A Case of Transient Visual Disturbance and Ocular Paresis after Endoscopic Sinus Surgery

Endoscopic sinus surgery (ESS) is widely used as standard surgical treatment for chronic rhinosinusitis. Orbital complications of varying degrees occurred during ESS have been widely reported. If the orbital symptoms occurred immediately after surgery, ocular damage associated with surgery is suspected if the patient’s preoperative ocular function was patent. If immediate action is not taken, permanent visual loss might develop, so it is very important to diagnose orbital complications and take appropriate action. In our case, there was no definite intraorbital hemorrhage when sudden visual loss was noted. The symptoms were fully recovered without further treatment and it is clinically suspected to be caused by transient ocular muscle toxicity of local anesthetics.

In Reply: Treatment for Acute Tympanic Membrane Perforation

No abstract available.

Analysis of Predisposing Factors for Hearing Loss in Adults

We aimed to estimate the effects of various risk factors on hearing level in Korean adults, using data from the Korea National Health and Nutrition Examination Survey. We examined data from 13,369 participants collected between 2009 and 2011. Average hearing thresholds at low (0.5, 1, and 2 kHz) and high frequencies (3, 4, and 6 kHz), were investigated in accordance with various known risk factors via multiple regression analysis featuring complex sampling. We additionally evaluated data from 4,810 participants who completed a questionnaire concerned with different types of noise exposure. Low body mass index, absence of hyperlipidemia, history of diabetes mellitus, low incomes, low educational status, and smoking were associated with elevated low frequency hearing thresholds. In addition, male sex, low body mass index, absence of hyperlipidemia, low income, low educational status, smoking, and heavy alcohol consumption were associated with elevated high frequency hearing thresholds. Participants with a history of earphone use in noisy circumstances demonstrated hearing thresholds which were 1.024 dB (95% CI: 0.176 to 1.871; P = 0.018) higher, at low-frequencies, compared to participants without a history of earphone use. Our study suggests that low BMI, absence of hyperlipidemia, low household income, and low educational status are related with hearing loss in Korean adults. Male sex, smoking, and heavy alcohol use are related with high frequency hearing loss. A history of earphone use in noisy circumstances is also related with hearing loss.

Clinical Outcomes of Silk Patch in Acute Tympanic Membrane Perforation

OBJECTIVES: The silk patch is a thin transparent patch that is produced from silk fibroin. In this study, we investigated the treatment effects of the silk patch in patients with traumatic tympanic membrane perforation (TTMP). METHODS: The closure rate, otorrhea rate, and closure time in all patients and the closure time in successful patients were compared between the paper patch and silk patch groups. RESULTS: Demographic data (gender, site, age, traumatic duration, preoperative air-bone gap, and perforation size and location) were not significantly different between the two groups. The closure rate and otorrhea rate were not significantly different between the two groups. However, the closure time was different between the two groups (closure time of all patients, P=0.031; closure time of successful patients, P=0.037). CONCLUSION: The silk patch which has transparent, elastic, adhesive, and hyper-keratinizing properties results in a more efficient closure time than the paper patch in the treatment of TTMP patients. We therefore believe that the silk patch should be recommended for the treatment of acute tympanic membrane perforation.

Bilateral Sequential Pneumolabyrinth Resulting from Nose Blowing

Pneumolabyrinth describes a condition with entrapped air in the labyrinth and usually occurs in temporal bone fractures that involve the otic capsule. While sporadic cases of bilateral pneumolabyrinth have been reported, cases lacking head trauma are very rare. We report the case of a 43-year-old man who had sudden hearing loss bilaterally after blowing his nose at an interval of 1 year. Although conservative management for the right ear and exploratory tympanotomy with sealing of the possible site of perilymphatic leakage in the left ear were performed, hearing outcome was poor in both ears. To our knowledge, this is the first case of bilateral pneumolabyrinth occurring as a result of nose blowing.

The Successful Reduction of an Anterior Maxillary Fracture with Foley Catheter and Real-Time Ultrasonography / 대한이비인후과학회지

Maxillary fractures are common traumas in facial lesions, frequently involving the thin bony anterior wall. Minimally invasive operations have been tried in these maxillofacial areas; for example, the Foley balloon inflation technique guided by nasal endoscopy in orbital blow-out fractures have been recently reported with a high success rate. However, in maxillary anterior wall fractures, these minimally invasive surgical procedures have seldom been reported. This report presents the case of a 24-year-old man with an anterior maxillary wall fracture. The fracture was treated with a minimally invasive method that uses an endoscopic approach to the maxillary antrum with a Foley catheter ballooning, which was monitored by real-time ultrasonography. This report presents the imaging studies and a description of the endoscopic procedure.

