Resection of Ewing Sarcoma in the Paranasal Sinus Via the Endoscopic Modified Lothrop (Draf III) Approach

Ewing sarcoma is a rare type of bone tumor that typically occurs in the head and neck regions. Appropriate management strategies remain controversial. Herein, we report a case of Ewing sarcoma originating from the ethmoid sinus in a 38-year-old woman. The patient initially presented with unilateral nasal obstruction. Pathologic examination revealed a tumor composed of small round blue cells under hematoxylin and eosin staining with positive expressions for CD-99, CK, and FLI-1. The patient was successfully treated with neoadjuvant chemotherapy followed by complete surgical excision via the endoscopic modified Lothrop (Draf III) approach, adjuvant chemotherapy, and radiation therapy. There was no recurrence or complication up to the writing of this article. This study presents an appropriate management strategy for an extensive case of Ewing sarcoma invading the frontal sinus using an endoscopic approach.

Expression of vesicular glutamate transporter in transient receptor potential vanilloid 1-positive neurons in the rat trigeminal ganglion

Activation of transient receptor potential vanilloid 1 (TRPV1), a calcium permeable channel expressed in primary sensory neurons, induces the release of glutamate from their central and peripheral afferents during normal acute and pathological pain. However, little information is available regarding the glutamate release mechanism associated with TRPV1 activation in primary sensory neurons. To address this issue, we investigated the expression of vesicular glutamate transporter (VGLUT) in TRPV1-immunopositive (+) neurons in the rat trigeminal ganglion (TG) under normal and complete Freund’s adjuvant (CFA)-induced inflammatory pain conditions using behavioral testing as well as double immunofluorescence staining with antisera against TRPV1 and VGLUT1 or VGLUT2. TRPV1 was primarily expressed in small and medium-sized TG neurons. TRPV1+ neurons constituted approximately 27% of all TG neurons. Among all TRPV1+ neurons, the proportion of TRPV1+ neurons coexpressing VGLUT1 (VGLUT1+/ TRPV1+ neurons) and VGLUT2 (VGLUT2+/TRPV1+ neurons) was 0.4% ± 0.2% and 22.4% ± 2.8%, respectively. The proportion of TRPV1+ and VGLUT2+ neurons was higher in the CFA group than in the control group (TRPV1+ neurons: 31.5% ± 2.5% vs. 26.5% ± 1.2%, VGLUT2+ neurons: 31.8% ± 1.1% vs. 24.6% ± 1.5%, p < 0.05), whereas the proportion of VGLUT1+, VGLUT1+/TRPV1+, and VGLUT2+/TRPV1+ neurons did not differ significantly between the CFA and control groups. These findings together suggest that VGLUT2, a major isoform of VGLUTs, is involved in TRPV1 activation-associated glutamate release during normal acute and inflammatory pain.

Expression of vesicular glutamate transporter in transient receptor potential vanilloid 1-positive neurons in the rat trigeminal ganglion

Activation of transient receptor potential vanilloid 1 (TRPV1), a calcium permeable channel expressed in primary sensory neurons, induces the release of glutamate from their central and peripheral afferents during normal acute and pathological pain. However, little information is available regarding the glutamate release mechanism associated with TRPV1 activation in primary sensory neurons. To address this issue, we investigated the expression of vesicular glutamate transporter (VGLUT) in TRPV1-immunopositive (+) neurons in the rat trigeminal ganglion (TG) under normal and complete Freund’s adjuvant (CFA)-induced inflammatory pain conditions using behavioral testing as well as double immunofluorescence staining with antisera against TRPV1 and VGLUT1 or VGLUT2. TRPV1 was primarily expressed in small and medium-sized TG neurons. TRPV1+ neurons constituted approximately 27% of all TG neurons. Among all TRPV1+ neurons, the proportion of TRPV1+ neurons coexpressing VGLUT1 (VGLUT1+/ TRPV1+ neurons) and VGLUT2 (VGLUT2+/TRPV1+ neurons) was 0.4% ± 0.2% and 22.4% ± 2.8%, respectively. The proportion of TRPV1+ and VGLUT2+ neurons was higher in the CFA group than in the control group (TRPV1+ neurons: 31.5% ± 2.5% vs. 26.5% ± 1.2%, VGLUT2+ neurons: 31.8% ± 1.1% vs. 24.6% ± 1.5%, p < 0.05), whereas the proportion of VGLUT1+, VGLUT1+/TRPV1+, and VGLUT2+/TRPV1+ neurons did not differ significantly between the CFA and control groups. These findings together suggest that VGLUT2, a major isoform of VGLUTs, is involved in TRPV1 activation-associated glutamate release during normal acute and inflammatory pain.

