A Case of Postradiation Chondrosarcoma of the Sphenoid and Clivus / 대한이비인후과학회지

Radiation-induced chondrosarcoma is very rarely encountered in the head and neck malignancy. Rate of chondrosarcoma is 9% of all radiation-induced bone sarcomas. Postradiation chondrosarcoma, like their spontaneous counterparts, are relatively radioresistant tumors, and prompt radical surgery has been the mainstay of therapy. However, not all postradiation chondrosarcoma are amenable to radical surgery. The location of the tumor is one of the most important factors in choosing a therapeutic modality and significantly influences the survival rate. The authors experienced a case of chondrosarcoma of the sphenoid sinus and clivus accompanying sixth and ninth cranial nerve palsies after radiation therapy of nasopharyngeal carcinoma.

Clinical Investigations in Patients with Taste Disorder / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Taste disorders have not received sufficient attention by otolaryngologists and only a few studies have documented the clinical characteristics of taste disorders. We therefore analyzed the characteristics of patients with taste disorders who visited our Taste and Smell Clinic over a 3-year period. SUBJECTS AND METHOD: Sixty patients with taste disorders were investigated. The efficacy of treatment was evaluated according to the age, sex, duration of symptom, cause, and severity of taste disorder. RESULTS: Sixty percent of patients visited the clinic within 6 months of the onset of decrease in taste sensation. Multiple etiology was more common than single etiology. Taste disorder due to olfactory disorder was the most frequent etiology, followed by drug induced taste disorder and taste disorder due to zinc deficiency. Sixty percent of the patients experienced improvement of the taste abnormality. The efficacy of treatment decreased with increasing severity of taste disorder at the initial visit. CONCLUSION: Careful history taking and physical examination are needed for determination of the cause of any taste abnormality. The site and severity of dysgeusia should be determined through the chemical and electrical taste threshold test. Treatment should direct toward the causative abnormality, if possible.

Two Cases of Isolated Congenital Anosmia with Agenesis of the Olfactory Bulbs and Tracts / 대한이비인후과학회지

Congenital anosmia is usually described as a familial disorder in association with various sexual and other developmental abnormalities. Congenital anosmia occurring as an isolated defect in a single family member is extremely rare. That is said to exist when a patient has no recall of smell sensation dating from early childhood. We report two cases of isolated agenesis of the olfactory bulbs and tracts unrelated to pathological, syndromic diseases. We outline the investigations which should be undertaken in such cases.

Orbital Complications of Sinusitis: A Retrospective Clinical Analysis

BACKGROUND AND OBJECTIVES: Sinusitis is frequently accompanied by severe orbital or intracranial complication which require a fast multidisciplinary therapy because a diagnostic delay may cause the patient's sequeles. We aim to evaluate the clinical features, radiologic findings, disease courses and therapy of sinogenic orbital complication. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 34 patients with sinogenic orbital complications from January, 2002 to December, 2007. The clinical features of the complication, the radiologic findings, admission duration and treatment given to the patients were evaluated. The prognosis of each case was set according to the Chandler's classification. RESULTS: Periorbital cellulitis is the most common complication and it is found more frequently in children (54.5%) than in adult (21.7%). The most common symptom of sinogenic orbital complication is periorbital edema. In addition, facial and orbital pain is a common symptom. We identified the frequency of involved sinus in sinogenic orbital complications as follows;maxillary sinus (85.3%), anterior ethmoid sinus (82.4%), posterior ethmoid sinus (64.7%), frontal sinus (50.0%) and sphenoid sinus (35.3%). In terms of treatment, endoscopic surgery was needed in most cases except for periorbital cellulitis. CONCLUSION: Rhinosinusitis patients who have headache and ocular pain in spite of medical treatment need to consider the possibility of sinogenic complications. And early diagnosis and adequate treatment are important to prevent severe orbital complications.

Solitary Fibrous Tumor of the Sublingual Gland / 대한이비인후과학회지

Solitary fibrous tumor, a mesenchymal neoplasm that arises most commonly from the pleura of the lung, has been described in a variety of extrapleural sites including the abdominal cavity, soft tissue, upper respiratory tract and rarely in head and neck region. We present a rare case of solitary fibrous tumor that occurred in the sublingual gland. A 52-year old woman presented with a painless mass in the left side of the floor of mouth. The tumor was well-demarcated and easily dissected, and it showed highly cellular areas of spindle cells with pattern-less architecture alternating with hypocellular areas. The tumor cells were positive for CD34 but negative for cytokeratins and S-100 protein. During the 12 months of follow-up, there was no recurrence of tumor growth.

