A Case of Lateral Ectopic Thyroid Mimicking the Metastatic Lymphadenopathy / 대한이비인후과학회지

Ectopic thyroid means that thyroid tissue is present at an unusual area rather than at the orthotropic thyroid position. The most common form of ectopic thyroid is lingual thyroid, followed by thyroglossal duct cyst. Ectopic thyroid in the lateral neck area is extremely rare, with only a few case reports found in the literature review. Several studies recommended that metastasizing malignancy should be considered in lateral ectopic thyroid. Described here is a case of 60 year-old woman with lateral ectopic thyroid, which was newly found during a follow-up and was mistaken for metastatic lymphadenopathy.

Comparison of the Postoperative Outcome for Pediatric Obstructive Sleep Apnea According to the Type of the Tonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#Partial intracapsular tonsillectomy and adenoidectomy (PITA) has become a well-recognized technique for tonsillectomy in children. Several studies have reported that PITA shows better postoperative morbidity compared to the conventional technique. However, there is still concern about the regrowth of remnant tonsil tissues. The authors evaluated the postoperative results of PITA, combined extracapsular and intracapsular tonsillectomy, and conventional tonsillectomy.SUBJECTS AND METHOD: The authors studied 97 children (male: 62, female: 35) aged 2 to 13 years old, who underwent tonsillectomy and adenoidectomy (PITA, combined extracapsular and intracapsular tonsillectomy, and conventional tonsillectomy). The degree of adenotonsillar hypertrophy, apnea-hypopnea index and lowest oxygen saturation was confirmed for all subjects. Operation time, quality of life, scale for postoperative pain, frequency of postoperative bleeding, and recurrence with tonsillar regrowth were compared after surgery performed by different surgical procedures.@*RESULTS@#Regardless of the surgical technique, all the cases presented significant improvement in the quality of life before and after surgery. On the day of surgery and four days after surgery, PITA showed superior results in terms of postoperative pain level compared to the conventional technique. There were no statistically significant results with respect to the operation time and postoperative bleeding. Six months after the surgery, the recurrence of sleep apnea due to the regrowth of remaining tonsil was not obvious.@*CONCLUSION@#Tonsillectomy technique preserving tonsillar capsule may show better results on early postoperative pain. It can be a good alternative to the conventional technique in surgical treatment for pediatric obstructive sleep apnea in terms of early postoperative pain control.

Extranasopharyngeal Angiofibroma of the Nasal Septum: A Case Report

Angiofibroma is benign hypervascular tumor that usually occurs in the nasopharynx of adolescent male patient and rarely originates from outside of the nasopharynx, called extranasopharyngeal angiofibroma. The clinical and radiologic findings of extranasopharyngeal angiofibroma are similar to other hypervascular tumors, which may delay diagnosis and treatment. We present a case of extranasopharyngeal angiofibroma arising from nasal septum of a 43-year-old male who complained of right nasal obstruction. Contrast enhancement CT revealed a hypervascular tumor of the nasal septum and the tumor was removed by endoscopic resection. Histopathologic examination confirmed the diagnosis of angiofibroma.

Comparison of the Postoperative Outcome for Pediatric Obstructive Sleep Apnea According to the Type of the Tonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Partial intracapsular tonsillectomy and adenoidectomy (PITA) has become a well-recognized technique for tonsillectomy in children. Several studies have reported that PITA shows better postoperative morbidity compared to the conventional technique. However, there is still concern about the regrowth of remnant tonsil tissues. The authors evaluated the postoperative results of PITA, combined extracapsular and intracapsular tonsillectomy, and conventional tonsillectomy. SUBJECTS AND METHOD: The authors studied 97 children (male: 62, female: 35) aged 2 to 13 years old, who underwent tonsillectomy and adenoidectomy (PITA, combined extracapsular and intracapsular tonsillectomy, and conventional tonsillectomy). The degree of adenotonsillar hypertrophy, apnea-hypopnea index and lowest oxygen saturation was confirmed for all subjects. Operation time, quality of life, scale for postoperative pain, frequency of postoperative bleeding, and recurrence with tonsillar regrowth were compared after surgery performed by different surgical procedures. RESULTS: Regardless of the surgical technique, all the cases presented significant improvement in the quality of life before and after surgery. On the day of surgery and four days after surgery, PITA showed superior results in terms of postoperative pain level compared to the conventional technique. There were no statistically significant results with respect to the operation time and postoperative bleeding. Six months after the surgery, the recurrence of sleep apnea due to the regrowth of remaining tonsil was not obvious. CONCLUSION: Tonsillectomy technique preserving tonsillar capsule may show better results on early postoperative pain. It can be a good alternative to the conventional technique in surgical treatment for pediatric obstructive sleep apnea in terms of early postoperative pain control.

A Case of Lateral Ectopic Thyroid Mimicking the Metastatic Lymphadenopathy / 대한이비인후과학회지

Ectopic thyroid means that thyroid tissue is present at an unusual area rather than at the orthotropic thyroid position. The most common form of ectopic thyroid is lingual thyroid, followed by thyroglossal duct cyst. Ectopic thyroid in the lateral neck area is extremely rare, with only a few case reports found in the literature review. Several studies recommended that metastasizing malignancy should be considered in lateral ectopic thyroid. Described here is a case of 60 year-old woman with lateral ectopic thyroid, which was newly found during a follow-up and was mistaken for metastatic lymphadenopathy.

