The Prevalence of Onodi Cells and Analysis of Relationship With Optic Nerve in Koreans / 대한이비인후과학회지

Background and Objectives@#It is important to identify variations of paranasal sinuses during sinus surgery. The Onodi cell (OC), a variant of the paranasal sinuses, is the most posterior ethmoid cell with a close relationship with the optic nerve (ON). The purpose of this study is to evaluate the prevalence of OCs and analyze the relationship of OCs with ON in Koreans.Subjects and Method This retrospective study utilized CT images of 526 slides from 263 Korean adults. The prevalence of the OCs and the degree of indentation of the ON within the OC was determined using binary logistic regression analysis. @*Results@#The OCs were observed in 37.3% of 263 subjects and in 27.6% of 526 slides. The OCs are found more frequently in males than in females (p=0.01), and also more frequently in the right side than in the left side (p=0.001). Binary logistic regression analysis revealed that the ON protrusion in female was 0.339 times lower than in male and 1.052 times higher with the increased age. The ON protrusion within the OC in the postsellar type was 10.214 times higher than that in the presellar. @*Conclusion@#The OCs were observed in 37.3% of the Koreans. The protrusion of the ON within the OCs increased in male and in the postsellar type of the sphenoid sinus.

Sinonasal Anatomic Variations According to Frontal Sinus Pneumatization in a Korean Population / 대한이비인후과학회지

Background and Objectives@#It is necessary to understand the variations of the paranasal sinuses (PNS) and other anatomical structures during an endoscopic sinus surgery (ESS). The purpose of this study was to investigate any association between the degree of frontal sinus (FS) pneumatization and the development of the PNS structures. Subjects and Method We analyzed 311 PNS computed tomography (CT) scans (622 sinuses, including the left and right sides). We classified FS into type I (aplasia), type II (hypoplasia), and type III (control). We assessed and compared the middle turbinate pneumatization (MTP), superior turbinate pneumatization (STP), agger nasi cell (ANC), infraorbital cell (IOC), optic nerve (ON) type, and vidian nerve (VN) type with the pneumatization of the FS. We further studied for any association between the degree of pneumatization of the FS, maxillary sinus (MS), and sphenoid sinus (SS) and the lateral lamella length (LLL). @*Results@#MTP, ANC, and IOC rates according to the FS types were not significant (p>0.05). Both type II and III showed more frequent occurrences of STP than type I (p=0.005). The ON type III and IV were significantly frequent in the FS type III (p0.05). In the FS type II and III, the LLL was significantly greater than in type I (p<0.001). @*Conclusion@#Increased FS pneumatization shows greater indentation of ON and VN into the SS, as well as increased LLL. During ESS, it is important to recognize the possibility of structural damage of ON, VN, and LLL according to FS pneumatization.

A Case of Binder Syndrome: Rhinoplasty Surgeon's Perspective / 대한이비인후과학회지

Binder syndrome, also called the congenital flat nose syndrome, is a rare congenital malformation with a flat facial profile, intermaxillary hypoplasia and malocclusion. Rhinoplasty plays an important part in the multidisciplinary surgical protocol for this syndrome, for which weak nasal framework and soft tissue underdevelopment have been considered a great challenge. We present a case of Binder syndrome of a 27-year-old male. The nose was reconstructed with a caudal septum replacement graft and bilateral extended spreader grafts using costal cartilage.

A Case of Early Septal Reconstruction with Autogenous Cartilage Graft with Bioaborbable Plate in a 13-Year-Old Male of Nasal Septal Abscess / 대한이비인후과학회지

Nasal septal abscess is a serious condition that necessitates urgent surgical management, and it may lead to saddle nose deformity caused by the loss of cartilaginous support. To date, there is no consensus among clinicians with regard to early versus late surgical management of the saddle nose deformity. For the growing child, reconstructing the septum is essential for the normal development of the nose. We present a case of nasal septal abscess with a nearly total loss of septal cartilage of a 13-year-old male. His nasal septum was reconstructed immediately with autologous ear cartilage attached to a bioabsorbable plate through open approach. The aesthetic problems such as the saddle nose have not occurred during the follow-up period.

