Correlation between Radiologically Identified Osteitis and Prognosis in Chronic Rhinosinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We studied the correlation between radiologically identified bony osteitis and prognosis of the functional endoscopic sinus surgery in chronic rhinosinusitis patients. SUBJECTS AND METHOD: A retrospective review of medical records were carried out on 77 patients who had been diagnosed as chronic paranasal sinusitis and undergone endoscopic sinus surgery from 2002 through 2003 at our institution. Computed tomography scans were used for grading according to the Lund-Mackay radiologic grading system and diagnosis the pansinusitis coexistence. Medical records were used for grading according to the Lund-Mackay surgical grading system and for follow-up observation and age. Statistical analysis was done for correlation between radiologically identified indices and post-operative prognosis. RESULTS: The study revealed that radiologically identified bony osteitis need a longer post-operative medical management period and also found that if pansinusitis coexist with osteitis, poorer outcome would be accompanied. CONCLUSION: This study provides further evidence that radiologically identified bony osteitis and pansinusitis may act as poor prognostic factors.

Treatment of Frontal Sinus-Supraorbital Cell Mucocele: Endoscopic Surgery with Trephination & Transillumination Technique: Case Report / 대한이비인후과학회지

Mucoceles of the paranasal sinuses are chronic expanding lesions containing inspissated mucus, which occurs when sinus ostium is obstructed. A variety of conservative and radical surgical procedures have been introduced, with each approach having advantages as well as disadvantages. Diseased frontal sinus mucosa and bone were commonly ablated by radical frontal sinus surgery such as osteoplastic flap surgery in the past. During the last decade, endoscopic sinus surgery has become the major choice for the treatment of paranasal sinus mucoceles, and the technique of endoscopic sinus marsupialization has been considered non-invasive and successful. But the technique has limitation in cases with small frontal recess or mucocele in the lateral portion of the frontal sinus which is not accessible via the nose, and hypertrophic mucosa obstructing the entire sinus. A 52-year-old man was presented with a supraorbital cell mucocele located in the lateral side of frontal sinus mucocele, which could not be treated by endoscopic surgery alone. Endoscopic surgery with sinus marsupialization, trephination and transillumination technique was introduced. We report this case with a review of related literatures.

Radiologic Findings of Vestibulocochlear Nerve Deficiency: CT and MRI / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sensorineural hearing loss (SNHL) could be caused by dysfunction of the cochlea, abnormality of vestibulocochlear nerve (VCN), or disorder of central auditory pathway. Among these causes, VCN deficiency is one of the causes of profound sensorineural hearing loss. The aim for this study was to evaluate radiologic characteristics of VCN deficiency by reviewing temporal bone computed tomography (TBCT) and magnetic resonance image (MRI) findings of patients with profound unilateral SNHL, diagnosed as VCN deficiency and also, we compared the width of the bony canal of the cochlear nerve (BCCN) between the normal and affected side on TBCT and tried to clarify the diagnositc value of BCCN. MATERIALS AND METHOD: We reviewed TBCT and temporal submillimetric axial and parasagittal 3D turbo spin echo (3D-TSE) T2-weighted MRI of 9 patients who were diagnosed as unilateral VCN deficiency. We evaluated MRI findings in terms of the presence and comparative size of the component nerves (facial, cochlear, superior vestibular, inferior vestibular nerve) then we classified the type of VCN deficiency, according to the Casselman's proposal. We compared the difference of width of IAC and BCCN between normal and affected side on TBCT. RESULTS: We could find the detail anatomic feature of VCN in IAC by parasagittal MRI and could classify the type of VCN deficiency of patients, based on the Casselman's classification. According to the result of the classification, 8 patients were type 2A and the other one was type 1. In the TBCT study, the size of IAC and BCCN of the affected 8 ears were smaller than that of side and one patient had normal IAC but narrow BCCN of the affected ear. CONCLUSION: In this study, we conclude that TBCT and MRI could be useful methods for diagnosis of VCN deficiency. Also, the hypoplastic bony canal of the cochlear nerve on TBCT is finding to overlook easily and may be another important indicator for evaluating VCN deficiency.

A Case of Malignant Myoepithelioma in Parotid Gland / 대한이비인후과학회지

Myoepithelial cells are a significant component of most types of salivary gland neoplasms, but, pure myoepitheliomas are rare, comprising less than 1% of all salivary gland tumors. Malignant myoepithelioma, or myoepithelial carcinoma, is even more rare. It occurs most frequently in the parotid gland among salivary glands, and is similar to benign myoepitheliomas. The palate is the most common intraoral site of involvement. As far as the treatment of myoepithelial carcinoma is concerned, surgical excision is the mainstay of therapy. The role of radiation therapy and chemotherapy is not yet established. We present a case of malignant myoepithelioma of the left parotid gland in a 67-year-old female patient who was treated with surgical excision followed by adjuvant radiation therapy.