A Study for the Effect of Stellate Ganglion Block on Herpes Zoster Oticus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES : Facial palsy of herpes zoster oticus has rapid onset, is usually severe in degree, and poorer in prognosis than Bell's palsy. In the past, herpes zoster oticus has usually been treated with acyclovir and steroid, but recently, applying stellate ganglion block for herpes zoster oticus has been recognized as an additional treatment that may improve facial palsy. This study was designed to evaluate the effect of stellate ganglion block on herpes zoster oticus. Subjects and METHOD : We reviewed retrospectively the medical records of 30 patients with herpes zoster oticus who were treated with acyclovir, steroid and stellate ganglion block between January 1995 and December 2004. The follow-up period was at least over than 6 months. RESULTS : All patients suffered from otalgia, vesicle, and facial palsy. The average degree of House-Brackmann classification on admission was 3.26 in the complete recovery patients and 4.61 in the incomplete recovery patients. Seventeen patients were completely recovered from facial palsy (56.7%), and 13 showed residual facial palsy 13 patients(43.3%). The poor prognosis may be related with early onset of facial palsy, high degree of House-Brackmann classification on admission and high degenerative ratio on electroneurography of facial nerve. CONCLUSION : The additional treatment of stellate ganglion block in herpes zoster oticus may not be effective on improving the complete recovery rate and prognosis.

Evaluation of Computed Tomography and Magnetic Resonance Imaging of Sinonasal Inverted Papilloma / 영남의대학술지

BACKGROUND: Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in cases of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP. MATERIALS AND METHODS: CT and MRI were retrospectively reviewed in 9 cases of IP. Patients were categorized into stages based on CT and MRI findings, according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. RESULTS: Differentiation of IP from inflammatory disease may be more successful in routine cases where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. CONCLUSION: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.