The Efficacy of Posterior Turbinoplasty in Combination with Tonsillectomy and Adenoidectomy in Pediatric Sleep Disordered Breathing Patients / 대한이비인후과학회지

Background and Objectives@#Tonsillectomy and adenoidectomy (T&A) are effective for the treatment of pediatric sleep disorder breathing. However, in some pediatric patients, there remain unresolved snoring and mouth breathing problems after the operation. This study is aimed at evaluating the efficacy of coblation of hypertrophic posterior turbinate in combination with tonsillectomy and adenoidectomy.Subjects and Method We analyzed data from 50 children aged between 5 to 13 years old who were scheduled to undergo T&A operation from June 2018 to December in 2018. We randomly divided them into two groups. The first group consisted of 25 patients who were scheduled to perform only tonsillectomy and adenoidectomy. The second group was 21 patients who were scheduled to perform posterior turbinoplasty in combination with tonsillectomy and adenoidectomy. We evaluated preoperative and postoperative polysomnogram [Apnea-Hypopnea Index (AHI), O2 saturation], acoustic rhinometry (minimal cross section area, nasal volume), and Korean Obstructive Sleep Apnea-18 Survey (KOSA-18) score. @*Results@#After additional turbinoplasty (coblation of hypertrophic posterior turbinate), the rate of snoring and mouth breathing remaining was decreased. There were significant improvements in AHI, oxygen saturation, Visual Analog Scale and Epworth Sleepiness Scale in two groups. Symptoms (snoring and mouth breath) remaining postoperatively was much more decreased in the posterior turbinoplasty combined with T&A group than in the single T&A group in terms of KOSA-18. @*Conclusion@#When it comes to pediatric sleep disorder breathing surgery, nasal cavity evaluation is an important factor for patient’s postoperative satisfaction for sleeping and snoring. For pediatric sleep disorder breathing patients with hypertrophic posterior turbinate, who are scheduled to do tonsillectomy and adenoidectomy, an additional coblation of posterior turbinate should be considered.

Effect of Filmogen Topical Gel on Pain and Hemorrhage after Tonsillectomy / 대한이비인후과학회지

Background and Objectives@#Tonsillectomy is one of the most common operative procedures in otorhinolaryngology. Most patients following tonsillectomy suffer from postoperative pain and hemorrhage. This study was performed to investigate whether filmogen topical gel (PHARGELⓇ, Vitrobio SAS), applied to the tonsillectomy site after tonsillectomy reduced pain and hemorrhage.Subjects and Method A total of 40 patients over 15 years old scheduled for elective tonsillectomy were randomly divided into two groups. After tonsillectomy and postoperative day 0, 1, 2, and 7, one group was applied with the filmogen topical spray 3-5 times a day but the other group remained without applying it. Pain and postoperative hemorrhage were measured at the postoperative day 0, 1, 2, and 7 of the operation. Pain was measured by using a visual analogue scale. @*Results@#Patients who applied the filmogen topical spray presented lower pain scores than patients who didn’t applied the spary. There was no difference for postoperative hemorrhage between two groups. @*Conclusion@#Filmogen topical spray is an effective postoperative control for pain but not for hemorrhage on the tonsillectomy site.

The Protective Effect of Epigallocatechin-3-Gallate Against Gentamicin Vestibular Ototoxicity in Type I Vestibular Hair Cell of Guinea Pig / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Gentamicin (GM) is well known for its vestibulotoxicity. There have been many reports about vestibulotoxicity, however, its mechanism is still unclear. So far, it is known that GM affects the voltage-dependent K+ current and nitric oxide (NO) production. Epigallocatechin-3-gallate (EGCG) is the major component of green tea and is known to have anti-oxidative and anti-toxic effect. This study was undertaken to investigate the protective effect of EGCG against gentamicin on vestibular hair cell (VHC). MATERIALS AND METHOD: White guinea pigs (200-250 g) were rapidly decapitated and the temporal bones were immediately removed. Under a dissecting microscope, the crista ampullaris was obtained. The dissociated VHCs were transferred into a recording chamber mounted onto an inverted microscope. Whole-cell membrane currents and potentials were recorded using standard patch-clamp techniques. In addition, measurements of NO production were obtained using the NO-sensitive dye, 4,5-diamino-fluorescein diacetate (DAF-2DA). RESULTS: Type I VHCs Voltage-dependent K+ current was activated from low depolarizing stimulation. As the stimulation increased, higher current was detected. Voltage-dependent K+ current in type I VHCs was decreased when GM (200 microM) was administrated and GM effects of K+ current inhibition was significantly blocked by EGCG. Extracellular GM-induced an increase in DAF-2DA fluorescence, which thus indicates NO production in VHCs. Also, the GMinduced NO production was inhibited by EGCG. CONCLUSION: GM inhibits voltage-dependent K+ current by releasing NO in isolated type I VHCs. EGCG blocks this inhibitory effects, suggesting a protective role on GM vestibulotoxicity.

