A Case of Intraparotid Facial Nerve Neurilemmoma / 대한이비인후과학회지

Neurilemmomas are benign tumors originating from the nerve sheath. These can arise from all kinds of cranial nerves. About 25% to 40% of all neurilemmomas are found in the neural structure of the head and neck. Neurilemmomas of the acoustic tumor are most common and there are several reports of neurilemmomas that developed in the facial nerve. The clinical presentations are generally insidious and the nature of the disease depends on the location and extent of the tumor. But intraparotid neurilemmomas are extremely rare. We experienced one case of intraparotid facial nerve neurilemmoma and report it with reviews of literature.

A Case of Ileoileocolic Type Intussusception Presented with Hematemesis Due to Meckel's Diverticulum / 대한소아소화기영양학회지

Intussusception is the most common cause of intestinal obstruction in early childhood and characterized by periodic colicky abdominal pain or irritability, vomiting, current jelly stool, and sausage-like abdominal mass. Meckel's diverticulum is common intestinal anomaly presenting with painless rectal bleeding during first 2 year of age. It is recognized as a common leading point of intussusception in childhood. Hematemesis is the rare clinical manifestation of both intussusception and Meckel's diverticulum. A 7-year-old girl presented with hematemesis was diagnosed as having intussusception by abdominal ultrasonography. Meckel's diverticulum was the leading point of intussusception in this case.

Management of Cerebrospinal Fluid Rhinorrhea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The cerebrospinal fluid rhinorrhea usually occurs as a result of trauma or surgical procedure such as endoscopic sinus surgery, neurosurgery and its incidence has shown tendency to increase recently. This study demonstrates the outcome of the treatment method of 24 CSF rhinorrhea cases. SUBJECTS AND METHOD: We reviewed the medical records of 24 patients treated at Chonnam National University Hospital from 1994 to 2003. RESULTS: The most common cause of cerebrospinal fluid rhinorrhea was iatrogenic trauma. The most common site was ethmoid. The treatment methods were selected according to the cause, interval to treatment, underlying diseases and subjective symptoms. In our review were conservative treatments only or operations such as endoscopic approach and external ethmoidectomy. The overall success rate was 91% (22/ 24). CONCLUSION: Management and repair of cerebrospinal fluid rhinorrhea should be individualized.

The Effect of Postural Restrictions in the Treatment of Benign Paroxysmal Positional Vertigo / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The treatment of Benign Paroxysmal Positional Vertigo (BPPV) consist of repositioning maneuver in order to remove otolithic debris, and subsequent postural restrictions to prevent debris from reentering into the canal. But, it is doubtful how much postural restrictions could have an effect on the final outcomes of BPPV. The purpose of this study is to find out the effect of postural restrictions when imposed on as one of the treatment methods of BPPV, out-broken due to otolithic debris in the posterior semicircular canal, and to find out the necessity of postural restrictions. SUBJECTS AND METHOD: Seventy cases diagnosed as BPPV of the posterior semicircular canal were studied. All the patients were treated by modified Epley Maneuver. They were divided into two groups. The first group (group A, 35 patients) was instructed to sleep in a semi-sitting position and not to move their heads forward or backward, whereas the second group (group B, 35 patients) was not taught to do any specific thing. The gathered information from all the patients was analyzed by age of onset, gender, duration of the disease, and cure rates or recurrence rates. RESULTS: In group A, the average age was 54.5 years and mean duration of symptoms was 116.5 days. On the other hands, in the group B, the average age and the mean duration was 54.8 years and 86.7 days, respectively. The cure rates of the group A and B were 91.4% and 94.3%, respectively. The recurrence rates were 12.5% and 9.1% for group A and group B patients, respectively. No statistically significant difference was found between two groups regarding patient age, duration of symptoms, and cure rates or recurrence rates. CONCLUSION: From the analysis of this study, it can be said that postural restrictions imposed after the repositioning maneuver do not have a significant effect on the final outcomes of BPPV, so they are not recommendable.

Studies on Relationships between Inflammatory Cell, Cytokines and Clinical Features in Pediatric Otitis Media with Effusion / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Retension of inflammatory cells and cytokines in the middle ear cleft can result in ongoing chronic otitis media with effusion. This study aims to investigate the role of these inflammatory cells and cytokines in the middle ear effusion (MEE) of children with otitis media with effusion. MATERIALS AND METHOD: We analyzed 46 pediatric middle ear effusion samples for IL-6, IL-10, TNF-alpha and inflammatory cells and tried to elucidate the relationship between the concentration of these cytokines, inflammatory cells and clinical features. RESULTS: 1) The concentration of TNF-alphain MEE from children younger than 2 years was significantly higher than the levels of children older than 2 years (p<0.05). 2) The concentration of TNF-alpha in MEE of preoperative medication group was significantly lower than the levels of non-medication group (p<0.05). 3) The concentration of IL-6 in MEE of the ears with hearing threshold poorer than 35 dB was significantly higher than the levels of the ears with hearing threshold better than 35 dB (p<0.05). CONCLUSION: The results showed that TNF-alpha and IL-6 are intimately involved in the inflammatory cascade of the middle ear and suggest regulation of these cytokines as possible sites of future therapeutic intervention in otitis media with effusion.