Clinical Analysis of Deep Neck Infection / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Deep neck infection may still be lethal especially when life-threatening complications occur. The objective of this study is to clarify the therapeutic module for deep neck infection and analyze epidemiologic characteristics, clinical course, microorganisms and site of infections. SUBJECTS AND METHOD: We retrospectively reviewed the medical charts of 98 patients who were confirmed with deep neck infection and who received treatment at the Soonchunhyang University Hospital between 2000 and 2009. We analyzed the data for deep neck infection using the statistical tools like t-test and Spearman's coefficient of correlation. RESULTS: The parapharyngeal space was the most commonly involved space in deep neck infection. The most common pathogen was Streptococcus. The most common underlying disease was Diabetes mellitus. CONCLUSION: Statistical dada showed that there was no significant correlation between the hospitalization period and deep neck infection.

A Case of Middle Ear Lipoma / 대한이비인후과학회지

We present a case report of primary middle ear lipoma diagnosed in right ear of a 25-month-old girl with right otitis media. We identified injection and retraction at right ear drum. Impedance tympanometry of right ear was type B and temporal bone CT was suggestive of a congenital cholesteatoma. During the tympanoplasty, a mass of tissue obstructing the eustachian tube orifice was noted in the middle ear. We have treated a case of a lipoma that originated from the middle ear; only 5 such cases have been reported worldwide.

Cochlear Implantation in a Deaf Patient with Bilateral Temporal Bone Fractures / 대한이비인후과학회지

Transverse temporal bone fracture can make a profound sensorineural hearing loss. This temporal bone fracture usually happens in the single side; however, the bilateral temporal bone fracture can make the postlingual deafness. Therefore, the deafness from bilateral temporal bone fractures can be one of the indications for the cochlear implantation. We report on the experience of the cochlear implantation in a deaf patient after bilateral temporal bone fractures.

Endoscopic Removal of Parathyroid Tumors via an Unilateral Axillo-Breast Approach / 대한이비인후과학회지

Since Gagner introduced the first endoscopic parathyroidectomy in 1996, various approaches for endoscopic thyroidectomy & parathyroidectomy have been proposed. We have recently developed an unilateral axillo-breast approach for endoscopic thyroid surgery without gas insufflation. Through our experiences of more than 100 cases of endoscopic thyroidectomy, we have recently performed the endoscopic removal of parathyroid tumors. Case 1 was diagnosed as parathyroid adenoma, and we could not exclude the possibility of a thymic cyst, bronchogenic cyst, or brachial cleft cyst before the operation in Case 2. The final pathologic diagnosis of case 2 was a parathyroid cyst. To our knowledge, this is the first report of endoscopic removal of parathyroid tumor by an ENT surgeon in this country. This report suggests that endoscopic removal of parathyroid tumor or paratracheal mass via unilateral axillo-breast approach without gas insufflation could be a valid option for selective patients with major concern of cosmesis.

Prevention of Lateral Synechia Formation with Silastic Sheet in the Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Lateral synechia formation between the middle turbinate and the lateral nasal wall is one of the most common complications in endoscopic sinus surgery. Unstable and floppy middle turbinate occurs not infrequently and it may make meticulous postoperative dressing difficult during healing period, and consequently increases the risk of synechia and recurrence of sinusitis. The aim of this study was to investigate whether insertion of the silastic sheet in the middle meatus can effectively prevent the synechia formation. SUBJECTS AND METHOD: Twenty eight patients (31 sides including 3 bilateral cases) with unstable and floppy middle turbinate occurred during endoscopic sinus surgery were enrolled in this study. The silastic sheet was designed in fan-shape and inserted between the middle turbinate and the lateral nasal wall. The silastic sheet was secured to the caudal septum and removed 2 to 3 weeks after the operation. We performed a follow-up study for 5 months and investigated the occurrence rate of synechia. RESULTS: The success rate of our method was 90.3% and synechia in the middle meatus developed in 3 of 31 sides (9.7%). Although synechia between the middle turbinate and nasal septum occurred in 4 sides, the patients did not complain of olfactory disturbance. CONCLUSION: The results of this study suggest that insertion of the silastic sheet in the middle meatus can be a useful method in the prevention of lateral synechia formation when unstable and floppy middle turbinate has developed during endoscopic sinus surgery.