A Case of Giant Cell Granuloma of Maxillary Sinus: Long-Term Follow-Up / 대한이비인후과학회지

Giant cell granuloma is an uncommon bony lesion in the head and neck region that most commonly affects the maxilla and mandible. Although it is a benign disease process, it can also be locally destructive. The most common treatment for giant cell granuloma is surgery, ranging from simple curettage to resection. More recently, nonsurgical treatments have been reported. Systemic calcitonin and intralesional glucocorticosteroids have shown varying degrees of success and, when successful, have reduced the necessity for major reconstructive surgery, thus preventing any large surgical defects. We report a case of giant cell granuloma of the maxilla that responded favorably to treatment with surgical excision, followed by intralesional injection of steroid.

A Case of B-Cell Lymphoma Combined with Sinusitis in AIDS Patient / 대한이비인후과학회지

We report an unusual case of primary extranodal non-Hodgkin's lymphoma combined with sinusitis in an AIDS patient. A 39-year-old male presented with sinusitis as initial manifestation. A nasal endoscopy revealed nasal polyposis with mucopurulent discharge in both middle meatus and paranasal sinus (PNS) CT scans demonstrated pansinusitis without lamina papyracea or skull base defect. He received antiretroviral and antibiotics therapy due to low CD4 count representing immunocompromised state. The patient was not followed up for observation and he returned with reduced right visual acuity and diplopia, and proptosis after 6 months. A PNS CT scan showed bilateral sinonasal polyposis with pansinusitis and soft tissue density in the right orbit and frontal lobe through bone defect of lamina papyracea and skull base. Endoscopic sinus surgery for orbital decompression and biopsy of intraorbital mass was performed under general anesthesia. The mass was infiltrated into orbital contents and was confirmed as an diffused large B-cell lymphoma with anaplastic variant. The patient received radiotherapy because his general condition was poor. Proptosis and ocular pain were decreased; however, he complained of a persistent headache. Brain CT and MRI showed diffused parenchymal edema around brain abscess in the right frontal lobe. Stereotactic evacuation of the right brain abscess was performed. He has no specific complaints for the last 14 months and antiretroviral therapy is concluded at the present.

Restoration of Volume after Partial Resection of Tongue in Rabbit: Comparative Analysis according to Scalpel, Electrocautery and Diode Laser with or without Closure / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Performing oncologically safe, wide surgical excisions and postoperative volumetric restoration of resected tongues to gain functional recovery are contrary problems to deal with in performing glossectomy. There is no report about the volumetric restoration of a resected tongue according to resecting devices until now. The purpose of this study is to clarify the difference of postoperative volumetric changes of a resected tongue using a scalpel, electrocautery and laser with or without closure. MATERIALS AND METHOD: We used 12 rabbits for each group according to the resecting devices and also equally divided each group according to the closure or non-closure method. The volumetric changes of a resected tongue were measured by the Archimedes principles in one, two, three, and six months postoperatively. RESULTS: Regardless of resecting devices, the postoperative volume of a resected tongue was gradually increased as elapsed time. The nonclosure method was better than the closure method with respect to the volumetric restoration of the resected tongue regardless of the resecting devices, but there was no statistical significance of volumetric restoration between the closure and nonclosure methods in each group (p>0.05). The superior resecting device for the volumetric restoration of a resected tongue was diode laser, especially compared to electrocautry, in both closure and nonclosure method (p<0.05). CONCLUSION: The volumetric restoration after resection of the tongue using laser and nonclosure method are superior to electrocautery and to the closure method, respectively.

