A Case of Tracheal Carcinoma Diagnosed by Rigid Bronchoscopy in Lidocaine Anaphylaxis Patient / 결핵및호흡기질환

The majority of flexible bronchoscopies are performed under topical anesthesia with lidocaine being the most commonly used agent. Anaphylaxis rarely occurs after local administration of lidocaine, but can be a fatal complication. We experienced a case of unexpected anaphylaxis. A 66-year-old woman was scheduled for flexible bronchoscopy to evaluate a tracheal mass and stenosis. The oral and nasal mucosa were pretreated with lidocaine. About 2~3 minutes later, the patient developed hypotension and we treated for anaphylaxis in the emergency room. Then, we decided to perform rigid bronchoscopy in this patient, under conditions of general anesthesia. A rigid bronchoscopy was performed in this patient, safely and successfully. The tracheal mass was determined to be squamous cell carcinoma.

Two Cases of Fractured and Embolized Implanted Central Venous Chemoports in Lung Cancer / 결핵및호흡기질환

Totally implanted central venous access devices for chemotherapy (chemoport) are being used increasingly in lung cancer patients. Vascular catheters are associated with various complications including infection, thrombosis as well as spontaneous fractures and embolization of the catheter, which is known as 'pinch-off syndrome'. 'Pinch-off syndrome' refers to the compression of a subclavian central venous catheter between the clavicle and first rib resulting in an intermittent or permanent obstruction, which can lead to tears, transection, or embolization. We report two cases of fractured and embolized implanted subclavian venous catheters in which the fragments were removed percutaneously. A 62-year-old man presented with back pain with a duration of a few weeks. The chest radiograph revealed complete transsection and embolization of the catheter into the right atrium. In addition, a 47-year-old woman with a chemoport had a grade 3 pinch-off sign in a chest radiograph demonstrating complete transsection and embolization of the catheter into the pulmonary artery. Both cases were managed by retrieving the embolized distal fragment percutaneously and removing the proximal section of the catheter.

A Case of Meningioma Invading the Middle Ear / 대한이비인후과학회지

Frequency of meningioma is reported to be 18 percent of all incidences of intracranial primary tumors, and tumor extension to the extracranial structures occurred in about 20 percent of intracranial meningiomas. Involvement of the middle ear is quite rare and meningioma in the middle ear can be seen either as a primary tumor or an extension of intracranial tumors. Since predominant symptoms of meningioma are hearing loss, otorrhea and other otologic symptoms, one can be mislead to chronic otitis media with diagnosis. Recently, we incidentally found a meningioma in the middle ear during chronic ear surgery in a 40-year-old female, who was confirmed by histopathologic diagnosis to have meningioma. We report herewith this case with the review of literatures.

The Effect of Tonsillectomy and Adenoidectomy on Nasality in Children / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tonsillar and adenoid hypertrophy is one of the common causes of nasal obstruction, mouth breathing, snoring and sleep apnea in children. Tonsillectomy and adenoidectomy (T & A) could relieve these symptoms but may also cause voice changes after the operation. The aim of this study was to evaluate the voice changes objectively by nasometric and acoustic rhinometric analyses. MATERIALS AND METHODS: Thirty-eight patients who underwent T & A and twenty-two control children who had no sinonasal or tonsillar hypertrophy problems were selected. A visual analogue scale was used for determining the subjective nasality changes and nasometric analyses were used to determine the objective nasalance differences. Acoustic rhinometry was used to measure the nasopharyngeal volume changes and the removed adenoid tissue were directly measured. Data were collected prior to the operation, and on the second, 7th and 14th days after the operation. Data were compared and analyzed statistically. RESULTS: The volume of removed adenoid tissue was not statistically related with the subjective nasality changes which increased significantly after T R. A. Nasalance in the patient group increased significantly after the operation compared to that in the control group. The voiume of nasopharynx increased significantly after adenoidectomy, but it had a minimal statistical correlation with the volume of the removed adenoid tissue. CONCLUSION: Nasometric and acoustic rhinometric tests can serve as objective tools for evaluating the subjective nasality changes after T 5z A.

A Case of Allergic Mucin Sphenoiditis without Fungus

Allergic fungal sinusitis is characterized by eosinophilic allergic mucin with fungal hyphae in histopathologic aspect. "Allergic mucin sinusitis without fungus" or "Allergic fungal sinusitis-like syndrome" is a new term used to describe patients who have clinical and histopathologic features of allergic fungal sinusitis but fail to demonstrate fungi in histopathologic sections or cultures of sinus tissue. In this study, we report on a case of allergic mucin sinusitis which involved only sphenoid sinus of the left side in a 31 year old female.

A Case of Relapsing Polychondritis / 대한이비인후과학회지

Relapsing polychondritis is a rare disorder that involves a multisystem characterized by recurrent inflammation, degeneration of cartilage and connective tissue. The following tissues, in the order of decreasing frequency, may be involved: auricules, joint, nose, eyes, respiratory tract, heart valve and skin. The cause is unknown but an autoimmune mechanism has been thought to be the causative factor. Authors have recently experienced a case of relapsing polychondritis in a 71 year old man diagnosed by direct immunofluoroscene and auricular chondritis.

Sound Localization in Subjects with a Unilateral Hearing Loss according to Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sound localization in subjects with normal hearing is done by recognition of interaural difference of time, intensity and phase of sound source. Individuals with unilateral hearing losses, deprived of the binaural cues, are expected to have difficulty in localizing sound. The purpose of the research is to investigate the sound localizing ability in subjects with unilateral hearing losses to localize sound in horizontal plane by comparing with normal control group, and to know the effects of age, gender, stimulus type and hearing level. MATERIALS: Two groups of subjects participated in this study. The first group consisted of 60 normal hearing adults, in each age groups of 10 subjects, ranging from teens to sixties. The second group consisted of 50 subjects with unilateral hearing losses. METHODS: Sound localization ability was assessed by means of an array of eight loudspeakers positioned at the azimuth of 45 degrees each in the horizontal plane at a distance of 100 cm from the subject. The stimuli consisted of speech noise, narrow band noise centered at 500 Hz and 4000 Hz, pure tone of 500 Hz and 4000 Hz at the level of 45 dB HL for 5 seconds. RESULTS: 1) Speech noise was the most easily detected stimulus (p0.05). 3) The localization errors for speech noise increased significantly as hearing threshold increased in patients with unilateral hearing losses (p<0.001). CONCLUSION: The results suggest that speech noise is the most easily detected stimulus in directional discrimination test and that the ability of sound localization is degraded as hearing threshold is increased for patients with unilateral hearing losses.

The Prevalence of Nasal Septal Deformities among Children in Kindergarten and First Grade in Anyang and Kunpo Cities

Nasal septal deformity (NSD) is a common nasal disorder, but its prevalence among children has not been reported in Korea. The aim of this work was to study the prevalence of NSD among children in kindergarten and first grade in Anyang and Kunpo cities and to evaluate whether the occurrence of NSD in children was affected by school activity or correlated with sex. We examined 1,646 nasal septa of 1,491 students (average age : 7.5 years ; range : 6.3-8.9 years) at three elementary schools and 155 children (average age : 6.5 years ; range : 5.9-7.1 years) at two public kindergartens. The overall prevalence of NSD was 13.6%. A significant difference in prevalence was found between male and female children and between male and female firstgraders. No difference was found between the children in kindergarten and the children attending first grade and between male and female children in kindergarten. The most common type of NSD, based on the Mladina's classification, was type 1, followed by types 2 and 5.