Two Cases of Pneumocele of Maxillary Sinus / 대한이비인후과학회지

Pneumocele is a rare disease involving one or more paranasal sinuses. It is defined as abnormal dilatation of paranasal sinus, which is air-filled with either focal or generalized thinning of bony sinus walls. The aim of pneumocele treatment is two-fold: to re-establish permanent pressure equilibrium in the involved sinus and to correct the possible facial deformities. The first goal can be achieved by middle meatal antrostomy. When alterations of the maxillary or orbital contour are present, corrections can be obtained by osteotomies through Caldwell-Luc or an infraorbital approach. We report two cases of pneumocele of maxillary sinus. The first case was treated with osteotomy via Caldwell-Luc approach and the second case was treated simultaneously with osteotomy and rhinoplasty. No recurrence was observed after surgical treatment in both cases.

A Case of Multifocal MALT Lymphoma in Salivary Glands / 대한이비인후과학회지

Primary malignant lymphomas of the salivary glands are uncommon. The parotid gland was most frequently involved, followed by the submandibular gland, minor salivary glands and sublingual gland. The most common subtype is mucosa-associated lymphoid tissue (MALT) lymphoma. MALT lymphoma is a relatively indolent disease and tends to remain localized for prolonged period of time. But, we experienced a case of a multifocal salivary MALT lymphoma involving both parotid glands and right submandibular gland during its progression of disease. We report a case with a review of the literature.

Management for the Children with Otitis Media with Effusion in the Tertiary Hospital

OBJECTIVES: Recently, new evidence-based recommendations have been introduced for diagnosing and managing otitis media with effusion (OME) in children. However, there are some difficulties to follow the general guidelines in the tertiary hospitals. The purpose is to evaluate the efficiency of antibiotics or antihistamines for treatment of children with OME in the tertiary hospital with a randomized prospective clinical study. METHODS: Eighty-four children with OME who had been diagnosed in the tertiary hospital were randomized to receive 5 different medications for 2 weeks. We prescribed antibiotics (amoxicillin-clavulanate syrup) in Group I (n=16), antibiotics/steroids (prednisolone) in Group II (n=18), antibiotics/antihistamines (ebastine) in Group III (n=15), antibiotics/steroids/antihistamines in Group IV (n=17), and mucolytics (ivy leaf extract) in Group V (n=17) for control. We followed-up children every 2 weeks and evaluated the state of OME at 3 months. RESULTS: Thirty six (42.9%) of 84 children were resolved within average 6.9 weeks after the treatments. Thirty-six (42.9%) were treated with ventilation tube insertion and 12 patients (14.3%) were observed. There was no difference in the resolution rates of OME among the five different protocols (P>0.05). There was no difference in the resolution rates among groups who used steroids, antihistamines, steroids and antihistamines, or other medications to manage 42 children with allergies (P>0.05). CONCLUSION: In the tertiary hospital, the cure rate of children with OME was not as high as well-known, and antibiotics or anti-allergic medications were not more effective than control. We may, therefore, need any other guidelines which are different from the previous evidence-based recommendations, including early operation in the tertiary hospitals.

Prognostic Factors of Nasal NK/T Cell Lymphoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nasal natural killer T (NK/T) cell lymphomas are relatively common in Asia, but the prognostic factors are not well known. The purpose of this research was therefore to evaluate those prognostic factors. SUBJECTS AND METHOD: We reviewed and analyzed the medical records of 68 patients diagnosed as nasal NK/T cell lymphomas between 1984 and 2003 at Ajou University Hospital and at Yonsei University Hospital. Prognostic factors that include age, B symptoms, serum lactate dehydrogenase (LDH) levels, Eastern cooperative oncology group (ECOG) performance status, international prognostic indices (IPI), treatment modality, and Ann Arbor tumor stages were analyzed using the methods of univariate and multivariate statistics. RESULTS: The five-year overall survival rate was 43%. By univariate analysis, we found ECOG performance status, Ann Arbor tumor stages, B symptoms, and IPI to be significant prognostic factors of nasal NK/T cell lymphoma. The multivariate analysis showed that ECOG performance status and B symptoms were significant. CONCLUSION: ECOG performance status, Ann Arbor tumor stages, B symptoms, and IPI could all be prognostic factors of the nasal NK/T cell lymphoma. Among these factors, ECOG performance status and B symptoms may be regarded more useful in diagnosis of the disease than others.

Clinical Analysis of Orbital Complications of Acute Sinusitis according to Age

BACKGROUND AND OBJECTIVES: Acute sinusitis is a mild, self-limiting disease. In children, however, sinusitis may lead to other severe, even life-threatening, conditions. Therefore, appropriate diagnosis and management are needed. Orbital complications from sinusitis are caused by expansion through natural suture lines, foramen, dehiscence of lamina bone and bony erosion due to acute infection and necrosis. The purpose of this study was to analyze the common types of orbital complications and to compare the symptoms, prognoses and treatments of children and of adults, respectively. Materials and Method: Twenty-one children under15 years of age and thirteen adults over 15 were enrolled in the study. Symptoms, durations of treatment, treatment modalities, prognoses, and CT findings were analyzed. RESULTS: Preseptal cellulitis was found in 6 children (28.6%) and 8 adults (61.5%) ; subperiosteal abscess in 9 children (42.9%) and 3 adults (23.1%) ; and orbital cellulitis in 6 children (28.6%) and 2 adults (15.4%). Eye lid swelling was found in all subjects, while diplopia and limitation of eye movement was found in 4 children (19%) and 2 adults (15.4%). Medical treatment was the first line of therapy for both children (76.2%) and adults (61.5%), with the remaining children (23.8%) and adults (38.5%) receiving surgical treatment. CONCLUSION: While generally more severe, orbital complications in children can be treated more conservatively than those arising in adults.