Comparison of Tonsillectomy by Conventional Dissection, Electrocautery, Laser, and Coblation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tonsillectomy remains to be an ordinary operative process in otorhinolaryngology. The aim of this study is to evaluate four current tonsillectomy techniques, conventional dissection, electrocautery tonsillectomy, laser tonsillectomy, coblation tonsillectomy, comparing operation time, postoperative pain, postoperative otalgia and postoperative hemorrhage. SUBJECTS AND METHOD: From March 2012 to December 2012, a total of 61 patients between the ages of 10 years and 58 years scheduled for tonsillectomy were randomly assigned to conventional dissection, electrocautery, laser, coblation groups. All tonsillectomies were performed under general anesthesia. RESULTS: Coblation tonsillectomy technique produced the shortest total surgical time, averaging 19.1 minutes. Electrocautery was the most painful method and postoperative pain was less in laser and coblation, but there was no statistically significant difference between the two. The incidence of primary and secondary hemorrhage was statistically insignificant between the surgical methods. CONCLUSION: This study found that coblation tonsillectomy led to statistically shorter surgical time. However, the four techniques showed no statistically significant difference in the postoperative pain, postoperative otalgia and hemorrhage. Coblation tonsillectomy and laser tonsillectomy are found to be both useful in patients who are sensitive to postoperative pain.

The Efficacy of DizzyFIX for Residual Dizziness after Successful Repositioning Maneuvers in Posterior Benign Paroxysmal Positional Vertigo / 대한평형의학회지

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the critical life events that can affect physical, emotional, and functional aspects of quality of life. Canalith repositioning procedure (CRP) provides rapid and long lasting relief of symptoms in most patients with BPPV. However, some patients express nonspecific symptoms such as anxiety or discomfort after treatment, The purpose of this study was to assess the residual symptoms after CRP in patients with BPPV using Dizziness Handicap Inventory (DHI) in a questionnaire format and to evaluate the therapeutic efficacy of CRP according to accompanying the DizzyFIX device. MATERIALS AND METHODS: We performed a prospective investigation in 135 consecutive patients with confirmed posterior semicircular canal BPPV. CRP was performed until nystagmus and vertigo disappeared. Patients were divided into three group using the DizzyFIX (group A), not using the DizzyFIX (group B) and closed observation (group C) after treatment. Then patients were asked to complete the questionnaire for Korean form DHI before treatment, 1, 2, 3, 4, and 8 week after treatment. RESULTS: There was a significant improvement in DHI scores when comparing the pre CRP and post CRP three groups (p<0.05), although emotional items showed incomplete improvement at 1 week. But at 2 week after treatment, there were statistically significant differences between group A and other groups in DHI scores specially in emotional items. CONCLUSION: Even after successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms may remain. For these patients additional follow up and management are necessary and using of the DizzyFIX will be helpful to reduce the incidence of residual dizziness especially emotional aspect.

A Case of Sparganosis Infesting in the Scrotum / 대한비뇨기과학회지

Sparganum mansoni is an animal parasite infesting principally in cats and dogs, but sometimes it also infests human bodies. We have experienced a case of sparganosis in scrotum. Herein we report this case with a brief review of the literatures.

A Case of Malignant Renal Hemangiopericytoma / 대한비뇨기과학회지

Hemangiopericytoma of the kidney is rare. It seems to be slowly progressive and grows locally with 5cm consistency and well encapsulation, and may infiltrate surrounding tissue but the incidence and degree of its malignancy appears to be low. Herein we report a case of malignant renal hemangiopericytoma associated with asymptomatic hypoglycemia and presenting radiologically as a hypovascular mass which was developed from the left kidney in 32 years old sea man who was treated with radical nephrectomy and chemotherapy.

A Case of Reiter`s Syndrome / 대한비뇨기과학회지

Reiter`s disease can no longer be considerded a rare and relatively benign syndrome, defined by the clinical triad of urethritis, conjunctivitis and arthritis. In the etiology of Reiter`s disease, it can be regarded as a post-infectious syndrome after certain enteric disease or veneral infection and usually occurs in patients between 20 and 40 years old, with a male to female ratio of 10:1 in dysenteric cases and 50:1 in veneral cases. The diagnosis of Reiter`s disease should quite obious when the clinical manifestation of non specific urethritis, conjunctivitis, arthritis and mucocutaneous lesions. Recently, HLA-B27 antigen is strogly associated with Reiter`s syndrome and may be diagnosticlly useful when HLA-B27 is positive. There is no specific therapy for Reiter`s disease, but conservative treatement is aviable of acute stage oir recurrence of the disease. We have experienced a case of Reiter`s syndrome in 27 years old male and reproted with review of some literatures.