Clinical Review of Orbital Complications Caused by Paranasal Sinusitis: 10-Years Experience / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Orbital complications due to sinusitis are generally uncommon, but in certain cases, it may cause a significant problem such as visual loss. We aim to evaluate the clinical features of orbital complications due to sinusitis. We will also discuss the treatment modalities associated with orbital complications. MATERIALS AND METHOD: We retrospectively reviewed the medical records of 21 patients with sinogenic orbital complications from Jan. 1995 to Jan. 2005. The clinical features of orbital complications, the radiologic findings and the treatment given to the patients were evaluated. The prognosis of each case was set according to the Chandler's classification. RESULTS: Six out of 21 patients had preseptal cellulitis, 7 had orbital cellulitis, another 7 had subperiosteal abscess and only 1 patient had orbital abscess. Proptosis, opthalmoplegia and decreased visual acuity were more significant in patients with postseptal cellulitis than in those with preseptal cellulitis. In terms of treatment, medical therapy was the sole treatment modality for preseptal cellulitis, whereas surgical management was more frequently used for postseptal complications. CONCLUSION: The presence of a postseptal complication may be assumed when patients have clinical symptoms such as proptosis, opthalmoplegia and decreased visual acuity. CT scan is helpful in deciding the appropriate treatment for such cases. If there is absence of such symptoms, we can consider the orbital complication as preseptal, which can be treated medically.

A Case of Osteoma with Cholesteatoma in the External Auditory Canal / 대한이비인후과학회지

Osteoma in the external auditory canal is an uncommon benign lesion, which presents as a solitary, unilateral, and slow-growing pedunculated mass in the outer half of the bony canal. It is usually asymptomatic; but symptoms can arise if a canal obstruction occurs. External canal cholesteatoma is also a rare lesion of the external auditory canal. Cholesteatoma of the external auditory canal may arise via several mechanisms. However, an occlusion or narrowing of the external auditory canal is the basic pathogenesis. The association of an osteoma with cholesteatoma is extremely rare, and there have been very few reports published. We encountered a case of a 49-year-old man with an osteoid osteoma that was complicated by a cholesteatoma in the external auditory canal. The canal wall down mastoidectomy and tympanoplasty removed the osteoma and the cholesteatoma successfully, and there was no recurrence or complications during the following 6 months postoperatively.