Radiological Examinations of Inferior Turbinate in Patients with or without Deviated Nasal Septum by Using Computed Tomography / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to analyse the radiological anatomic dimensions of the inferior turbinate in patients without deviated nasal septum and compare it to those in the patients with deviated nasal septum using computed tomography. SUBJECTS AND METHOD: The OMU CTs of 98 patients, 196 nostrils with or without deviated nasal septum were evaluated (control group: 42 patients, deviated septum group: 56 patients). The analysis of the CT scans contained the mucosal and bony length, mucosal width of the turbinate and the anterior and posterior mucosal overlay. And also evaluated the cross-sectional area and the type of inferior turbinate bone. RESULTS: All subjects were divided into three groups: the concave, convex, and control groups. The correlations of fifteen measuring points such as anterior, middle and posterior medial mucosal thickness, total width, bone width, medial mucosa width of inferior turbinate, and area of inferior turbinate bone were significantly different among the groups (concave side>con-trol group>convex side). Of the demographic factors, age was negatively correlated with mucosa and bone length. Types of inferior turbinate bone were as follows: lamella type (38%), combined type (37%), compact type (25%). CONCLUSION: There were statistical differences in some measured anatomical points among the concave, convex, and control groups. Greater septum deviation was correlated with greater degree of hypertrophysm of the inferior turbinate. The age of patients showed negative correlation with inferior turbinate length. Most frequent type of inferior turbinate was lamella type. The results of this study may provide important information when considering turbinate surgery.

Correction of Caudal Septal Deviation: Septal Batten Graft with a Bioabsorbable Plate / 대한이비인후과학회지

Caudal septal deviation is difficult to correct due to elasticity of cartilage. Septal batten graft is a useful surgical technique used for correction of caudal septal deviation and the septal cartilage is used mainly for graft material. However, in some cases (i.e., revision surgery), its quality may be insufficient or inadequate to be useful. Septal batten graft with a bioabsorbable plate can be an alternative in these cases. The use of a bioabsorbable plate connected with septal cartilage would facilitate surgical correction of severe caudal septal deviation and offer mechanical stability until the manipulated cartilage heals. With a brief review of the literature, we describe our experience of treating a 29-year-old woman with severe caudal septal deviation and clinical summary of 7 patients who underwent septal batten graft using a bioabsorbable plate for caudal septal deviation.

A Clinical Analysis of Sudden Sensorineural Hearing Loss Cases

BACKGROUND AND OBJECTIVES: High-dose systemic steroid therapy is the mainstay treatment for sudden sensorineural hearing loss (SSNHL). Recovery rates from SSNHL range are about 47-63% and are influenced by various prognostic factors. To evaluate the prognostic value of specific clinical parameters, we reviewed 289 cases by clinical and statistical analysis. SUBJECTS AND METHODS: This study included 289 patients with SSNHL who visited the Department of Otolaryngology at Soonchunhyang University Hospital from January 2005 to December 2012. The cases were reviewed retrospectively based on clinical charts. Hearing improvement was evaluated in relation to pure-tone audiogram results, duration between SSNHL onset and time of initial treatment, seasonal incidence, dizziness, patient age, degree of hearing loss, patterns of initial pure-tone audiogram and presence of underlying disease. RESULTS: Hearing improvement was observed in 196 of 289 (67.8%) patients; such improvement began within 7 days in most patients, followed by rapid hearing recovery. Cases that failed to show improvement within 14 days were unlikely to achieve hearing recovery. The more severe the hearing loss during the early stage, the lower the hearing recovery rates. Patients aged less than 60 years appear to have better prognosis of hearing improvement compared to those who are over 60 years. CONCLUSIONS: Important prognostic factors for recovery in patients with SSNHL include the time of initiating treatment after symptom onset, the degree of early-stage hearing loss, and the age of the affected patient.

