Association of Dietary Factors with Presence and Severity of Septal Deviation: Results of the Korean National Health and Nutrition Survey 2010–2012 / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#The data of Korean National Health Survey from 2010 to 2012 were used to analyze the correlation between the westernized dietary style with the incidence of septal deviation in the Korean population.SUBJECTS AND METHOD: A total of 25532 candidates between the ages of 13–97 was analyzed with their nutrition uptake, body characteristic differences, and the incidence of septal deviation. Inclusion criteria for the candidate were normal values for the smell test, no rhinological abnormalities, and patients who underwent all of the otolaryngologic examinations. Nutrition uptake of the following was examined: total energy uptake per day (kcal), total daily uptake of food, carbohydrate, protein, fat, water (g), total daily uptake of fiber, potassium, calcium, phosphate, iron, and sodium (mg). Each category was examined, compared, and analyzed to investigate a possible relationship with the incidence of septal deviation.@*RESULTS@#When height, waist, and body mass index (BMI) were categorized according to sex and analyzed for relationship with the incidence of disease, the male group showed a positive correlation with the incidence of septal deviation in all three factors. BMI, an important clinical predictive factor for physical growth, showed a positive relationship for obesity rate and septal deviation with the males aged between 10 and 20.@*CONCLUSION@#Males in their 10's and 20's are the most affected by the westernized diet change; therefore, we believe that this is the reason for this age group's association with a higher septal deviation incidence rate compared to other age group.

Association of Dietary Factors with Presence and Severity of Septal Deviation: Results of the Korean National Health and Nutrition Survey 2010–2012 / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The data of Korean National Health Survey from 2010 to 2012 were used to analyze the correlation between the westernized dietary style with the incidence of septal deviation in the Korean population. SUBJECTS AND METHOD: A total of 25532 candidates between the ages of 13–97 was analyzed with their nutrition uptake, body characteristic differences, and the incidence of septal deviation. Inclusion criteria for the candidate were normal values for the smell test, no rhinological abnormalities, and patients who underwent all of the otolaryngologic examinations. Nutrition uptake of the following was examined: total energy uptake per day (kcal), total daily uptake of food, carbohydrate, protein, fat, water (g), total daily uptake of fiber, potassium, calcium, phosphate, iron, and sodium (mg). Each category was examined, compared, and analyzed to investigate a possible relationship with the incidence of septal deviation. RESULTS: When height, waist, and body mass index (BMI) were categorized according to sex and analyzed for relationship with the incidence of disease, the male group showed a positive correlation with the incidence of septal deviation in all three factors. BMI, an important clinical predictive factor for physical growth, showed a positive relationship for obesity rate and septal deviation with the males aged between 10 and 20. CONCLUSION: Males in their 10's and 20's are the most affected by the westernized diet change; therefore, we believe that this is the reason for this age group's association with a higher septal deviation incidence rate compared to other age group.

A Case of Maxillary Sinus Spindle Cell Sarcoma: Alert to Polyurethane Associated Malignancy / 대한이비인후과학회지

There has been no literature that reports a case of sino-nasal malignancy associated with polyurethane implants. However, several previous in vitro and animal model studies revealed that polyurethane implants may cause malignancy in body tissue. In this report, we describe a case of maxillary sinus spindle cell sarcoma diagnosed in a 59-year-old man who had undergone polyurethane nasal packing in the nasal cavity following endoscopic sinus surgery two years ago. Complete removal of the packing material was not confirmed as the patient has not returned for postoperative care. Although there are no direct evidence of association between this spindle cell sarcoma case and polyurethane nasal packing, surgeons should be alert to the complete removal of polyurethane nasal packing after sino-nasal surgery.

A Case of Multiple Osteomas in the External Auditory Canal / 대한이비인후과학회지

Osteoma is a benign neoplasm that can occur and extend beyond the nearest region in the external auditory canal (EAC); however, a multiple growth of the tumor in the ipsilateral ear has never been reported. A 41-year-old male patient having a past history of uncertain chronic otitis media complained of recent otalgia and progressive hearing loss in the same ear. Physical examination showed that two hard masses arising from both anterior and posterior aspect of the right EAC were contacting each other and obstructing most of the lumen. High resolution computed tomography scan revealed not only two growing exophytic bone lesions causing EAC stenosis but also inflammation of the middle ear and sclerotic mastoid cavity. We performed excision and middle ear surgery at the same time. Both specimens were pathologically confirmed as osteomas, so we report this unusual case with a review of literature.

Musculus Uvulae Shortening for the Treatment of Snoring

BACKGROUND AND OBJECTIVES: We investigated the effectiveness of shortening the uvula muscle for the treatment of snoring. This new and simple procedure was developed to promote the elevation of the uvula position using a minimally invasive technique. SUBJECTS AND METHODS: Fifteen habitual snorers were included in this study. In order to find the exact anatomical position of the uvula muscle, we first dissected the soft palate of a cadaver to better understand the exact anatomical location and structure of the uvula muscle. With this result, we developed a new surgical technique for treating snoring. The results of our surgery were evaluated by both the patient and bed partner before surgery, at 30 days, and 90 days after surgery respectively using the visual analogue scale (VAS). RESULTS: Post-operative physical examinations showed superiorly displaced uvula position. The lower half of the soft palate and uvula were also anteriorly flexed. Those findings remained unaltered beyond the 90th post-operative day. The patient and bed partner snoring symptoms assessed by VAS were significantly improved compared to the pre-treatment values (p<0.05). CONCLUSION: The uvula muscle shortening is an effective and simple method for the treatment of snoring.

