Adenoidectomy with the Suction Electrocoagulator / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The traditional adenoidectomy using adenotome and adenoid curette could not guarantee a clear operative field due to bleeding. Also the traditional transoral adenoidectomy was not always effective in the complete removal of adenoid tissues obstructing the choana and surrounding the eustachian tube. This study was performed to evaluate the effectiveness of using the electric suction coagulator for adenoidectomy. MATERIALS AND METHOD: This study was completed by 60 patients who underwent adenoidectomy or adenoidectomy with ventilation tube insertion. For adenoidectomy, 30 cases were performed using the variable sized suction coagulator via nasal cavity and the other 30 were performed using the adenotome and adenoid curette with oral approach. The amount of intraoperative bleeding and the duration of surgery were recorded. A preoperative and a at least one-month post operative nasal endoscopic photograph and lateral skull radiograph were obtained. RESULTS: Intraoperative bleeding amount was less and less time was needed in suction coagulator method (p<0.05). There was no statistical difference in the postoperative endoscopic grade, adenoid nasopharyngeal ratio, and the shortest nasopharyngeal diameter between two groups. The postoperative improvement of subjective symptoms was not different. CONCLUSION: Adenoidectomy using transnasal suction coagulator is an effective method for complete removal of adenoid with the advantages of excellent visualization and complete hemostasis. Especially, the authors think that this method is useful for the removal of superior part of adenoid and peritubal adenoid tissue.

The Effect of Combined Antiviral Agent Therapy and Stellate Ganglion Block for Sudden Sensorineural Hearing Loss and Appropriate Patients to Evaluate the Therapeutic Effect / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The etiology of Idiopathic sudden sensorineural hearing loss (ISSHL) is uncertain, but viral infection and disturbance of blood circulation in the inner ear are suspected as the causes of the disease, and a stellate ganglion block (SGB) and antiviral agent (Acyclovir) have been used in its treatment. The purpose of this study was to find out the effect of SGB and antiviral agent in the treatment of ISSHL and to find out appropriate patients to evaluate the therapeutic effect. MATERIALS AND METHODS: We reviewed the records of 193 patients (202 ears) who were admitted to the Presbyterian Medical Center from January 1994 to August 2000. Fifty-eight ears were treated with acyclovir and sixty nine ears were treated with SGB and seventy five ears were treated as a control group. RESULTS: The therapeutic result of SGB was better than that of control group and acyclovir had more effect on the subgroups when the initial hearing loss was 41dB~70dB. In the patients with initial hearing level worse than 71dB, the recovery rates were constant regardless of the group. And the patients who were treated after 8 days from the onset had analogic recovery rate to each remedy. CONCLUSION: The patients with the initial hearing level of worse than 71dB and who visited the clinic within 7days of the onset were found to be appropriate candidates for the evaluation of therapeutic effects of ISSHL and SGB. SGB was recommended for the treatment of ISSHL and antiviral agents for patients between the hearing levels of 410dB-70dB.