Massive Concha Bullosa with Secondary Maxillary Sinusitis

Concha bullosa is a common anatomic variation of the middle turbinate; however, sinusitis secondary to the concha bullosa is rare. A 52-yr-old woman presented with nasal obstruction and posterior nasal drip. Computed tomography and examination of the nasal cavity revealed septal deviation on the left side, and a massive concha bullosa and maxillary sinusitis on the right side. The lateral lamella of the affected turbinate was removed and the inspissated material was drained. Histopathologic examination of the excised lesion in the concha bullosa revealed bacterial colonies in the mucus plug. We report here on a massive concha bullosa with secondary maxillary sinusitis.

Treatment Outcome of Olfactory Neuroblastoma: Analysis of 11 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Olfactory neuroblastoma is a rare tumor arising from the olfactory neuroepithelium, for which surgery is the mainstay of treatment; but there are no generally accepted treatment approaches, according to tumor stage. In this study, we present our experiences with this tumor and the results of treatment to consider the clinical analysis and treatment modality. SUBJECTS AND METHOD: All of the patients, who had been treated for olfactory neuroblastoma at Severance hospital during the past ten years, were analyzed retrospectively and each of their diagnosis of olfactory neuroblastoma was histologically confirmed. RESULTS: Eleven patients aged 8 to 70 years were assessed, and 5 year disease-free survival rate were 60%. Sixty-four percent of those patients had received surgical treatment. Craniofacial resection was used mainly as an initial surgical treatment and followed by postoperative radiotherapy in 57% of the patients. If only cervical lymph node metastasis had developed at the initial diagnosis, elective neck treatment including bilateral neck dissection was performed. Chemotherapy was used either as postoperative adjuvant therapy, initial therapy with radiotherapy or salvage therapy, but not as an initial single treatment modality. Forty-five percent of the patients had recurrence and metastasis developed after the initial treatment. In the patients with cervical lymph node metastasis (n=1) and nodal recurrence (n=2), neck dissection was effective in nodal control. CONCLUSION: Complete surgical resection and postoperative radiotherapy were the main treatment modalities of olfactory neuroblastoma. Especially, postoperative radiotherapy is an essential treatment to both early- and advanced-stage olfactory neuroblastoma. Craniofacial resection is a main surgical modality, but in early stage, limited external intervention including endoscopic mass excision can be considered. If the patient has cervical lymph node metastasis or nodal recurrence, radical neck dissection should be performed. Chemotherapy seems to be considered as an adjuvant therapy, not single treatment modality.

Retropharyngeal Lymph Node Metastasis from Olfactory Neuroblastoma: A Report of 2 Cases / 대한이비인후과학회지

Olfactory neuroblastoma is a rare, malignant neoplasm arising from the olfactory epithelium. It has an aggressive biological behavior that is characterized by local recurrence, atypical distant metastasis, and poor long-term prognosis. The incidence of cervical lymph node metastasis in olfactory neuroblastoma is variable, and treatment modalities are controversial. Moreover, few reports have been published concerning retropharyngeal lymph node metastasis from olfactory neuroblastoma. We present two cases of olfactory neuroblastoma with retropharyngeal lymph node metastasis. In addition, we provided a review of the current literature regarding olfactory neuroblastoma and retropharyngeal lymph node metastasis from olfactory neuroblastoma.

Treatment Outcomes and Pattern of Failure in the Surgically Treated Squamous Cell Carcinoma of Floor of the Mouth / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Squamous cell carcinoma involving the floor of the mouth remains one of the most aggressive neoplasms of the head and neck. Its propensity to invade the mandible and to involve the lymphatic beds of both necks often makes local and regional control exceedingly difficult. This study reports the oncologic results of the surgically treated squamous cell carcinoma of the floor of mouth. SUBJECTS AND METHOD: From July 1992 to September 2001, 27 previously untreated floor of the mouth squamous cell carcinoma patients were treated with surgery with or without postoperative radiotherapy at Severance Hospital. Survival rates and factors affecting survival were studied using standard statistical analysis to determine statistical significance. RESULTS: The 2 year and 3 year disease-specific free survival rate in early staged carcinomas (stage I and II) were 85% and 77%, respectively, and in advanced staged carcinomas, 75% and 60%, respectively. Significantly decreased survival was seen in the patients with positive pathologic lymph nodes (p=0.001). However, there was no statistical significance for the effects of cT stage (p=0.56), performance of mandibular resection (p=0.755), mandibular invasion (p=0.688), and positive margins (p=0.98) on survival. Thirty-three percent of patients had recurrence. Recurrence was highest at the primary site, followed by the neck, and these were the most common sites of treatment failure. Two cases (67%) of nodal recurrence occurred in the anterior lymphatic chain (level VI). Distant metastasis was noted in 7.4% of the patients. CONCLUSION: Treatment with radical surgery of primary lesions and elective neck dissection including the anterior neck lymphatic chains may improve survival of patients with squamous cell carcinoma of the floor of mouth.

A Case of the Variant Type Neurofibromatosis / 대한이비인후과학회지

A case of neurofibromatosis in a 51 year old woman, with no other evidences of genetic defect, is described. Neurofibromatosis affects primarily cell growth of neural tissues and can cause tumors to grow on nerves. In the past, neurofibromatosis has been divided into 2 groups, Type I and Type II. The two groups have been shown to be distinct at clinical and molecular levels. Cafe-au-lait spots, neurofibroma, freckling in axilla, lisch nodule, family history and defect of chromosome 17q are the distinctive features of neurofibromatosis Type I, whereas bilateral vestibular schwannoma, family history and defect of chromosome 22q characterize the neurofibromatosis Type II. We experienced a case of neurofibromatosis having multiple neurofibromas in both neck, left thoracic inlet, and spinal cord without abnormal chromosomal findings. We present this case with a review of the literature.