A Case of Epithelioid Hemangioendothelioma on the Choana

Epithelioid hemangioendothelioma is a rare vascular tumor with intermediate malignity and metastasis risk. It presents epithelioid cells with intracytoplasmic vacuoles and low mitotic activity. Its vascular nature can be confirmed by immunohistochemical studies (vimentin, CD31, CD34, and factor VIII). It is extremely rare in the nasal cavity, with only one case reported on the middle turbinate in Korea. The authors present a case of epithelioid hemangioendothelioma on the choana with a size of 2mm, which easily coult have been misdiagnosed as a blood clot.

Low-Grade Fibromyxoid Sarcoma Arising in Posterior Nasal Cavity: Case Report and Review of the Literature / 대한이비인후과학회지

Low-grade fibromyxoid sarcoma (LGFMS), a soft tissue tumor that has high recurrence and metastasizing potential, rarely occurs in the head and neck region. Therefore, the treatment for LGFMS in the facial area is challenging in terms of cosmetic and functional maintenance. The authors report a case of LGFMS in the posterior nasal cavity. It was completely removed in parallel with the nasal endoscopic and oral approach, but the lower margin was closed by preserving the soft palate. The patient is well without any recurrence or metastasis after 5 years of follow-up.

C-Reactive Protein and High Blood Pressure are the Predictive Factors of Deciding the Surgical Treatment in Deep Neck Infection: A Retrospective Cohort Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In clinical settings, some deep neck infections may be managed by conservative treatment but some still require surgical treatment. In this study, we use univariate and multivariate analysis to discuss whether or not there are significant differences between conservative treatment and surgical treatment on patients with deep neck infections. SUBJECTS AND METHOD: We conducted a retrospective analysis using medical records of 88 patients with deep neck infections from January 2010 to December 2015. Among 88 patients, 56 patients were managed by conservative treatment with antibiotics and 32 patients were managed by surgical treatment via transcervical approach with antibiotics. As for data analysis, Mann-Whitney U test and multiple logistic regression analysis was used. RESULTS: Age, duration from symptom onset to hospitalization, hospital days, incidence of underlying disease, white blood cell count, erythrocyte sedimentation rate, and C-reactive protein (CRP) were found higher in the surgical treatment group than in the conservative treatment group. But there was no statistical significance except for the incidence of high blood pressure and CRP. CONCLUSION: CRP and incidence of high blood pressure were significant predictive factors for choosing the surgical treatment in deep neck infection. Contrary to our expectations, the incidence of diabetes mellitus was not a significant factor that determined the treatment options for the patients with deep neck infection.

The Results of Unilateral Osteotomy to Correct the Deviated Nose / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Osteotomy, usually carried out bilaterally, is a commonly performed procedure to correct the bony dorsum of deviated nose. However, it is an invasive maneuvers which can affect the stability of nasal bone and develop complications, such as, edema and ecchymosis. This study aims to evaluate the usefulness of unilateral osteotomy in correcting a deviated nose with various scoliosis. SUBJECTS AND METHOD: We studied 9 of the 69 patients who underwent corrective rhinoplasty with unilateral osteotomy to correct the bony nasal dorsum between 2010 and 2014. For patients whose bony nasal dorsum was corrected well after performing osteotomy on the convex side of the bony dorsum, the opposite side was not operated on; however, if correction was incomplete, osteotomy was additionally performed on the opposite side. For this study, patients who underwent bilateral osteotomy were excluded from the study. The improvement of correction was assessed by comparing the preoperative and postoperative photos. RESULTS: Of the nine patients treated with unilateral osteotomy, 5 cases were C or reverse C type deviations, 1 case was S type deviation and 3 were straight deviations. Five of the nine patients improved greatly and the rest improved significantly. None of the patients experienced worsening change postoperatively. CONCLUSION: Osteotomy is essential but invasive maneuver, so it is desirable to reduce the number of times to execute. By performing osteotomy on the convex side of the nose first, we can correct the deviated nose effectively while reducing the number of implementation.

Nasal Obstruction and Palate-Tongue Position on Sleep-Disordered Breathing

OBJECTIVES: We wanted to evaluate whether the presence of nasal obstruction makes a change on the association between the modified Mallampati score and the severity of sleep-disordered breathing (SDB) and the sleep quality. METHODS: Polysomnography (PSG), the modified Mallampati score (MMS), the body-mass index, and a questionnaire about nasal obstruction were acquired from 275 suspected SDB patients. The subjects were divided into two groups according to the presence of nasal obstruction. The clinical differences between the two groups were evaluated and the associations between the MMS and PSG variables in each group were also assessed. RESULTS: Significant correlations were found between the MMS and many PSG variables, including the apnea-hypopnea index, the arousal index and the proportion of deep sleep, for the patients with nasal obstruction, although this was not valid for the total patients or the patients without nasal obstruction. CONCLUSION: The severity of SDB and the quality of sleep are well correlated with the MMS, and especially for the patients with nasal obstruction. The MMS can give more valuable information about the severity of SDB when combined with simple questions about nasal obstruction.