Relation between Stress-Related Hormone and Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The plasma stress-related hormonal [cortisol, growth hormone, prolactin, antidiuretic hormone (ADH), adrenocorticotropic hormone (ACTH)] levels have been reported to be elevated in sudden sensorineural hearing loss (SSNHL) patients. However, little is known regarding the mechanisms related with the elevation of stress-related hormonal levels in SSNHL. Therefore, we measured the level of plasma stress-related hormones in SSNHL patients and in normal persons to demonstrate the association between the stress-related hormones and SSNHL. SUBJECTS AND METHOD: Stress-related hormonal levels were measured from 68 patients who were diagnosed with SSNHL. These values were compared with the stress-related hormonal levels of 24 healthy control subjects. RESULTS: The plasma ADH levels was significantly higher in SSNHL group compared with that in their normal control group, as shown by their respective values, 4.46 [95% confidence interval (CI): 3.80-5.24 pg/mL] and 3.05 (95% CI: 2.34-3.98 pg/mL). The values for plasma cortisol, growth hormone, and ACTH levels whose values were 2.07 (95% CI: 1.65-2.61 microg/L), 0.20 (95% CI: 0.14-0.29 microg/L), and 12.79 (95% CI: 11.16-14.66 pg/mL), respectively, were significantly lower in the SSNHL group than those in the normal control group whose values were 7.86 (95% CI: 5.33-5.24 microg/L), 0.61 (95% CI: 0.36-1.04 microg/L), 18.48 (95% CI: 14.99-22.78 pg/mL), respectively. But there was no significant difference in prolactin between the two groups. CONCLUSION: This study demonstrates a possible role of stress-related hormones in the pathogenesis of SSNHL. However, only ADH level was higher than the control group. Furthermore, ACTH, growth hormone and cortisol levels were lower than the control groups. This means ADH, growth hormone, cortisol, ACTH levels are related with SSNHL. However, the impact of this hormone on the inner ear and endolymph homeostasis is still unknown. Further investigation is necessary to identify the action mechanism of these hormones in the inner ear.

Effects of Electrical Stimulation for Dysphagia Caused by Stroke

OBJECTIVE: To investigate the benefit of electrical stimulation for dysphagia caused by stroke. METHOD: Ten consecutive stroke patients with dysphagia for 3 months or more were enrolled in this study and assigned to one of the two group (electrical stimulation group or sham group) according to randomization table. Five patients were allocated to electrical stimulation group and 5 patients to sham group. One patient in the sham group dropped out because of transfer to other hospital. Electrical stimulation with a maximal tolerable intensity was applied on both digastric muscles and both thyrohyoid muscles for 1 hour, 5 days a week for 4weeks in electrical stimulation group. Sham group received electrical stimulation in same condition except stimulation intensity of 1 mA. Clinical dysphagia scale, functional dysphagia scale and kinematic analysis of hyoid bone movement were assessed at baseline (before treatment), 2 weeks later (during treatment), 4 weeks later (after treatment). RESULTS: The clinical dysphagia scale decreased in both group, of which the difference was not statistically significant. The functional dysphagia scale decreased significantly in the electrical stimulation group. The electrical stimulation group revealed greater improvement in clinical dysphagia scale and functional dysphagia scale compared to sham group. CONCLUSION: Electrical stimulation therapy with a maximally tolerable intensity to digastric and thyroid muscles might be effective in chronic stroke patients with dysphagia.

A Case of Intraductal Papilloma in the Parotid Gland / 대한이비인후과학회지

Intraductal papilloma is a rare benign salivary gland tumor that occurs most commonly in the minor salivary gland. We recently experienced a case of intraductal papilloma arising from the parotid gland in a 24-year-old woman. Radiologic imaging shows a well-circumscribed unicystic mass in the right parotid gland. Superficial parotidectomy was performed. Micoscopically, the mass has papillary epithelial proliferation within the dilated lumen of the salivary duct. We report this case with a brief review of literature.

Expression Patterns of Injected Adenovirus in the Nasal Cavity and Paranasal Sinus Mucosa of the Rat / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A potential use of gene therapy to deliver therapeutic peptides to the nasal mucosa has not been investigated. The purpose of this study was to assess the feasibility of using a recombinant adenovirus vector to target the nasal cavity and paranasal sinus mucosa of the rat. MATERIALS AND METHOD: Ten male Sprague Dawley rats were used in this experiments, and adenovirus vectors containing green fluorescent protein (GFP) were injected into rat via tail vein. On fourteen days after gene transfer, 10 rats were sacrificed. The turbinate, nasal septum and paranasal sinus mucosa were examined by fluorescent microscope, and immunohistochemical analysis using anti-GFP antibody was performed. RESULTS: The turbinate and septal mucosa after injection of adenovirus vector expressing GFP showed diffused distribution of fluorescent produced by GFP. Immunohistochemical analysis showed that GFP expression in the turbinate mucosa was localized to the largely ciliated colmnar epithelium and to some lamnina propria, and that in the septal mucosa, it was localized to the ciliated columnar epithelium. Expression in the turbinate mucosa was more obvious than that in the nasal septal mucosa. There was no expression in the paranasal sinus mucosa. CONCLUSION: This study suggests that recombinant adenovirus vectors can be used to transfer genes to turbinate and nasal septal mucosa. Gene therapy targeting mucosal epithelium can be a helpful method to treat patients with chronic inflammatory disease of the nasal mucosa such as allergic rhinitis or neoplasm of the nasal cavity.