Corrective Rhinoplasty Through the Correction of Combined Deformities / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recently, the demand for corrective rhinoplasty has increased due to a higher frequency of accidents as well as improved socioeconomic status. Thus, there is an increased interest in the correction of deviated noses in the otorhinolaryngologic field. This study offers a clinical analysis of our experiences in the corrective rhinoplasty and makes a case that the simultaneous correction method by the exteral approach is suitable for combined deformities of the nose. MATERIALS AND METHODS: A retrospective study was performed on 69 patients who underwent corrective rhinoplasty during the last four years. Initially, patients were put under general anesthesia, and the procedures were performed through the external approach. Following the initial corrective rhinoplasty was a simultaneous correction of combined deformities of the nose such as deviated noses with saddle deformity or hump nose or camouflage of the deviation with one or two straight layered cartilage on the nasal dorsum. RESULTS: Satisfactory results were achieved in most cases except in the two cases of incomplete correction, one case of cosmetical unsatisfaction and one case of intermittent nasal obstruction. CONCLUSION: Deviated noses frequently have combined deformities. For better results, it is necessary to correct combined deformities simultaneously. The authors obtained satisfactory results through simultaneous correction of complicated deformities using the external approach.

Local Production of IgE in Nasal Polyp

Among the several possible etiologic factors for the development of nasal polyp, localized nasal allergy had been insisted to be one of the major factors. This study aims to explore the existence of local production of IgE within nasal polyp, which can be the indirect evidence of localized nasal allergy. Fifty-two patients, who underwent nasal polypectomies between April 1993 and December 1995, were selected. The levels of total IgE and specific IgE of serum and polyp fluids were assessed. By using Donovan's equation, the percentage of local production of IgE in nasal polyp were calculated. Local production of total IgE was demonstrated in 18 cases of 28 polyp patient group (64.3%). Local production of specific IgE for Dermatophagoides pteronyssinus and Dermatophagoides farinae were demonstrated in 6 cases of 24 polyp patient group (25%). These results suggest the existence of local production of IgE in nasal polyp.

The Surgical Treatment of Acute Rupture of the Lateral Ligaments of the Ankle / 대한정형외과학회잡지

Inappropriate treatment of the injury of the lateral collateral ligaments of the ankle produce residual instability, which causes serious disability. There is considerable divergence of opinion as to whether fresh rupture of the lateral ligaments of the ankle are best treated by conservative or opreative method. We have conducted a trial to analyze thirty patients, who were treated by immediate open surgical rupair of rupture of the lateral ligaments of the ankle between April 1991 and February 1992. The results were as follows: 1. All patients were active, young men, Injuries to left ankle were three times more than right side. The most common cause of injury is occurred during sports, especially association football. 2. The decision to operate was based on 1)Talar tilt angle of the injured ankle measures 8-10 degrees more than that of the stress uninjured ankle. 2)A positive arthrogram showing contrast leakage into peroneal tendon she-aths & anterolateral aspect of the lateral malleolus. 3. Diagnostic accuracy rate of arthrography is 94.5%, stress radiography 61.1 %. Arthrography is more reliable than stress radiography in the diagnosis of acute injuries to the lateral ligament of the ankle. 4. At operation, isolated rupture of anterior talofibular ligament was in 5 cases, isolated rupture of middle calcaneofibular ligament in 3 cases, concomittant ruptures of anterior talofibular and middle calcaneofibular ligements in 22 cases. 5. Location of tears of anterior talofibular ligament was mostly mid-portion, middle calcaneofibular ligament in mid-portion or distal portion. 6. On radiologic results, average angle of talar tilt was 14.4° preoperatively, 5.2 preoperatively. There was correction of talar tilt angle of average 9.2°. 7. Clinical results of treatment were excellent in 9 patients, good in 6 patients, fair in 4 patients, poor in 2 patients by authors rating system. The satisfactory result was achieved in 15 patients(71.4%). 8. Postoperative complication was reduced mobility in 4 cases, functional instability 1 case, neuroma in operation scar in 2 cases, minor sensory loss in 4 cases. 9. Primary surgical repair gave good results in the aspect of radiologic & fun ctional instability, but clinical results were not satisfactory, due to high incidence of postoperative complication.