The Normal Width of the Anterior Commissure of the True Vocal Cord in Korean Adults Measured by Helical CT

PURPOSE: To evaluate the mean width of anterior commissure of true vocal cord in Korean adults by measuringits dimension on spiral CT scans. MATERIALS AND METHODS: We reviewed the CT scans of 53 Korean adults(age range,23-73years; mean age 39.2years; M:F=41:12) without laryngeal disorders. Spiral CT scanning was performed aroundthe anterior commissure with 1mm slice thickness and table incrementation for 15 seconds. The anteroposteriorwidth of the anterior commissure was measured on CT scan where the true vocal cord and arytenoid, cricoid andthyroid cartilages were all present. We determined the mean width of the anterior commissure and whether there wasa relationship between age and the width of the anterior commissure. RESULTS: The width of the anteriorcommissure was between 0.9mm and 2.3mm ; mean width was 1.60+/-0.38mm(mean+/-SD). Using two SDs above the mean wouldhave defined 2.36mm as the upper limit of normal width. Statistically, no significant correlation existed betweenthe age and the width of the anterior commissure(p>0.05). CONCLUSION: An awareuess of the normal width range ofthe anterior commissure in Korean adults evaluated by spiral CT enhances the possibility of early detection ofinvasion of the anterior commissure by glottic cancer.

CT Findings of Orbital Blow-out Fracture

PURPOSE: To evaluate the usefulness and radiologic findings of CT in the diagnosis of orbital blow-outfracture. MATERIALS AND METHODS: Forty-four patients with orbital blow-out fractures diagnosed by clinicalfindings and CT were evaluated retrospectively. On CT images, we evaluated the site and frequency of fracture,herniation of orbital fat, extraocular muscle abnormality, intraorbital hematoma, and intrasinus hemorrhage. RESULTS: Forty-eight sites of orbital wall fractures were seen. Of these, 25(52.1%) were observed at the medialwall and 18(37.5%) at the inferior wall. Combined fracture of the medial and inferior wall was seen in fivecases(10.4%), and orbital fat herniation to adjacent sinuses in 25. Associated extraocular muscle abnormalitieswere seen at the medial rectus (n=20) and inferior rectus muscle(n=18). Intrasinus hemorrhage was seen in 15cases, and intraorbital hematoma in five. CONCLUSION: CT is a useful diagnostic modality for the evaluation oforbital blow-out fracture and associated soft tissue abnormalities.

Design and Clinical Application of Safe Air-Pressure Reduction System for Intussusception

PURPOSE: This study was performed to design a safe air-pressure reduction system which can absorb rapidlyrising intraluminal pressure during intussusception, and comparison with other reduction systems to test itsclinical availability. MATERIALS AND METHODS: The air-pressure reduction system consisted of a pressure gauge,air insufflators, a pressure controller, buffers, and rapid exhaustion devices, and to determine itsabsorbability, it was connected with a bowel model. By using it in 20 infants with intussusception, we comparedthe absorbability of our air-pressure reduction system with preexisting systems. RESULTS: While extraluminalpressure was applied to the bowel model in which baseline intraluminal pressure was set to 120mmHg, this rose to176mmHg (56mmHg high to standard, 100%) in the direct infusion system, but to only 130 mmHg (10mmHg high tostandard, 17.9%) in a system connected to a large buffer of 10,500 mL capacity. Immediately after the applicationof extraluminal pressure for less than 1 sec, this air-pressure reduction system showed better absorbability thanthe hydrostatic reduction system. Applying this system to 20 infants with intussusception, this was successfullyreduced in 19 cases(95%), without complications. CONCLUSION: In this experiment, it was proved that the systemabsorbed rapid intraluminal pressure elevation. Its use would help prevent bowel perforation during air reductionoccurring during intussusception.

Roentgenographic Findings in Hyaline Membrane Disease Treated with Exogenous Surfactant: Comparison with Control Group

PURPOSE: To compare, with the use of chest radiographic findings, improvement and complications in newborns treated with exogenous surfactant for hyaline membrane disease(HMD), and an untreated control group. MATERIALS AND METHODS: Thirty-six patients with HMD were randomly assigned to a control group (n=18) or surfactant treated group (n=18). As part of an initial evaluation of their pulmonary status, we then performed a retrospective statistical analysis of chest radiographic findings obtained in exogenous surfactant treated and untreated infants within the first 90 minutes of life. Subsequent examinations were performed at less than 24 hours of age. RESULTS: Chest radiograph before treatment showed no significant differences between the two groups, but significant improvement was noted in the surfactant treated group, in contrast to the control group. The most common chest radiographic finding after surfactant administration was uniform (n=15) or disproportionate (n=2) improvement of pulmonary aeration. Patent ductus arteriosus developed in three treated neonates and in four cases in the control group. Air leak occurred in three cases in the treated group and in five cases in the control group. In one treated patient pulmonary hemorrhage developed and intracranial hemorrhage occurred in three treated neonates and in four cases in the control group. Bronchopulmonary dysplasia was developed in 6 cases of treated group and 3 cases of control group. CONCLUSION: A chest radiograph is considered to be helpful in the evaluation of improvement and complications of HMD in infants treated with surfactant.