Retrospective Study on 527 Patients with Maxillofacial Trauma: A 5-year Experience / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In modern society, maxillofacial trauma is correlated with an increase in population and traffic accident due to industrialization and urbanization. Many studies have examined maxillofacial trauma, although these studies have shown various results due to investigator's viewpoint and regional and cultural differences. Hence, we conducted this study to examine the current status of patients with maxillofacial trauma. SUBJECTS AND METHOD: Based on patients' clinical data, we retrospectively reviewed clinical characteristics, demographic information and radiographic findings of 527 patients (633 cases based on the fracture sites) with maxillofacial trauma who had visited our hospital between January 1998 and December 2002. We analyzed patients' sex, cause of trauma, and fracture sites. Furthermore, we analyzed the type of treatment for each fracture site. RESULTS: Patients with maxillofacial fracture showed a male predominance of 2.9: 1, and were prevalent in the 20's, 10's and 30's in the order of frequency. These patients showed an increasing tendency in their numbers on a yearly basis, and were the most prevalent in 2002 and on November according to year and month, respectively. The most common etiology was `violence (36.6%)'. Predilection sites were `nasal bone (52.1%)' and `orbit (21.5% [blowout fracture of the orbital wall])'. CONCLUSION: Patients with maxillofacial trauma showed an increasing tendency in their numbers on a yearly basis and frequently exhibited nasal bone fracture and blowout fracture of the medial orbital wall. Accordingly, these patients frequently consult otolaryngologits in comparison with the past. otolaryngologists will pay more attention to these patients.

Reduction of the Blowout Fracture of the Inferior Orbital Wall Using Elasticity of Silicon Tube / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: For the cases of the blowout fracture of the inferior orbital wall, reduction was performed frequently through transantral approach supporting herniated orbital tissue with silastic block, gauze or ureteral ballon catheter. But transantral approach has significant drawbacks such as instability, displacement of materials, and incomplete reduction. To overcome these shortcomings, we used an elastic silicon tube through transantral approach. In this paper, we compare the operative results between the group in which silastic blocks were used and the group in which silicon tubes were used. MATERIALS AND METHOD: We examined 19 patients whose maxillary sinuses were packed with silastic blocks or silicon tubes through only transantral approach. Among them, silastic blocks were used in nine cases ("block group") and silicon tubes in ten ("tube group"). Differences in preoperative and postoperative ocular symptoms, the percentage of revision operation, and occurrence of the infection of maxillary sinuses were compared between the two groups. RESULTS: In the block group, revision operations were carried out in three cases. Among those, one case was due to the undercorrection of fracture and two were due to the displacement of supporting material. In the tube group, one revision operation was necessary due to the overcorrection of fracture. Postoperative diplopia was observed in two cases among the block group and in one case among the tube group. One case with limitation in extraocular muscle movement was postoperatively detected among the block group. One case of infection of maxillary sinus was observed among the tube group. CONCLUSION: Reduction technique using silicone tube was easy and fast to perform by surgeons. We consider this reduction technique is a good surgical procedure instead of using silastic blocks.

The Allergenicity of the Storage Mites(Tyrophagus Putrescentiae and Acarus Siro) in Patients with Allergic Rhinitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Storage mites, Tyrophagus putrescentiae (TP) and Acarus siro (AS), known as the major causative allergens to people who deal with stored foods and grains, may occur more frequently in house dust than expected. During the recent 6 months, positive reactions to TP and AS were observed as frequently as those to Dermatophagoides pteronyssinus (DP) in patients with allergic rhinitis in Pusan. The purpose of this study was to identify allergenic components within TP and AS, and evaluate the cross reactivity with DP. MATERIALS AND METHODS: Using extracts of DP, TP and AS, prepared after dialysis and lyophilization, allergenic components were identified using SDS-PAGE and western blotting. Cross reactivity among them were evaluated by inhibition tests using pharmacia CAP system. RESULTS: The protein components of DP, TP and AS, showed different patterns in SDS-PAGE. Molecular weight of major IgE binding components of TP were 17 kD, 25 kD and 67 kD, and those of AS were 18 kD, 19 kD, 25 kD and 27 kD. TP- or AS-specific IgE was partially inhibited by DP extract; however, DP-specific IgE was not significantly inhibited either by TP or AS extract. Significant inhibition were noted between TP and AS. CONCLUSION: TP and AS may share common allergens with DP. However, sensitization to TP or AS was also suspected in some cases. The percentage of Acaridae family in Pusan was 12% of total mites. Therefore, storage mites should be considered as causative allergens and included in allergy test battery.

Clinical Study of Frontal Sinus Fractures: A Review of 14 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The incidence of frontal sinus fractures has increased as traffic and industrial accidents have increased. However, they are still uncommon compared to other facial traumas because of the arch configuration and the thickness of the anterior wall of the frontal sinus. Accurate evaluation is highly recommended in cases of frontal sinus fractures because they are likely to result in serious complications, including frontal sinusitis, meningitis, and mucocele. In this paper, we reviewed 14 cases of frontal sinus fractures and investigated the clinical characteristics and treatment results. MATERIALS AND METHODS: A retrospective review was performed on 14 patients with frontal sinus fractures who had been treated in our department from June, 1995 to August, 1997. RESULTS: Eleven patients were treated with surgery, including osteoplastic frontal sinus surgery with fat obliteration (5 patients), open reduction and internal fixation of the anterior wall (4 patients), and cranialization (2 patients). Three patients were treated with conservative methods. There were no complications such as infection, meningitis, and mucocele formation in the patients who underwent surgery for an average follow-up period of 19 months. CONCLUSION: Our results show that an aggressive approach is justified for treatment of frontal sinus fractures.

Clinical Study on Blowout Fractures of the Inferior and Medial Orbital Walls / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A blowout fracture is the outward fracture of orbital wall that occurs at the inferior wall or medial wall as intraocular pressure, caused by the impact of trauma, increases rapidly. The importance of diagnosis and treatment for blowout fractures have increased as heavy industrialization, high speed transportation and violent accidents have increased recently. We caaried out a retrospective study of blowout fracture according to different incidences, treatment methods and their results. MATERIALS AND METHOD: A retrospective review was performed on 154 cases of blowout fracture. They were diagnosed with 5mm facial CT, and treated in our department from March, 1989 to March, 1998. RESULTS: Severnty-four patients (48%) had medial fractures, 49 patients (32%) had inferior fractures and 31 patients (20%) had medial and inferior fractures. The cases of inferior fractures were treated with the reduction of fractured area with autologous bone harvested from the anterior wall of maxillary sinus, titanium mesh, and silastic sheet. Medial fractures were treated with endoscopic intranasal reduction with silastic sheet. CONCLUSION: In this study, medial fractures comprised 68%, demonstrating more incidence than inferior fractures. Anterior wall of maxillary sinus was very useful in reduction of inferior wall fracture. We operated on 92 patients of the 154 cases of inferior and medial blowout fractures, and had successful results.