Expression Profile of Fas-Fas Ligand in Spiral Ganglion Cells During Apoptosis

OBJECTIVES: To examine the expression profile of Fas-Fas ligand (FasL) during glutamate (Glu)-induced spiral ganglion cell (SGC) apoptosis. METHODS: Cultured SGCs were treated with 10-mM, 25-mM, and 50-mM concentrations of Glu and incubated for 24 or 48 hours. The expression intensity of FasL, Fas, caspase 3, and morphology of single SGC were evaluated using immunofluorescence staining. RESULTS: In semiquantitative analysis of the Glu-treated SGC, FasL, and caspase 3 expression intensity were increased with concentration- and time-dependent manner. Fas expression intensity did not change with different concentration at 48 hours. In morphologic analysis of the Glu-treated SGC, number of apoptotic cells were increased with concentration- and time-dependent manner. CONCLUSION: FasL was expressed in apoptotic SGCs, suggesting that the Fas-FasL signaling pathway may be involved in the Glu-induced apoptosis of dissociated SGCs.

Histologic Serial Changes of Obliterating Materials in the Rat Temporal Dorsal Bullae / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mastoid obliteration surgery is a modern trend for otitis media either with or without cholesteatoma. The aim of our study is to evaluate histologic changes and effectiveness over time resulting from different obliterating materials and the existence of mucosa in the temporal dorsal bullae in rats. MATERIALS AND METHOD: Rats were divided into two groups. One group had the mucosa removed and was treated with trichloroacetic acid (TCA). The other group with mucosa remaining was untreated. The temporal dorsal bullae of the two groups of rats were obliterated with Mimix(R) (hydroxyapatite cement), Regenafil(R) (demineralized bone matrix), cartilage chip, and bone chip. Three months and again six months after the implantation, 5 animals in each group were examined. A histological study was performed to evaluate inflammation, new bone formation, and mucocele formation within the bullae. RESULTS: The group that had Mimix(R) implanted had a high inflammatory reaction, low implanted material resorption and cyst formation. The group with Regenafil(R) implanted had high cyst formation and more cyst formation with the passage of time. The group with bone chip implanted had high new bone formation, but also high cyst formation. The group that had cartilage chip implanted had high new bone formation, low implanted material resorption and low cyst formation. CONCLUSION: Cartilage chip is the only material that should be used in the air cell with mucosa remaining. Demineralized bone matrix and bone chip should not be used in the air cell with mucosa remaining. Hydroxyapatite cement should not be used due to severe inflammation.

Reconstruction of the Posterior Canal Wall with Mastoid Obliteration after Canal Wall Down Mastoidectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There have been heated controversies over the choice of the canal wall down mastoidectomy (CWD) and canal wall up mastoidectomy (CWU), which are operational methods used to eliminate the lesion of cholesteatoma. Combining the advantages of both methods, we reconstructed the posterior canal wall with conchal cartilage plate and obliterated mastoid cavity with bone chips (group I), or hydroxyapatite mixed with bone chips (group II) since 2001. This study was designed to evaluate the surgical outcomes of posterior canal wall reconstruction with mastoid obliteration in the treatment of cholesteatoma. SUBJECTS AND METHOD: From January of 2001 to March of 2007, the posterior canal wall reconstruction with mastoid obliteration was conducted on 66 patients. There were 30 cases of cholesteatoma and 36 cases of old radical cavity. The postoperative observation period ranged from 5 to 74 months, with the average period of 34.7 months. We analyzed the postoperative complications, and hearing results of the 33 ossicular reconstruction cases. RESULTS: There was 1 case of residual cholesteatoma in the middle ear cavity, but no recurrent cholesteatoma. In most cases, reconstructed canal wall was maintained well, but partial canal wall resorption and postauricular dimpling occurred in 5 cases of group I. On the other hand, the epithelization of posterior canal wall was incomplete in 4 cases of group II. After surgery, no patients complained any cavity problems at all. CONCLUSION: The present study suggests that this procedure can prevent cavity problems and reduce the recurrence of cholesteatoma with destructed canal wall.

