Endoscopic Laser Dacryocystorhinostomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Dacryocystorhinostomy is commonly performed through an external incision. Several transnasal approach were described earlier in this century but they failed to gain popularity probably because of difficult exposure. Whether the endoscopic laser dacryocystorhinostomy improved intranasal visualization and decreased intraoperative complications than external incision. MATERIALS AND METHODS: During recent 3 years, we performed endoscopic laser dacryocytorhinostomy about 10 cases at Joong Ang Gil Hospital. RESULTS: Success rate of revision groups (3 cases) was very good. CONCLUSION: Small-diameter endoscope with angled field of view provides excellent intranasal visualization. Endoscopic laser dacryocystorhinostomy avoids the possibility of pathologic scar formation and injury to the medial canthus. Endoscopic laser dacryocystorhinostomy appears to be the safe treatment especially for revision procedure.

A Case of Angiolymphoid Hyperplasia with Eosinophilia / 대한이비인후과학회지

Angiolymphoid hyperplasia with eosinophilia is a disorder of the skin and subcutaneous lesion of unknown cause. It is characterized by painless, vascular tumor-like nodules of various size, primarily affecting the head and neck region. The histological hallmark of angiolymphoid hyperplasia with eosinophilia is a benign angiomatous or angioma-like proliferation within the background of the stroma, which is heavily infiltrated by lymphocytes and eosinophils, and includes lymphatic follicles with prominent germinal centers. The authors have recently experienced a case of angiolymphoid hyperplasia with eosinophilia in a 29-year old male who had painless and enlarging nodules in the nasal cavity and the buccal mucosa for a year. We present this case with the review of literatures.

A Clinical Study of Deep Neck Infection / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Deep neck space infections, which affect soft tissues and fascial components of the head and neck, were frequently encountered in the preantibiotic era, but their frequency has been remarkably reduced after the development of chemotherapeutic agents and antibiotics. However, they may still result in significant morbidity and mortality despite the use of chemotherapeutic agents and antibiotics. The purposes of this study has been to assess clinical findings and the effectiveness of the treatment of deep neck infection through statistical analysis. MATERIALS AND METHODS: A retrospective study was performed on 86 cases of deep neck space infections in patients admitted for diagnosis and treatment during a 9-year period from January 1988 to December 1996. RESULTS: All cases were treated with either conservative treatment only as in 47 cases (55%), or surgical drainage and antibiotics as in 33 cases (33%), or surgical drainage with tracheostomy and antibiotics as in 6 cases (7%). At the end of the treatment, 83 cases were cured of the disease and 3 cases were reported to have complications. CONCLUSION: We concluded that treatment of deep neck infection requires knowledge of the natural history of the disease and a detailed understanding of anatomy. Management guidelines include (1) hospitalization, (2) culture and sensitivity tests, (3) antibiotic therapy, (4) diagnostic radiographic procedures, and (5) surgical intervention.

A Case of Malignant Triton Tumor In Nasal Cavity / 대한이비인후과학회지

Malignant triton tumor is a rare and usually aggressive sarcoma consisting of a malignant schwannoma with rhabdomyoblastic differentiation. Although this tumor is usually found at the extremities, 20% of cases are located in the head and neck region. This unusual tumor has not yet been described in the Korean Journal of Otolaryngology-Head and Neck Surgery. Malignant triton tumor is histologically high-grade, with large numbers of mitoses, prominent necrosis, and cellular pleomorphism. The clinical course for malignant triton tumor is usually one of rapid growth, early metastasis, and poor outcome in spite of therapy. Recently we experienced a case of malignant triton tumor, which involved the nasal cavity, maxillary and ethmoid sinus. The malignant tumor was treated with wide surgical excision followed by radiation therapy.

Endoscopic Intranasal Reduction of Medial Blowout Fracture / 대한이비인후과학회지

Medial blowout fracture with persistent diplopia and enophthalmos was required surgical treatment. Conventionally, surgery of blowout fracture of the medial wall has been performed by the transorbital approach with external incision. The conventional method had some disadvantages of external scar, increased morbidity, and general anesthesia. We performed endoscopic endonasal surgery without external incision in 2 cases of medial blowout fracture under local anesthesia. The bony fragments were removed after the intranasal ethmoidectomy. And the entrapped medial rectus muscle was released from the bony fragments. Merocel(R) was placed in the ethmoid sinus for the support of the orbital defect for 48 hours. Results of the surgery in all 2 cases were satisfactory and there were no evidences of diplopia and enophthalmos so far.