Pathologic Change of Perichondrium on Recurrent Otohematoma / 대한이비인후과학회지

Otohematoma is a fairly common disease in otolaryngologic clinics. Many physicans have been challanged with various method of management on auricular hematoma. The initial treatment usually involves simple aspiration and a compression bandage. But most of these treatments are recurrent problems and eventually become the cauliflower ear. A treatment involves a total excision of the newly formed fibroneocartilaginous layer. If hematoma persists, perichondrium becomes irregular by thickned fibroneocartilage formation. We treated 11 patients with otoplasty to remove fibroneocartilage under local anesthesia. We found that the perichondrium formed severe fibroneocarilage and organization after 2 weeks. We studied the sequence of pathological changes that occurs after injury.

The Effect of Mitomycin C in Middle Meatal Antrostomy Site / 대한이비인후과학회지

BACKGROUND AND OBJECTIVE: Adhesion and stenosis are important in causing poor results of sinus surgery. Mitomycin C (MMC) is an antibiotic-antineoplastic agent that decreases fibroblast proliferation and scar formation. This study was designed to observe the effect of intraoperative application of mitomycin C on the size of the antrostomy site and mucociliary clearance rate after an endoscopic sinus surgery. MATERIALS AND METHODS: A total 20 patients diagnosed with chronic sinusitis with nasal polyp were used. After middle meatal antrostomy, a piece of merocel soaked with 0.04 mg/mL MMC 1.5 mL was applied on right antrostomy site for 5 minutes. Left antrostomy site was used as control without applying MMC. The antrostomy size was measured by using gauze instrument under endoscopy at operation, 1, 3 and 6 months after surgery. Mucocilliary clearance rate was assessed by saccharine time test after 2 weeks, 1, 3 and 6 month. RESULTS: The MMC group has showed lower incidence of stenosis, granulation and adhesion than the control group. At 1 month, the percentage of remaining antrostomy size was 61.6+/-31.6% in MMC group, whereas that of the control group was 46.9+/-23.3%. There was a significant difference in the antrostomy size between the two groups at 1 month, but there was no significant difference at 3 and 6 month. The saccharine time test between the two groups showed no significant difference after operation. CONCLUSION: The use of MMC will improve the success rate of sinus surgery if it is used as adjuvant therapy after antrostomy. Further study will be needed on the duration of application time, concentration of MMC and method.

A Case of Extramedullary Plasmacytoma of the Adenoid and Palatine Tonsil / 대한이비인후과학회지

Extramedullary plasmacytomas (EMPs) are rare, low-grade and malignant transforming solitary tumors consisting of neoplastic plasma cell proliferation that occurs in the bones of the head and neck. Ninety percent of solitary EMPs occur in the head and neck region: these constitute, however, less than 1% of all head and neck malignancies. EMPs represent up to 4% of nonepithelial lesions of the upper respiratory tract. On initial presentations, they must be differentiated from multiple myeloma. At first, EMPs are frequently seen as masses or swellings, accompanied by nasal or pharyngeal symptoms. EMPs are of special interest to otolaryngologists, because the majority of these unusual tumors are present in soft tissues of the head and neck. We present the patient with EMPs of tonsil and adenoid and discuss the related literature on the presentation, epidemiology, workup and management of patient with this rare neoplasm.