Cyclic Changes of Nasal Obstruction with Nasal Cycle in Septal Deviation Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: he purpose of this study was to determine the relationship between cyclic changes of unilateral nasal obstruction and nasal geometry in patients with septal deviation. MATERIAL AND METHODS: Twenty-one young adults with anteriorly located septal deviation were selected. With acoustic rhinometry, we measured minimum cross-sectional area (MCA) and nasal volume (NV) in 20 minutes interval for 7 hours. The patients were required to assess their own unilateral nasal obstruction on a linear visual analogue scale immediately prior to acoustic rhinometric measurements. After plotting of MCA and VAS as a function of time, we determined whether cyclic changes were present or not. Correlation between subjective scores and objective measurements were calculated using Pearsons correlation coefficient. We calculated delta (sigma) value in patients with cyclic changes of MCA and VAS to compare the unilateral MCA changes to corresponding VAS changes of each nasal cavity. The formula for calculating Delta value was Delta value=m(Npeak-Wtrough)/m(Wpeak-Wtrough): where m is the sample mean, Npeak the peak of narrow side, Wpeak the peak of wide side, Wtrough the nadir of wide side. RESULTS: Fifteen subjects showed classic alternating nasal cycle in MCA and ipsilateral VAS with significant positive linear correlation. Despite the diverse distribution of delta value of MCA cycle (sigma(M)), the mean delta value of VAS cycle (sigmaV) was about 0.8, thus representing a small difference of patency of each nasal cavities in patients with septal deviation. CONCLUSION: In most patients, nasal sensation of patency fluctuated with a similar amplitude with each other regardless of the degree of septal deviation.

Reconstruction after Surgical Treatment of the Hypopharyngeal Cancer: Forearm Free Flap and Pectoralis Major Myocutaneous Flap / 대한이비인후과학회지

BACKGROUND: The comparison of information and complication after pharyngoesophageal reconstruction using the forearm free flap and pectoralis major myocutaneous flap was rarely reported. OBJECTIVES: To compare the information(duration of the procedure, nasogastric tube feeding and hospital stay etc) and complications after pharyngoesophageal reconstruction using the forearm free flap and pectoralis major myocutaneous flap, we reviewed the records of 19 patients with squamous cell carcinoma of the hypopharynx. MATERIALS: The records of 19 patients with squamous cell carcinoma of hypopharyx between June 1989 and November 1995 at Chungnam National University Hospital were reviewed retrospectively. Ten of 19 patients were reconstructed with forearm free flap and the others were reconstructed with pectoralis major myocutaneous flap. RESULTS: In 10 patient using forearm free flap, the duration of procedure, the duration of hospital stay, duration of nasogastric tube feeding and viability of flap were 13.7 hours, 38.5 days, 24 days and 80% respectively. In 9 patients using pectoralis major myocutaneous flap, the duration of procedure, the duration of hospital stay, the duration of nasogastric tube feeding and viability of duration were 7.38 hours, 29.1 days, 19 days and 88.9% respectively. There was no significant difference in complications between the groups. CONCLUSION: The pectoralis major myocutaneous flap was slightly superior to forearm free flap in aspect of the duration of procedure, hospital stay, duration of nasogastric tube feeding and viability. There was no statistically significant difference of complications. But we think that the more cases were required to compare the forearm free flap and pectoralis major myocutaneous flap.