Clinical Analysis of Cervical Neurilemmoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Neurilemmoma is a benign tumor originating from the spinal nerve root, peripheral nerve and all kinds of cranial nerves except the optic nerve and olfactory nerve. Approximately 25% to 40% of all neurilemmomas are found in the neural structures of the head and neck. We performed this study to analyze the clinical features, diagnosis, treatment and prognosis of neurilemmomas. SUBJECTS AND METHOD: Twenty-one patients who were diagnosed with cervical neurilemmoma and had received treatment at the Department of Otolaryngology-Head and Neck Surgeries from 1994 to 2004 were analyzed retrospectively. RESULTS: The mean age of 21 patients was 41.0 years, with 10 being male and 11 female. The most common symptom was palpable neck mass and the mean duration of symptoms was 28.2 months. The most common location of tumor was level II and the most common nerve of origin was the vagus nerve (23.8%). Preoperative diagnostic tools were FNA, CT and MRI. Operation was most commonly performed via transcervical approach. In 10 cases, nerves of origin were preserved, whereas, in 5 cases, nerves of origin were sacrificed and in 6 cases, nerves of origin were not found. The postoperative complications were vocal cord palsy (14.3%), arm weakness (14.3%), facial weakness (9.5%), Horner's syndrome (9.5%), sensory (4.8%) and motor (4.8%) impairment of tongue. The mean follow-up period was 5.3 years and recurrence was not found during this period. CONCLUSION: CT or MRI is more helpful than FNA in the diagnosis of neurilemmoma. In excising neurilemmoma, the nerve must be preserved as much as possible.

Correlation between Quality of Life and Personality, Behavior Problem in Children with Sleep Disordered Breathing / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sleep disordered breathing (SDB) in children can have an effect on the quality of life as it may produce sleep disturbance, physical symptoms, and emotional distress in daytime function. It may also lead to the change of children's personality and behavior. We aimed to estimate the impact of SDB in children on the quality of life and the correlation between the quality of life and personality or behavioral problem. SUBJECTS AND METHOD: A total of 116 children aged 4 through 15 years old (M: 79, F: 37) with symptoms of snoring, mouth breathing, sleep apnea and physical examination results demonstrating tonsillar size of 3+ or greater were included. Two standard questionnaires, K-CBCL (Korean Child Behavior Checklist) and KPI-C (Korean Personality Inventory for Children) were used for evaluation of personality and behavior in children, and then a clinical analysis was carried out by pediatric psychologist for interpretation. To evaluate the quality of life in children, two other standard questionnaires, KOSA-18 (Korean Obstructive Sleep Apnea-18 Survey) and KOSA-6 (Korean Obstructive Sleep Apnea-6 Survey), were given to the parents of the children to complete. RESULTS: There was a significant correlation between the KOSA-18 score and the K-CBCL total problem behavior T score, the mean of KPI-C T scores (R=0.513, R=0.435 respectively), KOSA-6 score and K-CBCL total problem behavior T score, the mean of KPI-C T scores (R=0.347, R=0.398 respectively). CONCLUSION: In children, the larger the impact of SDB on the quality of life is, the higher the rate of personality or behavioral problem is. Therefore, the early and active treatment is needed in children with SDB who are scored highly by KOSA-18 or KOSA-6.

Clinical Analysis of The Thyroid Papillary Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Papillary carcinoma of the thyroid is the most common malignant neoplasm in the thyroid gland. We performed this study for the purpose of getting further understanding and more supporting ideas for the diagnosis and treatment of thyroid papillary cancer. SUBJECTS AND METHOD: One hundred seventy eight cases of papillary carcinoma of thyroid gland who had been diagnosed and had received treatment at the department of otolaryngology-Head and neck surgery at the Korea university hospital from 1992 to 2001 were analyzed retrospectively. RESULTS: The mean age of cases was 43.6 years in females and 47.9 years in males. The most common symptom was anterior neck mass. Symptoms were usually presented within three months. The size of thyroid mass was not related to the duration of illness. The most frequently performed operative procedure was total thyroidectomy (76.4%). The post operative complications were temporary vocal cord palsy (4.5%), iatrogenic vocal cord palsy (1.7%), temporary hypocalcemia (16.9%) and permanent hypocalcemia (3.9%). Of all patients, 43 (24.1%) had preoperatively metastatic cervical nodes. Of the 175 patients, 52 (29.2%) had postoperative nodal metastasis. Local recurrences had occurred in 17 patients (9.6%). According to the AMES classification, 114 cases (64.1%) fell into the low risk group and 64 cases (35.9%) to the high risk group. The 10-year survival rate was 100% for the low risk group but 91.2% for the high risk group. The 10-year disease free survival rate was 92% for the low risk and 81.2% for the high risk group. CONCLUSION: We reaffirmed that the clinical characteristics of thyroid papillary cancer corresponded with the reports of other foreign studies. We suggest that this study needs to be followed up by a larger, long-term research.

Wegener's Granulomatosis Involving Nasal Cavity / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Wegener's granulomatosis is a chronic multisystem vasculitis. The otolaryngologist has an important role in the early diagnosis of Wegener's granulomatosis because of the high incidence of nasal involvement. In this study, we analyze seven cases of Wegener's granulomatosis involving nasal cavity and describe clinical features, laboratory findings, treatments and outcomes. MATERIALS AND METHOD: Selected for this study were 7 inpatients with Wegener's granulomatosis treated at the department of otolaryngology of Korea University Medical Center from January, 1985 and December, 2002. Their clinicopathologic records were reviewed retrospectively. RESULTS: The nasal manifestations included nasal crusting, nasal obstruction, serous and bloody nasal discharge, septal perforation and saddle nose. All patients showed positive cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) and an elevated erythrocyte sedimentation rate (ESR). Wegener's granulomatosis was confirmed by the results of nasal mucosal biopsy performed in all patients. CONCLUSION: If multiple and large biopsy sites were selected properly, the diagnostic efficacy of nasal biopsy in Wegener's granulomatosis may increase and it may help early diagnosis since nasal mucosa is the most commonly affected site in Wegener's granulomatosis and nasal cavity is an easily accessible biopsy site.