A Case of Cavernous Hemangioma in the Submandibular Gland: A Review of Clinicoradiologic Features and Treatment Methods / 대한이비인후과학회지

Cavernous hemangiomas in the submandibular gland (SMG) are rare; therefore, there are few clinicoradiologic pathognomonic findings upon which to base a diagnosis. Thus, a preoperative diagnosis of hemangioma is rare. We reviewed all English language literature on cavernous hemangioma involving SMG published after 1990. The characteristic clinical finding of cavernous hemangiomas involving the SMG is a fluctuant swelling that is unrelated to food intake. On computed tomography, cavernous hemangiomas appear as cystic or enhancing lesions either with or without calcification; however, this is not a pathognomonic finding for diagnosis. Most cavernous hemangiomas are best treated by complete surgical excision; preoperative angiography or embolization is not always required. Cavernous hemangioma should be added to the list of the masses presented a fluctuant swelling that is not associated with postprandial swelling. The treatment of choice is surgical excision without angiography and embolization.

A Case of Neurofibroma Arising from the Aryepiglottic Fold of Type I Neurofibromatosis / 대한이비인후과학회지

Neurofibroma of the larynx is a rare disease and associated with von Recklinghausen's disease may take place as an isolated lesion or a part of multiple neurofibromatosis. A case of laryngeal neurofibroma was the first reported by Suchanek in 1925. Especially the aryepiglottic folds are the usual sites of occurrence for laryngeal neurofibroma, because the branch of the superior laryngeal nerve is involved. We present here a case of neurofibroma in a 23-year-old male who complained of voice change and throat discomfort, all of which persisted for 6 months. We report a case of huge neurofibroma arising from the aryepiglottic fold.

Analysis of Clinical Feature and Management of Fish Bone Ingestion of Upper Gastrointestinal Tract

OBJECTIVES: Fish bone impaction in the upper gastrointestinal tract is a common reason for patients to seek emergent care. The aim of this study was to find a clinical characteristics of patients with fish bone impaction in the upper gastrointestinal tract. METHODS: The study was conducted on 286 fish bone ingestion patients who complained of dysphagia and irritation after eating fish. The patients were treated according to the hospital protocol regarding the removal of fish bone. The parameters for the analysis included the age and sex of the patients, location and characteristics of the foreign body, method of removal, and type of fish. RESULTS: The fish bone could be observed by the physical examination in the oral cavity and laryngopharynx in 198 patients (69.23%). For those patients in whom the foreign body could not be observed in oral cavity and laryngopharynx, noncontrast computed tomography (CT) (from nasopharynx to diaphragm) was performed. The fish bone was discovered in the esophagus of 66 patients (23.08%). The esophageal fish bone was successfully removed by transnasal flexible esophagoscopy (TNE) in 55 patients, the fish bone moved to the stomach in 10 patients and one fish bone was removed by rigid esophagoscopy due to esophageal abscess. The esophageal fish bone was mostly found in patients aged 50 years and older. CONCLUSION: Fish bone foreign body ingestion in the esophagus appeared to be more common in older patients. Incorporating noncontrast CT and TNE can facilitate decision-making and adequate treatment for patients with fish bone impactions.

Parental Awareness Survey of Tonsil and Adenoid Hypertrophy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Patients with tonsil and adenoid hypertrophy are increasing, and cases of tonsillectomy & adenoidectomy also are steadily on the rise. However, the awareness of patients visiting outpatient is much lower. This study was performed to understand the cognitive level of general public associated with tonsil and adenoid hypertrophy and to suggest the needs of educational program and promotion. SUBJECTS AND METHOD: Prospective survey using structured questionnaire was conducted for 100 parents of patients before the age of 10 who were scheduled to undergo tonsillectomy & adenoidectomy. RESULTS: The total percentage of correct answers in questions related to the awareness level of tonsil and adenoid hypertrophy was 51.7%. In particular, the lowest awareness level corresponded to questions regarding post-operative complications and notes. More detailed information regarding post-operative course and notes was required of 47% of the subjects. CONCLUSION: The survey results indicate poor public awareness about tonsil and adenoid hypertrophy, suggesting more efforts on the behalf of Korean Society of Otorhinolaryngology-Head and Neck Surgery.

Type 1 Posterior Glottic Stenosis with a Calcified Interarytenoid Band / 대한이비인후과학회지

A 64-year-old woman presented with Gullain-Barre Syndrome and prolonged intubation. The patient had undergone a decannulation earlier, after which she developed symotoms of hoarseness, dyspnea, and repeated aspiration. Bilateral vocal cord immobility with type 1 posterior glottic stenosis (PGS) was identified under laryngoscope. During operation, direct laryngoscopic finding and histologic finding revealed interarytenoid ossification. We present a rare case of PGS with a calcified interarytenoid band.