Mast Cell Apoptosis Induced by Cyclosporin A / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mast cell is a key cell in the pathogenesis of allergic rhinitis. It is expected that apoptosis of mast cell is an important step that can lead to treatment of allergic rhinitis. Meanwhile, the cyclosporin A (CsA) is immunosuppresant agent to inhibit the action of various immune cells. The purpose of this study is to identify whether CsA directly induces apoptosis of mast cells in vitro. MATERIALS AND METHOD: After the culture of p815 cells, mouse mastocytoma cells, the cells were treated with 1 micrometer, 2 micrometer, 5 micrometer, and 10 micrometer CsA, and then LD50 of p815 cells were calculated by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide) assay. For identification of apoptosis of p815 cells, electrophoresis and flow cytometry after CsA treatment were done and morphological changes in light microscope was observed. We also quantified apoptotic cells by TUNEL assay and Hoechst stain. RESULTS: The LD50 of p815 cells is 9.87 micrometer after CsA treatment during 24 hours, 6.11 micrometer during 48 hours and 6.21 micrometer during 72 hours. With the higher concentration of CsA treatment, the greater effect on apoptosis of p815 cells was revealed. We observed laddering pattern for DNA fragmentation in electrophoresis. Nuclear fragmentation and chromatin condensation of p815 cells was observed under the light microscope. Results of flow cytometry were similar to the MTT assay results. Quantification of apoptotic p185 cells by TUNEL assay and Hoechst stain were calculated. CONCLUSION: Apoptosis of mast cells can be induced by CsA treatment in vitro.

Analysis of Influencing Factors on the Olfactory Function of Diabetic Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Diabetes mellitus has been known as a multisystemic disorder that causes chronic complications, and diabetic peripheral and autonomic neuropathy may affect olfaction. The aim of this study was to evaluate the olfactory status of diabetic patients and the influencing factors on olfaction. Materials and Method: The olfactory status was evaluated with the recognition threshold of T and T olfactometery to diabetic group of 37 patients (19 male, 18 female) and control group of 115 healthy adults (56 male, 59 female). To the diabetic group, retrospective analysis of diabetic duration, alcohol and smoking history, and associated chronic complication such as neuropathy, retinopathy and nephropathy was done. And fasting blood sugar and HbA1c level was assessed. The statistical analysis was performed using Students t-test and Spearman methods. RESULTS: The olfactory recognition threshold of the diabetic group was significantly higher than that of the control group according to age, and there was no significant difference of the recognition threshold between male and female in both diabetic and control groups. The recognition threshold was significantly correlated with diabetic duration, associated complications and serum HbA1c level in the diabetic group. However, serum fasting sugar level and smoking history did not affect the recognition threshold in diabetic group. CONCLUSION: The diabetic patients with inappropriate sugar control have decreased olfaction than healthy normal control. We suggest that diabetic duration, associated chronic complications, and serum HbA1c level may be the influencing factors of olfactory dysfuction of diabetes.

The Vocal Tract and Speech Intelligibility of Tracheoesophageal Shunt Patients after Total Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In this paper, rehabilitation of voice after total laryngectomy has been suggested through the correct estimation and simulation of patients' vocal tract. Material and Methods: The author studied the shape of vocal tract during the phonation of five Korean vowels /u, o, a, e, i/ in tracheoesophageal shunt patients by magnetic resonance images (MRI). The same vocal tract was determined in each vowels from MRI. First, speech data produced by them were analyzed and also checked for speech intelligibility. Then the author tried to synthesize vowels from the vocal tract area of each vowels and from the expanded pharyngeal section of the vocal tract. RESULTS: The obtained results were as follows: 1) The sounds of /a/, /e/, /i/ were similar to natural sounds in actual patients' speech. The sound of /o/ was heard as /sigma/. The sound of /u/ was heard as strained /u/. 2) The synthesized vowels of /a/, /e/ from MRI were heard as natural sounds. The sounds of /u/, /o/, /i/ were heard as other sounds. 3) The synthesized vowel by the expanded pharyngeal section of 3 times in vowel /o/ was more naturally heard than that of 2 times. The synthesized vowel from Formfrek was more naturally heard than that from AreatoFormant. CONCLUSION: In conclusion, some of the synthesized sounds from MRI disagrees with the actual sounds produced by the subjects. This could be best identified by the synthesis from the area data. Future MRI studies should consider this problem for more accurate measurements. Also, pharyngeal areas with varied sizes should be experimented to secure better speech output because the correct shapes of vocal tract ensures correct vowel pronunciation.