A Clinical Analysis of Fungal Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Since its first recognition in 1885 by Schubert, the prevalence of human fungal sinusitis has increased. Recently, endoscopic sinus surgery has emerged as a successful surgical modality in the treatment of fungal sinusitis. In this study, we aimed to investigate the clinical characteristics of fungal sinusitis and evaluate the efficacy of endoscopic sinus surgery (ESS) for treating fungal sinusitis. SUBJECTS AND METHOD: Of the 8750 cases who underwent ESS between 1995 and 2003, 157 cases that were pathologically confirmed to be fungal sinusitis were retrospectively analyzed by reviewing their medical records. RESULTS: There were 52 males and 105 females patients: the age ranged from 14 to 88 years, with the mean age of 54 years. The peak incidence was found in the 70's. The most common chief complaints were nasal obstruction (44%). The number of human fungal sinusitis treated with ESS were 41 from 1995 to 1998, and 116 since 1999. Recently, the number of cases has increased. The radiological findings in these cases included haziness, calcification and bone destruction of the involved sinuses. Preoperative CT revealed mottled calcific densities within involved sinuses in 37% of the cases. During operation, fungal ball and debris were observed in 52 cases and nasal polyps in 58 cases. All patients received ESS and showed no recurrence during the mean follow-up period of 6.2 months. CONCLUSION: The review of 157 cases of fungal sinusitis revealed that the incidence was increased recently, symptoms were non-specific, CT and nasal endoscopy were excellent diagnostic tools, and that the ESS is a good modality for treatment.

The Evaluation of Olfactory Function in Patients with Septal and Turbinate Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Septoplasty with turbinate reductive surgery is a frequently performed operation for the treatment of nasal obstruction. However, the effect of septoplasty on olfactory function has not been systematically evaluated. The purpose of this study is to investigate changes of olfactory function following septoplasty with turbinate reductive surgery and to evaluate correlations between the change of minimal cross sectional area (MCA) of nasal cavity and nasal volume and olfactory function after nasal surgery. SUBJECTS AND METHOD: Olfactory threshold and identification test of 25 patients with nasal septal deviation and compensated hypertrophy of inferior turbinate were taken pre- and postoperatively. Nasal volume and MCA were measured using acoustic rhinometry before and after the nasal surgery. RESULTS: Septoplasty with turbinate reductive surgery increased the volume and MCA of the nasal cavity and scores of the olfactory identification test were increased after the septal surgery (p<0.05). However, some patients have decreased scores in the olfactory function test after surgery. There were no correlation between the changes of olfactory threshold and acoustic rhinometric parameters of nasal cavity. CONCLUSION: Septoplasty with turbinate reductive surgery has some beneficial effect on olfactory function. However, there are no correlation between changes of olfactory function and changes of parameters in acoustic rhinometry. Preoperative olfactory test is advisable and informed consent for postoperative change of olfaction is necessary in assessing patients for nasal surgery.

The Expression of Bcl-xL and Bax in Nasal Polyps / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The etiology and the pathophysiology of nasal polyps are still not definitely known and recently, it is suggested that inflammatory responses involving eosinophils may play a major role. The process of the infiltration of eosinophils in tissues is explained by the increase of the movement of eosinophils to the inflammatory area and the delay of apoptosis which results in the longer survival of eosinophils. Recently, there have been studies showing how eosinophils extracted from blood expressed their anti-apoptotic Bcl-xL genes and pro-apoptotic Bax genes when put in a delayed apoptotic condition. The purpose of this study is to investigate Bcl-xL and Bax expressions of eosinophils in nasal polyps and how allergic rhinitis affect their expressions. MATERIALS AND METHOD: Nasal polyps were obtained from patients with chronic paranasal sinusitis (30 cases) and nasal polyps were divided into two groups, one obtained from the patient with allergic rhinitis (15 cases) and the other obtained from the patient without allergic rhinitis (15 cases). The normal control group consisted of 5 cases of normal nasal mucosa in the inferior turbinate. The immunohistochemical stain was used to detect eosinophils and the cells expressing Bcl-xL and Bax. RESULTS: In nasal polyps, a significant statistical correlation between eosinophil numbers and Bcl-xL positive cell numbers was detected. But there was no correlation between them in the normal control. The Bax positive cell numbers had a correlation to eosinophil numbers in both the normal control and nasal polyps. And allergic rhinitis did not affect the expression of Bcl-xL and Bax of eosinophils in nasal polyps. CONCLUSION: The authors propose that in eosinophils of nasal polyps, Bcl-xL plays an important role in delayed apoptosis and allergic rhinitis has no effect on the expression of Bcl-xL and Bax.