Long-Term Results of Endoscopic Dilatation for Tracheal and Subglottic Stenosis

OBJECTIVES: The purpose of this study was to assess the long-term results of endoscopic dilatation of airway stenosis and to evaluate predictive factors for favorable results. METHODS: Fifty-four patients with tracheal and subglottic stenosis who underwent endoscopic dilatation with at least 12 months follow-up were enrolled in this study. We evaluated predictive factors for final treatment outcome such as stenosis length, location, characteristics, procedure type, and the severity of stenosis. RESULTS: The final outcome of endoscopic dilatation showed a cure rate of 40.7%, improvement rate of 46.3%, and failure rate of 13.0%. Patients with mild stenosis or a shorter stenotic segment and those who underwent a touch-up procedure following tracheal resection with end-to-end anastomosis showed better outcomes. The cure rate of endoscopic dilatation for patients with shorter mild stenosis was 72.2%. CONCLUSION: Endoscopic dilatation may be a primary treatment modality for patients with airway stenosis characterized by mild severity and a short stenotic segment.

The Utility of Sono-Guided Sclerotherapy for Benign Thyroid Cyst: Prospective Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Ultrasonography (USG)-guided sclerotherapy using a sclerotherapic agent such as ethanol, OK-432, recently has gained popularity as a treatment for nonfunctioning benign thyroid nodules. The study evaluates the efficacy and safety of the USG-guided sclerotherapy for that purpose. SUBJECTS AND METHOD: Included in the study were 23 patients who had complaints of applied pressure or cosmetic problems due to cystic thyroid nodules, which had been diagnosed as benign and nonfunctioning by fine-needle aspiration biopsy and thyroid function test. Sclerotherapy was performed with OK-432 or 99.9% ethanol following nearly complete evacuation of the fluid from the cystic portion of thyroid nodule. At each USG follow-up, we measured the volume of cysts, symptom scores, cosmetic scores using a visual analog scale, and related complications were examined at postoperative dates of one and six months. RESULTS: The volume of thyroid cysts were significantly reduced (p<0.01) with mean volume reduction rates of 77.3+/-21.2% at postoperative 6 months. The cosmetic score and symptom score were significantly improved following sclerotherapy (p<0.01). Major complications related to sclerotherapy, such as vocal cord paralysis, thyrotoxicosis and tissue necrosis, did not happen during the follow-up observation. CONCLUSION: USG-guided sclerotherapy could be a simple and effective treatment modality for benign cystic thyroid nodules.

Comparison of Myringoplasty for the Chronic Small Tympanic Membrane Perforations: Fat versus Perichondrium / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There are several techniques to perform myringoplasty for tympanic membrane perforations as an outpatient procedure. The aim of this study is to compare the results of fat and perichondrium myringoplasty for the treatment of chronic small tympanic membrane perforations. SUBJECTS AND METHOD: This investigation included 46 patients with chronic tympanic membrane perforations smaller than 3 mm. The patients were equally divided into 2 main groups according to surgical procedures. The patients underwent fat, or perichondrium myringoplasty without skin incision via transcanal approach under local anesthesia. The healing results of perforation and hearing improvement were investigated. RESULTS: Closure rates of the perforations in the fat, perichondrium myringoplasty groups were all the same as 87% (20/23). There were no significant differences between techniques in tympanic membrane closure rates with regard to size and location and in hearing improvement. However, the recovery time was a little faster in perichondrium myringoplasty during follow up. CONCLUSION: Conservative myringoplasty using fat and perichondrium is a feasible procedure that can be perfomed on outpatient basis for chronic small tympanic membrane perforations.

Evaluation of the Interaural Attenuation for Pure Tone Audiometry in Korean

BACKGROUND AND OBJECTIVES: The masking should be used in pure tone audiometry when the difference between the air-conduction threshold of the tested ear and the bone-conduction threshold of the non-tested ear is more than interaural attenuation (IA). But the standardized average value of IA in Korean has not been evaluated until now. The purpose of this study is to evaluate the interaural attenuation in Korean population. SUBJECTS AND METHODS: Of the patients who visited our department from March, 2007 to August, 2009, 44 patients were selected who had unilateral severe sensorineural hearing loss or deafness and contralateral normal hearing. When the difference between air-conduction threshold with and without masking was more than 10 dB, the interaural attenuation at each frequency was obtained by subtracting the contralateral bone conduction from the air-conduction threshold without masking. RESULTS: The interaural attenuations at each frequency were 45-75 dB (250 Hz), 50-75 dB (500 Hz), 40-75 dB (1 kHz), 45-85 dB (2 kHz), 50-90 dB (4 kHz). 77.2% of the subjects showed interaural attenuation of 55-65 dB at 250 Hz, and 80.9% in 50-60 dB at 500 Hz, 79.5% in 55-65 dB at 1 kHz, 83.4% in 45-60 dB at 2 kHz, and 76.4% in 50-65 dB at 4 kHz. Most of the patients were distributed 15-25 dB higher than the minimal interaural attenuation at 1 kHz. At 2 kHz and 4 kHz, most of the patients were distributed around 15 dB of the minimal interaural attenuation. CONCLUSIONS: These results can be used as reference values for masking of pure tone audiometry. But, further studies with large population should be done to get more precise results and contributing factors to IA values.

A Case of Posterior Fossa Meningioma Mimicking Meniere's Disease / 대한평형의학회지

Posterior fossa meningioma constitute approximately 10% of meningiomas. It can rarely involve the endolymphatic sac and produce symptoms of Meniere's disease. We present the case of a 41-year-old male patient who was suffering from recurrent vertigo. The pure tone audiogram revealed low tone hearing loss on right side and temporal magnetic resonance image revealed a meningioma in posterior fossa. Posterior fossa meningioma should be considered in the differential diagnosis of patients with signs and symptoms of Meniere's disease.

A Case of the Schwanomma Originated in the Middle Ear Cavity / 대한이비인후과학회지

Schwannoma is benign tumor that is originated from the schwann cell. It rarely occurs in the middle ear. Schwannomas of the middle ear may originate from the nerves of the middle ear cavity or by extensions from its neighboring structures. Most schwannomas arising from the middle ear are facial nerve schwannomas. We present a case of a 16-year-old male patient with primary middle ear schwannoma believed to arise from Jacobson's nerves. The tumor was easily dissected from the facial nerve and the chorda tympani nerve. The mass was successfully removed by canal down mastoidectomy, while preserving the hearing and facial nerve functions of the patient.

A Case of Dermoid Cyst of the Nasal Septum / 대한이비인후과학회지

Nasal dermoid cysts are rare neoplasms, which are diagnosed frequently in childhood. These lesions are derived from both ectoderm and mesoderm, and have keratinizing epithelium with skin appendages. A fistula, pit, or mass is the common clinical presentation. The diagnosis is primarily based on the medical history, physical examination, clinical symptoms, and radiologic findings. Complete surgical excision is the treatment of choice. A 15-year-old boy presented with a fistula on the nasal vestibule, which existed from birth. Fistulography revealed a contrast-filling fistulous tract and cyst in the caudal portion of the nasal septum. The lesion was removed surgically and pathology confirmed the diagnosis of dermoid cyst. We report, with a review of the literature, a rare case of dermoid cyst that occurred from the nasal septum.