The Use of Microdebrider in Reduction Rhinoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Surgeons commonly employ osteotome and rasp to remove the bony hump of the nasal dorsum in reduction rhinoplasty. The thickness of skin-soft tissue envelope and nasal bone is not consistent in nasal dorsum. Therefore, the tendency is to over-resect at the rhinion and under-resect at the nasofrontal angle, thereby leaving an excessive amount of thicker superior nasal bone. Manual rasps can cause avulsion injury of upper lateral cartilage and soft tissue trauma. So we introduced a powered instrument (microdebrider) in reduction rhinoplasty to improve precision and technical ease while minimizing tissue trauma. SUBJECTS AND METHOD: We operated on eleven patients either with hump nose only (N=6) or deviated nose with hump (N=5). Endonasal approach was used in 3 cases and external approach in 8 cases. We used the microdebrider only for 5 cases and microdebrider after osteotome for 6 cases to smoothen the dorsal edges of open roof after osteotome. We used the powered instrument XPS 2000 Microresector system for rhinoplsty (XOMED(R)). RESULTS: Ten patients were satisfied with the results subjectively. Bony irregularity of the nasal dorsum was not observed and we found less eccyhmosis and edema compaired with the usage of rasp. CONCLUSION: A microdebrider offers a precise alternative to the rasp and can be used in a more precise and limited fashion in reduction rhinoplasty with reduced complication than rasp.

Dual Ectopic Thyroid / 대한이비인후과학회지

Dual ectopic thyroid is an uncommon entity and seven cases have been reported in the literature. Clinically, most cases in ectopic thyroid were noted at adolescence or postpartum due to increased physiologic hormonal demands. The sublingual area is the most common site of ectopic thyroid tissue, accounting for 90% of the cases, followed by the area in high cervical thyroid. Clinical manifestation, thyroid function test, and radiologic imaging should be employed for making diagnosis and therapeutic plan of this disease. The primary therapeutic goal is to restore the thyroid function. We describe a patient with dual ectopic thyroid tissue in the sublingual and subhyoid area.

Analysis of Factors that Affect the Result of Vestibular Rehabilitation in the Treatment of Benign Paroxysmal Position Vertigo / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Canalith repositioning procedure (CRP) is an effective treatment for benign paroxysmal positional vertigo (BPPV). However, there is a significant number of patients who require multiple treatment visits for reliefs of symptoms. The purpose of this study is to identify factors that may be associated with these difficult to treat cases. MATERIALS AND METHODS: A retrospective review was made of 179 patients who were diagnosed as BPPV. 20 patients who required more than three treatment visits for CRP were included in this study. Statistical analysis included age and sex of patients, the kind of involved semicircular canal (SCC), direction of nystagmus, latency of nystagmus on electronystagmography (ENG) and duration of symptoms. RESULTS: There was no significant statistical association between the number of treatment visit and patient's age, sex. Although significant statistical association was not found, the therapeutic efficacy of lateral SCC BPPV was lower than that of posterior SCC BPPV. In the cases where the direction of nystagmus was ageotrophic, the efficacy of CRT was decreased and statistical significant association was found. Also when short latency of nustagmus on ENG and long duration of symptoms appeared, more trial of CRP was needed and statistical significant association was found. CONCLUSION: In the treatment of BPPV by CRP, we can consider latency of nystagmus on ENG, duration of symptoms, direction of nystagmus and type of involved semicircular canal as prognostic factors.