The Relationship between Osteoarthritis of the Knee and Bone Mineral Density of Proximal Femur: A Cross-Sectional Study from a Korean Population in Women

BACKGROUND: The relationship between osteoarthritis (OA) and osteoporosis (OP) is complicated and it may differ according to the site or stage of disease. The purpose of this cross-sectional study is to examine the relationship between the severity of radiological knee OA and the degree of OP in the ipsilateral proximal femur as denoted by bone mineral density (BMD) in a Korean population, especially among women. METHODS: One hundred ninety-five female patients who had knee pain and radiological knee OA were investigated with respect to the relationship of knee OA severity with BMD. The BMD of the proximal femur and spine was measured by dual energy X-ray absorptiometry, and the severity of knee OA was evaluated based on Kellgren-Lawrence (K-L) radiographic criteria, joint space narrowing (JSN) and mechanical axis of knee alignment. Partial correlation analysis and ANCOVA adjusted for confounding factors (age and body mass index) were performed to assess the relationship. RESULTS: There was a statistically significant relationship between the BMD of the proximal femur and JSN, and the BMD of the proximal femur was positively associated with increased joint space width. There was a lack of association between the spine BMD and JSN. The BMD of the proximal femur was also significantly lower in patients who had a higher K-L grade. CONCLUSIONS: The radiographic finding of severe OA in the knee is associated with decreased BMD of the ipsilateral proximal femur including the femoral neck, trochanter, intertrochanter, and region of the entire hip (neck, trochanter, and Ward's triangle).

A Case of Gossypiboma Associated with Xanthogranulomatous Inflammation / 대한이비인후과학회지

A mass formed around a cotton matrix left within the body is termed as gossypiboma. It is a rare complication of surgery and often occurs mainly after abdominal operations. The incidence of gossypiboma is underreported, due to legal implications of their detection. Furthermore, a correct diagnosis can be made only in one-third of cases. Clinical presentation is variable, depending on the location of the foreign body and on the type of inflammatory reaction. The recommended choice of treatment is excision, with the most important consideration given to prevention. Xanthogranulomatous inflammation is an uncommon form of chronic inflammation, which is destructive to affected organs. To the best of our knowledge, we report the first case of gossypiboma associated with xanthogranulomatous inflammation. A gauze accidently left in the lateral neck after a neuro-surgical intervention was found during resection of mass-like lesion and xanthogranulomatous inflammation was diagnosed on histopathologic exam.

Conservative Parotidectomy for Benign Parotid Tumors / 대한이비인후과학회지

Superficial parotidectomy is the most widely accepted form of the treatment for benign parotid tumors. But the risk of postoperative complications for the treatment of a benign condition cannot be ignored. Recent studies suggest that conservative parotidectomy (partial superficial parotidectomy or extracapsular dissection) might be the reliable option for the resection of benign parotid tumors. Conservative parotidectomy showed similar recurrence rate and lesser post operative complications than superficial parotidectomy.

Meta-Analysis of Squamous Cell Carcinoma of Thyroid / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Primary squamous cell carcinoma (SCC) of thyroid is an unusual tumor, accounted for approximately 1.1% of all neoplasms of the thyroid gland. It is highly lethal, like anaplastic thyroid carcinoma, in terms of aggressive clinical behavior. In the literature, the best treatment of this tumor is by surgery and the use of combination therapy that includes postoperative radiation, chemotherapy and radioiodine therapy; however, the effect of treatment is very poor. This study aims to identify the clinical features of SCC of thyroid, and to devise a better treatment method. SUBJECTS AND METHOD: Journals citing SCC of thyroid were identified from Pubmed, Korea Med, and Google and the clinical records reported therewithin from 1990 to 2013 were reviewed. A total of 40 patients were analyzed from 21 well-organized papers by searching the following keywords: squamous cell carcinoma, primary, thyroid, excerpt of the patient's age, sex, clinical features, pathologic findings, therapy, course and prognosis. RESULTS: We analyzed the treatment results of 40 patients from a total of 21 papers. Patients, consisting of 17 men and 23 women, were found in the age range of 24-88, with the mean age of 63.2. The follow-up period ranged from one to 96 months, with the mean being 15 months, and the size of the mass varied from 1 cm to 15 cm. Histopathologically, we found 13 patients with only SCC mixture of SCC and 22 patients with papillary thyroid carcinoma (PTC). Each of the following diseases were identified with one patient: a mixture of SCC and Hashimoto thyroiditis, a mixture of follicular thyroid carcinoma (FTC), SCC and FTC and mixed Hurtle cell cancer, SCC and PTC and mixed Hashimoto thyroiditis, and SCC, PTC with mixed insula cancer. Thirty-two patients underwent total thyroidectomy, and 30 patients underwent total thyroidectomy accompanied by neck dissection. Twelve patients received postoperative radiation therapy, and five patients received postoperative chemotherapy. Nineteen patients were observed without recurrence of the disease, and ten patients were found to be in stage III or less. CONCLUSION: SCC of the thyroid showed aggressive clinical characteristics, however, good results can be expected with early diagnosis and treatment. If tumor is found only within the thyroid, we expect good therapeutic results after the same treatment as PTC.

