ABSTRACT
Cylindrical cell papilloma (CCP), also named as oncocytic Schneiderian papilloma, is the rarest papilloma of the nasal cavity and paranasal sinuses. It accounts for 3 -5% of the total sionasal papillomas. Histoloycally, it is characterized by proliferating multilayered columnar cell and neoplastic epithelium containing varying numbers of small mucous-containing cystic structures with numerous microvillous projections on the apical cell membrane. Clinically, CCP is characterized by coexistence with malignancy, malignant transformation, local invasion, bony destruction and frequent recurrence. Because of its rare incidence, high recurrence rate and the possibility of misdiagnosis as malignancy, CCP must be carefully managed and needed to be Followed up closely. Recently, we experienced a case of cylindrical cell papilloma which originated from the frontal sinus and extended into frontal recess in a 55 year-old male patient. The subject was treated successfully by osteoplastic frontal sinus surgery, and we thus report on the treatment of this case, along with a review of literature.
Subject(s)
Humans , Male , Middle Aged , Cell Membrane , Diagnostic Errors , Epithelium , Frontal Sinus , Incidence , Nasal Cavity , Papilloma , Paranasal Sinuses , RecurrenceABSTRACT
BACKGROUND AND OBJECTIVES: Identification of primary maxillary sinus hypoplasia (PMSH) is important diagnostically and therapeutically. Recently, the clinical significance of associated abnormalities in PMSH has been suggested. The aim of this study is to investigate the incidence of PMSH, their associated abnormalities and relationship of anatomical variations and paranasal sinusitis. MATERIALS AND METHODS: We evaluated radiologic diagnostic criteria of PMSH and analyzed the relationship of the anatomical variations of nasal cavity and paranasal sinuses in paranasal sinus CT scans, retrospectively. We measured the volume estimated ratio (VER) in PMSH cases. RESULTS: The incidence of unilateral and bilateral PMSH were 11 cases (5.9%) and 10 cases (5.3%). respectively. According to the Bolger's classification, there were 13 sites (41.9%) of type I with the mean VER of 0.71, 14 sites (45.2%) of type II with the mean VER 0.50, and 4 sites (12.9%) of type III with the mean VER of 0.27. The most common anatomical anomalies in both of the unilateral and bilateral PMSH were zygomatic (90.3%) and alveolar pneumatization (90.3%); the second most common abnormal finding was high maxillary sinus floor (77.4%). Of the anatomical variations, the frequency of uncinate process abnormalities (41.9%), paradoxical middle turbinate (32.3%) and Haller's cell (19.4%) were statistically significant. CONCLUSION: These results suggest that zygomatic and alveolar pneumatization, and high maxillary sinus floor are additionally important anatomical abnormalities associated with PMSH. Careful preoperative assessment of anatomical variations in the paranasal sinus CT scans may be essential to avoid incidental iatrogenic complications during functional endoscopic sinus surgery (FESS) or Caldwell-Luc operation in patients with PMSH.
Subject(s)
Humans , Classification , Incidence , Maxillary Sinus , Nasal Cavity , Paranasal Sinuses , Retrospective Studies , Sinusitis , Tomography, X-Ray Computed , TurbinatesABSTRACT
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.
Subject(s)
Humans , Early Diagnosis , Head , Laryngeal Neoplasms , Laryngectomy , Larynx , Medical Records , Neck , Neoplasm Staging , Prognosis , Radiotherapy , Retrospective Studies , Sex Distribution , Survival Rate , Treatment FailureABSTRACT
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.