A Case of Binder Syndrome: Rhinoplasty Surgeon's Perspective / 대한이비인후과학회지

Binder syndrome, also called the congenital flat nose syndrome, is a rare congenital malformation with a flat facial profile, intermaxillary hypoplasia and malocclusion. Rhinoplasty plays an important part in the multidisciplinary surgical protocol for this syndrome, for which weak nasal framework and soft tissue underdevelopment have been considered a great challenge. We present a case of Binder syndrome of a 27-year-old male. The nose was reconstructed with a caudal septum replacement graft and bilateral extended spreader grafts using costal cartilage.

A Case of Early Septal Reconstruction with Autogenous Cartilage Graft with Bioaborbable Plate in a 13-Year-Old Male of Nasal Septal Abscess / 대한이비인후과학회지

Nasal septal abscess is a serious condition that necessitates urgent surgical management, and it may lead to saddle nose deformity caused by the loss of cartilaginous support. To date, there is no consensus among clinicians with regard to early versus late surgical management of the saddle nose deformity. For the growing child, reconstructing the septum is essential for the normal development of the nose. We present a case of nasal septal abscess with a nearly total loss of septal cartilage of a 13-year-old male. His nasal septum was reconstructed immediately with autologous ear cartilage attached to a bioabsorbable plate through open approach. The aesthetic problems such as the saddle nose have not occurred during the follow-up period.

A Securing Suture Technique of Autologous Cartilage for the Prevention of Septal Perforation during Septal Surgery

BACKGROUND AND OBJECTIVES: Septoplasty is a commonly performed operation in otolaryngological practice. In cases of septal mucosal tearing, septal perforation can easily occur. The aim of this study was to investigate patients who underwent an autologous cartilage securing suture technique to prevent nasal septal perforation. SUBJECTS AND METHODS: A total of 403 patients who underwent septoplasty alone or with endoscopic sinus surgery for the past three years were enrolled in this study. Septal mucosal tearing occurred in 27 patients. In group 1 (15 patients), autologous cartilage was inserted between the injured mucosa. In group 2 (12 patients), autologous cartilage was inserted between the injured mucosa with a securing suture technique. We investigated the septal perforation rate between the two groups. RESULTS: In group 1, septal perforation occurred in 7 of 15 patients (46.6%) and in group 2 there were no perforations. The occurrence rate of perforation in group 2 was significantly lower than that in group 1 (p<0.01). CONCLUSION: The securing suture technique of autologous cartilage can be an effective method for prevention of septal perforation during septal surgery.

Pneumatization of the Frontal and Sphenoid Sinus in Korean Adults: A Study of Using Computed Tomography Scans / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: For safe sinus surgery, it is essential to understand the anatomical structure and developmental state of the paranasal sinuses. Structural abnormalies such as aplastic and marked hypoplastic sinuses may not be amenable to sinus surgery or balloon sinuplasty. The purpose of this study is to evaluate the degree of pneumatization of the frontal and sphenoid sinuses in Korean adults. SUBJECTS AND METHOD: This retrospective study utilized CT images of 1190 sides from 595 Korean adults. The frontal sinus was classified into normal, hypoplasia, aplasia and unilateral hidden aplasia. The sphenoid sinus was evaluated the incidence regarding the aplasia and unilateral hidden hypoplasia. RESULTS: Bilateral frontal sinus hypoplasia was observed in 8.5% of women and 4.2% of men (p 0.05). Bilateral frontal sinus aplasia was observed in 7.1% of women and 2.9% of men (p 0.05). Unilateral hidden frontal sinus aplasia was observed in 1.7% of women and 1.5% of men (p>0.05). There was no bilateral sphenoid sinus aplasia and only one woman had unilateral sphenoid sinus aplasia. Unilateral hidden sphenoid sinus hypoplasia was observed in 1.4% of women and 2.9% of men (p>0.05). CONCLUSION: Bilateral frontal sinus hypoplasia and aplasia are more common in women than in men. Although the incidences of unilateral hidden frontal sinus aplasia and hidden sphenoid sinus hypoplasia are low, sinus surgeons should carefully review CT for sinus surgery or balloon sinuplasty.