Measurement of Korean Ossicles / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There are several factors affecting the result of the ossiculoplasty such as the severity of the pathology, the operating technique and the reconstruction material, etc. So far, most of the ossicular materials that have been developed were not perfect and some of the commercialized materials are not suitable for Koreans. We investigated the dimensions of the Korean ossicles and the space between the handle of the malleus and the plane of the stapes in order to standardize the artificial ossicles to fit Koreans. MATERIALS AND METHODS: Sixteen cadaveric Korean temporal bones which did not have any pathology of tympanic membrane and ossicles were used for this study. We dissected the temporal bones and measured the related dimensions of ossicles under a surgical microscope. RESULTS: The dimensions of the part of ossicles are as follows: (1) length (mm),1) malleus head 3.46+/-0.57, neck 0.91+/-0.17, handle 4.40+/-0.29: 2) incus short process 2.42+/-0.35, long process 3.31+/-0.57: 3) stapes head and neck 0.79+/-0.19, height of crura 2.24+/-0.34: (2) diameter (long, short) (mm), stapes head 0.95+/-0.20, 0.73+/-0.11, footplate 2.91+/-0.20, 1.38+/-0.16. The distance between the stapes head and the malleus handle was 3+/-0.3 mm, and between the stapes footplate and the malleus handle 5.1+/-0.4 mm. The angle between a line from the malleus handle to the head of stapes and a perpendicular line of stapes footplate passing the center of stapes head was 29+/-7 degree. The angle between a line from the malleus handle to the stapes footplate and a perpendicular line of stapes footplate passing the center of stapes head was 17+/-5 degree. CONCLUSION: We collected normal data of dimensions of the Korean ossicles from cadaveric temporal bones. The differences in the dimensions between ossicles of the Korean and the non-Koreans were observed. The observed data from this study should be useful in the development of the artificial ossicular materials suitable for the Koreans.

The Clinical Effects of Laser Surgery in Simple Snorers on Polysomnography / 대한이비인후과학회지

OBJECTIVES: We aimed to evaluate the clinical effects of the recently developed laser surgery in patients who were diagnosed by polysomnography as simple snorers. MATERIALS AND METHODS: We operated on 35 patients with apena index of below 5, using CO 2 laser, from June, 1993 through May, 1994 at Yongdong Severance Hospital. For these patients, we carried out before and after assessments of three different kind: first, a follow-up assessment of subjective symptoms, such as snoring, daytime somnolence, nocturnal arousal, and headache; second, a psychodynamic analysis done by a psychiatrist on insomnia and depression: and third, an assessment of subjective atisfaction for 24 weeks following the surgery. RESULTS: Snoring improved in 74.2% of the patients, and daytime somnolence improved in 80.0% of the patients. Nocturnal arousal showed improvement in all the subjects whereas headache showed improvement in 66. 7% of the patients. In the psychodynamic analysis, insomnia as observed in 22.9% of the subjects, showing significant improvemnt. However, depression didn't improve significantly. Subjecive satisfaction of the surgery was noted to be the greatest at the fouth week of the operation but it gradually decreased thereafter. The most common postoperative complication was foreign body sensation (31.4%), which disappeared spontaneously within 3 to 6-months of the operation. CONCLUSION: Laser snoring surgery in simple snorers is found to be an effective method to lessen snoring. However, patients should be informed beforehand that this method of surgery may not fully meet their expectations.

Transillumination of Maxillary Sinuses: A Clinical Re-evaluation / 대한이비인후과학회지

BACKGROUND: Transillumination of maxillary sinuses was an important method before the invention of X-rays. But as the more precise and valuable methods have been developed, its importance has been reduced in clinical practice. OBJECTIVES: To elucidate the vailidity of the transillumination in diagnosing the maxillary sinus diseases, the transillumination method was compared with the conventional PNS series. MATERIALS AND METHOD: We performed transillumination tests in 100 adults(48 males and 52 females). A fiberoptic cable with halogen light sorce was enough for the examination. The light detected in the face of examinee in the dark room was evaluated. We studied the clinical reliability of transillumination in representing the status of the maxillary sinus. RESULTS: For bilateral sinusitis group(N=48), transillumination matched with the conventinal PNS series in 64.6%(31/48) of the cases, unilateral sinusitis group(N=17) in 82.4%(14/17) and normal group(N=35) in 88.6%(30/35). The overall matched-rate was 75%(75/100). CONCLUSIONS: The transillumination is a helpful non-invasive mothod for clinical evaluation of the maxillary sinus conditions.

Surgical Anatomy for the Infracochlear Approach to the Petrous Apex / 대한이비인후과학회지

BACKGROUND: Infracochlear approach indroduced by Ghorayeb et al. in 1988, was performed to reach the petrous apex with the canal wall-down procedure. Giddings et al. described the transcanal infracochlear approach preserving the posterior wall of the external auditory canal for treatment of the cholesterol granuloma in the petrous apex in 1991. OBJECTIVES: Surgical anatomy for the infracochlear approach to the petrous apex was reviewed in order to understand clinical applicability of this approach. MATERIALS AND METHODS: This study was performed using 20 human cadaveric temporal bones by the microscopic dissection. Measurements were obtained between different structures to find reliable angles and distances to guide working in the petrous apex region. RESULTS: The petrous apex was entered through the fenestra between the cochlea, carotid, and jugular bulb. The mean area of the fenestrae was 11.7+/-5.5mm2. The distance from the vertical segment of the facial nerve to the petrous apex was 25.3+/-2.4mm. The angle of the approach to the petrous apex was 37.3+/-5.1degrees to the axis of the internal auditory canal. CONCLUSION: The infracochlear approach could be used to obtain the route for a drainage procedure or a biopsy at the petrous apex without damaging hearing organs and major vessels. The canal-down procedure was needed to assess the petrous apex successfully.

A Case of Choristoma of Tongue Base / 대한이비인후과학회지

The choristoma is a tumor like mass of normal cells in an abnormal location. Intraoral osseous and cartilaginous choristoma is distinctly uncommon. The etiology of choristoma is unknown. It is suggested that the intraoral choristoma is a developmental lesion. Correct diagnosis can be obtained only after histopathologic examination. The treatment of choice is surgical excision. We present a case of osseous and cartilaginous choristoma, occurred on the tongue base and treated by peroral excision, with review of the literatures.