Fungal Mastoiditis in an Immunocompetent Patient / 대한이비인후과학회지

Aspergillus has been recognized in infections of the paranasal sinuses since 1891, and in invasive external otitis since 1985. Fungal mastoiditis is a very rare entity, which is almost exclusively seen in immunocompromised patients. The authors present a case of fungal mastoiditis in a 43-year-old woman without immunocompromise. The patient showed symptoms of chronic intermittent otorrhea, otalgia and progressive hearing loss. On physical examination, attic destruction and adhesive tympanic membrane was seen in the right side. On temporal bone CT scans, soft tissue density was noted in the right mastoid antrum. After radical mastoidectomy, tissue pathology from mastoid cavity showed fungal ball of aspergillus. Fungal infection of mastoid cavity is very rare, however, it can cause serious complications. So, we report here, with a review of literature, a case of fungal mastoiditis in an immunocompetent patient.

The Changes of Olfactory and Trigeminal Pungency Thresholds in n-Aliphatic Alcohols with Different Carbon Chain in Normal Adults / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Using n-aliphatic alcohols whose physical properties change gradually as their length increases, we investigated the changes of olfactory threshold and trigeminal pungency threshold with the increase of carbon chain length. MATERIALS AND METHOD: Olfactory and trigeminal pungency thresholds were measured in ethanol (C2), 1-butanol (C4), 1-hexanol (C6) and 1-octanol (C8) in 40 normal adults using a two-alternative forced-choice modified by the ascending method of limit (CCCRC) test. Plastic bottles with 30 ml of four n-aliphatic alcohols were diluted threefold successively by mineral oil. Plastic bottles containing only mineral oil were used as controls. RESULTS: The olfactory and trigeminal pungency thresholds decreased and the ratio of olfactory threshold/trigeminal pungency threshold increased with the length of carbon chain in n-aliphatic alcohols. The correlation coefficients among olfactory thresholds in each alcohol were higher than those among trigeminal pungency thresholds. CONCLUSION: Alcohol with long carbon chains showed low olfactory and trigeminal pungency thresholds, indicating that high lipid solubility is an important factor in olfaction and trigeminal chemosensitivity.

Odorant Confusion Matrix Odor Identification Test Using Synthetic Odorants / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The odorant confusion matrix (OCM) odor identification test is a kind of suprathreshold odor identification test using 10 synthetic odorants as stimuli and confusion matrix consisted of closed alternatives. This test is known to have an advantage in qualitative diagnosis of olfactory dysfunction by analyzing mis-identification of odorants at specific nerve dysfunctions. The aim of this study is whether we can use this OCM odor identification test for comparing normals with patients with olfactory disturbance. MATERIALS AND METHODS: The OCM odor identification test using 10 synthetic odorants familiar to Korean was applied to 40 normals and 32 patients who showed decreased sense of smell without sinonasal diseases. Percent-corrects of normals were compared with patients and with olfactory thresholds by a modified ascending method of limits (CCCRC) test using successively diluted 1-butanol. RESULTS: Percent-corrects of normals in the OCM odor identification test was higher than those of patients with statistical significance (p<0.001), and the results of OCM odor identification test was well correlated with those of the CCCRC olfactory threshold test (r=0.77). CONCLUSION: The OCM odor identification test exhibited no problems in discriminating patients from normals and can be used in clinical contexts.