ABSTRACT
BACKGROUND AND OBJECTIVES: Popular myringoplasty techniques include either an underlay or an onlay approach using tissues such as temporalis fascia or perichondrium as grafting materials. The "cartilage butterfly technique" using a tragal cartilage graft that resembled butterfly wings without incising canal skin was described by Eavey in 1998. This study describes the results of using this technique and analyzes the postoperative hearings. MATERIALS AND METHODS: Cartilage butterfly inlay tympanoplasty was carried out in 28 patients to close small-to-medium tympanic membrane perforations from October 1998 to December 2000. We excluded one patient due to accidental removal of graft at another clinic. We evaluated the success rate and postoperative hearing results. RESULTS: The graft take rate was 96.3% (26/27) at the end of the follow-up period (mean follow-up was 6.0 months). All of successful cases had cartilage grafts that were intact and dry at the last visit. One patient failed due to otorrhea and extruding graft. Two patients were not evaluated, because one had profound preoperative hearing loss and the other was a cerebral palsy patient. Mean air-bone gap (A-B gap) was improved from 16.3 dB to 9.8 dB. Ten patients had an A-B gap average between 0 and 10 dB, 14 patients between 11 and 20 dB, and no patient greater than 20 dB. CONCLUSION: The cartilage butterfly technique was effective to close tympanic membrane perforations in selected patients. It could provide advantages in high success rate, ease, speed and patient comfort.
Subject(s)
Humans , Butterflies , Cartilage , Cerebral Palsy , Fascia , Follow-Up Studies , Hearing , Hearing Loss , Inlays , Myringoplasty , Skin , Transplants , Tympanic Membrane , TympanoplastyABSTRACT
BACKGROUND AND OBJECTIVES: Recently, there has been an increase in olfactory disorders due to many etiologies. Many therapeutic methods have been tried with some favorable results. Some of the therapeutic methods are functional endoscopic sinus surgery (FESS), oral and topical steroids, and other pharmacologic therapies (vitamin A, aminophylline, zinc sulfate, etc). In this study, we tried to find out the transition of olfactory recovery in patients with olfactory disturbance. MATERIALS AND METHODS: Sixty-one patients with olfactory disturbance were studied. There were 25 patients who had chronic sinusitis with nasal polyp, 10 patients who had chronic sinusitis without nasal polyp, 12 patients who had upper respiratory infection, 5 patients who had congenital disorder, 4 patients who had head trauma, and 5 patients who had nasal septal deviation. Chronic sinusitis was treated by functional endoscopic sinus surgery, nasal septal deviation was treated by septoplasty and others were treated by drug therapy and topical steroid. The degree of olfactory disturbance and recovery was scored with a KVSS test (Korean Version of Sniffin Sticks test) prior to treatment and also three and six months after the treatment. RESULTS: Twenty-one patients with chronic sinusitis with nasal polyp (84%) showed improvement of olfaction on the third postoperative month, and 6 months later (p<0.01). Seven patients with chronic sinusitis without nasal polyp (70%) also showed improvement of olfaction (p<0.01). But seven patients with upper respiratory tract infection (58%) did not show significant improvement of olfaction, and it would be necessary to follow up these patients longer. Patients with congenital disorder, nasal septal deviaton, and head trauma did not show significant improvement of olfaction. CONCLUSION: The mentioned test can aid in investigating the etiology of olfactory disturbance, and in accurately assessing the degree of the olfactory disturbance.
Subject(s)
Humans , Aminophylline , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Craniocerebral Trauma , Drug Therapy , Follow-Up Studies , Nasal Polyps , Nasal Surgical Procedures , Respiratory Tract Infections , Sinusitis , Smell , Steroids , Zinc SulfateABSTRACT
BACKGROUND AND OBJECTIVES: There has been considerable research interest in cholesteatoma in recent years but an understanding of the pathophysiology has been handicapped by the lack of a suitable research model. Recent advances in culture methods have contributed to the study of normal physiology or pathogenesis at the level of cells. However, the conventional keratinocyte culture of cholestearoma has some weak points, since it is done under a condition that is different from cellular environments and it cannot investigate cellular interaction among keratinocytes and other cells of cholesteatoma. The purpose of this study is as follows : first, we organize a new study model for cholesteatoma using a three-dimensional (3-D) culture method; and then we study fibroblast effects on keratinocytes under the 3-D culture system. MATERIALS AND METHODS: Aural cholesteatomas were obtained during middle ear operations. The keratinocytes and fibroblasts were first cultured separately and then co-cultured three-dimensionally. The pureness of keratinocyte layer was examined immunohistochemically. We studied fibroblast effects on keratinocytes under the 3-D culture system from the viewpoint of proliferation and differentiation. RESULTS: We could establish 3-D culture of keratinocytes under the influence of fibroblasts. The keratinocytes of the co-culture system showed more proliferation and less differentiation than keratinocytes under the same conditions except for anchoring fibroblasts. CONCLUSION: In this study, we successfully organized the 3-D culture system, a new study model for cholesteatoma, and identified fibroblast effects on keratinocytes. This new study model might be an effective tool for research on the interactions among various cells of cholesteatoma: however, further investigation and development would he necessary.
Subject(s)
Humans , Cholesteatoma , Cholesteatoma, Middle Ear , Coculture Techniques , Disabled Persons , Ear, Middle , Fibroblasts , Keratinocytes , PhysiologyABSTRACT
BACKGROUND AND OBJECTIVES: As a society develops, olfactory disturbance increases with the increased industrial disaster, traffic accidents, upper respiratory tract infection, chronic sinusitis and allergic rhinitis from air pollution, Parkinson's disease and Alzheimer's disease from aging process. Nevertheless, there is no practical clinical test of olfactory function in Korea. Authors decided to develop the "Korean olfactory test" using the odorants which are familiar to Koreans. MATERIALS AND METHODS: KVSS Test (Korean Version of Sniffin' Sticks Test) is composed of KVSS Test I (screening test) and KVSS Test II (comprehensive test). KVSS Test I was performed on 120 controls with normosmia, 39 patients with hyposmia, and 24 patients with anosmia. KVSS Test II was performed on 117 controls with normosmia, 29 patients with hyposmia, and 22 patients with anosmia. The subjects ranged in ages from 20 to 69 years. RESULTS: In KVSS Test I, the range of scores (smell test) was 5.36-7.34 in normosmia, 3.41-6.73 in hyposmia, and 1.14-3.16 in anosmia. In KVSS Test II, the range of T.D.I. score (the sum of olfactory threshold score, odor discrimination score, and odor identification score) was 25.98-35.48 in normosmia, 17.01-30.63 in hyposmia, and 7.32-14.06 in anosmia (p<0.001). CONCLUSION: It is concluded that KVSS Test I and II are suitable for the routine clinical assessment of olfactory performance in Koreans.
Subject(s)
Humans , Accidents, Traffic , Aging , Air Pollution , Alzheimer Disease , Disasters , Discrimination, Psychological , Korea , Odorants , Olfaction Disorders , Parkinson Disease , Respiratory Tract Infections , Rhinitis , SinusitisABSTRACT
No abstract available.