Characteristics and Outcomes of Septoplasty in Patients with Paradoxical Nasal Obstruction / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate clinical characteristics and outcome of septoplasty in patients complaining of paradoxical nasal obstruction. SUBJECTS AND METHOD: Medical records of 637 patients who underwent septoplasty from 2011 to 2016 were reviewed retrospectively. One hundred sixty-nine patients whose follow up periods were longer than 3 months were included. These patients were categorized into two groups, the experimental group (paradoxical nasal obstruction) and the control group. We analyzed the degree of nasal obstruction, the sino-nasal outcome test (SNOT)-22 score, which is the sino-nasal outcome, and the minimal cross-sectional area in acoustic rhinometry. The effect of concurrent turbinoplasty was also evaluated. RESULTS: Paradoxical nasal obstruction was found in 19 patients (11.2%). Compared to the control group, the degree of mucosal change (both concave and convex side) had no statistical significance. Although the degree of nasal obstruction and SNOT-22 scores were significantly improved after surgery in both groups (p<0.05), the values for the experimental group were slightly increased at 3 months of surgery after having been improved at one month of surgery. In contrast, those values improved steadily over time in the control group. The tendency of psychologic domain scores was significantly different between the two groups (p=0.021). The results of volume reductive turbinoplasty showed that it maintained the improved symptoms better when performed along with septoplasty. CONCLUSION: Although septoplasty showed beneficial effects in patients with paradoxical nasal obstruction, the effect of septoplasty decreased over time. Concurrent volume reductive turbinate surgery maintained the effect of septoplasty in paradoxical nasal obstruction.

The Impact of Allergic Rhinitis on Symptom Improvement in Pediatric Patients After Adenotonsillectomy

OBJECTIVES: It is well known that allergic rhinitis (AR) has positive association with adenotonsillectomy. However, the impact of AR on symptom improvement after adenotonsillectomy is not well documented. Hence, we aimed to evaluate the effect of AR on the symptom improvement after adenotonsillectomy between AR and nonallergic patients. METHODS: A retrospective analysis was performed on 250 pediatric patients younger than 10 years old who received adenotonsillectomy from June 2009 to June 2014 in a tertiary referral hospital. All patients underwent skin prick test or multiple allergen simultaneous test (MAST) before surgery and classified into AR group and control group. Obstructive and rhinitis symptoms including snoring, mouth breathing, nasal obstruction, rhinorrhea, itching, and sneezing were evaluated before and 1 year after surgery using questionnaire and telephone survey. RESULTS: AR group was 131 and control group was 119, showing higher prevalence (52.4%) of AR among adenotonsillectomized patients. Both groups showed dramatic improvement of symptoms such as snoring and mouth breathing after surgery (all P < 0.05). However, AR group showed significantly less improvement than control group in snoring, mouth breathing, nasal obstruction, and rhinorrhea (all P < 0.05). Multivariate analysis showed that preoperative mouth breathing and snoring were dependent on tonsil grade and postoperative symptoms were mainly dependent on presence of AR. Nasal obstruction was dependent on tonsil grade and presence of AR preoperatively and presence of AR postoperatively. These suggest the importance of AR as a risk factor for mouth breathing, snoring, and nasal obstruction. CONCLUSION: AR has positive association with adenotonsillectomy and not only allergic symptoms but also obstructive symptoms such as snoring and mouth breathing improved less in AR group than control group. Hence, patients with AR should be monitored for long-term basis and more carefully after adenotonsillectomy.

Characteristics and Outcomes of Septoplasty in Patients with Paradoxical Nasal Obstruction / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#The aim of this study was to evaluate clinical characteristics and outcome of septoplasty in patients complaining of paradoxical nasal obstruction.SUBJECTS AND METHOD: Medical records of 637 patients who underwent septoplasty from 2011 to 2016 were reviewed retrospectively. One hundred sixty-nine patients whose follow up periods were longer than 3 months were included. These patients were categorized into two groups, the experimental group (paradoxical nasal obstruction) and the control group. We analyzed the degree of nasal obstruction, the sino-nasal outcome test (SNOT)-22 score, which is the sino-nasal outcome, and the minimal cross-sectional area in acoustic rhinometry. The effect of concurrent turbinoplasty was also evaluated.@*RESULTS@#Paradoxical nasal obstruction was found in 19 patients (11.2%). Compared to the control group, the degree of mucosal change (both concave and convex side) had no statistical significance. Although the degree of nasal obstruction and SNOT-22 scores were significantly improved after surgery in both groups (p<0.05), the values for the experimental group were slightly increased at 3 months of surgery after having been improved at one month of surgery. In contrast, those values improved steadily over time in the control group. The tendency of psychologic domain scores was significantly different between the two groups (p=0.021). The results of volume reductive turbinoplasty showed that it maintained the improved symptoms better when performed along with septoplasty.@*CONCLUSION@#Although septoplasty showed beneficial effects in patients with paradoxical nasal obstruction, the effect of septoplasty decreased over time. Concurrent volume reductive turbinate surgery maintained the effect of septoplasty in paradoxical nasal obstruction.

A Case of Venous Malformation of the Pyriform Sinus Treated with Ethanol Sclerotherapy

We describe a case of venous malformation of pyriform sinus in 63 year-old patient, discovered incidentally. Venous malformation are the most common vascular malformations to arise in the head and neck. However venous malformation of the hypopharynx in the adult papulation are rare. The author performed successfully ethanol sclerotherapy for venous malformation of pyriform sinus, so we present the case with a review of the related literatures.