Comparison of open reduction and internal fixation with total elbow arthroplasty for intra-articular distal humeral fractures in older age: a retrospective study

Background@#Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older. @*Methods@#Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit. @*Results@#The ORIF and TEA groups showed a mean arc of flexion–extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups. @*Conclusions@#In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.

Morphological Changes of the Nasal Respiratory Epithelium of Mice Following Industrial Adhesive Vapor Inhalation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Social awareness of the narcotic effects of industrial adhesive vapors have been aroused by some teens who are reported to inhale these vapors to get the narcotic effects. When inhaled, the toxic effects of these chemicals are concentrated to the field of central nervous system, and the excretion system of metabolites like the liver and kidney. The effects of industrial adhesive vapors on the respiratory epithelium are unclear so far. MATERIALS AND METHOD: This was designed to study the morphological changes after exposure of the chemicals on the nasal mucosa in mice. Young healthy mice were exposed to industrial adhesive vapor (mixtures of acetone 5212+/-1268 ppm, c-hexane 3757+/-711 ppm, methyl cyclopentane 1820+/-375 ppm, n-hexane 139+/-30 ppm, toluene 0.9+/-1.4 ppm) for 20 min, once daily for 3 days, 5 days, 7 days, and 14 days. After adhesive vapor exposure, mice respiratory mucosa were excised, fixed in 4% paraformaldehyde for immuno-histochemistry and in 2.5% glutaraldehyde -1.5% paraformaldehyde for transmission electron microscopy and in 2.5% glutaraldehyde for scanning electron microscopy. Fixed tissues were processed for immunohistochemistry and for electron microscopy. RESULTS: Cellular degeneration and necrosis were seen on exposure day 3 and 5 which included erosion or ulceration of epithelium, exfoliation of cell, deciliation, shrinkage of goblet cells etc. The architecture of ciliated columnar cells and goblet cells were regenerated on day 7. Among the ciliated cells, most of the cells were replaced by cuboid ciliated cells. And the secretory pattern of the goblet cells were also changed from the merocrine to apocrine type at same days of exposure. On the other hand, the PCNA immunochemical study revealed that positive cells were increased on day 5. CONCLUSION: These results suggest that the nasal mucosa of mice can be damaged to some extent by daily regular exposure of industrial adhesive vapor. However, it could have a potency of regeneration to cuboidal cells, which are thought to change into more resistant cells in order to adapt to repetitive external stimuli.

A Case of Nasal Dermoid Sinus Cyst / 대한이비인후과학회지

Nasal dermoid sinus cyst (NDSC) is a rare congenital malformation which results from anomalous embryological development and occurs in the midline of the nose. An accurate diagnosis using CT or MRI is essential for an appropriate surgical treatment, which in some cases entails cooperation between the neurosurgeon and the oromaxillofacial surgeon. Surgical extirpation is the treatment of choice, and various surgical approaches like vertical-dorsal rhinotomy, lateral rhinotomy, transverse rhinotomy, external rhinotomy, and bicoronal flap approach have been advocated. Rut in the case of intracranial extension, the craniofacial approach is required. We report a 5-year-old girl with NDSC who was successfully managed using the external rhinoplasty approach.

Effect of iontophoresis anesthesia of the tympanic membrane on middle ear pressure / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES:The presence of encapsulated nerve corpuscles that is involved in regulating middle ear pressure has been noticed in previous studies. Based on those findings, how the sensory receptors in the tympanic membrane and tubal function are related was tested in the present study. MATERIALS AND METHODS: Tubal function was tested by 9 step test using Grason-Stadler institute(GSI) Middle ear analyzer II Eustachian tube function(ETF) test mode. Tubal function was recorded as compliance of the tympanic membrane on an otoadmittance meter. To anesthetize the sensory receptors in the tympanic membrane, iontophoresis was applied to the twenty right ears of the twenty subjects. RESULTS: Peak pressure difference in the middle ear was reduced after the tympanic membrane (TM) anesthesia, which indicates that the tubal function has decreased due to pressure change in the sensory receptors in the tympanic membrane. CONCLUSION: The findings of the present study suggest that there may be a neural connection between the sensory receptors in the tympanic membrane and the tubal muscle, as the eustachian tube function changed following the TM anesthesia.

Cholesteatoma of the Maxillary Sinus / 대한이비인후과학회지

Cholesteatoma of the paranasal sinuses is a rare entity: It is most often located in the frontal sinus and less commonly in the ethmoids and maxillary sinuses. The cholesteatomatous sinus has its otherwise normal respiratory epithelium lining partially or totally replaced by a hyperkeratotic squamous epithelium which in turn leads to the formation of lamellar sheets of keratin. Cholesteatoma in the sinus behaves as it does in the ear. The exact etiology of cholesteatoma is not known, and the diagnosis of cholesteatoma is difficult, largely due to lack of awareness. We present a 30-year-old man with cholesteatoma of the maxillary sinus and a left facial pain as his chief complaint. PNS CT revealed a homogenous soft tissue density containing calcific mass within the left maxillary sinus. Antral lesions was removed with a Caldwell-Luc approach with wide antrostomy. Histologic examination revealed cholesteatoma. We report this case of cholesteatoma of makillary sinus with a review of literature.

Clinical Analysis of Post-Operative Hemorrhage after Tonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Post-tonsillectomy hemorrhage is one of the most common complication and responsible for the majority of post-operative fatalities. Despite continuous efforts to eliminate this problem, it still remains a major risk. MATERIAL AND METHOD: The medical records of 1,510 tonsillectomized patients were reviewed for the frequency of post-tonsillectomy hemorrhage in relation to sex and age of the patients, seasons of year, operators as well as for the site, the type, and the control method of hemorrhage. RESULTS: Post-tonsillectomy hemorrhage was common in males with the incidence of 3.9%, of which the primary and secondary types accounted for 11.9% and 88.1%, respectively. The hemorrhage most frequently occurred in the left. There was no statistical significance associated with the seasons of year and with operators. Most of hemorrhages were controlled with electrocautery and conservative treatment. CONCLUSION: Although there are no obvious preventable means of post-tonsillectomy hemorrhage, complete bleeding control during operation and post-operative education are most important.

A Gigantic Osteoma of the Mandible Accompanied with Dyslalia / 대한이비인후과학회지

Osteoma of the mandible is a benign neoplasm of well defferentiated compact or cancellous bone that increase in size by continuous osseous growth and is extremely rare. Osteomas are found almost exclusively at the skull and at the facial and jaw bones. The most common location in the jaws is posterior lingual surface of the mandible. Possible pathogenesis is traumatic, congenital, inflammatory, or endocrine causes. Osteomas are usually asymptomatic unless their large size results in facial asymmetry and difficulty in mastication and swallowing. A CT scan was helpful to delineate the size of the lesion and the relationship of the tumor to important adjacent structures. Surgical excision is treatment of choice. Recently, we experienced a rare case of gigantic osteoma of the mandible ramus associated with dyslalia, which was surgically treated. This case is presented in this report with literature survey.

A study of the stimulation sound and its characteristics on auditory brainstem response in human adults / 대한이비인후과학회지

No abstract available.