Correlation between Presumed Chronic Sinusitis-Induced Pain and Paranasal Sinus Computed Tomographic Findings in Korea

The correlation between facial pain and/or headache in patients with chronic sinusitis and localized findings on paranasal sinus omputed tomography (CT) are poorly understood. So we prospectively evaluated the relationship of paranasal sinus pain symptoms with CT imaging. Fifty eight patients with headache and/or facial pain rated their pain in 9 areas at the time of CT scanning and 2 months after endoscopic sinus surgery (ESS). We scored the degree of air-fluid level, mucosal thickening, and mucus retention cysts using a grade scale of severity. The ostiomeatal unit, middle meatus and nasofrontal duct were also evaluated for patency. Bivariate analysis was performed to evaluate the relationship between patients' pain, that was improved after ESS and CT findings. Among 58 patients who had facial pain and/or headache at the time of CT scan, the pain improved in 51 patients after ESS. Bivariate analysis failed to show any relationship between pain symptoms and CT findings in 51 patients. This study suggests that findings on CT do not routinely correlate with the patients' symptoms of facial pain or headache. CT should therefore be reserved for delineating the anatomy and degree of sinus disease before surgical intervention.

The Effectiveness of Long-Term Immunotherapy with Every 3-Month Injection after 3-Year Immunotherapy in the Treatment of Perennial Allergic Rhinitis Using Quality of Life Questionnaires / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Long-term immunotherapy lasting for 3 to 5 years is known to be one of the effective treatment modalities for the perennial allergic rhinitis. However, it is questionable whether open-ended immunotherapy is beneficial to control the symptoms of perennial allergic rhinitis. This study was designed to confirm the effectiveness of open-ended immunotherapy with every 3-month injection after 3-year immunotherapy by comparing the results of immunotherapy between patients who received less than 3 years and those who received more than 3 years. MATERIALS AND METHOD: One hundred-one perennial allergic rhinitis patients who received immunotherapy more than 1 year and had no history of sinonasal operation were chosen. They were divided into two groups; the duration of immunotherapy was from 1 year to 3 years in one group and more than 3 years in the other group. They were surveyed with global study and the questionnaires regarding practical problems about nasal, eye, and generalized systemic symptoms as well as their medical treatment history. This questionnaire was administered twice in one sitting, with the first on recalling symptoms before immunotherapy treatment, and the second on an evaluation of current symptoms. RESULTS: Improvement in the allergic symptoms was preserved in group B as well as in Group A. With the treatment, the patients in both groups experienced decrease in the frequency of absence from work or school, hospital visits and the use of antibiotics. There were no significant differences in the results between two groups. CONCLUSION: The long-term maintenance of immunotherapy with 3-month injection after 3-year immunotherapy is effective for the prevention of recurrence of perennial allergic rhinitis.

The Clinical Significance of Vestibular Evoked Myogenic Potential Evoked by Click Sound / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The human vestibule is known to be able to induce cervical muscle potential secondary to strong acoustic stimulations. This reflex is assumed to originate in the saccule, and is called "vestibular evoked myogenic potentials" (VEMP). The responses consist of alternatively positive and negative successive waves (p13-n23). This study was designed to evaluate the clinical significance of VEMP. MATERIALS AND METHOD: We studied the difference among the latencies of p13, n23 and the amplitudes among the 10 normal volunteers, 5 patients with sudden sensorineural hearing loss and 10 patients with vestibulopathy. And we compared the result of the caloric test and VEMP in patients with vestibulopathy. RESULTS: In the normal group, VEMP was detected in all and all of the sudden sensorineural hearing loss patients showed VEMP both in the affected and unaffected side. In unilateral vestibulopathy patients, VEMP were present in the unaffected side but not in the affected side. The difference between the amplitudes and latencies were not found in those cases where VEMP was detected. In vestibulopathy patients, VEMP were well correlated with the result of the caloric tests. CONCLUSION: We confirmed that VEMP is originated from the vestibule, not from cochlea. VEMP could provide itself as an addition method for testing the vestibule.