Comparison of the Effects of Laser-Assisted Conchotomy (LACON)and Coblation-Assisted Partial Turbinoplasty (CAPT) in Allergic Rhinitis

BACKGROUND AND OBJECTIVES: There are many operative methods for allergic rhinitis such as partial or total turbinectomy, submucosal resection. Laser- assisted conchotomy (LACON) and coblation-assisted partial turbinoplasty (CAPT) are recently being commonly performed for minimal invasive surgery. The aim of this study is to compare the subjective and objective results in the groups of patients with allergic rhinitis who underwent LACON or CAPT after long term follow up. MATERIALS AND METHODS: From January 2006 to January 2007, 64 patients with allergic rhinitis refractory to medical therapy who underwent LACON or CAPT were enrolled in this study. 28 patients had LACON therapy and 36 patients underwent CAPT randomly. The symptom of allergy, duration of crust formation, and nasal patency in acoustic rhinometry were analyzed in months 3, 6, 9, 12 after surgery. RESULTS: With the Visual Analogue Scale (VAS), the patients who received LACON all reported significant differences in allergic symptoms. However, patients who received CAPT reported significant differences only in nasal obstruction and rhinorrhea. There were no significant differences in both groups in regard to nasal patency change (nasal volume, cm3) and duration of crust formation. CONCLUSION: As LACON is effective on all symptoms and CAPT is effective only on nasal obstruction and rhinorrhea, the procedures can be performed respectively, depending on the symptoms of patients.

Usefulness of Sialendoscopy in Unusual Obstructive Salivary Ductal Diseases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Ductal calculi and stenosis are well known causes of salivary ductal obstructive lesions. As a direct view of the ductal systems was not possible for the surgeons, sialendoscopy has been a convenient tool for finding out these obstructive lesions. This study contains some unusual endoscopic findings that we have found during diagnostic and interventional sialendoscopy. SUBJECTS AND METHOD: Retrospective chart reviews were done, and endoscopic findings were reviewed for patients who received sialendoscopy from September 2003 to January 2007. Sixtyfour patients received sialendoscopy for either diagnostic or interventional method. RESULTS: We found unusual findings in 7 cases (10.9%). Three cases of basin malformation were observed. Two cases had spontaneous ductal perforation, and we also observed 2 cases of occult stone. CONCLUSION: The sialendoscopy is an excellent method in evaluating and treating salivary ductal diseases. We found out that the sialendoscopy made it possible to explore ductal systems completely, as well as to detect unusual findings, and to help in the management of some salivary ductal diseases.

The Surgical Treatment of Locally Invasive Thyroid Papillary Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Thyroid papillary carcinoma usually progresses slowly and invades the surrounding tissues infrequently. About 10% of thyroid papillary carcinoma takes to local invasion that include larynx, pharynx, esophagus, and trachea. However, when invasion occurs, it becomes the source of significant morbidity and mortality to the patient. The main cause of death in thyroid papillary carcinoma is inappropriate treatment of local invasion. This study was designed to investigate the frequency and structure of local invasion, type of surgical treatment, complication and recurrence of locally invasive thyroid papillary carcinoma. SUBJECTS AND METHOD: Between August 1996 and July 2004, 114 patients were diagnosed with thyroid papillary carcinoma and were treated surgically at the Department of Otorhinolaryngology-head & neck surgery, Inha Univ. Hospital. Preoperative evaluation included needle aspiration biopsy, thyroid function test, computerized tomography and/or magnetic resonance imaging. Study was done retrospectively. RESULTS: Local invasion in thyroid papillary carcinoma was observed in 24% (27/114) of the thyroid papillary carcinoma. The most common invasion site was the recurrent laryngeal nerve. Total thyroidectomy was performed in all patients and was combined with radical procedures that included laryngectomy, pharyngectomy or with conservative procedures that included tracheal shaving and so on. Locoregional recurrence was observed in 19% of the cases and the most common site of local invasion was cervical lymph node. One case (4%) of patients died of locoregional recurrence. CONCLUSION: Thyroid papillary carcinoma frequently invades the surrounding structure. We believe that precise preoperative evaluation and treatment including primary resection specific to preoperative evaluation, the management of cervical lymph node metastasis and postoperative radioactive iodine therapy may all contribute to decreasing the mortality and morbidity of locally invasive thyroid papillary carcinoma.

Preoperative Factors in Prediction of Postoperative Pulmonary Complication in Patients with Conservative Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To predict postoperative pulmonary complication in patients with conservative laryngectomy, variable factors such as pulmonary function test (PFT) have been reported. Therefore, we reviewed the relationships between postoperative pulmonary complications and preoperative risk factors including the parameters of PFT. PATIENTS AND METHOD: From 1997 Jun. to 2005 July., conservative laryngectomy was performed under diagnosis of laryngeal cancer in 36 patients. The factors related to age, history of lung diseases, the parameters of PFT (FEV1, FEV1/FVC and FVC), and the types of surgery were analyzed to evaluate the postoperative pulmonary complication. We used a retrospective analysis of medical records and Fisher exact method to verify the relationships between preoperative risk factors and the pulmonary complications. RESULTS: 8 patients had postoperative pulmonary complication. Age, history of lung diseases and PFT parameters had no statistical significance. Among them, 7 patients and 1 patient had takensupracricoid laryngectomy and supraglottic laryngectomy, respectively. Supracricoid laryngectomy cases had more significant postoperative pulmonary complications than vertical partial laryngectomy cases. CONCLUSION: Age, the history of lung diseases, and parameters of PFT had no predictable value for postoperative lung complications. In the comparison between the surgery types, only supracricoid laryngectomy cases had statistical increase of postoperative pulmonary complications.