Treatment of Severe Pregnancy Rhinitis Using Microdebrider-Assisted Inferior Turbinoplasty: A Case Report

Pregnancy rhinitis is a relatively common condition. It is characterized by the presence of nasal symptoms, especially nasal congestion, not present prior to pregnancy, but typically present during the last 6 or more weeks of pregnancy, without other signs of respiratory tract infection or any known allergic causes, and disappearing completely within 2 weeks after delivery. Nasal saline irrigation, intranasal steroid spray, and oral antihistamines are usually recommended as the first line of treatment for rhinitis. However, most pregnant women refuse medical treatment for pregnancy rhinitis because of the fear of teratogenicity. Severe pregnancy rhinitis increases the risk of snoring, which has been suggested as having adverse effects on the fetus. In cases where the patients are unable to control their symptoms, pregnancy rhinitis can negatively affect the quality of life (QOL) as well as the pregnancy outcome. Therefore, special caution is required for determining the appropriate diagnosis and treatment modalities for pregnancy rhinitis. Here, we report for the first time, the successful treatment of pregnancy rhinitis that was unresponsive to conservative management and medical therapy by using microdebrider-assisted inferior turbinoplasty at the final stages of pregnancy, along with a review of the relevant literature.

Management of Attic Cholesteatoma While Preserving Intact Ossicular Chain; “Modified Bondy Technique” vs. “Canal Wall Up Mastoidectomy with Tympanoplasty Type I & Scutumplasty” / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study is to evaluate the clinical outcomes of two surgical techniques-modified Bondy technique and canal wall up mastoidectomy with tympanoplasty type I and scutumplasty (CWUM/T1)-to remove attic cholesteatoma while preserving ossicular chain intact. SUBJECTS AND METHOD: A retrospective study was performed on 23 surgical cases for the attic cholesteatoma with postoperative audiometry data of more than six months after surgery. The patients' postoperative clinical features and audiometric results were compared between the two surgical groups. RESULTS: Out of 23 patients, CWUM/T1 was performed in 13 cases and modified Bondy technique was used in 10 cases. There were no significant differences for the preoperative and postoperative audiograms between the two groups. But air-bone gap increased significantly after CWUM/T1 while it decreased after modified Bondy technique. Three cases with postoperative problems were seen after CWUM/T1 (recurrent cholesteatoma, pars tensa adhesion, recurrent otitis media with effusion). Two cases with postoperative problems were found after modified Bondy technique (mild attic retraction, pars tensa retraction). CONCLUSION: Both surgical techniques seem to be adequate to treat attic cholesteatoma while preserving intact ossicular chain. Given good postoperative hearing results and stability of open cavity against recidivism, the modified Bondy technique seems to be a good choice for the attic cholesteatoma with intact ossicular chain when mastoid is not highly pneumatized.

A Case of Schwannoma Located in the External Auditory Canal / 대한이비인후과학회지

Schwannoma is slowly-growing, benign tumor that originates from the schwann cell and is rarely found in the external auditory canal (EAC). In this article, we describe a 30-year-old female patient with 12x7x4 mm EAC schwannoma located between the helical crura and tragus of the left ear. The schwannoma was easily removed by local excision. We discuss the differential diagnosis, clinical and histologic features, and treatment of EAC schwannoma.

A Case of Nasal Extranodal NK/T Cell Lymphoma Misdiagnosed as Reccurent Periorbital Cellulitis or Acute Dacryocystitis

Nasal extranodal natural killer/T cell (NK/T cell) lymphoma is more common in East Asia than in the United States, comprising up to 7-10% of all non-Hodgkin's lymphoma. Early nasal symptoms are nonspecific and similar to chronic rhinosinusitis, such as nasal obstruction and nasal bleeding. With disease progression, inflammation and necrosis of the mucosa increase, hindering pathologic diagnosis. We experienced a case of nasal extranodal NK/T cell lymphoma in a 58-year-old woman who presented with recurrent periorbital swelling.

A Case of the Carotid-Cavernous Fistula Due to the Internal Carotid Artery Injury During Endoscopic Sinus Surgery

Rupture of the internal carotid artery (ICA) during endoscopic sinus surgery is a rare complication. However, it can potentially result in death within minutes. In the event of a traumatic injury to the ICA during sphenoid sinus exploration, it is very difficult to control the bleeding. We present a case of carotid-cavernous fistula after an accidentally-developed ICA bleed during endoscopic sphenoidotomy. The patient was successfully treated with endovascular embolization techniques that included detachable microcoils.