A Case of Mucocele Occurred in Nasal Septum / 대한이비인후과학회지

Mucoceles are expansile, encapsulated, benign cystic lesions with the potential for adjacent bony remodeling and resorption. Paranasal mucoceles predominantly develop in the frontal sinuses (60%), followed in frequency by the ethmoidal (20-30%), maxillary (10%), and sphenoid (2-3%) sinuses. Nasal septal mucoceles develop in only very seldom cases. Septal mucoceles might develop from infected nasal septum or trauma. In the differential diagnosis of a midline septal mass, dermoid cyst, encephalocele, meningocele or intraseptal abscess should be considered. We present a case of nasal septal mucocele, which was managed by endoscopic excision and marsupialization.

Persistent Dysphonia after Laryngomicrosurgery for Benign Vocal Fold Disease

OBJECTIVES: Laryngomicrosurgery (LMS) is used to manage most vocal fold lesions. However, the functional voice outcome of the LMS might be diverse due to the influence of various factors. We intend to evaluate the incidence and etiologic factors of persistent dysphonia after LMS for benign vocal fold disease (BVFD). METHODS: We performed a retrospective review of 755 patients who underwent LMS for BVFD. We analyzed the clinical characteristics, preoperative and postoperative two onths voice studies. Postsurgical dysphonia was defined as grade 1 or above in GRBAS (grade, roughness, breathiness, asthenia, and strain) scale. Thirty nine patients (5.2%; 25 males and 14 females; average, 42.9 years; range, 21 to 70 years) were diagnosed with postsurgical dysphonia. RESULTS: There was no correlation between the diagnosis, coexistence with laryngopharyngeal reflux disease, habit of smoking, or occupational voice abuse and voice outcome. The patients with a worse preoperative acoustic parameter had aworse voice outcome. Stroboscopic findings showed excessive scarring or bowing in 21 cases, presence of lesion remnant in eight cases, prolonged laryngeal edema in five and no abnormal findings in three. CONCLUSION: Great care should be taken in patients with worse preoperative jitter. With a few exceptions, postoperative dysphonia can be avoided by the use of an ppropriate surgical technique.

Expression of Bitter Taste Receptors in Human Nasal Respiratory Epithelium

The nasal cavity encounters various irritants during inhalation such as dust and pathogens. To detect and remove these irritants, it has been postulated that the nasal mucosa epithelium has a specialized sensing system. The oral cavity, on the other hand, is known to have bitter taste receptors (T2Rs) that can detect harmful substances to prevent ingestion. Recently, solitary chemosensory cells expressing T2R subtypes have been found in the respiratory epithelium of rodents. In addition, T2Rs have been identified in the human airway epithelia. However, it is not clear which T2Rs are expressed in the human nasal mucosa epithelium and whether they mediate the removal of foreign materials through increased cilia movement. In our current study, we show that human T2R receptors indeed function also in the nasal mucosa epithelium. Our RT-PCR data indicate that the T2R subtypes (T2R3, T2R4, T2R5, T2R10, T2R13, T2R14, T2R39, T2R43, T2R44, T2R 45, T2R46, T2R47, T2R48, T2R49, and T2R50) are expressed in human nasal mucosa. Furthermore, we have found that T2R receptor activators such as bitter chemicals augments the ciliary beating frequency. Our results thus demonstrate that T2Rs are likely to function in the cleanup of inhaled dust and pathogens by increasing ciliary movement. This would suggest that T2Rs are feasible molecular targets for the development of novel treatment strategies for nasal infection and inflammation.