Pediatric Fetal Rhabdomyoma Representing as Acute Mastoiditis: A Case Report and Literature Review / 대한이비인후과학회지

Rhabdomyomas are rare benign tumors. Most extracardiac rhabdomyomas are found in the head and neck region, especially in the pharynx and larynx. Herein, we have described the case of a 1-year-old boy presenting with recurrent otorrhea and postauricular swelling. His symptoms were due to a mass that was histologically diagnosed as fetal rhabdomyoma (FR). Here, we report the first case of FR in the postauricular area. Clinicians should keep in mind the possibility of FR if a child presents with external auditory canal mass associated with recurrent otorrhea and signs of mastoiditis.

Two Cases of Pediatric Pneumolabyrinth with Traumatic Tympanic Membrane Perforation after Penetrating Injury / 대한평형의학회지

Pneumolabyrinth is an uncommon condition in which air is present in the vestibule or cochlear. It is rarely found, even in otic capsule violating fractures or in transverse fracture of the temporal bone. So far, there is no consensus on management of pneumolabyrinth. We describe 2 new cases of pneumolabyrinth by penetrating injury with traumatic tympanic membrane perforation. They presented whirling vertigo with moderate conductive hearing loss. Temporal bone computed tomography clearly demonstrated the presence of air in the vestibule and cochlear.

Ossiculoplasty for Monocrural Stapes Anomaly / 대한이비인후과학회지

Congenital anomalies of ossicle in the middle ear are rare and could appear in various forms. The most common congenital isolated ossicular anomalies are stapes fixation and incudostapedial discontinuity, with isolated congenital stapes fixation representing about one third of ossicular malformations. We present a rare case of monocrural anomaly of unilateral stapes in a 36-year-old woman with nonprogressive conductive hearing loss. During explotympanotomy, the lateral half of the suprastructure of anomalous stapes was removed and sculptured total ossicular replacement prosthesis was fitted between the long process of incus and remained stapes. Postoperative pure tone audiogram showed a significant decrease in air-bone gap. We report this case with a review of literature.

A Case of Totally Lateralized Tympanic Membrane / 대한이비인후과학회지

Lateralized tympanic membrane is a complication of tympanoplasty resulting in conductive hearing loss. We describe a case of a 23-year-old patient who developed totally lateralized left tympanic membrane with hearing disturbance. The blind-pouch appearance of the left ear canal and conductive hearing loss were checked. The revision of underling tympanoplasty was performed using temporalis fascia and conchal cartilage. The ossicular chain was reconstructed with partial ossicular replacement prosthesis. Canaloplasty and split thickness skin graft were applied for the skin defect of the left external auditory meatus. Totally lateralized tympanic membrane was successfully reconstructed with cartilage tympanoplasty and canaloplasty, achieving improved hearing.

An Efficient Microvascular Anastomosis Training Model Based on Chicken Wings and Simple Instruments

OBJECTIVE: The aim of this study is to introduce a microvascular training model based on use of materials that can be easily obtained from the daily surroundings. METHODS: Simple microinstruments and a medical school laboratory microscope were used for anastomosis training. Chicken blood vessels were used as a material for this study. A long segment of blood vessel from the proximal brachial artery to the distal radial artery was used for training. End-to-side anastomosis was practiced first, and the training continued with end-to-end anastomosis of the appropriate segments. RESULTS: The instruments used for setting up this model were simple and easy to use; therefore, the time required for preparation of the materials and dissection of the chicken wings was only approximately five to ten minutes. The characteristics of 20 chicken wings were analyzed. The length of the brachial artery to the radial artery was 8 - 10 cm. The average diameter of the brachial artery was 1.3 mm +/- 0.2 mm and that of the radial artery was 1.0 mm +/- 0.2 mm. Taking advantage of these characteristics, the proximal brachial artery was grafted to the radial artery for practice of end-to-side anastomosis. CONCLUSIONS: This study suggests an effective and feasible method for microvascular anastomosis training using chicken wing arteries and simple microinstruments. This model may simulate the conditions of a superficial temporal artery to middle cerebral artery anastomosis surgery.

A Case of Ectopic Tooth in the Maxillary Sinus Associated with a Mucocele / 대한이비인후과학회지

Supernumerary, ectopic tooth eruption in a non-dental area is a rare entity. The ectopic development of tooth found in non-dental environment has been reported in places such as the nasal cavity, chin, maxillary sinus, mandibular bone, palate and orbital cavity. Ectopic tooth eruptions in the maxillary sinus are usually asymptomatic and are found incidentally during routine clinical or radiological investigations. The diagnosis is usually made by plain-film radiography. Computed tomography is indicated when an ectopic tooth is found prior to surgery. Standard treatment for an ectopic tooth is extraction of the tooth. Here, the authors present a case of supernumerary, ectopic tooth found in the maxillary sinus associated with a mucocele.

The Effects of Switching Cost Perceived by Patients and Negative Word of Mouth on Revisiting Intention for Hospital Patients / 간호행정학회지

PURPOSE: The purpose of this study was to examine the effect of patient perception of the switching cost and negative word of mouth on revisit intention of patients in out-patient departments (OPDs) of general hospitals. METHODS: The participants were 306 patients in general hospital, selected through convenience sampling. Data were collected using a structured questionnaire and analyzed using descriptive statistics, Spearman correlation coefficient, and logistic regression with SPSS Win. RESULTS: Relational switching cost was positively correlated with revisit intention (r=.58, p=<.001), but not financial switching cost or procedural switching cost. Negative word of mouth was negatively correlated with revisit intention (r=-.22, p=<.001). The significant predictors influencing revisit intention in patients was relational switching cost. CONCLUSION: The findings of this study suggest that hospital and nursing managers should seek to bolster perceptions of switching costs and negative word of mouth, which subsequently increases revisit intentions in small hospitals located in the country as well as urban large hospitals.