ABSTRACT
BACKGROUND AND OBJECTIVES: Otohematoma is a fairly common disease in otolaryngologic clinics. The principle treatment is composed of removal of the hematoma and compression. But this method is inconvenient both to the patient and doctor. To find another alternative that is simple and easy, we tried steroid injection in otohematoma. Steroid is used in various kinds of hemangioma, and if it is effective in hemangioma it also can be speculated that same phenomenon can be happened to otohematoma. MATERIALS AND METHODS: One hundred otohematoma patients were treated with triamcinolone injection on the lesion sites after aspiration of hematoma or seroma. The injection was repeated as necessary. RESULT: Among the 100 otohematoma patients 96 patients(96%) were healed without any complications. The numbers of injection needed were usually within 3 times(81%) : 1 time(42%), 2 times (20%), 3 times(19%). CONCLUSION: Steroid injection is a very good alternative in the treatment of otohematoma. It is easy to perform, convenient to the patients and usually results in complete resolution. The proposed mechanisms are vasoconstricting and anti-inflammatory action of steroid.
Subject(s)
Humans , Hemangioma , Hematoma , Seroma , TriamcinoloneABSTRACT
BACKGROUND AND OBJECTIVES: Nasal polyps usually develop in the ethmoidal and middle turbinate area, often in relation to inflammatory conditions. But the exact etiology and pathogenesis are still under debate. Histologically, the polyps are infiltrated by a number of inflammatory cells with eosinophil predominating in most specimens, and it is suggested that the nasal polyp is an inflammatory growth that is controlled by the local microenvironment. Eotaxin and RANTES have been postulated to be involved in the recruitment and activation of eosinophils to certain inflamed tissues. The purpose of this study is to investigate eotaxin and RANTES mRNA expression in nasal polyps and its effect on tissue and nasal eosinophils. MATERIALS AND METHODS: Seventeen allergic and 18 non-allergic nasal polyps were obtained from an endoscopic sinus surgery and 8 normal inferior turbinates were also taken. lmmunohistochemical staining for eosinophil and RANTES and quantitative RT- ICRs for eotaxin mRNA expression were performed. RESULTS: The eotaxin mRNA levels in allergic nasal polyps were 11.4 fold higher and non-allergic polyps were 6.4 fold higher than the normal inferior turbinates. But the RANTES didn't show any differences among the three groups. Tissue eosinophilia and its activation were significantly correlated with the eotaxin mRNA level but not with the RANTES level. CONCLUSION: In nasal polyp, eosinophilic infiltration and activation is mainly correlated with the increased eotaxin gene expression and, to some extent, with the case of RANTES.
Subject(s)
Chemokine CCL5 , Eosinophilia , Eosinophils , Gene Expression , Nasal Polyps , Polyps , RNA, Messenger , TurbinatesABSTRACT
BACKGROUND AND OBJECTIVES: Functional endoscopic sinus surgery (FESS) is an effective treatment for chronic sinusitis and nasal polyposis. But the extent of surgery is one of the major issues in FESS. To solve this problem, the shaver has been used from 1992. It dramatically reduced inadvertent trauma to nasal mucosa and improved visualization and tissue healing after surgery. This study is aimed at evaluating the clinical value of the shaver with degree of postoperative pain and the time required for surgery. MATERIALS AND METHODS: We studied bilateral chronic paranasal sinusitis patients of whom, 28 were operated with the shaver, and 15 cases were operated with the conventional instrument. This study evaluated the postoperative pain using Visual Analogue Scores (VAS) at 2, 6, 24 and 48 hours after operation and the time required for surgery. The results were then compared with the preoperative computed tomographic radiological staging and surgery scores. RESULTS: For the shaver group, the time requirement for FESS and the postoperative pain scores were much lower than the conventional instrument group. CONCLUSION: The shaver is a very useful instrument for sinus surgery and it can reduce surgical time and the discomfortness for the patient.
Subject(s)
Humans , Nasal Mucosa , Operative Time , Pain, Postoperative , SinusitisABSTRACT
Functional endoscopic sinus surgery(FESS) is now the surgical procedure of choice for treating chronic sinusitis in patients of all ages. We performed the olfactory threshold test after FESS and assessed its clinical value. From Feburary 1996 through July 1966, fifty bilateral sinusitis patients had received FESS and butanol threshold test and odor identification test were performed pre-operatively, at post-operative 1 month, and at post-operative 2 months. We analyzed preoperative computed tomography to determine the grade of sinusitis and status of olfactory fissure. The status of olfactory fissure significantly influenced the preoperative olfactory threshold score(p<0.001). At post-operative 2 months, the subjective symptoms of the patients were improved in 96% of patients and objective olfactory threshold were improve in 68% of patients. There was no correlation between subjective symptoms and olfactory threshold improvement. Our study suggests that the olfactory threshold test may predict the result of FESS, however for more accurate and reliable assessment, we should consider other objective methods like anterior rhinomanometry, acoustic rhinometry, ciliary beat frequency test, and post-operative endoscopic findings.
Subject(s)
Humans , Odorants , Rhinomanometry , Rhinometry, Acoustic , Sinusitis , SmellABSTRACT
Functional endoscopic sinus surgery(FESS) is now the surgical procedure of choice for treating chronic and recurrent sinusitis in patients of all ages. But successful eradication of disease from an obstructed frontal sinus ostium and frontal recess area is one of the most difficult procedures of FESS. It is known that the frontal sinus drainage is influenced by frontal cells, agger nasi cell, uncinate process attachment, concha cell, supraorbital cell and enlarged ethmoid bulla. We analyzed the coronal computed tomography of 118 frontal sinusitis cases and two control groups to compare which anatomic or mucosal factors can influence the developmemt of frontal sinusitis. In chronic sinusitis with frontal sinusitis group, frontal cell was observed in 11 cases(9.4%), agger nasi cell in 108 cases(91.5%), concha bullosa in 26 case(22.0%), supraorbital cell in 53 cases(44.9%), uncinate attachment to lamina papyracea in 76 cases(64.4%) and ethmoid bulla occupy 80.6% in the ostiomeatal area. In two control groups(chronic sinusitis without frontal sinusitis group and normal group) frontal cell was observed in 7 cases(10.5%) and 4 cases(6.0%), agger nasi cell in 54 cases(80.6%) and 43(65.2%), concha bullosa in 16 cases(23.9%) and 15 cases(22.8%), supra-orbital cell in 29 cases(43.3%) and 29 cases(43.9%), uncinate attachment to lamina papyracea in 55 cases(82.1%) and 53 cases(80.3%) and ethmoid bulla occupy 74.6% and 75.6% in ostiomeatal area. Our study concluded that the agger nasi cell, enlarged ethmoid bulla and attachment site of uncinate process can influence the development of frontal sinusitis(p<0.05).
Subject(s)
Humans , Drainage , Frontal Sinus , Frontal Sinusitis , SinusitisABSTRACT
Deep cervical space abscess may cause life-threatening complications despite the advent of antibiotics, so early detection and localization of the abscess are essential for management decision. To evaluate the efficacy of utilizing CT scanning in deep cervical space abscess, we retrospectively revieweed CT of 17 patients confirmed by surgery. CT was found tobe very accurate in defining the presence, location, and extent of the abscess along with the demonstration of life-threatening complications such as airway compression and mediastinal extension. In conclusion, CT can play and essential role in guiding surgical approach to deep cervical space abscess.