The Relationship between Nasal Septal Deviation and Inferior Turbinate Hypertrophy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the correlation of nasal septal deviation and coexistent inferior turbinate hypertrophy of both side. It also focused on proportional relationships between nasal septal deviation and each compartment of inferior turbinate hypertrophy. MATERIALS AND METHOD: PNS CT of 106 patients treated during the period from September, 2001 to July, 2002 at the Keimyung University Dongsan Medical Center were reveiwed retrospectively to measure nasal septal deviation angle and inferior turbinate hypertrophy. Using PACS (picture archiving and communicating system), we measured the thickness of medial and lateral mucosal, conchal bone by 0.1 mm unit. Each measurement was compared according to the degree of septal deviation angle and its correlation to the co-existent turbinate hypertrophy was analyzed. RESULTS: Inferior turbinates of the concave side were more hypertrophied when compared with the convex side (p<0.05) and its medial mucosa and conchal bone thickness were also increased more in the concave side (p<0.05). However, in view of correlations, there was no statistically significant relationship between septal deviation angle and the degree of hypertrophy of medial, lateral mucosa and conchal bone of inferior turbinate. CONCLUSION: Although it is a common belief that the nasal septal deviation may cause inferior turbinate hypertrophy of the concave side, there is a possibility of another explanation for this phenomenon, such as the developmental theory.

Hypocalcemia after Thyroidectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Incidence of hypocalcemia after thyroidectomy varies from 5.4 to 83%, and permanent hypocalcemia from 0.5 to 8%. The purpose of this study was to determine incidence and risk factors for the development of hypocalcemia and permanent hypocalcemia after thyroidectomy. MATERIALS AND METHOD: The medical records were reviewed for 130 patients who underwent thyroid surgery at the Department of Otolaryngology, Dongsan Medical Center, Keimyung University from January 1998 to June 2002. The subjects were reviewed according to sex, various thyroid diseases, unintentional removal of parathyroid gland, autotransplantation of parathyroid gland and various surgical modality that would affect postoperative hypocalcemia. Hypocalcemia was defined as a serum calcium level under 8.0 mg/dl on at least two consecutive measurements regardless of symptoms. Permanent hypocalcemia was defined for cases in which hypocalcemia persisted more than 6 months after thyroidectomy. RESULTS: Among 130 patients, 43 patients (33.1%) had hypo-calcemia and 9 patients (6.9%) permanent hypocalcemia. Factors significantly predictive of postoperative hypocalcemia in univariate analysis included malignancy (p < 0.001), extensive operation (total thyroidectomy, total thyroidectomy with neck dissection)(p < 0.001) and unintentional removal of parathyroid gland (p < 0.001). Independant risk factors on multivariate analysis were malignancy (p=0.027) and unintentional removal of parathyroid gland (p=0.048). CONCLUSION: Our study showed that the incidence of hypocalcemia after thyroidectomy was 33.1% and permanent hypocalcemia 6.9%. Our study found malignancy, extensive surgery, unintentional removal of parathyroid gland to be statistically significant risk factors. Hypo-calcemia can be kept to a minimum by profound knowledge of anatomy of thyroid and parathyroid gland, meticulous surgical technique and delicate autotransplantation of parathyroid gland.

Clinical Study of the Hospitalized Epistaxis Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Epistaxis is often regarded as trivial disease, but it may cause serious situation and requires hospital admission. With the advent of nasal endoscopy, localizing the precise location of nasal bleeding is possible in most cases and enables direct treatment rather than simple nasal packing. We analyzed the epistaxis patients who require hospital admission during recent 10 years. MATERIALS AND METHODS: One hundred and one patients who required hospital admission from January 1990 to December 1999 due to intractable or recurrent epistaxis were included in this study. Records of the hospital admission were reviewed and analyzed retrospectively. RESULTS: Male patients were predominant (72.1%) and the highest age distribution was in the 50's. Intervals between the initial attack of epistaxis and medical attention was 2-5 days (60.4%). The mean duration of hospital stay was 5-10 days (49.5%). The precise localization of bleeding point was possible in 98 cases (81.6%), whereas some sites of bleeding revealed Little's area (35.0%) and nasal turbinates (28.3%). The most frequent preexisting structural abnormality and systemic illness were nasal septal deviation and hypertension. In hypertension patients, the predominant age distribution was in the 60's (28.6%), and there was no difference in the bleeding frequency and the mode of management. CONCLUSION: We analyzed the epistaxis patients who required hospitalization. Nasal endoscopy enabled precise localization of the epistaxis and prompt focused management rather than conservative management.