Comparison of early tissue reactions between Plastipore and Polycel in rat middle ear / 대한이비인후과학회지

BACKGROUND & OBJECTIVES: There has been only a few reports of animal investigation of the fate of otologic polymer. This study was designed for comparing the early tissue reaction of Plastipore and Polycel that have been most commonly used. MATERIALS & METHODS: Plastipore and Polycel were inserted into middle ear of Sprague Dawley rats. After 1, 2 and 4 weeks, the temporal bones were removed and tissue reactions were observed with Hematoxillin-Eosin stain. RESULTS: More neutrophils were infiltrated along the septae of the Plastipore compared with Polycel after 1 week and 2 weeks. ibrotic changes were found on the surface of Plastipores. After 4 weeks, the tissue reaction of Polycel shows weaker than the Plastipore. It showed that the Plastipore had more pronounced and rapid tissue reactions with a thick fibrous encapsulation around it. CONCLUSION: Plastipore could have relatively worse biocompatibility compared with Polycel.

Clinical Study of Chondritis in the Burned Ear / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The chondritis of the auricle is a relatively common and severe complication of ear burns and frequently leads to the destruction of unburned cartilage, thus destroying the shape of the ear. The purpose of this study is to document the clinical nature of the injury, the results of various methods of treatment and to recommend the management protocol for chondritis of the burned ear. MATERIALS AND METHODS: A retrospective study of 69 patients who suffered the chondritis of the burned ear were carried out. These patients had been admitted to the Burn center at the Hangang Sacred Heart Hospital, Hallym University from January, 1993 through December, 1998. RESULTS: 1) The most common causative agent was flame burns (91.3%). 2) A mean interval of onset was 29.36 days. 3) Pseudomonas aeruginosa was noted on 68.5% of the cultures taken. 4) The sensitivity studics showed that Cefoperazone is the most sensitive antibiotics to P. aeruginosa. 5) The methods of treatment were dressing with cerettage (36%), incision and drainage with antibiotics soaking (22%), chondrectomy (35%), and chondrectomy with through and through drain (7%). 6) The final results of treatment were affected by the initial degree of burn. CONCLUSION: The most important preventive measures were strict avoidance of pressure on the injured ear and effective topical chemotherapy to control microbial proliferation. Early detection and early surgical intervention of chondritis were essential to limit progression of infection and necrosis, and to minimize the deformity of the auricle.

Change of the DPOAE on Contralateral Ear after Exposure of the Drilling Noise / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Drill-generated noise during chronic ear surgery, as well as surgical trauma, has been incriminated as a cause of sensorineural hearing loss in the operated ear. The contralateral ear, on the other hand, is subject to drill noise but is spared the surgical trauma. Using the distortion product otoacoustic emission recording, this study is aimed to evaluate changes in micromechanical cochlear properties which could occur in the contralateral ear following an ear surgery. MATERIALS AND METHODS: Twenty-seven patients undergoing mastoidectomy procedures were tested both preoperatively and postoperatively using pure tone audiometry, distorsion product otoacoustic emission. Surgical drilling duration was recorded. These patients had no otological history and showed no abnormalities on the physical examination of the contralateral ear. For all frequencies (1-6 kHz), amplitude were measured and analyzed. RESULTS: 1) Pure tone audiometry average was not significantly changed on the preoperative and postoperative day. 2) Average amplitude of DPOAE was significantly lower on the first postoperative day than on the preoperative day. 3) Average amplitude of' DPOAE was recovered on the seventh postoperative day. 4) Duration of drilling affected DPOAE results. CONCLUSION: The drill noise conducted to the nonoperated ear by vibrations of the intact skull exposure results in dysfunction of the outer hair cells, which produce a temporary hearing loss.

Hypothyroidism after Treatment for Laryngo-Hypopharyngeal Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hypothyroidism is a well recognized complication of radiotherapy and surgery in the treatment of head and neck cancer, especially laryngo-hypopharyngeal cancer. Several studies were undertaken to determine the thyroid stimulating hormone (TSH) levels in the population of patients with head and neck cancer, to better characterize clinical factors in the eventual elevated TSH levels. We evaluated the incidence and related factors of hypothyroidism following radiotherapy, surgery and combined treatment for laryngeal and hypopharyngeal cancer. MAERIALS AND METHODS: Forty-four patients who had been treated for laryngeal and hypopharyngeal cancer were divided into three groups according to the types of treatment they received: radiotherapy alone, surgery with partial thyroidectomy, surgery with partial thyroidectomy and postoperative radiotherapy. TSH and free thyroxin (T4) level were examined before and after the treatment. We analyzed the differences according to clinical factors and treatment modalities. RESULTS: The TSH level was higher in hypopharyngeal cancer than in laryngeal cancer (p>0.05). In the advanced stage and during longer follow-up periods, the TSH level were elevated (p<0.05). In patient with combined treatment modalities, the TSH level was higher than in patients who received radiotherapy or surgery alone (p<0.05). CONCLUSION: We concluded that hypothyroidism frequently develops following treatment for laryngeal and hypopharyngeal cancer even when thyroid resection has not been performed. Patient should be evaluated postoperatively and carefully monitored by means of serial thyoid function test.

Structure of the Ventilation Tube / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Ventilation tube is a percutaneous prosthesis which is exposed to external stimuli. The duration of retention and complication rate of ventilation tube partly depends on which type of tube is used. The purpose of this study is to classify ventilation tubes according to biofunctional characteristics and to design new ventilation tubes experimentally using computer graphics. MATERIALS AND METHOD:Two hundred and forty seven ventilation tubes were classified according to shape, size and material. Experimental design of a ventilation tube was performed with various graphic modellings. RESULTS: Grommet style was most common and most of flanges showed round type. Polymer has been a material of choice in making ventilation tubes. Length of the shaft ranged 1.5mm-15mm. Four kinds of models were created for designing a ventilation tube using computer graphics. CONCLUSION: Biofunctionality should be taken into account in designing ventilation tubes.

A Case of Relapsing Polychondritis / 대한이비인후과학회지

Relapsing polychondritis is a rare disorder that involves a multisystem characterized by recurrent inflammation, degeneration of cartilage and connective tissue. The following tissues, in the order of decreasing frequency, may be involved: auricules, joint, nose, eyes, respiratory tract, heart valve and skin. The cause is unknown but an autoimmune mechanism has been thought to be the causative factor. Authors have recently experienced a case of relapsing polychondritis in a 71 year old man diagnosed by direct immunofluoroscene and auricular chondritis.

A Case of Basal Cell Adenoma Arising in a First Branchial Cleft Cyst / 대한이비인후과학회지

Several types of cyst may occur in the neck. Branchial cleft cyst is the most common cystic lesion, but the first branchial cleft cyst is a very rare disease. Cystic cervical lesions may be mistaken for enlarged lymph nodes or tumors. To avoid interpretation errors, aspiration of all cysts or cystic lesions must be followed by careful palpation and reaspiration of any residual mass. Further, a careful analysis of the patient's clinical data is of value. In questionable cases, surgical excision of the cystic tumor for histologic examination is recommended. We report a case of basal cell adenoma arising in the first branchial cleft cyst. This case support the hypothesis that lymphoepithelial cysts of the major salivary glands arise from inclusions of salivary gland tissue in lymph node.