An Unusual Case of Luetic Lymphadenitis as a Solitary Submandibular Mass / 대한이비인후과학회지

Syphilis, a chronic systemic infection caused by Treponema pallidum, is usually sexually transmitted and characterized by episodes of active disease interrupted by a latent period. After an incubation period of averaging 2-6 weeks, a primary syphilis with a firm, non-tender chancre appears, often associated with regional lymphadenopathy. Secondary syphilis shows localized or diffuse mucocutaneous lesions and generalized non-tender lymphadenopathy. In about onethird of untreated cases, the tertiary stage appears, characterized by progressive destructive mucocutaneous, musculoskeletal or parenchymal lesions, aortitis or symptomatic central nervous system diseases. Without serological testing, the precise diagnosis is very difficult. In fact, it has often been called the great imitator because it was often confused with other disease. We report a very unusual case of luetic lymphadenitis presented as a solitary submandibular mass.

An Unusual Case of Tonsillar Lymphangiomatous Polyp / 대한이비인후과학회지

Tonsillar lymphangiomatous polyp is an uncommon hamartomatous lesion that generally arises from the tonsillar surface. Due to the uncommon clinical and pathological features of these polyps, pathologist and clinician may experience difficulty in correctly classifying them. Although this is a rare clinical and pathologic entity for pathologists and clinicians, the diagnosis is not so difficult if one has a bit of experience about that. Recently, we experienced a 37-year-old women with a pale lymphangiomatous polyp of 3x1.5 cm size, which was treated by tonsillectomy. We report this case with a review of literature.

An Unusual Case of Kinking Common Carotid Artery / 대한이비인후과학회지

An abnormal course of carotid artery may surprise surgeons during surgery and result in an transient ischemic attack or other ischemic symptoms. We report an unusual case of kinking in the common carotid artery located below the right thyroid lobe, which was found during a total thyroidectomy in a 74-years old patient. We emphasize in this case how important it is to palpate the neck before surgeries such as tracheostomy, thyroid surgery and so on.

Fibrovascular Polyp of the Hypopharynx: A Case Report

We report here on a case of fibrovascular polyp arising in the hypopharynx of a 62-year-old man. Laryngomicroscopic surgery with laser ablation was performed to excise the mass. Histopathologically, the surface of the polyp was covered with mature squamous epithelium. The polyp showed a characteristic lobular proliferation of mature adipose tissue that was separated by myxoid or collagenous connective tissue. Some scattered skeletal muscle bundles were seen in the central portions of the polyp and these bundles were surrounded by a concentric proliferation of the spindle cells; this was reminiscent of Pacinian corpuscles. Regarding their location and the intermingled pattern of proliferating tissues, it is more plausible that the skeletal muscle is a hamartomatous component rather than entrapped, preexisting tissue.

A Case Report of Brain Herniation into the Middle Ear Mimicking as Secondary Cholesteatoma Following Temporal Bone Fracture / 대한이비인후과학회지

Brain herniation into the middle ear cavity is a rare entity that occurs mostly as a complication of otologic surgery. Other causes include a congenital skull base defect, infection, trauma, neoplasm and irradiation. It gives rise to cerebrospinal fluid otorrhea, progressive hearing loss, tinnitus, meningitis and other neurologic symptoms. Such patients tend to be misdiagnosed as having chronic otitis media and are often treated for long periods with inadequate conservative therapy. We report a case of brain herniation into the middle ear following traumatic temporal bone fracture, which was treated surgically via a transmastoid approach.

