A Case of Ankylosing Spondylitis with Cricoarytenoid Arthritis / 대한류마티스학회지

The cricoarytenoid joint is a diathrodial synovial joint and it can be affected by various diseases. The etiology includes infectious, rheumatic and degenerative diseases. Cricoarytenoid arthritis that's caused rheumatoid arthritis is the most well known, yet cricoarytenoid arthritis that's caused by ankylosing spondylitis is very rare. Hoarseness, dysphagia, throat discomfort, dyspnea and dyspnea on exertion are the major symptoms. If there was no severe airway obstruction, this condition can be managed by systemic steroid or intraarticular steroid injection. We experienced a case of a 47 years old man with ankylosing spondylitis and he presented with hoarseness, dyspnea on exertion and dysphagia. He was finally diagnosed with cricoarytenoid arthritis and he improved after etanercept administration. So we report here on this case along with a review of relevant literature.

Malignant Melanoma of the Lacrimal Sac / 대한이비인후과학회지

Malignant melanoma of the lacrimal sac is extremely rare. There are only 22 cases that have been reported in the world literature. One report in Korea concerned a 56 year old man presenting a 1.5-year history of bloody and purulent ocular discharge from the right eye. Chocolate colored bloody discharge appeared when pressing on the right medial canthus. Cytological examination of bloody discharge suggested malignant melanoma. A dacryocystogram showed obstruction of blood flow in the right nasolacrimal duct. CT scan showed a soft tissue density in the right lacrimal sac without any associated bony destruction. Medial maxillectomy inc1uding dacryocystectomy and postoperative irradiation were done. The patient is currently 5 months after surgery with no evidence of recurrence. Prognosis of malignant melanoma of lacrimal sac is very poor. Thus, early diagnosis and treatment is important.

Trans-Inferior Turbinate Approach for Endoscopic Sphenopalatine Artery Ligation

BACKGROUND AND OBJECTIVES: With the recent development of endoscopic nasal surgery, endoscopic sphenopalatine artery ligation allows for secure control of posterior epistaxis with considerably low recurrence and complications. Surgical approaches to the sphenopalatine foramen to ligate the sphenopalatine artery are transantral, intranasal, and transseptal. However, the procedures have considerable limitations. Therefore, we have revised the transturbinal approach, which was described by Togawa for intranasal vidian neurectomy in 1977, to ligate the sphenopalatine artery in two patients of intractable posterior epistaxis, and describe our technique of the trans-inferior turbinate approach for endoscopic sphenopalatine artery ligation. SURGICAL TECHNIQUE: A longitudinal incision is made along the lower border of the inferior turbinate, and the mucoperiosteal flaps are developed to the lateral nasal wall. The posterior two-thirds of the inferior turbinate bone is removed from the lateral nasal wall. The posterior lateral nasal artery on the upper flap is positively identified, and followed to the posterior end of the middle turbinate bone. The sphenopalatine foramen can be localized after removing the posterior end of the middle turbinate bone, and the sphenopalatine artery is ligated with hemoclips or divided with bipolar electrocautery. RESULTS: With the trans-inferior turbinate approach, it was possible to identify and ligate the sphenopalatine artery and its branches in the sphenopalatine foramen with no immediate or delayed complications. CONCLUSION: The trans-inferior turbinate approach provides unobscured surgical access to the posterior nasal cavity, and enough working space for endoscopic manipulation. The posterior lateral nasal artery is a reliable surgical landmark leading to the sphenopalatine foramen.

Sudden deafness caused by acute anterior inferior cerebellar artery infarction : A case report / 대한이비인후과학회지

A rare case, 49 year old man, of cerebellar infarction with occurrence of the sudden deafness was reported. On the otoneurological examination, hearing test and calroric test showed deafness and 19% vestibular hypofunction on the right side respectively. Mild vertigo was noticed, but spontaneous nystagmus was not observed. Cerebellar function test was intact. Magnetic resonance imaging (MRI) showed the acute cerebellar infarction in the area of the anterior inferior cerebellar artery (AICA) on the right side. After 7 days heparinization treatment, hearing threshold was much improved. An early recovery of hearing loss may be attributable to the recanalized circulation disturbance or the developement of collateral circulation.