Subject(s)
Humans , Esthetics , Fistula , Mouth , Mouth Floor , Oropharyngeal Neoplasms , Oropharynx , Postoperative Complications , Wound Infection , Wounds and InjuriesABSTRACT
BACKGROUND AND OBJECTIVES: Antrochoanal polyp usually appears as a large, soft, gelatinous mass in the nasopharynx. Most incidents of antrochoanal polyp arise from mucosa around the natural ostium of the maxillary sinus. Surgical methods employed in the treatment of antrochoanal polyp are simple avulsion, Caldwell-Luc's operation, osteoplastic maxillary sinus operation, inferior meatal antrostomy, as well as endoscopic removal. Simple avulsion has been known to accompany a high recurrence rate, whereas the incidence of recurrence has been reported to be lower for endoscopic sinus surgery. In this regard, we compared postoperative results of simple avulsion or Caldwell Luc's operation with endoscopic sinus surgery in treating antrochoanal polyp. MATERIALS AND METHODS: We evaluated 42 patients who were treated for antrochoanal polyp from April 1991 until April 1996 by analyzing their clinical features, radiologic findings, postoperative results, and postoperative complications. RESULTS: Simple avulsion method was used to treat 21 cases (50%), and endoscopic sinus surgery method was used to treat another 21 cases (50.0%, three cases were combined with Caldwell-Luc's operation). Among those who received simple avulsion treatment, 9 showed recurrence, whereas none of those who underwent endoscopic sinus surgery and were treated successfully showed recurrence. CONCLUSION: The results suggest that endoscopic sinus surgery is a successful surgical method for treating antrochoanal polyp.
Subject(s)
Humans , Gelatin , Incidence , Maxillary Sinus , Mucous Membrane , Nasopharynx , Polyps , Postoperative Complications , RecurrenceABSTRACT
BACKGROUND AND OBJECTIVES: Malignant lymphoma is the most common type of cancer in the immunologic system. There have been many reports about malignant lymphoma, but etiologies and prognosis of malignant lymphoma remain controversial. This study was designed to carry out an immunohistochemical classification of malignant lymphoma and to define the relationship between Epstein-Barr virus (EBV) and malignant lymphoma by using the polymerase chain reaction (PCR), which is known to be more sensitive than than any other methods for detection of EBV. MATERIALS AND METHODS: Thirty six cases of cervical nodal non-Hodgkin's lymphoma tissue and twenty five cases of normal neck node tissue were used. RESULTS: We observed 72.7% (26 cases/36 cases) B-cell lineage expression and 27.8% (10 cases/36 cases) T-cell lineage expression in the cervical nodal of non-Hodgkin's lymphoma. The detection rate of EBV in the malignant lymphoma tissue was 27.8% (10 cases/36 cases) and 7.1% (2 cases/36 cases) in the normal neck node tissue. Of the B-cell lineage expression, EBV was detected in 6 cases (23.1%) and 4 cases (40.0%) in T-cell league expression. There was no statistical significance between the malignant lymphoma group and the normal group in the detection rate of EBV. However, the detection rate of EBV of the T-cell malignant lymphoma group was significantly higher compared with the normal group (p<0.05). CONCLUSION: These results suggest that the T-cell expression group of cervical nodal non-Hodgkin's lymphoma may be related to EBV.
Subject(s)
B-Lymphocytes , Classification , Herpesvirus 4, Human , Lymphoma , Lymphoma, Non-Hodgkin , Neck , Polymerase Chain Reaction , Prognosis , T-LymphocytesABSTRACT
Different techniques for culturing respiratory epithelial cells have been developed to overcome the limitations of studies on in vivo and on bioptic material. Traditionally, culture systems are divided into organ cultures, explant cultures and dissociated cell cultures. The first two contain both epithelial and non-epithelial cells. However, in monolayer cultures of dissociated cells only epithelial cells are present, the effects observed are caused by a pure epithelial responses. The purpose of this study is to establish primary culture method of human nasal epithelium (HNEC) by monolayer culture of dissociated cells to evaluate the role of the epithelial cells in the allergic and non-allergic nasal inflammatory reactions. HNEC was prepared by primary culture method of monolayer culture of dissociated cells from human inferior nasal turbinate mucosa of septal deviation patients. Primary cultured cells were characterized by indirect immunofluorescence assay and transmission electron microscopy. The immunoreactivities of cytokeratin-pan and cytokeratin No. 8 were observed in cultured HNEC. However, the immnoreactivities of vimentin and von Willebrand factor were not observed in cultured HNEC. The tonofilaments and desmosome were observed in cultured HNEC. The cultured epithelial cells were identified to be pure nasal epithelial cells. The monolayer culture of dissociated cells could successfully be employed for further study to investigate the role of the epithelial cells in allergic or non-allergic nasal inflammatory diseases.
