Comparison of Fungus Detection between PCR and Fungus Culture in Chronic Sinusitis and Normal Controls / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Fungi are found in normal flora in various amounts. However, fungi in chronic sinusitis are poorly understood, and it is not clearly defined whether it is a pathogen or simply a part of normal flora. The polymerase chain reaction (PCR) is proposed as a more reliable test to detect fungal DNA than the conventional culture technique. The aim of this study was to compare the sensitivity of conventional culture technique and PCR analysis in detecting fungus of the nasal cavity and to compare fungal species found in normal controls and patients with chronic sinusitis. MATERIALS AND METHOD: Sterile saline irrigation was performed and then mucin filled saline was collected from the nasal cavity of patients with chronic sinusitis and normal controls. Fungus culture and PCR analysis were carried out with irrigated saline. RESULTS: PCR for panfungal gene was positive in 92.5% and 97.5% while fungus cultures were positive in 23.3% and 30.5% of patients with chronic sinusitis and normal controls, respectively. There was no significant difference in the prevalence of fungus and species of fungus between patients with chronic sinusitis and normal controls. CONCLUSION: PCR for panfungal gene was more sensitive for fungus detection than fungus culture in patients with chronic sinusitis and normal controls. Presence of fungus alone was insufficient to implicate it as the pathogen of chronic sinusitis. It will be necessary to study further about fungal species in patients with chronic sinusitis and normal controls.

A Case of Extramedullary Plasmacytoma of the Adenoid and Palatine Tonsil / 대한이비인후과학회지

Extramedullary plasmacytomas (EMPs) are rare, low-grade and malignant transforming solitary tumors consisting of neoplastic plasma cell proliferation that occurs in the bones of the head and neck. Ninety percent of solitary EMPs occur in the head and neck region: these constitute, however, less than 1% of all head and neck malignancies. EMPs represent up to 4% of nonepithelial lesions of the upper respiratory tract. On initial presentations, they must be differentiated from multiple myeloma. At first, EMPs are frequently seen as masses or swellings, accompanied by nasal or pharyngeal symptoms. EMPs are of special interest to otolaryngologists, because the majority of these unusual tumors are present in soft tissues of the head and neck. We present the patient with EMPs of tonsil and adenoid and discuss the related literature on the presentation, epidemiology, workup and management of patient with this rare neoplasm.

A Case of Tracheopathia Osteoplastica Managed with Electrical Drill / 대한이비인후과학회지

Tracheopathia osteoplastica (TO) is a rare clinical and pathologic benign condition that causes irregularity, narrowing and rigidity of the trachea and the main bronchi, characterized by multiple submucosal cartilaginous and osseous nodules of various sizes lining the upper respiratory tract. The treatment of TO diagnosed with CT and bronchoscopic biopsy is mostly supportive, and sometimes laser vaporization is used. We experienced a case of TO with severe obstructed airway that was treated by drilling.