Leiomyoma of Finger: A Case Report / 대한골관절종양학회지

Leiomyoma is a benign solitary tumor which is originated from a smooth muscle cell and grows slowly. It is most commonly found in the uterus and can develop anywhere that smooth muscle is present, including esophagus, lower extremity, stroma of GI tract, and pleura. However, the occurrence of leiomyoma in the hand is so uncommon. We present one case of solid type leiomyoma found in the right 4th finger of a young woman.

Anterior Glottic Stenosis Treat with Silastic Sheet / 대한이비인후과학회지

Laryngeal stenosis is a partial or complete narrowing of the endolaryngeal airway and it may occur congenitally or may be acquired. Acquired stenosis is caused by iatrogenic injuries from endotracheal intubation or traffic accidents. We report a case of anterior glottis stenosis combined with subglottic granuloma with a history of neck trauma and intubation. We have successfully treated the stenosis using intra-laryngeal thin silicon sheets after adhesiolysis.

A Case of Giant Tonsillolith / 대한이비인후과학회지

The tonsillolith is a white or yellow colored calcified lesion that forms in the crypts of the palatine tonsil. Small tonsilloliths are frequently found on tonsils, while giant tonsilloliths are a rare clinical entity. We had a 35-years old female patient, who presented throat discomfort due to a giant tonsillolith. The stone was removed and tonsillectomy was performed. We reviewed the literature on this rare clinical entity.

Characteristics of Clinically Invasive Aspergillosis in Sphenoid Sinus

BACKGROUND AND OBJECTIVES: Because of the close vicinity of the orbit to the sphenoid sinus, invasive fungal sphenoiditis is a difficult disorder to correctly diagnose and treat. The aims of this study were to examine clinical characteristics of invasive sphenoidal aspergillosis and to discuss diagnostic and therapeutic priorities. MATERIALS AND METHODS: Eleven patients who presented with sphenoidal aspergillosis in our department since 1997 were reviewed retrospectively. These patients were classified into two groups:a clinically invasive group who experienced aggravation even after endoscopic surgery and required further treatments, including antifungal agent, and a non-invasive group who were cured after surgery. The presenting symptoms, age, underlying systemic diseases, CT and MRI findings, treatment modality, and prognosis were reviewed between the clinically-invasive fungal and non invasive groups. RESULT: Only the clinically invasive group presented with visual disturbance. Visual disturbance developed rapidly within several days. Age over 50 years and diabetes may be associated with visual disturbance. Bony erosion and expanding lesions upon CT or MRI were observed more frequently in the clinically invasive group than in the non-invasive group. Enhancement outside the sphenoid sinus was demonstrated only in the clinically invasive group. Endoscopic sinus surgery was performed with additional amphoterichin B and/or mega-dose steroid therapy. Recovery from visual disturbance was poor. Moreover, mega-dose steroid therapy had no effect on symptoms and caused two complications, uncontrolled diabetes and pneumonia. CONCLUSION: Aged diabetic patients, rapidly progressing eye symptoms, bony erosion, and expanding sphenoid lesions upon imaging incur high suspicion of invasiveness in a sphenoid fungus ball. Endoscopic sinus surgery to remove sphenoid fungus balls, as well as systemic antifungal treatment, should be started as early as possible in patients with these clinical features.

Organized Hematoma Presenting with Periorbital Swelling: A Case Report and Review of Literatures

Organized hematoma of the maxillary sinus is a rare clinical disease. We report a case of organized hematoma of the maxillary sinus presenting with acute sinusitis. This is the first article describing such a case. Included is a review of the literatures, highlighting the diagnostic signs of organized hematoma of the maxillary sinus.