Subject(s)
Humans , Cell Culture Techniques , Cells, Cultured , Desmosomes , Epithelial Cells , Fluorescent Antibody Technique, Indirect , Intermediate Filaments , Keratins , Microscopy, Electron, Transmission , Mucous Membrane , Nasal Mucosa , Organ Culture Techniques , Turbinates , Vimentin , von Willebrand FactorABSTRACT
The operative methods for the choanal atresia or stenosis are transseptal, transnasal, transpalatal and transmaxillary approaches. Among them, endoscopic transnasal approach provides excellent visualization and little age limitation. The use of CO2 laser in the management of choanal atresia enables the accurate incision and vaporization. We experienced a case of acquired bilateral choanal stenosis which developed after external irradiation for nasopharyngeal carcinoma. She presented with the symptoms of slowly progressive bilateral nasal obstruction and persistent nasal discharge for the past three years prior to visiting hospital. We successfully managed her by endoscopic transnasal repair with CO2 laser and found this technique to safe and simple.
Subject(s)
Choanal Atresia , Constriction, Pathologic , Lasers, Gas , Nasal Obstruction , VolatilizationABSTRACT
BACKGROUND: Inverted papilloma is a benign sinonasal tumor which is locally aggressive and has a significant malignant potential. Complete en bloc excision via lateral rhinotomy and medial maxillectomy has been the mainstay in the treatment in majority of patients. OBJECTIVES: The aim of this study is to evaluate clinical features and outcomes of surgical treatment according to various surgical approaches(external approach vs transnasal endoscopic approach) in the treatment of inverted papilloma of the nose and paranasal sinuses. MATERIALS AND METHOD: We retrospectively examined 24 cases of inverted papilloma of the nose and paranasal sinuses treated in our department from January 1990 to April 1995. We reviewed clinical features, radiologic findings, operative findings, association with malignancy, and outcomes of various surgical approaches. RESULTS: Fifteen patients underwent surgical excision. Of this patients followed up for at least 18 months, lateral rhinotomy was performed in 10 patients, midfacial deglobing in 1 patient and endoscopic surgery in 3 patients. The most common symptoms were nasal obstruction(93.3%) and nasal discharge(80.0%). Ten cases(66.7%) had history of previous nasal surgery. The lateral nasal wall was most frequent site of tumor involvement and concurrent involvement of the adjacent paranasal sinuses was observed in 11 cases. No recurrence was observed both external approach and transnasal endoscopic surgery. CONCLUSION: The optimal management of inverted papilloma of nose and paranasal sinuses is complete excision of tumor and choice of adequate surgical approach(external approach or transnasal endoscopic approach).
Subject(s)
Humans , Nasal Surgical Procedures , Nose , Papilloma, Inverted , Paranasal Sinuses , Recurrence , Retrospective StudiesABSTRACT
BACKGROUND: Orbital complications may be occured by means of surgical injury to lamina papyracea during endoscopic sinus surgery or intranasal ethmoidectomy. The frequency of orbital complications increases when the natural dehiscence of lamina papyracea(NDLP) with or without prolapse of orbital content into ethmoid sinus is present. OBJECTIVES: The aim of this study is to evaluate the incidence and radiologic characteristics of NDLP, and to evaluate association NDLP with anatomical variations of nasal cavity and paranasal sinuses. MATERIALS AND METHOD: The axial and coronal paranasal sinus CT scans of 183 patients with chronic paranasal sinusitis(366 sides) who had undergone endoscopic sinus surgery were retrospectively reviewed and analyzed. The incidence and radiologic features of NDLP, and the association NDLP with anatomical variations of paranasal sinus and nasal cavity were analyzed. RESULTS: The NDLP was found in 18 patients(9.8%, n=183 patients) or 22 sides(6.0%, n=366 sides). The most common site of NDLP was superior portion(45.5%) in coronal image of paranasal sinus CT scans and anterior ethmoid sinus area(68.2%) in axial image. Grade 1 of NDLP(86.4%) was observed most commonly. NDLP was not associated with anatomical variations of paranasal sinus. CONCLUSION: The incidence of NDLP with prolapse of orbital content is far beyond general expectation, and close preoperative evaluation of paranasal sinus CT scans is important to avoid possible orbital complications.