Psychiatric Distress as a Common Risk Factor for Tinnitus and Joint Pain: A National Population-Based Survey

Objectives@#. This study aimed to investigate the relationship between tinnitus and joint pain from representative samples of Koreans. @*Methods@#. The demographics and the responses to a questionnaire about tinnitus and joint pain severity and mental health status of adults aged ≥50 years in the 2010–2012 Korean National Health and Nutrition Examination Survey were analyzed. @*Results@#. Among 9,032 individuals, 26.7% reported experiencing tinnitus within the past year. Participants with tinnitus were more frequently older, hearing loss, and had lower education levels, income, and body weight. Participants with regular exercise and sleep had a lower tinnitus prevalence. The incidences of stress, depressed mood, and suicidal ideation were significantly higher in the tinnitus group and participants with joint pain. The rates of participants with tinnitus according to the number of joint pain sites (zero, one, two, and three) was 22.1%, 31.4%, 33.3%, and 44.2%, and those of participants with severely annoying tinnitus according to the number of joint pain sites (zero, one, two, and three) were 3.3%, 6.8%, 7.9%, and 10.7%, respectively. @*Conclusion@#. Tinnitus prevalence and severity were significantly related to joint pain, and both conditions were related to psychiatric distress. Thus, the authors suggest that psychiatric distress as a common risk factor for tinnitus and joint pain should be considered when deciding treatment strategies and in guiding public health policy.

Nationwide Analysis of Mortality Rates and Related Surgical Procedures in Hearing Disability Patients in South Korea

Background and Objectives@#Hearing loss (HL) and its repercussions are major problems in today’s society. There are limited data on the relationship between degree of HL and otologic disorders. The aim of this study is to estimate mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures in hearing disability patients in South Korea. @*Subjects and Methods@#Retrospective medical data for 160,205 patients with hearing disability was extracted. Mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures were compared with a normal control group consisting of 865,475 people; approximately 5 times the number of hearing disability patients. @*Results@#According to the Korean National Disability Registry (NDR), 0.458% of the population in South Korea suffered from hearing disability in 2015. Higher rates of mortality and sudden idiopathic HL were reported in hearing disability patients, increasing up to a maximum of 1.594 times and 1,039.695 times, respectively, compared to the normal control group. Mastoidectomy surgery was 2.5 times more frequently performed and pressure equalizing (PE) tube insertion was about 15 times more frequently performed in hearing disability patients. @*Conclusions@#Hearing disability is related to higher risks of mortality, sudden idiopathic HL and otologic surgical procedures, including mastoidectomy and PE tubing.

A Preliminary Study of Office-Based Transnasal Endoscopic Balloon Dilatation of Pharyngoesophageal Stricture after Total Laryngectomy / 대한연하장애학회지

OBJECTIVE: Pharyngoesophageal stricture formation and dysphagia following total laryngectomy negatively affect quality of life and result in nutritional compromise that can be successfully managed with various techniques. This study was conducted to describe our experiences of office-based balloon dilatation by transnasal endoscopy, which can be performed by an otolaryngologist. METHOD: The present study investigated three patients who underwent transnasal endoscopy guided balloon dilatation of pharyngoesophageal stricture. The assessment was performed based on the number of procedures and recurrences, final subjective outcomes, and complications. RESULT: There were no post-procedural complications. In one patient, a scarric band was found after the procedure; therefore, steroids were injected into the stricture site. There were 2–3 balloon dilatations and the interval between dilatations was 3–6 months. All patients were able to tolerate solid diet after 2 or 3 sessions. CONCLUSION: Transnasal endoscopic balloon dilatation, which can be easily performed by an otolaryngologist in an office setting without sedation or general anesthesia, can be a useful modality for treating pharyngoesophageal stricture after total laryngectomy.

Ultrastructure of Substance P Immunopositive Axons in the Human Dental Pulp

There exists very little information on the ultrastructure of substance P immunopositive (+) fibers in the human dental pulp, which may help in understanding the mechanism for substance P associated pulpal inflammatory pain. To address this issue, we investigated the presence of substance P+ fibers in the human dental pulp by light- and electron-microscopic immunohistochemistry. Light microscopy revealed that substance P+ fibers ran within neurovascular bundles in the radicular pulp and in the core of coronal pulp. They were also frequently present in the peripheral pulp. Substance P+ fibers showed beads like swellings interconnected by thin axonal strand, in a manner similar to bouton en passants and interconnecting axonal strand in the spinal cord. Electron microscopy revealed that almost all the substance P+ axons were unmyelinated. The axonal swellings of the substance P+ contained numerous clear round vesicles (40–50 nm in diameter) and many large dense-cored vesicles (80–110 nm in diameter) as well as many mitochondria. The vesicles and mitochondria were rarely observed in the thin axonal strand interconnecting the swellings. Intimate interrelationship or synaptic structure between the swellings of substance P+ axon and nearby pulpal cells or axons was not found. These findings suggest co-release of substance P and glutamate from the substance P+ pulpal axons and its action on nearby structures in a paracrine manner.

The Usefulness of Postoperative Direct Voice Therapy in Vocal Polyps / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Previous studies have suggested the usefulness and importance of postoperative voice therapy, for which there are indirect and direct methods. The aim of this study was to evaluate the efficacy of treatment according to different voice therapy methods. SUBJECTS AND METHOD: Patients with vocal polyp were divided into three groups. Group 1 received direct voice therapy after phonomicrosurgery and Group 2 indirect voice therapy after phonomicrosurgery. Group 3 did not receive any voice therapy. RESULTS: Perceptual, acoustic, aerodynamic voice outcome parameters differed significantly between pre and post-operative treatments. In almost all of the voice analysis, Group 1, who underwent direct voice therapy, improved more significantly compared with Group 2 and 3. CONCLUSION: Postoperative voice therapy following phonomicrosurgery may be an effective adjuvant treatment in patients with vocal polyps. In particular, direct voice therapy can be effective for improving postoperative voice outcome.