Nasal and Exhaled Nitric Oxide in Allergic Rhinitis

OBJECTIVES: The primary aim of this study was to assess whether one can use levels of nasal nitric oxide (nNO) and exhaled nitric oxide (eNO) as a means of evaluation in allergic rhinitis. METHODS: We used a chemiluminescence analyzer to measure nNO and eNO in normal controls (n=34) and allergic rhinitis patients (n=35), and compared these measurements with various parameters of clinical symptoms and laboratory data. RESULTS: Mean nNO (389+/-119 ppb) in allergic rhinitis patients was significantly higher than normal controls (276+/-88 ppb). Without asthma, mean eNO (64.8+/-55.9 ppb) in allergic rhinitis patients was significantly higher than normal controls (33.0+/-24.0 ppb). In the persistent allergic rhinitis group, eNO concentration was significantly higher, while nNO concentration was significantly lower than the intermittent group. CONCLUSION: We can use nNO and eNO levels for evaluation of allergic rhinitis. However, we should consider the fact that nNO levels can be reduced, when symptoms are severe and long-lasting. Additionally, in allergic rhinitis, eNO can be elevated without asthma.

Surgical Approach for Oropharyngeal Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In order to eradicate the disease and preserve function of oropharynx and facial contour, appropriate surgical approach should be chosen for surgical treatment of oropharyngeal cancer. This study was performed to evaluate the usefulness and effectiveness of various surgical approaches in the surgical treatment of oropharyngeal cancer. SUBJECTS AND METHOD: We analyzed 65 patients with oropharyngeal cancer who underwent surgery as a primary treatment from Jan. 1994 to Jun. 2009, retrospectively. Primary tumor site, TNM stage, surgical approach, management of neck, reconstruction method, complication, recurrence rate were analyzed to assess advantages and disadvantages of various surgical approaches. RESULTS: The surgical approaches applied were transoral approach in 25, mandibulotomy in 23, lower cheek flap in 4, trans-pharyngeal in 9, and mandibular lingual releasing approach in 4. Most of T1 lesion was resected by transoral approach (65.0%). For advanced T3 and T4, mandibulotomy was mainly used. Lateral pharyngotomy and mandibular lingual release approach were used for the surgery of moderate size of oropharyngeal cancer. The locoregional recurrence rate did not differ according to different surgical approaches with regard to T and N stages. CONCLUSION: Transoral approach is very useful for the most of small oropharyngeal cancer. Mandibulotomy provides most wide surgical view for advanced T3, T4 oropharyngeal cancer.

Measurement of Nasal and Exhaled Nitric Oxide in Nasal Disease / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) is present in high concentrations in the upper respiratory tract. The physiological role of this mediator is to contribute to the local host's defense, modulate ciliary motility and serve as an aerocrine mediator in helping to maintain adequate ventilation-perfusion matching in the lung. SUBJECTS AND METHOD: The purpose of the study was to assess the relationship of nasal NO (nNO) and exhaled NO (eNO) in nasal airway disease patients. NO concentration was measured using a chemiluminescence analyzer. nNO was analyzed by aspiration at a sampling flow rate of 700 mL/min with velum closure. eNO was analyzed during expiration against a constant resistance of 10 cm H2O. RESULTS: NO concentration of the normal control group (n=32) was compared with that of the allergic rhinitis group (n=31) and the rhinosinusitis with that of the nasal polyp group (n=30). The mean nNO level in the control group was 241+/-89 ppb and eNO was 20.5+/-6.4 ppb. The mean nNO level was significantly increased in the allergic rhinitis group (332+/-125 ppb) but decreased in the chronic sinusitis group (89+/-55 ppb). The mean eNO level was significantly increased both in the allergic rhinitis group (26.9+/-10.1 ppb) and chronic sinusitis group (29.8+/-12.8 ppb). CONCLUSION: nNO concentration was increased in patients with allergic rhinitis and decreased in patients with chronic sinusitis; however, eNO was increased in both patients. This shows that patients with upper respiratory inflammation may also have lower respiratory inflammation, supporting the concept of 'one airway, one disease'. This study shows that measurement of NO is useful for the study or evaluation of nasal diseases.

A Case of Cochlear Implantation after Bilateral Temporal Bone Fracture / 대한이비인후과학회지

The incidence of bilateral temporal bone fractures are reported in 9% to 20%. Otic capsule violating temporal bone fractures are highly related to sensorineural hearing loss, when compared with otic capsule sparing fractures. Patients with bilateral temporal bone fractures and profound bilateral sensorineural hearing loss may benefit from cochlear implantation. We present the case of a 44-year-old male with bilateral profound sensorineural hearing loss caused by bilateral temporal bone fractures who achieved successful auditory rehabilitation after a cochlear implantation.