Subject(s)
Humans , Ethmoid Sinus , Incidence , Intraoperative Complications , Nasal Cavity , Orbit , Paranasal Sinuses , Prolapse , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: The fungal sinusitis is relatively rare but its incidence is increasing due to increasing use of antibiotics, steroids, and chemotherapheutic agents. It is reported that aspergillosis is the most common fungal infection among the fungi which involve the nasal cavity and paranasal sinuses. The surgical treatment of Aspergillus sinusitis were traditional Caldwell-Luc's operation with or without intranasal ethmoidectomy, or endoscopic sinus surgery. OBJECTIVES: The postoperative results and complications of Caldwell-Luc's operation in Aspergillus sinusitis have been enough to report, but there were a few reports about the endoscopic sinus surgery. So, we reported postoperative outcomes and complications of endoscopic sinus surgery in Aspergillus sinusitis. MATERIALS AND METHODS: Eleven cases of Aspergillus sinusitis of paranasal sinuses from April 1994 through April 1996 were analyzed on their clinical features, radiologic findings, operative findings, postoperative results, and complications. RESULTS: All cases were treated successfully by endoscopic sinus surgery. No recurrence and postoperative complications were observed. CONCLUSION: These results suggest that endoscopic sinus surgery is successful surgical method in Aspergillus sinusitis.
Subject(s)
Anti-Bacterial Agents , Aspergillosis , Aspergillus , Fungi , Incidence , Nasal Cavity , Paranasal Sinuses , Postoperative Complications , Recurrence , Sinusitis , SteroidsABSTRACT
Most malignant lesions of the middle ear and mastoid cavity are usually originated from the epithelium. The squamous cell carcinoma accounts for 75-90% of all malignant tumors in this localization. However, malignant lymphoma of the middle ear cleft is very rare condition and usually occurs as an extension from the temporal bone, affected along the other organs in generalized lymphoma. Also, primary presentation of malignant lymphoma in the middle ear cleft is very extremely rare and only seven cases could be traced in the available literature2)5)6)11)12)13)14). We present a very rare case of diffuse large cell type non-Hodgkin's malignant lymphoma with primary presentation in the middle ear cleft in 30 year-old male patient. So, the authors first report a case of malignant lymphoma of the middle ear cleft in Korea with review of literature.
Subject(s)
Adult , Humans , Male , Carcinoma, Squamous Cell , Ear, Middle , Epithelium , Korea , Lymphoma , Mastoid , Temporal BoneABSTRACT
No abstract available.
Subject(s)
DNA , Herpesvirus 4, Human , Nasopharyngeal Neoplasms , Polymerase Chain ReactionABSTRACT
No abstract available.
Subject(s)
Humans , Carcinoma, Squamous Cell , Head , Interleukin-2 , NeckABSTRACT
Microvascular tissue transfers have facilitated primary closure of various complex defects after radical ablation of head and neck cancers. From Oct 1991 to Feb 1992, we used forearm free flap in two patients and delto-pectoral flap in one patient who had preoperative irradiation for pharyngoesophageal reconstruction. The stricture and fistula formation were most troublesome complication in forearm free flap, so we designed as lazy S shape in distal flap margin to prevent circular contraction and longitudinal margin was deepithelialized (5 mm) and sutured double layer to withstand fistular formation and this can be considered useful in place of a free jejuna transfer.