A Case of Tramadol Induced Asthma Attack in a Patient with Samter's Triad / 대한이비인후과학회지

Samter's triad is a well known syndrome and is characterized by a triad of asthma, aspirin or NSAID sensitivity and chronic sinusitis with nasal polyp. Chronic sinusitis with Samter's triad is difficult to treat completely and has poor prognosis. Tramadol is a non-opioid analgesic that rarely shows respiratory suppression and is known to be relatively safe because it does not inhibit prostaglandin synthesis. For that reason, patients with asthma may avoid drug-induced exacerbations of the disease by substituting Tramadol for NSAIDs. We experienced a case of asthma attack in a patient with Samter's triad after Tramadol injection.

Clinical Characteristics of Medically Intractable Deep Neck Infection Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In the era of antibiotics, some deep neck infections can be managed by conservative treatment, but some still need surgical treatment. In this study, we discuss whether or not there are significant differences between conservative treatment group and surgical treatment group in deep neck infections. SUBJECTS AND METHOD: We conducted a retrospective analysis of medical records of 56 patients with deep neck infections from January 2005 to December 2007. Among 56 patients, 39 patients were managed by conservative treatment with antibiotics and 17 patients were managed by surgical treatment via transcervical approach with antibiotics. As for data analysis, Mann-Whitney U test was used. RESULTS: In surgical treatment group, age, duration from symptom onset to hospitalization, hospital days, incidence of underlying disease, WBC (white blood cell) count, ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) were higher than the conservative treatment group. But, there was no statistical significance except hospital days, incidence of hypertension and CRP. Especially, initial CRP in conservative treatment group was 9.7 mg/dL and in surgical treatment group was 28.2 mg/dL. CONCLUSION: CRP in deep neck infection patients managed by surgical treatment via transcervical approach was about 3 times higher than patients managed by the conservative treatment only. Further study will be needed to determine the availability of CRP as a considering factor to decide the surgical treatment in deep neck infections.