Treatment Outcomes and Acoustic Rhinometric Results in Endoscopic Sinus Surgery of Adult Chronic Paranasal Sinusitis / 영남의대학술지

BACKGROUND: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. MATERIALS AND METHODS: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. RESULTS: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. CONCLUSIONS: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.

Treatment Outcomes and Acoustic Rhinometric Results in Endoscopic Sinus Surgery of Adult Chronic Paranasal Sinusitis / 영남의대학술지

BACKGROUND: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. MATERIALS AND METHODS: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. RESULTS: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. CONCLUSIONS: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.

A Case of Sinogenic Multiple Brain Abscesses / 대한이비인후과학회지

Intracranial complications of sinusitis are known as serious illness, however, they are often neglected because their initial symptoms are not definitively remarkable. Although the incidence is progressively decreasing since the development of antibiotics, these intracranial complications are still very dangerous to death until now. Brain abscess, along with meningitis, is regarded as one of the most common intracranial complication of sinusitis. Brain abscess of sinus origin develops most commonly in the frontal lobe and usually secondary to infection in the frontal or ethmoid sinus either as isolated infection or part of pansinusitis. Both craniotomy and sinus surgery as well as administration of massive intravenous antibiotics are necessary for complete eradication of sinogenic brain abscess. However, little information has been available on the appropriate management of sinogenic multiple brain abscesses. We have experienced a case of multiple brain abscesses secondary to acute pansinusitis in 17 year-old female patient. So we report a case of sinogenic multiple brain abscesses treated by craniotomy and endoscopic sinus surgery with massive intravenous antibiotics.

A Clinical Study of the Laryngeal Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Laryngeal cancer is the most common malignancy in head and neck region. The aim of this study was to evaluate the clinical features and treatment outcomes of laryngeal cancer. MATERIALS AND METHODS: We reviewed medical records of 169 patients from 1984 to 1997 retrospectively. We investigated age, sex distribution, TNM staging in 169 patients and treatment modalities, survival rate in 141 patients who were treated. RESULTS: In all patients, there were 64 glottic, 57 supraglottic, 46 transglottic and 2 subglottic cancers. Among 141 patients, we performed 92 surgical procedures and 49 radiotherapies. Total and near total laryngectomy were performed in 45 cases and conservation laryngectomy in 47 cases. Five year survival rate (YSR) was 88.4% totally. In early cancer cases, 5 YSR was excellent in both surgery and radiotherapy group. Glottic and supraglottic cancer showed much better prognosis than transglottic cancer. There was no statistical differences in the view of 5 YSR between surgery and radiotherapy group. Treatment failures were mainly found at primary sites. Functional preservation of larynx was successful in 79 cases after 3 year-follow up. CONCLUSIONS: Compared with previous studies, our study presented higher proportion of conservation laryngectomy and functional preservation procedues. Early diagnosis and treatment are important and required to improve patient's outcome.

Mandibular Lingual Releasing Approach to Oral and OropharyngealCarcinoma and Parapharyngeal Space Tumor / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The objectives of treating oral cavity and oropharyngeal cancer are complete removal of tumor, restoration of function and aesthetics, and such treatments require adequate exposure for direct visual and bimanual examination. For posterior oral cavity and oropharynx, the standard approach had been the composite resection. This approach requires mandibulectomy and lip-splitting incision, and thus, complications of mandibulectomy can not be avoided. There is no standard approach for parapharyngeal space tumors due to limited exposure, but most authors have agreed that the best approach is the external approach with or without mandibulotomy. Mandibular lingual releasing approach (MLRA) to oral cavity, oropharynx and parapharyngeal space provides excellent visualization for resection of tumors without lip-splitting, mandibulotomy, nor mandibulectomy. We analyzed the outcome and advantage of MLRA. MATERIALS AND METHODS: We used MLRA to treat 7 patients who had oral cavity or oropharyngeal cancers and one who had parapharyngeal tumor. RESULTS: All tumors could be removed by MLRA. Postoperative complications were wound infection, orocutaneous fistula, and mouth floor wound disruption. But, permanent deficit and complications of lip-splitting, mandibulotomy, or mandibulectomy did not occured. CONCLUSION: The MLRA provides excellent exposure of oral cavity, oropharynx and parapharyngeal space and excellent cosmetic and functional results. It canbe concluded that the MLRA is an excellent approach for tumors of oral cavity, oropharynx and parapharyngeal space.