Clinical Analysis of Medial Orbital Wall Fractures / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Medial orbital wall fractures are seen in association with fractures of the orbital floor or more complex bony disruptions. It is important to diagnose and manage medial orbital wall fractures as early as possible, because of the possibility of functional orbital damage later. In this study, fractures were divided into the following types based on location and severity of injury according to Nolasco and Mathog: type I (confined to the medial orbital wall), type II (medial orbital wall continuous with floor, type III (medial orbital wall with floor-malar fractures), and type IV (medial orbital wall and complex midfacial injuries). MATERIALS AND METHODS: We reviewed 22 cases of medial orbital wall fractures according to the classification of Nolasco and Mathog at Soonchunhyang University Chunan Hospital. RESULTS: 1) Types of fractures observed were type I (9 cases), type II (10 cases), type III (2 cases), and type IV (1 case). 2) The most common age groups were the thirties and the fourties. The male-to-female ratio was 3:1, and more injuries were found at the left orbit. 3) Assault was the most common cause, as observed in 10 of 22 cases (45.5%), and types III and IV injuries only occurred in falls. 4) Diplopia was the most common symptom, as in 15 of 22 cases (68.2%). Ecchymosis and periorbital swelling were more common with type I; diplopia was more common with type II. 5) Type I fractures were generally explored through intranasal approach, whereas the other types were commonly treated with subciliary or Caldwell-Luc approach. SUMMARY: Medial orbital wall fractures were more common in type I and II, the male, and the left side. Commonly, type I fractures caused ecchymosis and periorbital swelling and were treated with conservative treatment. In most cases, type II fractures caused diplopia and were treated with surgery 1 or 2 weeks after trauma.

Otolaryngologic Analysis of High Jugular Bulb Using Temporal Bone Computed Tomography / 대한이비인후과학회지

BACKGROUND: If the level of dome of jugular bulb is superior to the round window niche or inferior annulus of the tympanic membrane, it is called a high jugular bulb. OBJECTIVES: Laterally directed high fossae can result in case histories of bleeding from a dehiscent jugular bulb damaged at myringotomy and hearing loss caused by protrusion of a huge bulb into the middle ear space, this effects the function of the ossicles or the round window. Medially situated high fossae may affect the inner ear. MATERIALS AND METHODS: The authors analysed incidence of high jugular bulb and its relation to the diseases using CT scan films of 352 patients who visited Soonchunhyang University Hospital with chronic otitis media, cholesteatoma, Bell's palsy, vestibular neuronitis or Meniere's disease. RESULTS: The following results were obtained: 1) High jugular bulb was seen in 84 cases(23.9%) out of total 352 cases. 2) Of 247 cases of otitis media, 56 cases(22.7%) had high jugular bulbs. 3) Nine cases(23.0%) of high jugular bulb were found in 39 cases with cholesteatoma. 4) Six cases(24.0%) out of 25 cases with vestibular neuronitis were found to have high jugular bulbs. 5) In the cases with Meniere's disease, the highest incidence of high jugular bulb(8 cases out of 19 cases) was noted. CONCLUSION: This result may suggest that high jugular bulb is significantly related to Meniere's disease.