A Case of the Zone III Penetrating Neck Injury with Internal Carotid Artery Laceration Treated by an Urgent Endovascular Stent Technique / 대한이비인후과학회지

Penetrating neck injuries are potentially dangerous and require emergent management because of vital structures in the neck. A 35-year-old woman was transferred to the hospital with massive bleeding in her mouth and lacerations of her neck after the stab injuries. Contrast-enhanced computed tomography (CT) and angiography revealed a leakage at the pharyngeal portion of the right internal carotid artery. Emergent endovascular treatment was undertaken by using the stent technique. The leakage was completely occluded immediately after the procedure. There was no complication. The stent technique was safe and effective for the treatment of zone III carotid artery stab injuries.

A Case of Sudden Sensorineural Hearing Loss due to Intralabyrinthine Hemorrhage / 대한이비인후과학회지

Sudden sensorineural hearing loss (SNHL) that is due to intralabyrinthine hemorrhage (ILH) is a rare condition. A 64-year-old female presented with vertigo and a sudden onset of SNHL in the left ear. The audiograms revealed a severe left-sided SNHL. The brain MRI showed a hyperintense signal in the labyrinth on the pre-contrast T1-weighted image. Caloric testing revealed a decreased caloric response of 63% in the left side compared to the right side. The patient was given a course of prednisolone followed by a course of intratympanic dexamethasone injection; this was followed by a course of vestibular rehabilitation therapy. Her hearing substantially recovered from severe to mild SNHL following a combination of oral and intratympanic steroid therapy. We report here on an unusual case of sudden SNHL due to ILH with a review of the related literatures.

A Case of the Laryngotracheal Separation for Intractable Aspiration in Handicapped Child / 대한이비인후과학회지

Intractable aspiration may be the most severe life-threatening problem for handicapped children with altered laryngeal function secondary to neurologic disorders or abnormal laryngeal anatomy. If medical therapy fails to prevent intractable aspiration, surgical treatment of the upper airway from the digestive tract is necessary to prevent recurrent aspiration of the respiratory system. Here we describe a patient who underwent a laryngotracheal separation for intractable aspiration following a cerebral palsy. Laryngotracheal separation is relatively easy to perform and potentially reversible. It is known as a good choice of treatment for handicapped child with intractable aspiration.

Cutaneous Angiosarcoma in Face / 대한이비인후과학회지

A cutaneous angiosarcoma is a rare, aggressive malignancy with a poor prognosis, with only a few cases of it in head and neck have been reported. In the present case, we reported a primary angiosarcoma of the nasal dorsum in a 70-year-old man without prior irradiation of head and neck region. The authors reviewed the literature and discussed treatment and prognosis of cutaneous angiosarcoma in nasal dorsum.

Characteristics of Clinically Invasive Aspergillosis in Sphenoid Sinus

BACKGROUND AND OBJECTIVES: Because of the close vicinity of the orbit to the sphenoid sinus, invasive fungal sphenoiditis is a difficult disorder to correctly diagnose and treat. The aims of this study were to examine clinical characteristics of invasive sphenoidal aspergillosis and to discuss diagnostic and therapeutic priorities. MATERIALS AND METHODS: Eleven patients who presented with sphenoidal aspergillosis in our department since 1997 were reviewed retrospectively. These patients were classified into two groups:a clinically invasive group who experienced aggravation even after endoscopic surgery and required further treatments, including antifungal agent, and a non-invasive group who were cured after surgery. The presenting symptoms, age, underlying systemic diseases, CT and MRI findings, treatment modality, and prognosis were reviewed between the clinically-invasive fungal and non invasive groups. RESULT: Only the clinically invasive group presented with visual disturbance. Visual disturbance developed rapidly within several days. Age over 50 years and diabetes may be associated with visual disturbance. Bony erosion and expanding lesions upon CT or MRI were observed more frequently in the clinically invasive group than in the non-invasive group. Enhancement outside the sphenoid sinus was demonstrated only in the clinically invasive group. Endoscopic sinus surgery was performed with additional amphoterichin B and/or mega-dose steroid therapy. Recovery from visual disturbance was poor. Moreover, mega-dose steroid therapy had no effect on symptoms and caused two complications, uncontrolled diabetes and pneumonia. CONCLUSION: Aged diabetic patients, rapidly progressing eye symptoms, bony erosion, and expanding sphenoid lesions upon imaging incur high suspicion of invasiveness in a sphenoid fungus ball. Endoscopic sinus surgery to remove sphenoid fungus balls, as well as systemic antifungal treatment, should be started as early as possible in patients with these clinical features.