An Acoustic and Radiologic Study on Voice Change after Uvulopalatopharyngoplasty (UPPP) / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Many people have been concerned about the voice change after uvulopalatopharyngoplasty (UPPP). A number of studies reported acoustic changes after UPPP. However, there have not been any reports regarding the association of anatomic changes and acoustic results after UPPP. The purpose of this study is to analyze changes of the voice and changes in the vocal tract after UPPP and to evaluate whether the anatomical changes of vocal tract have an effect on the voice change or not. SUBJECTS AND METHOD: By using computerized speech laboratory (CSL), we analyzed fourteen UPPP cases on the formant frequencies of six vowels (/a/, /i/, /u/, /o/, /e/) and three nasal consonants (/eom/, /eoung/, /kin/). By using MR image, we analyzed the changes of vocal tract four weeks after UPPP with preoperative findings in one case. RESULTS: In acoustic analysis, the second formant frequencies of /i/ and /u/ phonation were significantly reduced postoperatively compared to those of preoperative status. In imaging study of /i/ and /u/, the soft palate were contracted along with the widening of the oropharynx and the tongue was shifted toward posterior pharyngeal wall to compensate. CONCLUSION: UPPP reduced the second formant of /i/ and /u/, which did not result in serious voice change.

Palatal Muscle Resection(PMR) for the Treatment of Snoring Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We aimed to introduce a new surgical method (Palatal Muscle Resection, PMR) for the treatment of snoring patients. This study contained the surgical technique of PMR and the objective and subjective outcomes of PMR. SUBJECTS AND METHOD: Twenty-one patients with snoring were examined (19 male, 2 female) in a prospective manner. Questionnaires based on the Epworth Sleepiness Scale (ESS) were completed by patients and their respective bed partners before and after PMR. Five patients who underwent PMR have completed pre and post operative (after 4 weeks) polysomnographic (PSG) studies. Visual Analogue Scale (VAS) was analyzed 1, 2, 3, and 7 days after the surgery. Statistical analysis was performed using the Wilcoxon signed rank test. RESULTS: Subjective questionnaires showed statistically significant improvements (ESS; from 10.7 to 6.7). The VAS was decreased from 4.3 in 1 dayto 2 in 7 days. CONCLUSION: The PMR is a simple and painless office-based method to treat snoring. Long term follow up studies with more patients would be required.

Bacteriology of Tonsillar Cores in Obstructive Tonsillar Hypertrophy and Recurrent Tonsillitis Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to find whether bacteriological characteristics can affect the size and recurrent infections of the tonsil by comparing the type and number of bacteria located in the core of palatine tonsil in obstructive tonsillar hypertrophy (OTH) and recurrent tonsillitis (RT) patients. SUBJECTS AND METHOD: Palatine tonsils of patients who received tonsillectomy due to OTH and RT were studied. The excised tonsil was dissected into two pieces and one gram of the core tissue was obtained for examination. Mixture of normal saline and homogenized tissue was inoculated using various culture media. The types of isolates and bacterial concentrations in each isolate was compared between the two groups. RESULTS: Commonly isolated aerobic bacteria in the order of frequency for the OTH group were Streptococcus viridans, Staphylococcus aureus, and Neisseria spp., whereas it was Neisseria spp., Streptococcus viridans, Staphylococcus aureus, and Haemophilus influenzae for the RT group. Peptostreptococcus spp. was the most frequently isolated anaerobe in both OTH group and RT group. There was no statistically significant difference in types of isolates between the two groups except for Haemophilus influenzae and Bacteroides spp. The density of cultured bacteria (number of bacteria per 1 gram of tissue) was greater in the RT group than in the OTH group. CONCLUSION: There was no definite difference in the number of isolate types between the OTH group and RT group. Bacterial density was higher in the RT group than in the OTH group. Therefore, bacterial density might have an influence on the recurrence of tonsillitis.

Verrucous Carcinoma of Nasal Vestibule: A Case Report / 대한이비인후과학회지

Verrucous carcinoma, an atypical variant of squamous cell carcinoma that is well-differentiated, is known to invade locally with rare metastasis. It was first reported by Ackerman in 1948 and has been reported in the areas of the head and neck and the external genitalia. A case of endonasal verrucous carcinoma was first reported by Krause. Cases of the sinus were reported to have occurred in the ostium of maxillary sinus and frontal sinus, and there has also been a reported case of a verrucous carcinoma that invaded the subnasal, which originated from the hard palate. However, no such case of verrucous carcinoma invasion originating from the nasal vestibule has been reported. Verrucous carcinomas are often clinically malignant, yet pathohistologically benign, thus, unlike most squamous cell carcinomas, they are of a low-risk group with rare metastasis, few recurrences, and good prognosis with proper treatment. In some cases of verrucous carcinoma treated with radiotherapy, anaplastic variations occur, thus surgical removal is known to be the treatment of choice. The authors report a recent case of verrucous carcinoma that originated from the nasal vestibule which was surgically removed and treated with adjuvant radiotherapy.

Effectiveness and Compliance of Immunotherapy in Allergic Rhinitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The objective of this article is to evaluate the effectiveness and the compliance rates of immunotherapy, and to identify the factors affecting the compliance of immunotherapy. SUBJECTS AND METHOD: We evaluated the charts of 120 patients with allergic rhinitis and/or asthma, for which allergen immunotherapy was carried out from 1998 and 2000. Information was obtained via chart reviews and telephone surveys. RESULTS: Among the 120 patients with allergic rhinitis, 41 patients also had asthma. The common allergens identified by the skin prick test prior to immunotherapy were D. farinae, D. pteronyssinus, dog fur, cat fur, and cockroaches, et al. The skin prick test reactivity to common allergens is significantly lower after three years of immunotherapy than it is prior to immunotherapy. The satisfaction of patients after immunotherapy between the allergic rhinitis group and allergic rhinitis with asthma group are as follows: much satisfied (25.4%/27.3%), fairy satisfied (31.6%/33.7%), a little satisfied (15.2%/17.2%), not satisfied (17.1%/13.3%), and unsure (10.7%/8.5%). In our study, the compliance rates of immunotherapy were 65.7%. The reasons cited for discontinuance of allergen immunotherapy were inconvenience (45%), lack of improvement in symptoms (23%), improvement in symptoms (15%), greater improvement in symptoms through medication (11%), and other reason (7%). CONCLUSION: If we increase the compliance of immunotherapy through various researches on the compliance of immunotherapy and educating patients about it, allergen immunotherapy may become more effective in treating allergic disorders.