Clinical Efficacy of Modified Inferior Meatal Mega-Antrostomy (Modified IMMA) Technique for Recalcitrant Chronic Isolated Maxillary Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Despite aggressive medical therapy and previous endoscopic sinus surgery, there are a subset of patients suffering from recalcitrant, persistent chronic isolated maxillary sinusitis which results from impaired mucocilliary clearance caused by long-standing inflammation. The corresponding patients underwent our newly devised Modified Inferior Meatal Mega-Antrostomy (Modified IMMA). The objective of this study was to review the clinical efficacy and complication after Modified IMMA in patients who had suffered from intractable maxillary sinusitis after endoscopic sinus surgery. SUBJECTS AND METHOD: Fourteen patients suffering from recalcitrant chronic isolated maxillary sinusitis underwent Modified IMMA between May 2010 and April 2013. The mean follow-up period was an average of about 13 months and regular intervals of postoperative 3-, 6-, 9-, 12-months were set. A retrospective review was performed to analyze the preoperative & postoperative Visual Analogue Scale score (VAS score) and Lund-Kennedy endoscopy score at each interval. VAS scores and endoscopic findings were processed statistically at the time of third postoperative month. The exclusion criteria were an obstructed ostiums, osteitis, systemic disease such as Ig A/G immunodeficiency, primary ciliary dyskinesia. RESULTS: The postoperative VAS scores and Lund-Kennedy scores, when compared with those prior to Modified IMMA, decreased from 16.5 to 2.5 and 5.0 to 1.0, respectively. Also, there was no serious complication or recurrence associated with the procedures. CONCLUSION: Our newly devised Modified IMMA could be a much effective option for surgical treatments in patients with recalcitrant chronic isolated maxillary sinusitis.

Bacterial Species Analysis and Proper Antibiotic Choices of Preauricular Fistular Abscess / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Infection of congenital preauricular fistula leads to preauricular abscess. Generally, the treatment for preauricular abscess is focused on subsiding abscess. Although incision & drainage is major point of therapy, the study of bacterial species and antibiotics for preauricular abscess is scant in literature. So, we investigated the most common species that cause preauricular abscess and the choice of proper antibiotics by using the databse available from the last 10 years. SUBJECTS AND METHOD: Our studies, from January, 2000 to December, 2010, included 86 patients in total (all in patients & out patients). We performed a retrospective review of bacterial species and culture analysis of each preauricular abscess. RESULTS: In this study, it was shown that most common pathogens causing preauricular fistula infection were Staphylococcus (27.9%), Enterococcus (9.3%), streptococcus and Klebsiella (5.8%) and Peptostreptococcus (4.6%). And Amoxicillin/cavulanate, Ciprofloxacin, Clindamycin had excellent effects of minimal inhibitory concentration through multiple pathogens. CONCLUSION: The choice of antibiotics for preauricular abscess will be targeted on Staphylococcus, Enterococcus, Streptococcus and anaerobic infection. Amoxicillin/clavulanate or Ciprofloxacin are the most effective antibiotics.