Frontal Sinus Reconstruction with Medpore(R) in Oncocytic Schneiderian Papilloma with Bone Destruction / 대한이비인후과학회지

The cylindrical cell papilloma, also known as oncocytic Schneiderian papilloma, is a rare benign sinonasal neoplasm. It accounts for 2-6% of the total sinonasal papillomas. Due to its rare incidence, this disease is not well-understood by clinicians. Recently, we experienced a case of cylindrical cell papilloma which was originated from the frontal sinus with bony destruction and had extended into the anterior ethmoid sinus in a 69-year old female patient. We adopted the frontal sinus approach via eye glass incision and removed the tumor thoroughly. The anterior wall of the frontal sinus was reconstructed with Medpore(R), and we thus report on the treatment of this case, along with a review of literature.

Are Cross-hatching Incisions Mandatory for Correction of Cartilaginous Septal Deviation?

OBJECTIVES: Cross-hatching incisions have been considered mandatory for correcting cartilaginous septal deviation. We evaluated the clinical outcome of septoplasty without cross-hatching incisions to determine the necessity for making septal cartilage incisions. METHODS: The reconstructed septal components during septoplasty were categorized into four anatomical areas: vomer, maxillary crest, perpendicular plate of ethmoid (PPE) and septal cartilage (the area for cross-hatching incisions). During septoplasty, we attempted to complete the surgery only by removing or fracturing the bony part of the septum without cross-hatching incisions on the cartilage. Only in the cases that the deviation was not immediately corrected, the cross-hatching incisions were made onto the cartilage at the end of the procedure. We analyzed the frequency of manipulating the septal components. The changes of symptoms were evaluated using a modified nasal obstruction symptom evaluation (NOSE) scale and a visual analog scale (VAS) preoperatively, 1 and 3 months after the surgery. RESULTS: Seventy five percents of the deviated septums were immediately corrected only by removing or fracturing of the bony septal components. In decreasing order of frequency, the sepal components for correcting septal deviation were the vomer (59%), maxillary crest (49%), septal cartilage (cross-hatching only: 25%) and PPE (15%). The modified NOSE scale and the VAS demonstrated significant improvement of the nasal symptoms postoperatively (P<0.05). CONCLUSION: Most of septal deviations could be corrected by manipulating only the bony septum. The results of this procedure were not different from conventional septoplasty with cross-hatching incisions. Our data suggest cross-hatching incisions during septoplasty might have been overemphasized and that the main cause for cartilaginous deviation may be the extrinsic forces that are generated by the neighboring bony structures.

Are Cross-hatching Incisions Mandatory for Correction of Cartilaginous Septal Deviation?

OBJECTIVES: Cross-hatching incisions have been considered mandatory for correcting cartilaginous septal deviation. We evaluated the clinical outcome of septoplasty without cross-hatching incisions to determine the necessity for making septal cartilage incisions. METHODS: The reconstructed septal components during septoplasty were categorized into four anatomical areas: vomer, maxillary crest, perpendicular plate of ethmoid (PPE) and septal cartilage (the area for cross-hatching incisions). During septoplasty, we attempted to complete the surgery only by removing or fracturing the bony part of the septum without cross-hatching incisions on the cartilage. Only in the cases that the deviation was not immediately corrected, the cross-hatching incisions were made onto the cartilage at the end of the procedure. We analyzed the frequency of manipulating the septal components. The changes of symptoms were evaluated using a modified nasal obstruction symptom evaluation (NOSE) scale and a visual analog scale (VAS) preoperatively, 1 and 3 months after the surgery. RESULTS: Seventy five percents of the deviated septums were immediately corrected only by removing or fracturing of the bony septal components. In decreasing order of frequency, the sepal components for correcting septal deviation were the vomer (59%), maxillary crest (49%), septal cartilage (cross-hatching only: 25%) and PPE (15%). The modified NOSE scale and the VAS demonstrated significant improvement of the nasal symptoms postoperatively (P<0.05). CONCLUSION: Most of septal deviations could be corrected by manipulating only the bony septum. The results of this procedure were not different from conventional septoplasty with cross-hatching incisions. Our data suggest cross-hatching incisions during septoplasty might have been overemphasized and that the main cause for cartilaginous deviation may be the extrinsic forces that are generated by the neighboring bony structures.

Clinical Study on the Reliable Temporal Bone Fracture Classification Scheme / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Until now, the temporal bone fracture patient has been classified mostly according to the classic definition of transverse or longitudinal one, but it is often obscure and has problems of discrepancy in correlation with otologic symptoms. So we investigated the practicality of other noticeable reporting schemes for reasonable adoption. SUBJECTS AND METHOD: We thoroughly reviewed the medical records of the temporal bone fracture patients in past two years. And high resolution CT images were also re-evaluated by the senior radiologist using traditional and newer (otic capsule sparing vs. otic capsule violating, petrous vs. nonpetrous) classification schemes. RESULTS: A total of 61 cases were identified as temporal bone fracture. Among various symptoms, only sensorineural hearing loss was significantly higher in the transverse type of traditional scheme and in otic capsule violating fracture. Symptoms such as subjective and verified hearing loss including conductive hearing loss and ear fullness were higher in nonpetrous fracture (p<0.05). CONCLUSION: Traditional and otic capsule scheme correlated poorly with clinical presentation, whereas the petrous classification was better matched with main symptoms. Therefore, the petrous scheme was suggested as the more discriminative classification plan of temporal bone fracture to predict its sequela.