Radiofrequency Diathermy for Rhinogenic Headache / 대한이비인후과학회지

Rhinogenic headache is a headache or facial pain syndrome secondary to mucosal contact points or rhinogenic causes in the absence of rhinitis/sinusitis. The authors report a case of atypical rhinogenic headache in a 72-year-old woman who presented with recurrent right side headache, which was aggravated by nasal breathing. A computed tomographic scan showed no evidence of rhinosinusitis and mucosal contact points. However, during nasal endoscopy, she had multiple pain-trigger points on the septum and lateral nasal wall. Treatment involved endoscopic reduction and radiofrequency diathermy of the pain-trigger point. Postoperatively, the headache was successfully relieved, and there was no evidence of recurrence. In this article, the authors present surgical option for the treatment of atypical rhinogenic headache.

Prevention Technique Using Inferior Turbinate Mucosal Flap for Septal Perforation after Septoplasty

BACKGROUND AND OBJECTIVES: Septal surgery is the most common cause of nasal septal perforation. The aims of this study are to introduce a new technique for the prevention of septal perforation during septal surgery by installingan inferior turbinate mucosal flap on the injured mucosal surface, and to determine its usefulness by evaluating the treatment outcomes. MATERIALS AND METHODS: Between March 2012 and March 2013, 90 cases of conventional septoplasty were performed. Bilateral mucoperichondrial tears on corresponding areas occurred in 4 cases. Autologous cartilage was inserted and then both sides were repaired using inferior turbinate mucosal flaps. Follow-up periods ranged from 5 to 6 months. RESULTS: Three of the four patients had successful outcomes with complete repair of injuries. The remaining patient had a septal perforation. CONCLUSIONS: The technique of using an inferior turbinate mucosal flap may be an easy, effective method for the prevention of septal perforation during septal surgery.

Bilateral Pneumosinus Dilatans of the Maxillary Sinuses with Facial Pain / 대한이비인후과학회지

Pneumosinus dilatans is a rare disease in which 1 or more paranasal sinuses are dilated without functional alteration. The frontal sinus is the most commonly affected site, with involvement of the maxillary sinus being rare. A 25-year-old man had complained of facial pain and headache of frontal area. These symptoms were aggravated after nose blowing. A computed tomographic scan showed a hyperaeration of both maxillary sinus and frontal sinus. We treated the condition by endoscopic sinus surgery (middle meatal antrostomy, both). Just after operation, facial pain and headache of frontal sinus have subsided. No recurrence was detected. In this article, the authors present surgical options for the treatment of pneumosinus dilatans of the maxillary sinus, including a review of the literature.

Use of Triamcinolone-Impregnated Nasal Packing Following Endoscopic Sinus Surgery

OBJECTIVES: To investigate the effectiveness of steroid-impregnated absorbable nasal dressing on wound healing and surgical outcomes after endoscopic sinus surgery (ESS). MATERIALS AND METHODS: Chronic rhinosinusitis patients with nasal polyps who were to undergo bilateral ESS were recruited and randomized to receive triamcinolone-impregnated bioresorbable dressing (Nasopore(R); Polyganics, Groningen, Netherlands) in one nasal cavity and saline-impregnated dressing contralaterally. Postoperative healing assessments of edema, crusting, secretions, and scarring were done at postoperative days 7, 14, and 21 and at 1 and 3 months using validated Lund-Kennedy scores. RESULTS: Analysis of the 20 enrolled patients who completed observation showed no significant difference in Lund-Kennedy scores between the preoperative cavity scores. There was, however, a statistically significant difference in Lund-Kennedy scores of the treatment and control groups at days 7 and 14 (P =0.005 and P=0.0039, respectively), and a significant difference in Lund-Kennedy scores was also detected between the groups at the 3-month time point (P =0.042). CONCLUSION: The results of the data analysis suggest a significant improvement in early postoperative healing and improved healing for up to 3 months postoperatively in nasal cavities receiving triamcinolone-impregnated absorbable nasal packing following ESS.