A Case of Secondary Trigeminal Neuralgia Caused by Infected Postoperative Maxillary Cyst

Postoperative maxillary cyst (POMC) is relatively common complication among patients who underwent Caldwell-Luc surgery. Patients with POMC usually have no symptoms, although cyst extension can result in bone destruction or cystic infection with pain. The trigeminal nerve consists of the ophthalmic nerve, maxillary nerve, and mandibular nerve. Among these branches, the maxillary nerve runs to the lateral and frontal sides of the maxillary sinus wall. POMC can rarely lead to trigeminal neuropathy caused by cyst enlargement that compresses some branches of the trigeminal nerve. Recently, we experienced a case with trigeminal neuralgia due to POMC. The patient was successfully treated with inferior meatal antrostomy. We report this rare case with a literature review.

A Case of Upper Gastrointestinal Hemorrhage Misdiagnosed as Post-Tonsillectomy Hemorrhage / 대한이비인후과학회지

Tonsillectomy, with or without adenoidectomy, remains the most frequently performed surgical procedure by otolaryngologists. Postoperative hemorrhage, which is classified as primary (24 h) hemorrhage, is recognized as a rare but potentially life-threatening complication. Although most oral bleedings occuring after tonsillectomy are considered as post-tonsillectomy hemorrhages, there could also be other origins such as gastrointestinal hemorrhage. We recently experienced a case of gastrointestinal hemorrhage that was misdiagnosed as secondary post-tonsillectomy hemorrhage. We report this case with a review of the literature.

Monostotic Fibrous Dysplasia of Inferior Turbinate / 대한이비인후과학회지

Fibrous dysplasia is a benign fibro-osseous lesion originally described by Lichtenstein in 1938. Currently, three general subtypes of disease are recognized: monostotic, polyostotic, and McCune-Albright syndrome. Fibrous dysplasia is not rare, with the incidence report being about 5% to 7%. Common sites of fibrous dysplasia are the skeletal system including long bones, ribs, craniofacial bones, and the pelvis. However, fibrous dysplasia is rare in the nasal cavity, especially involving the turbinate. In the review of literature over the past 50 years, we were able to discover only 4 cases in which the fibrous dysplasia involved inferior turbinate, with all of them being the polyostotic form found around the sinuses. There were only 4 cases in which monostotic fibrous dysplasia involved the middle turbinate, but none the inferior turbinate. We present this case, with a review of the relevant literature, as the first report on monostotic fibrous dysplasia of the inferior turbinate.

Immunologic Response to Cryoablation of Squamous Cell Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cryoablation has been recognized as a potential tool in the treatment of cancer. Beside its ability to cause local destruction of the primary tumor, cryoablation has been claimed to induce a systemic anti-tumor immune response. We compared cryoimmunologic responses between cryoablation and surgical excision in a murine model of squamous cell carcinoma (SCC). MATERIALS AND METHOD: Six-to 8-weeks-old female mice (total n=30) were used for this study. Tumors were established at the flank of C3H mice with the SCCVII cell line, which is an immunogenic murine SCC of spontaneous origin in the C3H/HeJ mice. The mice underwent surgical excision or cryoablation, when the tumors were between 0.3 and 0.6 cm in the largest dimension. Successfully treated mice were re-challenged with the murine bladder cancer cells, namely, SCCVII cell line or MBT-2 cells at the contralateral flank. One week later, secondary tumor growth was estimated. Spleens were harvested from the mice that had no tumor after re-challenge. Effector splenocytes were added to the target SCCVII cells prelabeled with 3H thymidine. Cytotoxicity was investigated by measuring 3H thymidine releases from target cells. RESULTS: After re-challenging the SCCVII cell line, tumors were developed in 33% (1/3) of the mice treated by surgical excision, compared to 0% (0/4) of mice treated by cryoablation. In the cytotoxicity assay, there were no significant differences between the excision and cryoablation group. CONCLUSION: These results suggest that the anti-tumor immunologic effect of cryoablation in the murine SCC model is not better than that of surgical excision.

Analysis of 33 Knees with Lateral Instability / 대한정형외과학회잡지

In acute tears of the lateral complex of the knee, it is extremely important to make a complete diagnosis not to overlook the other injured structures in the knee since tears are rarely limited to just the lateral collateral ligament. Among the primary individual structures of the lateral ligament complex that may be involved are the lateral collateral ligament, lateral capsule, popliteus muscle, arcuate ligament complex, iliotibial band, biceps femories, intermuscular septum, and of course, the lateral meniscus as well. Further, it is important to repair lateral tears as soon as possible after injury even though the lateral instability of the knee is less frequent but because it is more easily overlooked and more disabling than the other instability of the knee. Therefore, to evaluate the result of surgically treated patients having the lateral instability, we analyzed the 33 cases with minimum 1 year follow-up period who were treated at the Orthopaedic Department, Kangnam St. Mary's Hospital, from February, 1982 to June, 1985. Among 145 knee ligament injury cases, 39(26.9%) had lateral instability but six were lost to follow-up. Among these remaining 33 cases, 5(15.2%) had isolated lateral collateral ligament injury, 18(54.5%) had associated anterior cruciate ligament injury, 4(11.8%) had associated posterior cruciate ligament injury and 26(78.9%) had injury of other lateral structures including lateral collateral ligament. In all cases having associated anterior cruciate ligament injury there was severe anterolateral rotatory instability under the general anesthesia. The severity of the anterolateral rotatory instability was very much correlated with the severity of the lateral structural injuries. Eighteen out of 19 cases having associated injuries of anterior or posterior cruciate ligament, had 5 mm or more joint opening at the 0 varus stress radiogram. Thirteen(92.8%) out of fourteen isolated ligament complex injuries, and 8(53.3%) out of 15 cases having associated anterior cruciate ligament injury had good-excellent or fair(+) result. None of the patients who had associated anterior and posterior cruciate ligament injuries had good-excellet result. Therefore, the patients who had the lateral ligament complex injury associating with anterior cruciate ligament tend to have residual anterolateral rotatory instability even though the repair or reconstruction was carefully done in comparision with the patients of isolated lateral ligament complex or anterior cruciate ligament injury. Because anterior cruciate ligament injury associated with lateral ligament complex increases the anterolateral rotatory instability significantly.

Squamous Cell Carcinoma Arising from Chronic Osteomyelitic Sinus: A Report of Three Cases / 대한정형외과학회잡지

The developement of squamous cell carcinoma from the draining sinus of chronic osteomyelitis has long been recognized as a rare and late complication. The mode of developement of carcinoma at the site of chronic osteomyelitis is not well understood. This, however, is chiefly a disease of middle aged men, and tibia is the most common site. There are two types in this carcinoma; superficial and deep types. In the superficial type obvious presence of fungaiing growth makes diagnosis simple and easily confirmed by biopsy. In the deep type the diagnosis is difficult clinically, but the features most frequently described are an increase in pain and discharge with swelling and hemorrhage. Amputation at the adequate level is the treatment of choice. Three cases of the disease involving one left femur, and two left tibiae are reported with review of literature.