucosa. While CK10 expression was present only in the tissue of squamous cell carcinoma, CK18 and CK19 were not expressed. Specimens of Inverted papilloma expressed CK4 and CK13 only in the suprabasal layer, and CK17 in the basal and suprabasal layers. In contrast, normal epithelium expressed CK13 and CK17 only in the basal layer, and CK4 in the basal and suprabasal layers. CK8 and CK18 were less expressed in the specimen of inverted papilloma than in the normal nasal mucosa. The expression patterns of CK10 and CK19 suggest that they may play a role in determinating the malignant change of inverted papilloma and in investigating the pathogenesis of inverted papilloma and maxillary cancer.

Primary Adenoid Cystic Carcinoma of the Trachea / 대한이비인후과학회지

Primary adenoid cystic carcinoma of the trachea is rare and its diagnosis and management have still some controversies. In patients with dyspnea, tracheal mass is not usually considered and differential diagnosis of primary tracheal tumor should be ruled out. From 1989 to 1995, eight cases of adenoid cystic carcinoma of the trachea were diagnosed and managed in our clinics. Among these cases, differential diagnosis with thyroid carcinoma was difficult in two cases and in one case, the primary diagnosis was bronchial asthma. Most of patients underwent tracheal resection and end to end anastomosis or total laryngectomy with postoperative radiation therapy. The overall result of these series showed mean disease free survival period of 39 months and recurrence rate of 50%. The purpose of this article is to describe the clinical and radiological findings of adenoid cystic carcinoma of the trachea and give helps in differential diagnosis of tracheal mass.