Expression of Tonicity-Responsive Enhancer Binding Protein (TonEBP) in the Rat Cochlea: An Immunohistochemical Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The inner ear is an organ used for hearing and balance. For its normal function, the inner ear fluid homeostasis is required. There has been controversy over the regulatory mechanisms of maintaining inner ear fluid balance, and they have not yet been clearly defined. TonEBP is the protein that binds tonicity-responsive enhancer elements in the osmoprotective gene, which elevates the compatible osmolytes, which in turn induces cell survival in hypertonic condition. The aim of this study was to elucidate if there is an osmoregulatory mechanism in cochlea. Material and Method: The localization of TonEBP in the cochlea of male Sprague-Dawley rats was studied by immunohistochemistry with an anti rabbit polyclonal anti-rat TonEBP antibody. RESULTS: TonEBP was expressed at outer hair cells, Deiter cells, spiral ligaments, sprial limbus connective tissues, and epithelial lining of basilar membrane facing scala tympani. CONCLUSION: TonEBP in cochlea is one of the proteins involved in elucidating cell survival in changed tonicity during inner ear homeostasis.

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.

A Case of Extraskeletal Chondroma of External Auditory Canal / 대한이비인후과학회지

Chondroma is a relatively common tumor that occurs in any areas of the body and is characterized by the formation of abundant hyaline cartilage. However, benign extraosseous cartilaginous lesions are uncommon and extraskeletal chondroma of the bony external auditory canal (EAC) is extremely rare. We recently experienced a case of extraskeletal chondroma of the bony EAC in a young female who was treated with simple excision. This case is reported along with a brief review of the literature.

Blepharokymography: A New Tool for Dynamic Eyelid Motion Analysis Using Image Processing / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Evaluation of facial movements, especially eyelid movements, per se, depends largely on subjective judgments of trained clinicians. Recently, however, a few objective methods were reported although they required bothersome markers attached on the eyelids and a special-purpose high-speed video camera. This study aimed to develop a new dynamic and quantitative analysis system for eyelid motion using an image processing method without markers or a high-speed camera, and to evaluate parameters that could properly differentiate normal and abnormal states. MATERIALS AND METHOD: The system was consisted of a personal computer with a general-purpose frame grabber and a specially developed software which was named, Blepharokymography. Displacement of upper eyelids, duration of closing and opening segments, and closing and opening velocity were measured in 12 normal subjects and 5 facial nerve palsy patients of variable causes. Mean values of each parameter and the ratio of a palsy or slower side to a normal or faster side in normal and facial palsy groups were compared. RESULTS: In the normal group, the mean displacement of upper eyelids, mean closing time, mean and peak closing velocity were 8.3mm, 161 msec. 61.6 mm/sec and 146.2 mm/sec respectively. Among parameters, displacement, the closing time, mean closing velocity and peak closing velocity were significantly different between normal and facial palsy groups. CONCLUSION: By using blepharokymography system, it was possible to measure the eyelid motion objectively. Displacement, closing time, average and peak closing velocity were useful in differentiating the normal state as well as the facial nerve palsy state.

Congenital Middle Ear Cholesteatoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Congenital middle ear cholesteatoma (CMEC) is a keratinous mass behind an intact tympanic membrane. CMEC does not have a history of instrumentation and is less common than acquired one. Many theories have been put forward to explain the pathophysiology of CMEC, however, none of these so far have been convincingly proven. This clinical study was performed to investigate the characteristic features of CMEC and to evaluate the correlation between pathophysiology and CMEC by retrospectivly reviewing the cases. MATERIALS AND METHOD: The medical records of patients who underwent otologic procedures at the hospitals of the Catholic university from January 1993 to September 1998 have been reviewed. They were ten males and four females, ranging in age from 4 to 59 (mean age 18). RESULTS: Three of the 14 patients had the lesions isolated to the anterosuperior quadrant of the mesotympanum which were cystic, easily removed and did not affect hearing. The others had more serious condition with extension into the posterior mesotympanum, which were large, often too extensive to indicate a formative site, and causing ossicular damage. CONCLUSION: CMEC presents in two distinctive forms according to the site of formation: the anterosuperior and posterior mesotympanum. The review suggest that the pathophysiology of posterior lesions may be different from anterior ones. For early diagnosis of CMEC, screening program should be carried out in children to prevent the more extensive diseases.

Histopathologic Changes in Nasal Mucosa of Rat with Benzalkonium Chloride / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Benzalkonium Chloride (BZC) is one of the most often used preservatives that has strong germicidal effect. Not only is it used for nasal drops, but also for eye drops and cosmetics. However, there have been many reports that lesions such as dermatitis and conjunctivitis are considered the results of irritation induced by BZC. We evaluated the histological changes after long-term administration of BZC on rat nasal respiratory mucosa. MATERIAL AND METHODS: We divided 40 BZC treated animals into 4 groups. First group received low-concentrated BZC solution which is commonly used for nasal sprays. Second group received high-concentrated BZC solution which is reported to induce dermatitis in human. Third and Fourth group received steroid mixed in the BZC solutions of low and high concentrations, respectively. Control group was administrated with normal saline. After 1, 2, and 4 weeks of topical administration in each group, the symptomatic and histological changes with H&E stain were observed. RESULTS: Sneezing and nose rubbing with forelegs were observed in all subgroups on the 5th day of treatment. The BZC induced lesions, including glandular formation, inflammatory cell infiltration, and edematous changes. The symptomatic and histological changes were pronounced when the duration of BZC administration was increased. Similar results were observed in groups that received steroid mixed in the BZC solution. CONCLUSION: We found that even low concentration of BZC preservative can cause nasal lesions. Thus, there is a strong need to develope a preservative that can be used safely.

A Sphenoid Mucocele with Bilateral Ophthalmic Symptoms / 대한이비인후과학회지

Mucoceles of the sphenoid sinus are relatively rare and it is difficult to dignose them with the history of the illness or with the physical examination alone. However, if it is not treated rapidly, it may give rise to visual loss, extraocular motor disturbance or other ophthalmic sequalae. Recently, we experienced a case of mucocele originating from the sphenoid sinus, which was managed by functional endonasal sinus surgery-marsupialization. We obtained satisfactory results after steroid treatments were applied on the post-operative visual disturbance of the left eye and the pre-operative occular motion disturbance of the right eye.