Does Nasal Polyps Influence on the Location of Nasal Fontanelle? / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study aimed to evaluate the relationship between the location of the nasal fontanelle and either the chronic rhiosinusitis with nasal polyp in middle meatus (NP) or the chronic maxillary sinusitis (CMS). SUBJECTS AND METHOD: We classified the subjects without any nasal septal deviation (<5degrees) into three groups: the normal control group, the CMS group (CMS without NP) and the NP group (CRS with NP). Both angles of nasal septum and fontanelle were measured by CT imaging and nasal cavities were counted as an individual side. We compared 96 CT scans of normal controls with 79 of CMS groups and 54 of NP groups. In case of discrepancy in the locations of both fontanelles on their CT scans, we reconstructed all the images to identify the fontanelle location. The lateral side on which the fontanelle was actually located was assigned the positive angle and the medial side the negative angle to determine the presence of fontanelle deviation. The normal range of the fontanelle deviation was established by the mean angle obtained from the normal group, which included 50% of each medial and lateral side. RESULTS: The mean angles of the control group, the CMS group and the NP group were 1.34degrees, 3.47degrees, and 6.99degrees, respectively. A statistically significant relationship was noted between the control and NP group (p=0.001), but not between the control and CMS group, CMS and NP group (p=0.237 and 0.051, respectively). CONCLUSION: The nasal polyp in middle meatus influenced on the location of nasal fontanelle to lateral side compared to the normal controls.

A Case of Herpes Zoster Oticus without Facial Nerve Palsy Associated with Vertigo and Hearing Loss / 대한평형의학회지

Herpes zoster oticus (HZO) is characterized by facial nerve palsy, otalgia and auricular vesicles on the affected side and accepted to be caused by the reactivation of varicella zoster virus (VZV) in the geniculate ganglion. Vestibulocochlear deficits are known to be frequently accompanied by HZO. Unusual clinical manifestations such as only vertigo without facial nerve palsy or hearing loss has been reported. We report a case of 27-year-old man presented with vertigo, sensorineural hearing loss and vesicular eruptions on the left auricle without facial nerve palsy. Serologic test revealed that the patient was positive for immunoglobulin G (IgG) and IgM antibodies against VZV.

Analysis of Snoring Sound in Obstructive Sleep Apnea Patients Based on Obstruction Site / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The detection of obstruction site is very important for the surgical treatment of obstructive sleep apnea (OSA). Among the various diagnostic modalities for detection that have been tried, an analysis of snoring sound could be a simple and safe alternative. This study evaluates the usefulness of sound analysis in OSA as a detection tool of obstruction site. SUBJECTS AND METHOD: Fifteen patients who had been enrolled for the suspicion of OSA were studied. They were examined by videofluoroscopy and polysomnography to evaluate the obstruction site. During videofluoroscopy, snoring sound was recorded simultaneously. The snoring sound was analyzed by using Matlab program and its sonic characteristics were evaluated on the basis of the results in polysomnography and videofluoroscopy. RESULTS: According to the videofluoroscopy, 5 out of 15 patients showed narrowness only in the soft palate, while the rest of the 10 patients showed narrowness both in the soft palate and tongue base. Most of the snoring sound from the soft palate was of a low tone, under 1000 Hz, while the snoring sound from both soft palate and tongue base showed a high tone band, over 1000 Hz frequently and hump around 10 kHz. There was no specific correlation between apnea-hypopnea index and sonic characteristic. CONCLUSION: The analysis of snoring sound may be a useful tool for detecting the obstruction site in OSA.

Post-Operative Maxillary Cyst after Maxillary Orthognathic Surgery: Report of an Unusual Case

Postoperative maxillary cyst is a rare complication of surgical intervention associated with maxillary sinuses. The present paper describes a 25-year-old man presenting with a lump sensation in the left cheek area after Le Fort I osteotomy and mandibular sagittal split osteotomy. The orthopantomograph revealed a bony defect in the left maxillary alveolus. On the computerized tomography, a 1x2x3cm sized, lower density mass, between the left paramedian side of the maxillary alveolar process and hard palate was observed. The cyst was drained and enucleated. More frequent post-operative maxillary cysts may occur with an increase of Le Fort I osteotomies.

Survey of Continuous Positive Airway Pressure Use in Korea

BACKGROUND AND OBJECTIVES: Positive airway pressure (PAP) is the most effective treatment tool for obstructive sleep apnea (OSA), however adherence rate of PAP is known to be very low. The objective of this study is to investigate the adherence rate of PAP in Korea. MATERIAL AND METHOD: We reviewed sales data from a PAP vendor. OSA patients who were referred to this vendor had a chance to experience PAP for a month. After that, patients were supposed to buy PAP or return it. We investigate the rate of patients who bought PAP, and asked the patients who had bought it whether they are still using it or not. We asked the reason to the patients who are not using it anymore. RESULTS: Among 724 OSA patients who used PAP for one month, 256 patients bought PAP and others refused it. We could survey 190 patients among 256 who had bought PAP. Among them, 34 patients did not use PAP anymore. The rest 156 patients said that they are still using it. CONCLUSION: Contrary to our expectation, only a small number of obstructive sleep apnea patients use it. We must be cautious when to prescribe PAP to obstructive sleep apnea patients.