The Stabilizing Method of Zygomatic Arch Fracture Using Aqua Splint Suture Technique / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The zygomatic arch is the bony arch on both sides of the face consisting of the zygomatic bone. The zygomatic fractures are common maxillofacial injuries second only to nasal fractures due to its anatomical location of its structures. Various techniques have been applied for the treatment of zygomatic arch fractures but there is no desirable modality not only for the reduction but also for supporting depressed bony fragments without esthetic problems. The authors suggest aqua splint suture method, which is a new modality for the treatment of zygomatic arch fractures. SUBJECTS AND METHOD: In the period from March of 2004 to March of 2005, nine patients who had been performed reduction for zygomatic arch fractures were selected for clinical analysis. We repositioned depressed bony fragments by Gillies approach and stabilized repositioned bony fragments by external & internal fixation using aqua splint suture method. RESULTS: There were eight men and one woman, ranging in age from 19 to 68 years. All patients had chief complaints for trismus and facial deformities. Postoperative photographs and computed tomography, checked after 3 postoperative months, showed that all patients had the good facial contour and well stabilized bony fragments. CONCLUSION: The authors suggest that aqua splint suture method is a very simple, quick & effective technique for stabilizing repositioned zygomatic arch fractures.

A Case of Merkel Cell Carcinoma in the Auricle / 대한이비인후과학회지

Merkel cell carcinoma is an uncommon neuroendocrine neoplasm of the skin and arises in adults with a peak incidence in the sixth and seventh decades. Head and neck area and extremities are the most common location. Among primary sites of head and neck area, auricular Merkel cell carcinoma has proven to be rare and only twenty cases have been reported in the literature worldwide until today. The authors report a case of Merkel cell carcinoma in auricle for the first time in Korea with a review of literatures.

Combination Therapy of Earlobe Keloids / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES : Keloids are proliferative growths of dermal collagen which extends beyond the original wound. Many modalities are available for treatment of keloids but there is no desirable modality to prevent the recurrence of keloids until now. The authors suggest that the combination therapy of surgical excision, steroid injection and compression therapy is an effective method for prevention of recurrence. MATERIALS AND METHOD : Eleven patients who underwent surgical excision for earlobe keloids in the period from June of 2003 to July of 2005 were selected for clinical analysis. We injected steroid at the surgical margin after excision and compressed it by aluminum splint after skin closure. RESULTS : There were four men and seven women, ranging in age from 13 to 60 years (mean age, 29.2 years). The causes of keloids were earring in seven cases, trauma in two cases and middle ear surgery in two case. The keloids appeared at 1 to 17 years (mean, 3.9 years) after earring, trauma or middle ear surgery, and follow-up period ranged from 3 to 28 months (mean, 9.3 month). The sizes of keloids varied from 0.6x0.3x0.2 cm to 3.4x2.3x1.3 cm. Only one out of the 11 cases recurred and the remaining 10 cases had good results without recurrence. CONCLUSION : We believe that the combination therapy of surgical excision, steroid injection and compression by aluminum splint is a very effective therapy for treatment of earlobe keloids.

A Case of Septal Perforation Repair with Middle Turbinate Flap

The nasal septal perforation is an inadvertent complication of septal surgery which is caused by traumatic, iatrogenic, caustic or inflammatory reasons. Repair of the perforation is indicated when complications such as whistling sound, marginal crusting, frequent nasal bleeding and low-grade perichondritis develop. There is no standard surgical method for repair of a septal perforation. The size, site and the causing factor of perforation determine closure methods. A septal perforation using the concha bullosa flap of middle turbinate was successfully repaired.

Clinical Study of Open Nasal Bone Fracture

BACKGROUND AND OBJECTIVES: Little is known about the treatment of open nasal bone fracture (ONF). The operative technique, timing, and management of ONF is still confusing. This study presents our treatment policy of ONF to help otolaryngologists decide proper management plan. MATERIALS AND METHODS: Of 380 consecutive patients who required surgical intervention, 57 patients underwent open nasal reduction. Of 57 patients, 15 had one-stage operation, and 42 had two- stage operation. Postoperative patients' satisfaction was evaluated using a visual analogue scale and the reasons of dissatisfaction were analyzed. RESULTS: ONF had poorer outcome than closed nasal bone fracture. Unsatisfactory cosmetic results such as scan of the external nose and change of the skin color were the most common problems associated with open nasal reduction. CONCLUSION: Operation timing and technique should be selectively applied to different types of nasal bone fracture and wound state. Meticulous wound care as well as accurate nasal bone reduction is mandatory for ONF.

The Clinical and Radiological Evaluation of Results about Closed Reduction for Children with Nasal Bone Fractures / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has generally been accepted that closed reduction is the management of nasal fracture in children. But proper management is still confusing and clinical and radiological evaluation about long term results have yet to be determined. The purpose of this study is to determine which closed reduction method for nasal bone fractures in children is effective when considering clinical and radiological aspects. MATERIALS AND METHOD: We analysed the medical records of 35 children with nasal bone fractures up to the age of 15, who were operated by closed reduction between 2000 and 2002. We evaluated postoperative satisfaction of doctors and patients and postoperative CT scan score (Motomura et al 2001) of 14 children over more than at least 2 postoperative years. RESULTS: A peak incidence ages ranged from 13 to 15 years. The most frequent cause was sports injuries. The degree of postoperative satisfaction and postoperative CT scan score was favorable. CONCLUSION: In management of nasal fracture in children, closed reduction is effective and satisfactory when clinical and radiological aspects are considered.

A Case of Hodgkin's Lymphoma of Palatine Tonsil / 대한이비인후과학회지

Most lymphoma occurs within the lymph node. A small portion of the lymphoma can have extranodal involvements such as the oral cavity, oropharynx, nasopharynx, paranasal sinuses, and larynx, etc. Especially, Hodgkin's lymphoma with primary manifestation in the palatine tonsil is an extremely rare entity and seldom documented in the literature. Recently, we experienced a case of palatine tonsil mass as a first symptom of Hodgkin's lymphoma. The patient underwent a surgical excision and radiotherapy. The authors report the first case of Hodgkin's lymphoma of the palatine tonsil in Korea with a review of literature.

Clinical Analysis of Traumatized Auricular Laceration / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Contusions and lacerations of the auricle are common, but reconstructive procedures are difficult because the auricle has an intricate cartilage framework covered with delicate skin. The purpose of this study was to present therapeutic principles of traumatized auricular laceration. SUBJECTS AND METHOD: The study was performed retrospectively and included 35 traumatized auricular laceration patients. Their wound state, degree of laceration, whether or not had exposure of cartilage, methods of reconstruction used and postoperative complications were analyzed. RESULTS: Multiple laceration was found in 11 patients. Eight of 19 patients who had cartilage exposed had been performed cartilage suture method for alignment. Primary reconstruction was performed for two avulsed subtotal injury patients. Pocket principle technique was used for one patient whose auricle was contaminated and amputated. Postoperative complications were noted as paresthesia, color change, delayed healing, deformity and partial loss of auricle. CONCLUSION: Rapid and active management of traumatized auricular lacerations is important to prevent infection and postoperative complications.