Traumatic Pseudoaneurysm of the External and Internal Carotid Artery Presenting as Epistaxis: Case Report / 대한이비인후과학회지

Post-traumatic pseudoaneurysm of the carotid artery is extremely rare but present with progressively severe, often fatal epistaxis. Because temporal course of epistaxis in patients with traumatic pseudoaneurysm of the carotid artery commonly demonstrates a variable latency period, pseudoaneurysm is often a clinical challenge. Optimal management for this diseases demands rapid recognition and treatment to give the best functional outcome. The authors have experienced three cases of traumatic pseudoaneurysm of the carotid artery resulting in massive epistaxis and showing unusual clinical course that were successfully treated with endovascular techniques. In two patients, pseudoaneurysm formation resulted from hemorrhage of the internal carotid artery (ICA). The other one case resulted from the external carotid artery (ECA).

The Classification and Clinical Importance of the Anterior Attic Bony Plate on Temporal Bone CT / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Anterior attic bony plate (cog) is a coronally oriented bony septum which is suspended from the anterior petrosal tegmen, and the anterior epitympanic recess is partitioned from epitympanum by this bony plate. It is an important pathway for anterior drainage which can cause inflammation in obstructed conditions; therefore, it needs appropriate procedure to eradicate the lesions without recurrence. We aimed to classify types of the anterior attic bony plates on the temporal bone CT and to find correlation between the types of the anterior attic bony plates and the development of chronic otitis media and cholesteatoma. MATERIALS AND METHODS: We reviewed 264 cases of the temporal bone CT of the normal and the chronic otitis media patients, of which 64 cases were excluded as lesions could not be identified due to severe destruction and obscurity of the figure. RESULTS: In normal ears, the incidence of the anterior attic bony plate was 67% in the plate type, 28% in the pyramid type, and 5% in the anterior type. In the diseased ear, the incidences were 40%, 44%, 16%, in the plate type, pyramid type, and anterior type, respectively and in the cholesteatoma ear, 30%, 43%, 27%, respectively. The difference of incidence was statistically significant. CONCLUSION: We assumed that the development of the chronic otitis media is related to the type of the anterior attic bony plate in some degree. Especially, the anterior type was more prominent in cholesteatoma than in noncholesteatoma with a statistical significance. Further studies are needed to figure out the correlation between the type of the anterior attic bony plate and it's clinical importance.

Isolated Sphenoid Sinus Lesion: A Clinical Analysis of 17 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An isolated sphenoid sinus lesion is a rare disorder and is difficult to diagnose for several reasons. This lesion can easily spread to the adjacent structures and lead to severe complications. Thus, early diagnosis and treatments are needed. We experienced 17 cases of isolated sphenoid sinus lesions, including inflammatory, neoplastic, and vascular lesions, and reviewed the clinical findings, radiologic features, treatments and complications of these cases. MATERIALS AND METHOD: Isolated sphenoid sinus lesions were reviewed retrospectively of patients from January 1995 to July 2001. Patients were identified with radiologic findings and intraoperative endoscopic findings excluding other paranasal sinus involvements. RESULTS: The most common symptom was headache, and 13 patients (76%) complained. Nasal symptoms appeared only 4 patients (23%). Pathologic reviews showed 9 cases of acute and chronic sinusitis were 9 cases, 4 fungal sinusitis, 2 neoplastic diseases, 1 polyp, and 1 vascular disease. We carried out medical treatment in 5 cases, and diagnostic biopsy in 3 cases, and therapeutic surgery in 10 cases. In 7 cases, complications including cranial nerve palsy were observed, and 1 patient was expired due to meningitis. CONCLUSION: We can diagnose isolated sphenoid sinus lesions exactly with the use of radiologic findings and endoscopic examinations. With endoscopy, we can operate relatively less invasively and more effectively. It is apparent that early recognition and rapid treatment are essential if complications are to be avoided.