The Practical Role of Nasal Bone CT in the diagnosis of Nasal Bone Fractures / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The accurate diagnosis of nasal bone fracture by means of simple radiographs and physical examination is difficult in cases of severe soft tissue swelling or minimally displaced fracture. The purpose of this study is to evaluate the practical effectiveness of nasal bone CT for the diagnosis of nasal bone fracture. MATERIALS AND METHODS: The authors reviewed nasal bone CT and simple radiographs of 11 patients with nasal bone injury who were suspected to have nasal bone fracture after history taking and physical examinations. The nasal bone fracture was classified as one of three types on nasal bone CT : type I (simple fracture), type II (simple fracture with displacement) and type III (comminuted fracture). Associated facial bone injuries were also evaluated and simple radiographs of nasal bone were reviewed for comparison. RESULTS: Nine out of eleven patients showed followingfracture lines on nasal bone CT: 3 cases of type I, 4 cases of type II, and 2 cases of type III. Seven out of eleven patients showed fracture lines on simple radiographs, but one patient out of those seven showed no fracture lines on CT. Four patients showed no fracture lines on simple radiographs, but three of them showed fracture lines on CT. Out of three cases of type I fracture, only two cases were detected on plain radiographs. Four patients showed complicated nasal septal fracture on CT, which could not be detected on simple radiographs. One other patient had fracture of the frontal process of maxilla. Conclusion: Nasal bone CT is a useful tool for diagnosis of nasal bone fracture since it provides accurate identification and evaluation of associated injuries such as nasal septal fracture.

Acoustic Analysis of Benign Vocal Cord Lesions: Before and after Microlaryngeal Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Benign vocal cord lesions that are not responsive to medical and/or speech therapy are often treated by microlaryngeal surgery. The purpose of this study is to measure selected acoustic parameters to document quantitative changes in vocal quality before and after microlaryngeal surgery and to analyze differences of prognosis for various benign vocal cord lesions, such as vocal cord polyp, vocal cord nodule, and Reinke's edema. MATERIALS AND METHODS: The authors used a computerized acoustic analysis program (CSL-MDVP) to measure mean fundamental frequency (Fo), jitter, shimmer, and noise to harmonics ratio (NHR) from voice samples of selected patients who had benign vocal cord lesions before and after at least 10 weeks of surgery. RESULTS: The values of Fo and NHR showed no significant difference in all three groups. There was significant improvement in nodule regarding jitter. Also, there was significant improvement in the vocal cord polyp regarding jitter and shimmer. CONCLUSION: Jitter and shimmer will be effective acoustic parameters in documenting the quantitative changes in vocal quality before and after microlaryngeal surgery.

Acoustic Analysis of Voice in Individuals with Amyotrophic Lateral Sclerosis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Amyotropic lateral sclerosis (ALS) is a progressive neuromuscular disease that involves degeneration of upper motor neurons in the cortex and lower motor neurons in the brain stem and spinal cord. Although there is a decline in the articulatory dysfunction, respiratory, and phonatory dysfunctions are known to occur in ALS. However, the pattern of disease progression and early identification of phonatory changes are not well documented. The purpose of this study was to compare selected acoustic parameters of voice in the normal control group to the ALS group who were perceptually free of vocal symptoms. Significant differences between the two groups could indicate that signs of bulbar degeneration in ALS may be present even when the voice is clinically perceived as normal. MATERIALS AND METHODS: The authors used a computerized acoustic analysis program (CSL-MDVP) to measure mean fundamental frequency (Fo), jitter, shimmer, and noise to harmonics ratio (NHR) from voice samples of ALS patients and compared this results with the acoustic parameters of 60 control subjects (men: 30, women: 30) who have no history of neurologic disease and were over 60 years old. RESULTS: There were significant group differences for jitter, shimmer, and NHR in male ALS. There was significant group difference for jitter in female ALS. CONCLUSION: Certain acoustic measures of voice may be sensitive indicators of early laryngeal deterioration in ALS. Acoustic analysis of voice may be one way of detecting aberrant vocal features before the human ear detects dysphonia, and jitter may be the most sensitive acoustic variable.

Four Cases of Sinonasal Tuberculosis / 대한이비인후과학회지

Tuberculosis of the nose and paranasal sinuses is so rare that only 43 cases of primary tuberculosis of paranasal sinuses had been reported in literature worldwide. Recently, the authors have experienced 4 cases of tuberculosis developed in the nose and/or paranasal sinuses. We reviewed medical records, radiological and histopathological findings of these cases to find out the clinical features and treatment outcome. Chief complaints of patients were cheek swelling or nasal obstruction. One case had inactive pulmonary tuberculosis on the chest X-ray film, whereas the others had no evidence of previous tuberculosis infection. All cases revealed abnormalities in the maxillary sinuses. One case was diagnosed with tuberculosis after a tissue biopsy from the inferior turbinate, and the others were diagnosed with tissue biopsies from the maxillary sinus mucosa taken during endoscopic sinus surgery or Caldwell-Luc's operation. Histopathologic examinations revealed granulommatous inflammation and caseation necrosis. All cases showed positive reactions in acid fast bacteria (AFB) staining or culture for AFB. Patients were managed with periodic nasal dressing and antituberculous chemotherapy over 9 months and they became free of symptoms.