Two Cases of Mumps Involving Only Submandibular Glands / 대한이비인후과학회지

Mumps virus infections usually involve the parotid glands. It usually spreads from a human reservoir by airborne droplet of infected saliva. Therefore, early proper diagnosis and isolation of patients can help to inhibit dissemination of the disease. Diagnosis of mumps virus infection is mainly dependent on clinical inspection, palpation of the parotid and laboratory tests, because most mumps virus infections involve the parotid gland. Isolated submandibular gland involvement in mumps is rare and presents diagnostic challenge. We report unusual consecutive cases of mumps virus infections in two patients who were brothers, for whom bilateral submandibular glands were found to be involved paring parotid glands. These cases instruct us not to exclude mumps virus infection even in isolated uni/bilateral submandibular gland swelling.

Two Cases of Large Auricular Keloids / 대한이비인후과학회지

Keloids are fibrous overgrowth resulting from abnormal wound healing processes at the site of cutaneous injury. It extends beyond the confines of the original wound, begins later after injury, and does not regress with time contrary to hypertrophic scar. The gold standard has not been established in the treatment of keloids, yet. Excision of keloid alone showed a high rate of recurrence (45-100%). Recently, we have experienced two keloidal masses in the auricle (one on helix, the other on lobule), which were treated with surgery and adjuvant steroid injection. We developed an anteriorly-based skin flap from the skin covering of the keloidal mass and used it for several reasons. We also used triamcinolone injection after the surgery. In this paper, we are presenting the result of these cases with a review of literature.

Correction of Caudal Septal Deformity via Open Approach / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Caudal septal deformities are surgically challenging disorders. A number of corrective programs have been described with variable success. Causes of frequent failure in correction of the caudal deformities have been conservatism and unrealistic dependence on incisional method such as cross hatching, and limited comprehension of the extrinsic and intrinsic forces causing caudal deformities. We reviewed and evaluated the surgical techniques for correction of the caudal septal deformities performed at our institution. SUBJECTS AND METHOD: A retrospective study was performed on 24 patients who underwent septal surgeries for severe caudal septal deformities between Feb 2001 to May 2004. With open approach, all deforming forces around the caudal septum were released and definite intraoperative correction was possible. RESULTS: All 24 patients showed definite improvement in terms of functional and anesthetic outcomes. Potential complications related with structural instability as well as other inherent complications of nasal surgery have not been encountered. CONCLUSION: For successful correction of the caudal septal deformities, completed exposure and releasing all the extrinsic forces around the caudal deformities via open rhinoplasty approach is desirable to avoid frequent recurrences.

A Case of MALT Lymphoma Showing Mikulicz Syndrome / 대한이비인후과학회지

Since Mikulicz's description of symptomless hypertrophy of the salivary gland and lacrimal gland, the term, Mikulicz syndrome, has been used to describe enlargement of the salivary gland with or without lacrimal gland involvement occurring in leukemia, lymphosarcoma, sarcoidosis, tuberculosis syphilis, etc. However, there are still a tremendous amount of confusion in the application of the term, Mikulicz syndrome. In Korea, there has been no reported case of Mikulicz syndrome to date. Internationally, it is also extremely rare to spot a reported case of the disease originating primarily from submandibular glands. We would like to report a case in which a 56 year old female patient was reported to have the disease ; she was diagnosed initially as benign lymphoepithelial lesion (BLL) by submandibular biopsy, but later confirmed by lacrimal gland biopsy to have mucosa associated lymphoid tissue (MALT).

Bacteriologic Evaluation of Peritonsillar Abscess / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Peritonsillar abscess (PTA) is a collection of pus lateral to tonsil and is located between the fibrous capsule of the palatine tonsil, usually at its upper pole, and the superior to the pharyngeal constrictor muscle. It frequently occurs as a complication of acute tonsillitis. Bacteriology including clinical characteristics in PTA were evaluated. SUBJECTS AND METHOD: Sixty-one patients with peritonsillar abscess, who visited National Medical Center from January 1997 through August 2001 were entered into the study. Each patient was asked to answer a questionnaire for clinical aspects of PTA. Needle aspirations were performed and pus was drained in all cases. Bacterial susceptibility to ampicillin, cephazoline, ciprofloxacin, erythromycin, tetracyclin, and vancomycin was tested on the ioslated bacteria. RESULTS: Among 61 cases, aerobes were isolated in 15 cases (24.6%) and anaerobes in 16 cases (26.2%). There was no significant difference in the culture positive rate of aerobes (p=0.767) and anaerobes (p=1.0) between antibiotics-medicated patients and nonmedicated patients. Among the cultured organisms, peptostreptococcus was the most common and the second most common was beta-hemolytic streptococcus. However, alpha-hemolytic streptococcus, an important pathogen considered in the previous study, was detected at 1.6%. CONCLUSION: Antibiotics medication was not a significant factor in culture positive rate in our study. Peptostreptococcus as an anaerobe and beta-hemolytic streptococcus as an aerobe were the major causes that contributed to the decreased state of peritonsillar abscess and culture positive rate of alpha-hemolytic streptococcus.