Two Cases of Rhinocerebral Mucormycosis

Mucormycosis is a rare opportunistic fungal infection. The most common infection site is the paranasal sinuses, although it can also occur in the lungs and skin. The fungus adheres to tissue membranes and forms thrombi, causing ischemia and hemorrhagic necrosis. Rhinocerebralmucormycosiscan occurin the nose, but mightrapidly spread to the orbit and intracranium. Therefore, prompt and aggressive treatment is required. However, because of its low incidence, few reported cases have focused on accompanying disease, proper treatment period, and disease progression. Herein, we report two cases of rhinocerebralmucormycosiswith a brief literature review.

Diagnosis and Treatment of Temporal Bone Trauma / 대한이비인후과학회지

Trauma to temporal bone is common in head injury. The causes of temporal bone trauma are traffic accident, falling down injury, assault and gunshot etc. The main symptoms and signs of temporal bone trauma are facial nerve paralysis, hearing loss, vertigo and cerebrospinal fluid leakage. To avoid or minimize the complication, the physicians have to perform precise diagnosis. The tools of diagnosis include the history and physical examination, radiologic examination, audiologic examination, vestibular function test and electrodiagnostic methods for facial nerve. The physicians have to decide the early proper intervention, for example surgery or medication, for the patients suffered from acute facial palsy, dizziness and cerebrospinal fluid leakage. In this study, the authors have reviewed the pathophysiology, classification, symptom, diagnosis and treatment of the temporal bone trauma.

Outcomes and Prognosis of Patients Treated by Facial Nerve Decompression via Transmastoid Approach for Traumatic Facial Paralysis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study is to evaluate the outcomes and prognosis of traumatic facial paralysis in patients treated with facial nerve decompression via transmastoid approach. SUBJECTS AND METHOD: The authors retrospectively reviewed 20 patients who suffered from temporal bone fractures resulting in facial paralysis and received surgical facial nerve decompression treatment via transmastoid approach from 2004 to 2012. RESULTS: In 14 patients, the House-Brackmann grade improved to 1, 2, or 3. The preoperative average House-Brackmann grade of 4.95 improved from 4.95 to the postoperative average House-Brackmann grade of 3.15. Statistically significant improvements were found in all groups whether the operation was performed within two weeks, or from two weeks to four weeks, or after four weeks. CONCLUSION: Postoperative results of facial nerve decompression in traumatic temporal bone fracture can be excellent. Surgeons can expect better outcomes with early diagnosis and lesser nerve damage.

A Comparison of Clinical Outcomes between Decompressive Laminectomy Alone and with Arthrodesis in Lumbar Single Level Spinal Stenosis

OBJECTIVE: By comparing the data of patients with spinal stenosis who had undergone decompressive laminectomy alone or with arthrodesis, we retrospectively analysed the advantages and disadvantages of the subsequent surgical techniques. METHODS: We analyzed the radiological parameters, surgical techniques, and clinical outcomes of 35 patients, who had undergone operation for spinal stenosis. The patients were divided into two groups, laminectomy alone(15 patients) and laminectomy with arthrodesis(17 patients) and the patients' subjective outcomes and radiological results were compared. RESULTS: Subjective satisfaction was higher in patients who had received decompressive degrees laminectomy alone(80%) than patients who received degrees decompressive laminectomy with arthrodesis(70%). The mean preoperative spinal lordotic angle in the laminectomy alone groups improved from 32.3 degree to 33.9 degree, postoperatively, and 33.1 degree at the last follow up. The mean preoperative spinal lordotic angle in the laminectomy with arthrodesis groups improved from 33.5 degree to 37.8 degree postoperatively, and 37.4 degree at last follow up. The lamine- ctomy with arthordesis group showed better results regarding spinal lordotic angle correction but this was not directly related to the clinical outcomes CONCLUSION: There was no significant correlation in clinical outcome, correction of spinal lordosis angle and patients' subjective satisfaction between decompressive laminectomy alone and with arthrodesis. Therefore, we suggested that decompressive laminectomy alone was achived good outcomes in patients who has single level spinal stenosis with no proven spinal instability at preoperative stage.