A Randomized, Multi-Center, Single Blind, Active-Controlled, Matched Pairs Clinical Study to Evaluate Prevention of Adhesion Formation and Safety of HyFence in Patients After Endoscopic Sinus Surgery

OBJECTIVES: Recurrent mucosal disease and anatomic obstruction are commonly cited causes of failed endoscopic sinus surgery (ESS). Hyaluronic acid (HA) has been reported to reduce scarring and to promote wound healing in sinonasal surgery. HyFence is HA stabilized by 1, 4-butandiol diglycidyl ether, which makes it less-water-soluble and highly viscoelastic. The purpose of this study is to examine the anti-adhesion effect of HyFence after ESS compared to that of HA-CMC (Guardix-Sol). METHODS: Seventy-four patients with chronic rhinosinusitis who underwent ESS were included in the study. After the ESS procedure, Merocel was placed in the ethmoidectomized areas of the both sides. Five milliliters of Guardix-Sol was then applied to the Merocel of one side and HyFence LV was applied to the other side. The effect of the agents was evaluated at one, two, and four weeks after surgery by endoscopic examination. The severity of adhesion, edema, infection and complications were evaluated. RESULTS: There was no significant difference in the incidence of postoperative adhesion between the HyFence group and the Guardix-Sol group (P>0.05). Mean postoperative grades of edema and infection showed no significant difference between groups (P>0.05). There was no significant postoperative complications associated with either anti-adhesion agent (P>0.05). CONCLUSION: HyFence has equivalent anti-adhesion effect compared to Guardix-Sol following ESS.

A Case of Upper Gastrointestinal Hemorrhage Misdiagnosed as Post-Tonsillectomy Hemorrhage / 대한이비인후과학회지

Tonsillectomy, with or without adenoidectomy, remains the most frequently performed surgical procedure by otolaryngologists. Postoperative hemorrhage, which is classified as primary (24 h) hemorrhage, is recognized as a rare but potentially life-threatening complication. Although most oral bleedings occuring after tonsillectomy are considered as post-tonsillectomy hemorrhages, there could also be other origins such as gastrointestinal hemorrhage. We recently experienced a case of gastrointestinal hemorrhage that was misdiagnosed as secondary post-tonsillectomy hemorrhage. We report this case with a review of the literature.

A Case of Idiopathic Spontaneous Tonsillar Hemorrhage / 대한이비인후과학회지

Spontaneous tonsillar hemorrhage (STH) is an extremely rare event. Usually, the causes of STH are ascribed to vessel wall erosion secondary to bacterial or viral infection of tonsils. Other causes include vascular or tumorous lesions around tonsil, coagulation disorders and idiopathic one. On one hand, the total number of reported STH has slightly increased because STH is defined as all forms of "bleeding tonsils", including even minor bleeding. On the other hand, the portion of the total STH that is life-threatening has become relatively few. Management of STH involves the use of antibiotics, and early tonsillectomy is recommended. We have experienced a case of a 29 year-old female with tonsillar hemorrhage in the absence of any identifiable cause. We report the case with a review of the related literatures.

Monostotic Fibrous Dysplasia of Inferior Turbinate / 대한이비인후과학회지

Fibrous dysplasia is a benign fibro-osseous lesion originally described by Lichtenstein in 1938. Currently, three general subtypes of disease are recognized: monostotic, polyostotic, and McCune-Albright syndrome. Fibrous dysplasia is not rare, with the incidence report being about 5% to 7%. Common sites of fibrous dysplasia are the skeletal system including long bones, ribs, craniofacial bones, and the pelvis. However, fibrous dysplasia is rare in the nasal cavity, especially involving the turbinate. In the review of literature over the past 50 years, we were able to discover only 4 cases in which the fibrous dysplasia involved inferior turbinate, with all of them being the polyostotic form found around the sinuses. There were only 4 cases in which monostotic fibrous dysplasia involved the middle turbinate, but none the inferior turbinate. We present this case, with a review of the relevant literature, as the first report on monostotic fibrous dysplasia of the inferior turbinate.

A Case of Granulocytic Sarcoma Presenting as a Head and Neck Neoplasm / 대한이비인후과학회지

The granulocytic sarcoma is a rare tumor and occurs primarily in patients with acute myelogenous leukemia (AML). The granulocytic sarcoma can arise before, concurrent with, or following acute myeloid leukemia. This tumor can be rarely represented as the initial presentation of acute myeloid leukemia without any signs or symptoms of leukemia. Granulocytic sarcoma, rarely, can also occur in unexpected regions, including the head and neck. This tumor is very often misdiagnosed as a malignant lymphoma which leads to inappropriate treatment and poor outcome. Therefore, clinical, histopathological and immumohistochemical findings should be evaluated before any diagnosis of malignant lymphoma. We report, with a brief review of literature, a case of granulocytic sarcoma presenting as a head and neck neoplasm.