Gender Differences in the Polysomnographic Findings among Obstructive Sleep Apnea Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the influence of gender on the polysomnographic differences between men and women with obstructive sleep apnea (OSA). SUBJECTS AND METHOD: A retrospective review was performed of 110 patients who snore (91 males, 19 females) and were suspected of OSA. Polysomnography was performed for each patient. Gender comparison of polysomnographic parameters were made by performing Mann-Whitney U-tests. RESULTS: OSA was observed about five times more often in men than in women. Women were significantly older but were not heavier than men. Sleep structure showed no significant differences between men and women except that stage 1 sleep was observed more in men and stage 2 sleep more in women, respectively. The apnea hypopnea index (AHI) and non-rapid eye movement sleep were higher in men, but rapid eye movement sleep AHI in women was not different to men. The total and respiratory arousal indices (AI) and oxygen desaturation index (ODI) were higher in men than in women. CONCLUSION: The fact that more stage 1 sleep and the greater AHI, AI and ODI were found in men suggest that sleep quality may be worse in men than in women patients.

Intracavernous Sinus Arachnoid Cyst Confused with the Complication of Mycotic Sphenoidal Sinusitis / 대한이비인후과학회지

The arachnoid cyst is a rare disease that accounts for about 1% of the intracranial mass. The etiology of arachnoid cyst is due to either congenital compromise of arachnoidal development or acquired inflammatory reaction or trauma in the subarachnoid space. Computed tomography of arachnoid cyst demonstrates well-marginated low density lesions, whereas magnetic resonance image shows identical signal intensities of cerebrospinal fluid on T1 and T2 weighted image and low signal intensity on diffuse weight imaging without contrast-enhancement. The treatment of intracavernous sinus arachnoid cyst must be tailored to each patient according to the location of the lesion within cavernous sinus and the patient's symptoms. We experienced a case of arachnoid cyst of the cavernous sinus accompanying mycotic sphenoidal sinusitis. There are no previously reported cases of patients with an intracavernous sinus arachnoid cyst accompanying mycotic sphenoidal sinusitis.

Nuchal Fibroma Presenting as a Lateral Neck Mass / 대한이비인후과학회지

Nuchal fibroma (NF) is a rare, benign soft tissue tumor of the posterior neck, but can also occur extranuchally. Usually, it is a slow-growing, asymptomatic solitary mass that occurs more frequently in middle-aged males. Histologically, hypocellular dense collagens in the dermis and subcutaneous layer are characteristic. Careful total excision is necessary for the treatment and accurate diagnosis. We report an unusual case of a NF occurring at the lateral neck deeply under platysma muscle. This lesion should be included in the differential diagnosis of soft tissue masses arising in the posterior neck or rarely in the lateral neck as in our case, especially when the diagnosis is not definite.

Correlation among Diagnostic Methods for Adenoid Hypertrophy in Children / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To determine correlation among diagnostic methods for adenoid hypertrophy in children. SUBJECTS AND METHOD: We included 29 patients who visited our clinic with the complaints of upper airway obstruction. To estimate the extent to which the adenoid narrowed the choana, evaluations were made using the skull lateral film, video fluoroscopy and nasal endoscopy. Adenoid-nasopharynx (A/N) ratio was calculated from the skull lateral film using the Fujioka Method and airway-soft palate (A/S) ratio was determined from the skull lateral film and video fluoroscopy using the Cohen and Konak method. Digital images obtained during endoscopic examination were evaluated on computer and obstruction ratios [adenoid-choana (A/C) height and area ratio] were calculated. Five ratios of each patient were then compared. The Spearman correlation test was used to statistically evaluate the data. RESULTS: The mean A/N ratio was 0.62+/-0.07 (range: 0.47-0.79). The mean A/S ratio of the skull lateral film and video fluoroscopy was 0.85+/-0.34 (range: 0.2-1.96) and 1.02+/-0.33 (range: 0.49-2.02), respectively. There was no correlation between A/N and A/S ratios. In the nasal endoscopy, the mean A/C height ratio was 0.77+/-0.09 (range: 0.59-0.94) and the mean A/C area ratio was 0.70+/-0.10 (range: 0.48-0.90). There was a statistically significant correlation between the A/C height and the area ratio (r=0.92; p<0.001). The A/S ratio calculated from the skull lateral film showed a good correlation with nasal endoscopic findings (p<0.01), but the A/S ratio from the video fluoroscopy did not. CONCLUSION: The A/S ratio in the skull lateral film and A/C ratios showed a good correlation. They can be used to properly evaluate the upper airway and the adenoid in children.