Nasopharyngeal Width and Its Association With Sleep-Disordered Breathing Symptoms in Children

OBJECTIVES: Although adenotonsillar hypertrophy is the main cause of sleep-disordered breathing in children, surrounding anatomic factors, such as the width of the nasopharynx, can affect upper airway patency. However, there have been no reports of the association of nasopharyngeal width with sleep-disordered breathing in children. This study was undertaken to measure nasopharyngeal width in children undergoing adenotonsillectomy for sleep-disordered breathing and to investigate the clinical implications of this factor. METHODS: This was a retrospective study with a follow-up period of 1 year, performed at a tertiary referral center. We reviewed the operative records of children who underwent adenotonsillectomy at our center for symptoms of sleep-disordered breathing, such as snoring, apnea, and mouth breathing. The nasopharyngeal width was measured immediately before adenotonsillectomy, which was performed under general anesthesia with a microscopy-assisted mirror view. Adenotonsillar hypertrophy was graded on a four-point scale, and symptoms of sleep-disordered breathing were evaluated by using the Korean version of the Obstructive Sleep Apnea-18 questionnaire before and after surgery. The relationships between the average nasopharyngeal width and patient age and sex, adenotonsillar hypertrophy, and the Korean version of the Obstructive Sleep Apnea-18 score were analyzed. RESULTS: The study included 549 children (343 boys) with a mean age of 6.0 years (range, 2 to 11 years). The average nasopharyngeal width was 11.9 mm (range, 7.0 to 18.0 mm) and increased with age (range, 11.2 to 13.3; β=0.264; P<0.001). At 1 year after surgery, children with a greater nasopharyngeal width at the time of surgery exhibited additional improvements in symptoms of obstruction relative to those at 1 month after surgery. CONCLUSION: The average nasopharyngeal width in children is approximately 11.9 mm and exhibits a slight increase with age. The width of the nasopharynx may be a factor associated with the degree of improvement in symptoms of sleep-disordered breathing after adenotonsillectomy.

A Case of Phantosmia Occurred by Glioblastoma

Phantosmia is defined as the false perception of odors without any environmental odor stimulus. It is a very rare phenomenon, but it can be caused by a wide variety of conditions, such as viral or allergic rhinosinusitis, head trauma, brain tumor, migraine, temporal lobe epilepsy, stroke, and psychiatric conditions. If it is caused by a brain tumor such as glioblastoma, it can be controlled with steroids or antiepileptic drugs. Phantosmia can also be treated with surgical resection or adjuvant radiotherapy combined with chemotherapy. We report a case of glioblastoma presenting with phantosmia.

Comparison of Free-Beam- and Fiber-Type CO₂ Laser Delivery Systems in Stapes Surgery

BACKGROUND AND OBJECTIVES: A free-beam-type CO₂ laser, which use a micromanipulator mounted on a microscope as the delivery system, has the merit of not being affected by hand tremor at the time of shooting. However, this delivery system has several disadvantages, including a restricted operation range and a risk of incorrect focusing. A fiber-type CO₂ laser uses a hand-held delivery system and has the opposite merits and demerits. We compared the results of stapes surgery with free-beam and fiber type delivery systems. SUBJECTS AND METHODS: The study enrolled 36 patients who underwent stapedotomy with free-beam- (n=26) or fiber- (n=10) type CO₂ lasers. The air-bone (AB) gap closure, bone conduction (BC) change, and operating time were evaluated. The AB gap closure was calculated by subtracting the preoperative BC thresholds from the postoperative air conduction thresholds. The BC change was calculated by subtracting the postoperative BC thresholds from the preoperative BC thresholds. RESULTS: The mean operating time was significantly (p=0.035) shorter in the fiber-type group (72.5±8.2 min) than in the free-beam-type group (80.5±11.4 min). The mean AB gap closure did not differ significantly (p=0.297) between the free-beamand fiber-type groups (5.8±10.1 and 1.4±6.8 dB, respectively). The mean BC change did not differ significantly (p=0.873) between the free-beam- and fiber-type groups (2.4±6.9 and 2.8±5.3 dB, respectively). The hearing outcomes did not differ significantly between the two groups. CONCLUSIONS: Operating times were significantly shorter using the fiber-type CO₂ laser, while hearing outcomes did not differ significantly between the two groups.

Gastric Duplication Cyst with Ectopic Pancreas in a Child / 대한소화기학회지

No abstract available.

A Case of Multiple Myeloma with Biclonal Gammopathy / 대한혈액학회지

Multiple myeloma is lethal plasma cell proliferation that produces monoclonal M-protein and presents bone pain, pathologic fractures, anemia, hypercalcemia, renal failure, abnormalities of the coagulation system, and dysfunctions of the nervous system. About 1% of the multiple myeloma have more than one such protein (monoclonal M-protein). We experienced a case of mutiple myeloma presented as biclonal gammopathy. Protein electrophoresis and immunoelectrophoresis showed biclonal band that consisted of IgG-landa and IgA-k.

Gottron's Acrogeria Syndrome: a case report / 대한정형외과학회잡지

Gottron's acrogeria syndrome is a rare genetic disease of unknown etiology with some features suggestive of accelerated aging. The typical clinical presentation consists of premature aging of the skin with atrophy of the cutis and the subcutis. After a brief review of the literature available on this syndrome, we report a case of Gottron s acrogeria syndrome in a 19 year-old man whose right rectus femoris muscle had a fibrotic contracture.

A study on the repair of osteochondral defects of rabbit knee jointusing carbon fiber

No abstract available.

Experimental Study for Peripheral Nerve Reconstruction using Skeletal Muscle and Omentum / 대한정형외과학회잡지

The experimental study for peripheral nerve reconstruction was performed using degenerated skeletal muscle and omentum. At the sciatic nerves of 26 rabbits, about 10mm gaps were made under ketamine anesthesia. Degenerated skeletal muscles were made through the procedure of freezing with liquid nitrogen and thawing in distilled water. And omenta were taken through midline abdominal incisions. On 14 rabbits of experimental group, the nerves were connected with the degenerated skeletal muscles and surrounded with the omenta. On 6 rabbits of control group, the nerve gaps were connected with the degenerated skeletal muscles without surrounding with the omenta. And the other 6 rabbits of control group, the gaps were lets without further treatment. After 3, 6, 9 and 12 weeks, the results were compared using light microscope and transmission electron microscope. There were contractions and fragmentations at the skeletal muscles during the freezing and thawing. There were nerve regenerations through the degenerated skeletal muscles. The nerve tissues of the experimental group were more abundant than the control group using the degenerated skeletal muscles only.

Surgical Treatment in Congenital Ulnar Drift of Fingers / 대한정형외과학회잡지

The Congenital Ulnar Drift of the fingers is a relatively uncommon and has symmetrical malformations of hand, face and foot characterized by MP joint flexion contracture and ulnarward deviation of the fingers and microstomia, In tarsal deformity, there are clubfoot and congenital vertical talus with rocker bottom deformity. In treatment, the report of the surgical treatment was rare. We experienced congenital ulnar drift of fingers in 2 patients in one family, which were treated by dome resection corrective osteotomy of the metacarpals. Therefore remarkable symptomatic improvement was obtained.