Histopathologic Study on the Obliteration of the Temporal Dorsal Bullae in Rat Using Hydroxyapatite Cement and Demineralized Bone Matrix / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mastoid obliteration surgery is a useful technique for otitis media either with or without cholesteatoma. Obliterating materials have to satisfy low antigenecity, less inflammation, little tissue resorption, high regeneration power and good integration into the host tissue. The aim of our study is to evaluate histopathological changes and effectiveness resulting from the different obliterating materials in the temporal dorsal bullae in rats. MATERIALS AND METHOD: We divided the rats into two groups. Group A was untreated, but group B underwent removal of mastoid mucosa with 2% trichloroacetic acid (TCA). Both groups had mastoid obliteration by the implantation of hydroxyapatite cement (Mimix(R)) and demineralized bone matrix (Regenafil(R)). Twelve weeks after the implantation, a histological study was performed to evaluate remaining implanted material, new bone formation and the formation of cysts within the bullae. RESULTS: There was no or minimal inflammation or foreign body reactions in the mastoid obliteration groups with Mimix(R) and Regenafil(R). In the obliterated group that was not treated with 2% TCA, the remaining implanted material with Mimix(R) group was more than in the Regenafil(R) group (p<0.05). The obliterated groups of Mimix(R) and Regenafil(R) were similar with respect to new bone formation. The mucocele formation in the obliterated groups treated with 2% TCA was less than in the obliterated groups not treated with 2% TCA (p<0.05). CONCLUSION: We suggest that Mimix(R) and Regenafil(R) could be valuable resources as graft materials for mastoid obliteration procedures. The research continues for evaluation of long term results of these materials and their potential as graft materials.

Cerebrospinal Fluid Rhinorrhea Secondary to Acute Sphenoid Sinusitis

Acute sphenoid sinusitis is a relatively uncommon disease in the post-antibiotic era. Furthermore direct bony destruction and intracranial complications secondary to sphenoid sinusitis are extremely rare. However, it can have a high morbidity and mortality rate. If the diagnosis is delayed, serious problems can occur, so early diagnosis and treatment are required. We represent and discuss a case of cerebrospinal fluid (CSF) rhinorrhea with wide bony destruction directly, secondary to acute sphenoid sinusitis.

A Case of Traumatic Neuroma in Infraorbital Nerve / 대한이비인후과학회지

The term "traumatic neuroma" is used to describe the nodular mass of regenerating axons and Schwann cells that develop at the end of a proximal nerve stump following partial or complete transection of a nerve. Traumatic neuromas of the head and neck are relatively rare, and pain is the main symptom. Several cases of the traumatic neuromas of the head and neck have been reported in the literature at such sites as oral cavity, maxillary division of the trigeminal nerve, the inferior alveolar of the mandible, the auriculotemporal nerve, the glossopharyngeal nerve, and the facial nerve. We experienced a 60-year-old woman with a painful mass in her right cheek, appearing 10 years after she had pricked her right cheek with an umbrella. This mass was excised and the pathologic diagnosis was traumatic neuroma. We report this case here with a review of the literature.

Results of Bone Mineral Density Measurement in Woman Patients with Idiopathic Benign Paroxysmal Positional Vertigo / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has been proposed that displaced particles arising from otoconial degeneration are the leading cause of idiopathic BPPV (iBPPV). Otoconial degeneration might be linked with skeletal decalcification due to both conditions being related to a disturbance in calcium metabolism. The aim of this study was to evaluate the results of bone mineral density (BMD) measurement in women with iBPPV. SUBJECTS AND METHOD: Fifty-four women with iBPPV underwent BMD test and the results were given as a T-score. We compared the T-scores of the patients with those of 173 healthy women by age and by the presence of menopause, and we also compared the T-scores by type of iBPPV among the premenopausal patients. RESULTS: In all age groups, the mean T-score was significantly lower in the patients group than in the control group (p<.001). Regardless of the presence of menopause, the mean T-score in the patients was significantly lower than that in the control group (p<.001). By type of iBPPV, there was no significant difference in the T-scores among the groups. CONCLUSION: This study demonstrates that the values of BMD measurement in women with iBPPV were significantly lower than in the control group regardless of age or the presence of menopause. The results of this study suggest that iBPPV is linked with calcium metabolism. Future study will elucidate the utility of the therapy for disturbed calcium metabolism to decrease the recurrence of iBPPV.

A Case of Glossopharyngeal Neuralgia after Tonsillectomy / 대한이비인후과학회지

Tonsillectomy is one of the most common procedures performed by an otorhinolaryngologist. Postoperative hemorrhage and dehydration are two of the most common complications, but glossopharyngeal neuralgia is an unusual complication encountered in tonsillectomy. Glossopharyngeal neuralgia is characterized by paroxysms of ipsilateral and severe lancinating pain occurring in the distribution of the nerve. The pain may be spontaneous or precipitated by a variety of actions that stimulate the region supplied by the glossopharyngeal nerve namely yawning, coughing, swallowing and talking. The proximity between the glossopharyngeal nerve and the tonsillar fossa suggests that dissection in the correct surgical plane during tonsillectomy is important for avoiding injury to the glossopharyngeal nerve. Glossopharyngeal neuralgia after tonsillectomy is induced by intraoperative cauterization, nerve compression or iatrogenic trauma. Management of glossopharyngeal neuralgia induced by tonsillectomy should be given a trial of anti-convulsant medication like carbamazepine or glossopharyngeal nerve resection. A case of glossopharyngeal neuralgia caused by tonsillectomy was experienced by a 29-year-old man, and this case was reported and its aetiology was discussed.