Shielded Swab: A New Swab Technique Avoiding Contamination in Endoscopically Guided Middle Meatal Culture / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Endoscopically guided middle meatal culture is recommended to determine organ-specific antibiotic therapy in sinusitis. This study was designed to decrease the chance of contamination in endoscopically guided middle meatal swab through a shielded pathway using a sterile straw to bypass the contaminated area in the nose from the vestibule to the middle meatus. SUBJECTS AND METHOD: Seventeen healthy volunteers underwent endoscopically guided middle meatal culture. With or without the sterilization of the nasal vestibule, endoscopically guided middle meatal culture was performed by using a sterile cotton swab (routine swab) and using a sterile cotton swab through a sterile straw (shielded swab). We compared the contamination rates between the routine swab versus shielded swab. RESULTS: With and without the sterilization of the nasal vestibule, the contamination rates of the routine swab was 11.7% and 64.7%, respectively and the contamination rates of the shielded swab was 5.8% in both. CONCLUSION: In endoscopically guided middle meatal culture, the contamination rates was significantly decreased by using the shielded swab without sterilization of the nasal vestibule. This study suggests that the shielded swab is a new and reliable swab method that can be used easily and simply at the office.

A Rat Model of Acute Rhinosinusitis Induced by Alpha-Toxin of Staphylococcus Aureus

BACKGROUND AND OBJECTIVES: Staphylococcus Aureus (S. Aureus) is one of the most common and predominant form of bacteria in the nasal airway that roduces toxin. Alpha toxin from S. Aureus, also known as alpha-hemolysin, causes damage to the membrane in many types of cells. The purpose of this study is to develop a rat model of rhinosinusitis induced by the intra-nasally applied alpha-toxin of S. Aureus. MATERIAL AND METHODS: Forty micro-liters of 100 microgram/ml of alpha-toxin was applied intra-nasally to 4-6 weeks-old Sprague-Dawley rats and the same amount of vehicle was applied to control rats. At days 1, 5 and 14 the rats were sacrificed and their nasal cavity prepared for histological investigation. RESULTS: Inflammatory cell clusters were observed in the alpha-toxin applied rats. The number of sinus air spaces occupied by inflammatory cell clusters increased significantly at days 1 and 5 compared with the control rats. Comparisons across the time interval demonstrated statistically significant changes, showing a peak at day 1 among alpha-toxin applied rats. CONCLUSION: Intra-nasally applied alpha-toxin induces acute rhinosinusitis in the rats. The histological evidence of rhinosinusitis revealed the appearance of inflammatory cell clusters in the sinonasal air spaces. These findings indicate that this rat model of alpha-toxin induced rhinosinusitis may be applied for better understanding of the role of bacterial toxin in the pathogenesis of rhinosinusitis.

Analysis of 32 Cases of Acute Laryngeal Trauma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Laryngeal trauma occurs uncommonly, but when it does, it can cause acute airway obstruction and longterm voice and airway problems. The purpose of this study was to analyze the clinical presentation of larynx trauma and to assess the outcome of the treatment. MATERIALS AND METHOD: We analyzed the medical records of 32 patients with acute laryngeal trauma from 1992 to 2006, retrospectively. RESULTS: The most common cause of injury was traffic accident. Voice change was the most common symptom. Vocal cord palsy in patients with redistributed in minor injury was improved in all of the group that received conservative management. If there are significant endolaryngeal laceration or arytenoid disruption, which can occur with major trauma, consideration should be given to placing an endolaryngeal stent. But there was no difference in improvement rates between those receiving treatment with stent and those without stent. Thus, consider severity, treatment with stent is likely to yield to significant benefit. CONCLUSION: Vocal cord palsy in patients with redistributed in minor trauma may be managed conservatively. We conclude that patients with major trauma of endolaryngeal mucosa should use a stent in their treatment.

Correlation between Olfactory Dysfunction Measured by T&T Olfactometer and Disease Severity Staged by CT in Chronic Rhinosinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Chronic rhinosinusitis is a common etiology in olfactory dysfunction. There have been several studies regarding olfactory dysfunction in chronic rhinosinusitis using olfactory diagnostic tools, other than T & T olfactometer. To establish a relationship between the disease severity and severity of olfactory dysfunction, we evaluated the correlation between disease severity by using sinus CT scan as graded by the Harvard system and olfactory function by using the Butanol threshold test and T & T olfactometer. SUBJECTS AND METHOD: Fifty patients with chronic rhinosinusitis were evaluated. We scored each CT scan on the Harvard system, and the Butanol threshold test and T & T olfactemeter were performed for each patient. Correlation between the CT scores, Butanol test scores and T & T olfactometer scores was assessed. We also assessed for correlation between the 5 odorants used in the T & T olfactometer with the CT scores. RESULTS: The CT scores graded by the Harvard system and the score of Butanol threshold test was correlated significantly (p<0.01). The CT scores and the scores of T & T olfactometer, and those of each odorant used in the T & T olfactometer were correlated significantly (p<0.01). CONCLUSION: Using a T & T olfactometer, we found that disease severity is correlated with the severity of olfactory dysfuction. All odorants of T & T olfactometer were similarly correlated with the disease severity.

A Case of Primary Tuberculous Otitis Media Complicated by Defect of External Auditory Canal Skin / 대한이비인후과학회지

Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and mastoid. In the past, painless watery discharge and multiple perforation of tympanic membrane were considered as classical symptoms and signs but recently, these clinical features have changed. And also, tuberculous otitis media can be difficult to diagnose due to confusion with other acute or chronic middle ear conditions. Moreover, a delayed diagnosis can lead to complications such as sensorineural hearing loss, facial nerve paralysis, and intracranial dissemination, etc. We experienced a case of tuberculous otitis media complicated by defect of external auditory canal skin and facial nerve paralysis. The diagnosis was missed until after surgery. So we report this case with a review of related literature.