Assessment of Anxiety using Beck's Anxiety Inventory in Patients with Vestibular Neuritis / 대한평형의학회지

BACKGROUND AND OBJECTIVES: The intimate relationship of vertigo and anxiety has been previously recognized. Anxiety may have an important influence on recovery of symptoms in vestibular neuritis (VN). The aim of study was to evaluate subjective anxiety of the pre-VN, at the time of onset of VN, and just after vestibular rehabilitation therapy (VRT) using Beck Anxiety Inventory (BAI) questionnaire, respectively. MATERIALS AND METHODS: Twenty-eight patients with VN were asked to complete the BAI and dizziness handicap inventory (DHI). Each of the BAI and DHI was scored. We also evaluated the relationship between the DHI and BAI scores. RESULTS: The VN patients at the time of attack had significantly more anxiety with vertigo and related symptoms (p<0.05). In most patients, anxiety level decreased following VRT. CONCLUSION: These findings indicate that almost every VN patients can recovery from anxiety as vertigo regressed. However, the emotional support as well as physical and/or functional rehabilitation may be required to provide a more rapid and complete return to normal daily lives for these patients.

Blindness Secondary to Sphenoid Fungus Ball

The close vicinity of the optic nerve to the sphenoid sinus may cause visual loss in the sphenoid fungus ball. We present a case of blindness secondary to sphenoid fungus ball without any evidence of orbital invasion in imaging studies. A 61-year-old man, suffering from uncomplicated diabetes, was referred for right visual loss that developed 1 day ago. He perceived hand motion on the right. CT and MRI revealed a fungus ball in the right sphenoid sinus. However, there was no evidence of orbital invasion. Endoscopic sphenoethmoidectomy was performed to remove the fungus ball. Systemic mega-dose steroid and amphotericin B were started because he lost the light perception 3 days after surgery. Biopsy revealed aspergillus fungus ball and no evidence of mucosal invasion. However, blindness was not reversed. Evidence of orbital invasion in imaging diagnosis is elusive in sphenoid fungus ball; therefore, systemic antifungal treatment should be initiated and early endoscopic sphenoidotomy should be performed in case of rapidly progressing visual loss, especially in diabetic or immunocompromised patients. Mega-dose steroid therapy for optic neuropathy should be selective because it may aggravate underlying systemic diseases to cause early termination of systemic antifungal treatment.

Laparoscopic Extirpation of the Term Sized Huge Ovarian Cyst / 영남의대학술지

A 23 years old single nulligravida woman underwent laparoscopic removal of a huge cystic adnexal mass that occupied her entire abdomen, giving the appearance of a full term pregnancy. After anesthesia, a vertical infra-umbilical incision, 1 cm long, was made and a telescope was introduced through the port to determine the status of the intra-abdomen and the surface contour of the mass. A needle tipped with a laparoscopic suction apparatus was inserted into the cyst through the infra-umbilical port, directly under the mass. Subsequently, 3, 200 ml of cystic fluid was aspirated without spillage. A huge cyst, reaching to the level of the xyphoid process was effectively excised through the operative laparoscopy after prelaparoscopic drainage. Operation time was 140 minutes and hospital stay was 2 days. There were no complications during hospital stay and after discharge. It seems the size of the cyst is not a criteria for the contraindication of laparoscopic surgery.

A Case of High Grade Endometrial Stromal Sarcoma Metastatic to the Lung / 대한산부인과학회잡지

The High grade endometrial stromal sarcoma is very rare. It has occasional local recurrence, which might be arisen from endometrial stroma, from adenomyosis, rarely from endometriosis. We experienced this infrequent malignant tumor in a 33 years old woman showing invasion to endometrium, cervix, adenomyosis and even penetration to the uterine serosa. She underwent total abdominal hysterectomy with bilateral salpinogo-oophorectomy followed by cisplatin-epirubicin chemotherapy. Metastatic pulmonary lesion was found after hysterectomy. The authors report this case with the clinicopathologic findings and brief review of literatures.

Trigger points: clinical implications of digital infrared thermographic imaging

No abstract available.

A Case of Incontinentia Pigmenti / 대한피부과학회지

Incontinentia pigmenti is an uncommon genodermatosis. It affects female infants predominantly, described first by Bardach in l925, with the diagnosis of systematized nevus and Bloch in 1926, and Sulzberger in 1928 rnore compIetely. Skin lesions are characterized by 3 stages such as vesicobullous, verucous and finally pigmentary lesions and leave brownish pigmentation on the extremities and trunk. Hesides skin lesions some ectodermaI and mesodermal organs are affected and show developmental abnormalities. We experienced a case of incontinentia pigmenti in a 45-day-old female infant and present it with the review of literature. She showed extensive vesicobullopustular eruption with linear and reticular pigmentation on the extremities and trunk. Clinical and histopathologic findings of these lesions are compatible with Bloch-Sulzberger type of incontinentia pigmenti.