A Fatal Case of Vocal Cord Dysfunction: A Case Report / 대한구급학회지

Vocal cord dysfunction is characterized by the paradoxical adduction of the vocal cord during inspiration, causing relapsing wheezing or stridor, chest tightness, shortness of breath, and coughing. If the patient exhibiting symptoms of asthma is not responsive to treatment, there is a need to test whether vocal cord dysfunction is complicated by asthma. Herein, we report a case of vocal cord dysfunction with acute respiratory failure in old age with underlying disease. The patient presented with resting dyspnea, an audible wheeze, and was first diagnosed with acute exacerbation of bronchial asthma. However, her symptoms were not controlled with medical treatment and laryngoscopy showed paradoxical adduction of the vocal cords. Sudden cardiopulmonary arrest occurred after meal on the day of laryngoscopic examination. Although successful cardiopulmonary resuscitation, the patient developed ventilator-associated pneumonia, and multiple organ failure, eventually leading to death. Because the case was fatal, a report is being issued.

A Case of Deep Neck Infection by Tuberculosis Destroying the Cervical Vertebrae / 대한이비인후과학회지

Deep neck infections affect fascial compartment of the head and neck, and their contents. Fever, pain, and swelling are the most common presenting symptoms. Also, the development of septic shock or mediastinitis depends on the degree of progression of the disease. The advent of antibiotics decreases the incidence and mortality of the deep neck infection. Antibiotics also alters the causation and management of this disease. In a recent report, mixed species with anaerobe were found in 50% of patients, whereas Staphylococci and Hemolytic streptococci were the leading causes of deep nect infections in the past. Also, in the case of immunocompromised host, deep neck infections caused by tuberculosis or fungus are not excluded. We experienced a 23 year old man with deep neck infection caused by tuberculosis presenting bone destruction of cervical spine. In this article, we reviewed the etiology, diagnosis, and treatment of this case, with a review of literatures.

A Case of Leiomyosarcoma of the Tongue / 대한이비인후과학회지

Leiomyosarcoma is a malignant neoplasm of smooth muscle origin. This tumor represents 5% to 10% of all soft tissue sarcomas and occurs mainly in the uterus, gastrointestinal tract, and retroperitoneum. Leiomyosarcoma of the tongue is extremely rare because there is limited smooth muscle in this area. To date, 7 cases of primary and one case of metastatic leiomyosarcoma have been reported concerting leiomyosarcoma of the tongue. Recently however, we experienced a case of leiomyosarcoma of the tongue in a 48-year-old woman who was considered initially as havire a benign tumor. So, we report here an additional case of leiomyosarcoma of the tongue with a review of literatures.

A Case of Monostotic-Type Fibrous Dysplasia in the Sphenoid Sinus / 대한이비인후과학회지

Fibrous dysplasia is a rare fibro-osseous lesion characterized by replacing the skeletal structure. Its main feature is the involvement of one or several bones of the skeletal and extra-skeletal systems. Fibrous dysplasia arising in the paranasal sinus is rare, especially in the ethmoid and sphenoid sinuses. Only one case of fibrous dysplasia originating in the sphenoid sinus have been reported in the regional and international literature. Recently we experienced a case of monostotic fibrous dysplasia which derived from the sphenoid sinus in a 33-year-old female. So the case will be discussed with literature review.

Olfactory Changes in Patients of Dementia / 대한이비인후과학회지

BACKGROUND: Dementia has emerged as a major healthy challenge, not only for clinicians but for society as a whole. So, there is a growing need for study of dementia. Evaulating the patients with dementia, examination of the sense of smell is not routinely performed. However, one of several neurologic changes include alterations in olfaction. OBJECTIVES: The aim of this study was to evaluate the value of olfactory function test in demented patients as diagnostic tool. MATERIALS AND METHOD: We studied the olfactory functions in 35 patients with dementia of the Alzheimer's type(DAT) and 20 patients with vascular dementia(VD) and compared with normal controls(n=30). These subjects were divided according to the Mini-Mental State Examination(MMSE). We used the T & T olfactometer for the olfactory function test. RESULTS: In the group of questionable DAT, the detection and recognition threshold were 0.25+/-0.95, 2.38+/-1.87, in the group of definitive DAT, 1.51+/-1.52, 3.91+/-1.55 and in the group of definitive vascular dementia, 2.03+/-1.48, 4.53+/-1.45. But, in the normal controls, the detection and recognition threshold was 0.66+/-0.90, 1.55+/-0.81 respectively. CONCLUSION: These findings suggest that olfactory function test are valuable in demented patients as diagnostic tool, but not specific in DAT group and that early detection of DAT is possible by olfactory function test.

Changes of the Olfaction after Nasal Surgery in Chronic Sinusitis / 대한이비인후과학회지

It is well known that olfactory dysfunction relates to many etiologies such as obstructive nasal and sinus diseases, upper respiratory tract infections, head trauma, aging, congenital anomalies, endocrine diseases, drugs and so forth. Chronic paranasal sinusitis is the most common etiology of olfactory dysfunction. So, We studied the effect of the surgery on olfaction in patients with chronic paranasal sinusitis. A preoperative and postoperative evaluation of the olfactory function was carried out in 80 patients using the T and T olfactometer. All patients were divided into two groups-chronic paranasal sinusitis and chronic paranasal sinusitis with polyposis. According to the preoperative recognition threshold, olfactory function of all patients were divided into five groups. The group 1 was normal, group 2 was mild decreased, group 3 was moderate decreased, group 4 was severe decreased and group 5 was anosmia. Almost patients were improved on olfaction in the postoperative state. The olfactory fissure was usually closed in patients with nasal polyp. In the patients with closed olfactory fissure, recognition threshold was 4.9+/-1.5 and in opened olfactory fissure, 1.9+/-1.8. Therefore the olfactory fissure was the one of the most important factors on olfaction.