A Case of Endoscopic Surgical Treatment of the Middle Turbinate Headache Syndrome

Middle turbinate headache syndrome is rare, and the true incidence of headache from this cause is unknown. Pneumatization or hypertrophy of the middle turbinate can result in its contact with the septum or the lateral nasal wall and may give rise to headache in the periorbital region. It may occur in the absence of inflammatory sinus disease. Clinical history, nasal endoscopic examination, and coronal CT -scan should point to the diagnosis. Treatment is achieved by relieving the contact point by medical or surgical means. The authors experienced a case of middle turbinate headache syndrome, therefore we report this case with a review of literature.

Orbital Decompression for Dysthyroid Orbitopathy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Exophthalmos from Graves' disease can result in visual disturbance and cosmetic deformity. Surgical treatment of this disorder is possible through a transnasal endoscopic approach or transantral approach. We aimed to evaluate the efficacy of the transnasal endoscopic orbital decompression and transantral orbital decompression in the management of dysthyroid orbitopathy. MATERIALS AND METHODS: Transnasal endoscopic orbital decompression or transantral orbital decompression was performed on 25 orbits in 14 patients for treatment of progressive exophthalmos or visual loss. Transantral orbital decompression was performed on seven patients simultaneously. RESULTS: Proptosis was reduced an average of 2.8 mm (range 0.5 to 6 mm) by transnasal endoscopic decompression alone and of 3.5 mm (range 0.5 to 8 mm) by transnasal endoscopic decompression and transantral decompression. In five patients who complained of visual disturbance, visual acuity was improved in three of them, and stationary in two of them postoperatively. Four patients who had no diplopia preoperatively developed diplopia after the decompression. Among them the diplopia was only temporary in three patients and the remaining one was referred to an ophthalmologist for correction of persistent diplopia. CONCLUSION: Orbital decomprerssion can be performed successfully via the transantral and transnasal endoscopic approach without significant complications and external scar.

Light and Scaning Electromicroscopic Study on the Experimental on the Experimental Endolymphatic Hydrops in Guinea Pigs / 대한이비인후과학회지

BACKGROUND: Despite numerous investigations, the pathogenesis of Meniere's disease is uncertain. Endolymphatic hydrops (ELH) has been the main histologic finding of Meniere's disease. Experimentally induced ELH in animal model has been developed in order to understand better the consequences of this morphopathology on inner ear structure and function. OBJECTIVES: The aim of this study is to develope the animal model of ELH. MATERIAL AND METHODS: We made an animal endolymphatic hydrops model on giunea pigs by mechanically obliterating the right endolympatic sac and duct. The left ears were used as a controls. RESULTS: After twelve weeks, the temporal bones were prepared for light and electron microscopic examination. The light microscopic study showed the distension and folding of Reissner's membrane, however other pathologic changes were uncertain in hydropic aminal. Under scanning electron microscopic examination, the cellular population of Reissner membrane remained normal but the microvilli of Reissner membrane were significantly decreased in hydrops group. The damage pattern of stereocilia were most severe in the apical turns, followed by the middle and the basal turns, in the order of severeity. The outer hair cell third row was most severely damaged in the entire cochlea, whereas the outer hair cell first row was relatively spared. On the single hair cell examination, abnormal distensions of the tip of stereocilia started from longer stereocilia. The number of microvilli on marginal cell was reduced in stria vascularis, but atrophic change was not observed.