The Effect of Electrical Stimulation at Tympanic Membrane on Tinnitus Suppression / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Electrical stimulation is one of various methods of treatment for patients suffering from tinnitus. However, the effect or mechanism of electrical stimulation is still unclear. Also, although the success rate of electrical stimulation ranged from 13% to 80% in other studies, the best condition of electrical stimulation is unknown yet. The purpose of this study is to elucidate the effect of alternate current electrical stimulation at tympanic membrane on tinnitus suppression and to seek the best condition that yield maximum tinnitus reduction. SUBJECTS AND METHOD: Forty-five patients who suffered from tinnitus with moderately severe hearing loss above 56 dB and 20 patients with limited frequency hearing loss above 56 dB were selected for this study. The study was performed in 4 phases. Fourty-five patients who passed the screening phase received 10 min duration of electrical stimulation twice a week for 6 weeks. RESULTS: The results were as follows. 1) Among the 65 patients, alternate current stimulation suppressed tinnitus in 45 patients (69%) in the screening phase. So 45 patients were selected for the electrical stimulation group. 2) Tinnitus suppression was most effective in patients with sudden deafness in the screening phase. 3) Effective tinnitogram for electrical stimulation was white noise and 8 kHz (pure tone) in the screening phase. 4) The most common optimal stimulation was the low frequency square wave. 5) The mean intensity of the current was 47.5 microliterA. 6) Suppression of tinnitus was achieved in 30 patients (67%) among 45 patients who received electrical stimulation therapy. 7) Long term treatment was more effective than short term, but adaptation phenomenon was noted during the treatment phase in 15 patients (33%). CONCLUSION: These results showed that alternate current stimulation for patients with tinnitus is effective and that the optimal condition to use is the low frequency square wave. We found good response to electrical stimulation in patients with sudden deafness and moderate to severe hearing loss. Therefore, we think electrical stimulation is a good treatment for patients with tinnitus for whom it is difficult to apply TRT (tinnitus retraining therapy).

C-fos Expression in Brain Stem of Rats after Salicylic Acid Treatment / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Subjective tinnitus, a distracting internal noise, is experienced by humans. Tinnitus is evoked by salicylic acid treatment in rats as confirmed by Jastreboff in 1994 in an animal behavior model of tinnitus with salicylic acid. The objective of this study is to evaluate c-fos expression in the brain stem of rats after salicylic acid treatment. MATERIALS AND METHOD: After salicylic acid (450 mg/kg) and saline treatment (450 mg/kg), c-fos immunohistochemical staining expression in the auditory and nonauditory brain stem nuclei were observed. RESULTS: Many immunoreactive cells were observed in the Locus Ceruleus of the salicylic acid treated animals, but not in the saline treated animals. No immunoreactive cells were found in the auditory brain stem nuclei. CONCLUSION: The Locus Ceruleus is the nucleus of the brain stem and produce norepinephrine which results in arousal of the neuronal activity for stress. These results suggest that salicylic acid may evoke tinnitus through a combined effect on the auditory and nonauditory brain nuclei. It seems possible that the interaction of these effects at particular locations of the brain causes tinnitus.

The Efficacy of Palatine Tonsillectomy Under Local Anesthesia: Comparative Analysis with Tonsillectomy Under General Anesthesia / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tonsillectomy is one of the most common surgical procedures in otolaryngologic field and it can be carried out under general anesthesia or local anesthesia. The author compared tonsillectomy under local anesthesia to general anesthesia with respect to operation, anesthesia and recovery time as well as satisfaction of the patients. SUBJECTS AND METHOD: Fifty patients who underwent tonsillectomy were divided into a local anesthesia group (25 patients) and a general anesthesia group (25 patients). Parameters such as time spent for anesthesia, operation, recovery time, episodes of cautery, initiation of normal daily life including normal diet, pain, and complication were compared between the two groups. Paired student t-tests were used for statistical analysis. RESULTS: Among other parameters, local tonsillectomy was superior in terms of saving time during anesthesia, operation, recovery as well as hospital course compared to tonsillectomy under general anesthesia. However, ease on the initiation of normal daily life including normal diet, pain, and complication did not differ between the two groups. CONCLUSION: The author feels that local tonsillectomy should be advocated not only for time saving during operation, anesthesia and recovery but also for the satisfaction or compliance of the patients. In these respects, it is suggested that more active training should be provided to surgeons during their residency on tonsillectomy under local anesthesia.

A Case of Extracranial Primitive Neuroectodermal Tumor that occured in the temporal fossa / 대한이비인후과학회지

No abstract available.