Interaction between Peripheral Blood Immune Cells and Activated Respiratory Epithelial Cells with Airborne Fungi / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Fungi are ubiquitous in the environment and their products may contribute to the development and exacerbation of airway diseases. The respiratory epithelium is the first barrier encountered by airborne allergens and an active participant in airway inflammation. During inflammatory reaction, many inflammatory cells are recruited to tissue from circulation, and they are located in close proximity to the epithelium. In this study, we hypothesized that respiratory epithelial cells and immune cells would interact and fungi could enhance their inflammatory reactions. MATERIALS AND METHOD: BEAS-2B was stimulated with airborne fungi (Alternaria, Aspergillus, Cladosporium, etc) for 24 hours, and then co-cultured with peripheral blood mononuclear cells (PBMCs), CD4+ lymphocytes, natural killer (NK) cells, and monocytes for 3 to 5 days. Interleukin-6 (IL-6), IL-1beta, granulocyte- macrophage colony stimulating factor (GM-CSF), tumor necrosis factor-alpha (TNF-alpha) were measured to determine the activation of immune cells. Transwell insert system was used to determine the importance of physical contact between epithelial cells and immune cells. RESULTS: Fungi, especially Alternaria, enhanced the production of chemical mediators from respiratory epithelial cells. When epithelial cells were co-cultured with immune cells, supernatants contained larger amounts of chemical mediators than when epithelial cells were cultured alone. When co-cultured with activated epithelial cells, TNF-alpha production was significantly increased by PBMCs, and physical contact was needed to interact between epithelial cells and PBMCs. CONCLUSION: This study suggests that fungi enhances the immune reaction between respiratory epithelial cells and peripheral blood immune cells, and the physical contact between epithelial cells and immune cells is needed to enhance the production of cytokines.

The Clinical Effects of Topical Lanolin Ointment for the Treatment of Dry Nose

BACKGROUND AND OBJECTIVES: Many people experience problems with a dry nasal mucous membrane, often without wondering why. The cause of problem is known as rhinitis sicca, senile rhinitis, and atrophic rhinitis, etc. A common form of treatment for patients who have such symptoms has been to begin by rinsing the inside of the nose with saline solution, to drop peanut oil, to apply antibiotic-ointment and moisturizing agents. Lanolin has been know as a safe skin moisturizing agent and used to treat dry nose. The purpose of this study was to evaluate the effect of lanolin on a group of patients seeking treatment for dryness of the nose. MATERIAL AND METHODS: Ninety-three patients experiencing problems with dry nasal mucosa were selected from the out-patient clinic. Fifty-seven patients, average age 36.3 years old, were treated with 1:2 mixture of lanolin and vaseline ointment. Thirty-six patients, average age 32.0 years, were treated with vaseline ointment. Both ointments were applied three times a day for two weeks. The efficacy of treatment was determined with pre and post-treatment six symptoms on a visual analogue scale: nasal obstruction, crust formation, mucosal dryness, respiratory discomfort, sleep disturbance, and general discomfort. RESULTS: For subjects treated with lanolin, the average VAS value for nasal obstruction was 5.84+/-2.28 and it decreased to 2.89+/-1.29, while the corresponding values for subjects treated with vaseline were 4.39+/-1.77 decreasing to 3.11+/- 1.24 (p<0.05). Crust formation of lanolin treated subjects were 5.67+/-2.39 and it decreased to 2.09+/-1.46, while the vaseline treated subjects were 4.83+/-1.99 decreasing to 2.33+/-1.31 (p<0.05). Average total symptom improvement was 65.7% (from 27.95+/-9.30 to 9.86+/-4.58) in lanolin treated group, while it was 44.8% (from 20.9+/-76.59 to 11.64+/-4.18) in vaseline treated group. CONCLUSION: We found that the efficacy of lanolin was statistically signigicantly better than that of vaseline. During the study period, there was no local reactions have been reported, nor have any allergic reactions. The present study underlines the fact that the way to treat nasal mucosal dryness is to use lanolin ointment.