Radiologic and Histological Study of Healing Process on Malunion Rat Model after Zygomatic Arch Fracture

BACKGROUND AND OBJECTIVES: Zygomatic arch fracture should be treated early, because failure of prompt treatment of these injuries November result in significant morbidity, including malar asymmetry, enopthalmos, and sensory deficits. The purpose of this study was to evaluate the radiologic and histological changes of healing process on zygomatic arch fracture with malunion in animal model. MATERIALS AND METHOD: Ten rats with malunion after zygomatic arch fracture were used in this study. Using micro computerized tomography, we evaluated the defect of fracture site with serial weeks (1, 2, 4, and 8). We also analyzed the histological findings at same period. RESULTS: The 2-D images were able to assess a difference in recovery process of a bone fracture, but it was too small to be recognized. However, we could find to the definite changes of healing process by using the 3-D reconstructed image according to time sequence. Additionally, fracture sites were healed by primary bone healing process in the zygomatic arch fracture malunion state. CONCLUSION: The 3-D image is more useful to evaluate for fracture healing state. Moreover, the proper evaluation and adequate management is necessary even after eight weeks, because healing of fracture was not completed.

Radiologic and Histological Study of Healing Process on Malunion Rat Model after Zygomatic Arch Fracture

BACKGROUND AND OBJECTIVES: Zygomatic arch fracture should be treated early, because failure of prompt treatment of these injuries November result in significant morbidity, including malar asymmetry, enopthalmos, and sensory deficits. The purpose of this study was to evaluate the radiologic and histological changes of healing process on zygomatic arch fracture with malunion in animal model. MATERIALS AND METHOD: Ten rats with malunion after zygomatic arch fracture were used in this study. Using micro computerized tomography, we evaluated the defect of fracture site with serial weeks (1, 2, 4, and 8). We also analyzed the histological findings at same period. RESULTS: The 2-D images were able to assess a difference in recovery process of a bone fracture, but it was too small to be recognized. However, we could find to the definite changes of healing process by using the 3-D reconstructed image according to time sequence. Additionally, fracture sites were healed by primary bone healing process in the zygomatic arch fracture malunion state. CONCLUSION: The 3-D image is more useful to evaluate for fracture healing state. Moreover, the proper evaluation and adequate management is necessary even after eight weeks, because healing of fracture was not completed.

Basaloid Squamous Cell Carcinoma in Nasal Cavity

Basaloid squamous cell carcinoma (BSCC) is often founded in the head and neck region. However, BSCC in the sinonasal tract is rare. We report here on the case of a 58-yr-old woman who presented with nasal obstruction and epistaxis. Computed tomography and examination of the nasal cavity revealed a tumor mass that originated from the right inferior turbinate with erosion of the nasal floor. The tumor that was attached to the inferior turbinate, the lateral nasal wall and the eroded right side hard palate, and so all this was resected. Histopathologic examination of the excised tumor confirmed BSCC in the nasal cavity. We report here on a nasal cavity BSCC that was treated with partial maxillectomy only.

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.

Activation of the intrinsic mitochondrial apoptotic pathway in swine influenza virus-mediated cell death

The mitochondrial pathway of swine influenza virus (SIV)-induced apoptosis was investigated using porcine kidney (PK-15) cells, swine testicle (ST) cells, and HeLa cervical carcinoma cells which are known not to support viral replication. As judged by cell morphology, annexin V staining, and DNA fragmentation, PK-15 and ST cells infected with three different subtypes of SIV (H1N1, H3N2, and H1N2) were obviously killed by apoptosis, not necrosis. SIV infection in PK-15 and HeLa cells was shown to decrease the cellular levels of Bcl-2 protein compared to that of mock-infected control cells at 24 h post-infection, whereas expression levels of Bax protein increased in the PK-15 cells, but did not increase in HeLa cells by SIV infection. Cytochrome c upregulation was also observed in cytosolic fractions of the PK-15 and HeLa cells infected with SIV. Apoptosome (a multi-protein complex consisting of cytochrome c, Apaf-1, caspase-9, and ATP) formation was confirmed by immunoprecipitation using cytochrome c antibody. Furthermore, SIV infection increased the cellular levels of TAJ, an activator of the JNK-stressing pathway, and the c-Jun protein in the PK-15 and HeLa cells. Taken together, these results suggest that the mitochondrial pathway should be implicated in the apoptosis of PK-15 cells induced by SIV infection.