Endoscopic Sinus Surgery and Septoplasty Performed Under Local Anesthesia: Comparative Analysis of Patient Discomfort

OBJECTIVES: The goal of this study is to compare the degree of patient discomfort between endoscopic sinus surgery (ESS) and septoplasty under local anesthesia. MATERIAL AND METHODS: A total 95 patients that underwent ESS and septoplasty under local anesthesia between July 2009 and January 2010 were enrolled in this study. The patients estimated the parameters of their own discomfort (pain, position, noise, anxiety, and memory). The score of each of the parameters ranged from 0 to 4. We compared the scores of the parameters between the ESS and septoplasty groups. RESULTS: Of the 95 patients, 61 (64%) received ESS, 32 (34%) received septoplasty, and 2 (2%) received both. The scores of all the parameters were not greater than moderate in both groups. There were no significantly statistical differences between the two groups. However, the ESS group had lower scores than the septoplasty group in the parameters of pain, position, noise, and memory. No remarkable complications occurred. CONCLUSION: The patients in this study had modest discomfort and no noticeable complications during the surgeries under local anesthesia. Although no statistical difference existed between the two groups, the ESS group experienced relatively lower discomfort levels during the surgery under local anesthesia compared to the septoplasty group.

A case report of prenatally diagnosed tetrasomy 18p

Tetrasomy 18p, one of the most commonly observed isochromosomes, consists of two copies of the p arms on chromosome 18[i(18p)]. It is known as a de novo occurrence of non-disjunction or centromeric mis-division during meiosis II in the vast majority of cases. It has a prevalence of 1/140,000-180,000 live births and affects both genders equally. A 28-year-old woman was referred at 33+2 weeks gestation to rule out fetal congenital heart disease. Her prenatal ultrasonography showed intrauterine growth retardation, cardiomegaly, and imperforate anus. Doppler ultrasonographic finding showed fetal anemia. Tetrasomy 18p was confirmed by conventional karyotyping and fluorescence in situ hybridization. Because of its very low prevalence rate, only several cases of tetrasomy 18p has been reported worldwide and it has not yet been reported in Korea before. Therefore, we report a case of prenatally diagnosed tetrasomy 18p.

Clinical Analysis of Leukoplakia in the Larynx: Long-Term Follow-Up / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Leukoplakia is a clinical term solely designating a white patch or a plaque of the mucosa without considering its histological feature. Leukoplakia ranges microscopically from a hyperplasia to an invasive squamous cell carcinoma. This study attempted to find out the clinical progress and characteristics of leukoplakia in the larynx. SUBJECTS AND METHOD: Included in the study were 154 patients clinically diagnosed as leukoplakia from 1997 to 2010. We reviewed their medical records retrospectively for age, sex, smoking and drinking history, medical record, histopathologic finding, treatment method, and the follow-up records. RESULTS: Histopathologic findings of leukoplakia in the larynx showed hyperkeratosis (101 patients), invasive carcinoma (19 patients), dysplasia (14 patients), nodule (9 patients), papillomatosis (4 patients), chronic inflammation (4 patients) and tuberculosis (3 patients). Of the 128 patients, 39 patients who were diagnosed as hyperkeratosis, dysplasia, nodule or chronic inflammation in the larynx had recurrence and received re-biopsy over 2 times. Eight patients of these 39 who had recurrence had progression to invasive carcinoma. The mean interval between diagnosis of leukoplakia and invasive carcinoma was 53 months (ranged 7-114 month). Heavy smoking (more than 20 pack year) and drinking were significantly associated with recurrence or progression to invasive carcinoma. Age, gastroesophageal reflux disease and treatment method were not associated with recurrence. CONCLUSION: Leukoplakia in the larynx led to various histopathologic diagnoses, high recurrence rate, and progressed to invasive carcinoma even after 5 years. Smoking and drinking should be managed and longterm follow-up is needed.

A Case of Benign Fibrous Histiocytoma of Nasal Dorsum

Fibrous histiocytoma usually develops indiscriminately in skin and any soft tissues of the body. To date, tumors occurring in soft tissues of the head and neck, especially around the nose, have been rarely reported. In most cases, benign fibrous histiocytoma develops as a painless mass lesion and most commonly originates in sun-exposed skin, extremities, and orbital tissue. Recently, we experienced a case of benign fibrous histiocytoma in the nasal dorsum in a 36-year-old woman who complained of a mass in the nasal dorsum. To the best of our knowledge, this is the first reported case of benign fibrous histiocytoma originating in the nasal dorsum in a Korean.

The Significance of Radiologic Positive Finding of Paranasal Sinus in Bone Marrow Transplant Patients

BACKGROUND: Bone marrow transplantation (BMT) is a beneficial and curative technique used in different hematologic conditions or malignant neoplastic diseases. However, bone marrow transplant patients are at a higher risk of developing infections and complications due to previous chemotherapy, radiotherapy, immunosuppression, antibiotics therapy, multiple viral infections, and GVHD (graft-versus-host disease). OBJECTIVES: The purpose of this study is to determine the prevalence and clinical data of rhinosinusitis among patients with BMT. We also investigated whether pre-BMT positive radiologic finding could predispose patients to the development of post-BMT rhinosinusitis or not. MATERIALS AND METHODS: We reviewed the records of 203 patients who had received BMT in Kyungpook National University's hospital from September 1998 to August 2006. RESULT: Sixteen patients (7.8%) had radiologic positive finding before BMT. Fifteen patients had no sinonasal symptoms and did not get any treatment. Only one patient had rhinosinusitis so that BMT was delayed and treated with antibiotics. Among these patients, one patient got newly developed rhinosinusitis after BMT. After BMT, sinusitis developed in ten patients (4.9%), including one patient who had invasive fungal sinusitis. Our study revealed a higher incidence of rhinosinusitis among allogenic BMT patients than among autologous BMT patients. The most common symptoms and signs were fever. Only one patient complained of typical sinonasal symptoms. CONCLUSION: Even though the prevalence of rhinosinusitis is low (4.9%) among post-BMT patients, maintenance of a high index of suspicion among these patients is necessary because sinonasal symptoms and signs are generally minimized after BMT. The study concluded that pre-BMT positive radiologic findings without sinonasal symptoms is unlikely to develop post-BMT rhinosinusitis.