Nasal Obstruction and Palate-Tongue Position on Sleep-Disordered Breathing

OBJECTIVES: We wanted to evaluate whether the presence of nasal obstruction makes a change on the association between the modified Mallampati score and the severity of sleep-disordered breathing (SDB) and the sleep quality. METHODS: Polysomnography (PSG), the modified Mallampati score (MMS), the body-mass index, and a questionnaire about nasal obstruction were acquired from 275 suspected SDB patients. The subjects were divided into two groups according to the presence of nasal obstruction. The clinical differences between the two groups were evaluated and the associations between the MMS and PSG variables in each group were also assessed. RESULTS: Significant correlations were found between the MMS and many PSG variables, including the apnea-hypopnea index, the arousal index and the proportion of deep sleep, for the patients with nasal obstruction, although this was not valid for the total patients or the patients without nasal obstruction. CONCLUSION: The severity of SDB and the quality of sleep are well correlated with the MMS, and especially for the patients with nasal obstruction. The MMS can give more valuable information about the severity of SDB when combined with simple questions about nasal obstruction.

Chronic Maxillary Sinusitis Occurred after Reconstruction of Inferior Orbital Wall Fracture / 대한이비인후과학회지

A 27-year-old man presented with symptoms of chronic postnasal drip and nasal obstruction, which had begun one year earlier. He had undergone an ophthalmologic operation due to inferior orbital wall fracture 12 years ago. During physical examination, mucopurulent discharge was observed from the right middle meatus. On the paranasal sinus computed tomography, a sheet-like foreign material was observed inside the right maxillary sinus and haziness was found in the right maxillary, ethmoid, and frontal sinuses. Endoscopic sinus surgery was performed and a silastic sheet, which had been inserted during previous surgery, was removed. After surgery, the patient's symptoms disappeared gradually. We report a case of maxillary sinusitis that occurred after orbital wall reconstruction with a silastic sheet and discuss about the efficacy of the silastic implant.

Two Cases of Pneumocele of Maxillary Sinus / 대한이비인후과학회지

Pneumocele is a rare disease involving one or more paranasal sinuses. It is defined as abnormal dilatation of paranasal sinus, which is air-filled with either focal or generalized thinning of bony sinus walls. The aim of pneumocele treatment is two-fold: to re-establish permanent pressure equilibrium in the involved sinus and to correct the possible facial deformities. The first goal can be achieved by middle meatal antrostomy. When alterations of the maxillary or orbital contour are present, corrections can be obtained by osteotomies through Caldwell-Luc or an infraorbital approach. We report two cases of pneumocele of maxillary sinus. The first case was treated with osteotomy via Caldwell-Luc approach and the second case was treated simultaneously with osteotomy and rhinoplasty. No recurrence was observed after surgical treatment in both cases.

Two Cases of Diffuse Large B-cell Lymphoma of Sinonasal Tract

Nasal lymphoma is an uncommon neoplasm in the sinonasal tract. The NK/T-cell type of lymphoma is more commonly found in Asian populations. However, B-cell lymphoma is more common in the western countries whereas it is rare in Asia. Recently, we experienced two cases of sinonasal B-cell lymphoma, which are rare cases in Korea, one in an advanced stage and one in an early stage. Both patients had no specific nasal symptoms or systemic B symptoms (fever, night sweat, weight loss). As our cases demonstrate, diagnosis of B cell lymphoma is often delayed in many cases because B-cell lymphoma does not show any specific symptoms. Thus, careful physical examination and biopsy under suspicion of malignancy are important for early diagnosis of nasal lymphoma.