Application of Three Dimensional-Printed Polycaprolactone Nasal Mesh With the Figure of 8 Anchoring Suture Technique for Correction of Caudal Septal Subluxation / 대한이비인후과학회지

Background and Objectives@#We evaluated the symptom improvement, surgical outcomes and post-operative complications of the figure of 8 anchoring suture technique using polycaprolactone (PCL) nasal mesh for the treatment of caudal septal subluxation.Subjects and Method We conducted a retrospective study of patients who underwent between March 2020 and March 2021 endonasal septoplasty using the figure of 8 anchoring suture technique and a PCL nasal mesh as a protective supporting graft. Fourteen patients were divided into two groups, the allergic and non-allergic rhinitis group. Symptom improvements were assessed using the Nasal Obstruction Symptoms Evaluation (NOSE) scores and visual analog scale (VAS) scores for epistaxis and headache. Post-operative patient-reported subjective changes in nasal obstruction were also recorded. All evaluations were conducted one to four months post-operatively. @*Results@#Post-operative endoscopic examination revealed that all patients had their septum straightened. The mean post-operative NOSE scores in overall and each item were significantly lower than the mean NOSE scores in the pre-operative period (p<0.05). The mean post-operative NOSE scores for patients both with and without allergic rhinitis were also significantly decreased compared to those in the pre-operative period (p<0.05). A decrease in VAS scores was significant (p=0.008) for headache but not for epistaxis (p=0.141). All patients reported improvement of subjective nasal obstruction post-operatively. @*Conclusion@#The use of figure of 8 anchoring suture technique with a PCL nasal mesh as a protective and supportive graft was proven to be a successful method for correcting caudal septal subluxation.

Good’s Syndrome Presenting With Chronic Rhinosinusitis (1 Case Report) / 대한이비인후과학회지

The Good’s syndrome is a rare immunodeficiency disease characterized by thymoma and hypogammaglobulinemia. The most common cause of infection in patients with Good’s syndrome is the recurrent sinopulmonary infection. One may assume that there could be an unknown immunocompromising condition such as Good’s syndrome in cases of chronic rhinosinusitis refractory to treatment. We experienced a patient with Good’s syndrome, presenting with chronic rhinosinusitis refractory to treatment. We report this case with a brief review of the literature.

Complications of Nasopharyngeal Swabs and Safe Procedures for COVID-19 Testing Based on Anatomical Knowledge

Nasopharyngeal swabs have been widely to prevent the spread of coronavirus disease 2019 (COVID-19). Nasopharyngeal COVID-19 testing is a generally safe and well-tolerated procedure, but numerous complications have been reported in the media. Therefore, the present study aimed to review and document adverse events and suggest procedural references to minimize preventable but often underestimated risks. A total of 27 articles were selected for the review of 842 related documents in PubMed, Embase, and KoreaMed. The complications related to nasopharyngeal COVID-19 testing were reported to be rarely happened, ranging from 0.0012 to 0.026%. Frequently documented adverse events were retained swabs, epistaxis, and cerebrospinal fluid leakage, often associated with high-risk factors, including severe septal deviations, pre-existing skull base defects, and previous sinus or transsphenoidal pituitary surgery. Appropriate techniques based on sufficient anatomical knowledge are mandatory for clinicians to perform nasopharyngeal COVID-19 testing. The nasal floor can be predicted by the line between the nostril and external ear canal. For safe testing, the angle of swab insertion in the nasal passage should remain within 30° of the nasal floor. The swab was gently inserted along the nasal septum just above the nasal floor to the nasopharynx and remained on the nasopharynx for several seconds before removal. Forceful insertion should be attempted, and alternative examinations should be considered, especially in vulnerable patients. In conclusion, patients and clinicians should be aware of rare but possible complications and associated highrisk factors. The suggested procedural pearls enable more comfortable and safe nasopharyngeal COVID-19 testing for both clinicians and patients.

Tumor Necrosis Factor-Alpha and Interleukin-4 Levels in Patients With Idiopathic Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

Background and Objectives@#The pathogenesis of idiopathic sudden sensorineural hearing loss (ISSNHL), an otologic emergency disease, remains unclear. Several studies have attempted to illustrate the association between cytokines and ISSNHL. The purpose of this study was to evaluate the prognostic significance of various cytokines in patients with ISSNHL. Subjects and Method In this case-control study, a total of 55 patients with ISSNHL underwent treatment with oral prednisolone for 2 weeks. Serum cytokine levels, including interleukins (ILs) (IL-1a, IL-1b, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12), and tumor necrosis factors (TNF-α and TNF-β), were measured using human cytokine panels at first visit. Patient characteristics such as age, gender, the status of hypertension, diabetes mellitus, vertigo, time from onset to visit, and initial hearing levels were also evaluated. @*Results@#Serum levels of cytokines were correlated with the prognosis of ISSNHL patients. IL-4 ≥0.225 (pg/mL) and TNF-α ≥5.155 (pg/mL) were significantly associated with poor therapeutic outcomes (OR=44.317, p=0.015 and OR=269.465, p=0.006, respectively). In addition, age and initial hearing levels were also significant prognostic factors. @*Conclusion@#Patients’ age, initial hearing levels, and serum levels of IL-4 and TNF-α prior to treatment are associated with hearing recovery and can be used as prognostic factors for patients with ISSNHL.

Sleep Disorder in Tinnitus Patients / 대한이비인후과학회지

Background and Objectives@#One of the most common complaint of tinnitus patients has been sleep disorder. The aim of this study was to evaluate the relationship between sleep disorder and tinnitus.Subjects and Method Patients with tinnitus from July 2018 till August 2019 were enrolled. Subjects who had any acute/chronic disease in the inner and middle ear or external auditory canal, sleep apnea and had more than 3 caffeinated beverages a day was excluded. Study participants completed Beck Depression Inventory (BDI), the tinnitus symptom questionnaire, tinnitus handicap inventory (THI), Pittsburg Sleep Quality Inventory (PSQI), pure tone audiometry, a full otologic examination and an interview on past medical history. @*Results@#THI was correlated with PSQI global score and BDI. The PSQI subscale most relevant to THI was PSQI 1 (subjective sleep quality). Hearing impairment was correlated with the THI functional subscale. BDI was individually related to PSQI. @*Conclusion@#Tinnitus is found to be highly related to sleep disorder, suggesting a common pathway of aggravation and treatment target. Tinnitus is also more affected by sleep disorder than by depression. A further examination and treatment of comorbid sleep disorder in tinnitus patients is recommended.

Change in Self-Evaluation of Hearing Status According to Age: A Population-Based Study / 대한이비인후과학회지

Background and Objectives@#Self-reported hearing levels determined by self-report questionnaires are not always correlated with the audiometric hearing level. It is necessary to ascertain the subjectively perceived normal hearing threshold to determine the need for hearing aids at the appropriate time. The objective is to identify the level of correlation between the self-reported hearing level and the audiometric hearing level and ascertain the subjectively perceived normal hearing threshold for each age group.Subjects and Method This cross-sectional study, using the data from the Korea National Health and Nutrition Examination Survey V, looked at participants with hearing loss who were aged ≥40 years. Pure tone audiometry was conducted bilaterally. Self-reported hearing level was ascertained via survey enquiring about hearing loss. The level of correlation between self-reported hearing level and audiometric hearing level, age-specific patterns of hear-ing self-evaluation and subjectively perceived normal hearing values at which participants complained of hearing loss were main outcomes. @*Results@#Mean audiometric thresholds (MATs) increased with the age and degree of self-reported hearing level. The accuracy of self-reported hearing level compared to the audiometric threshold decreased with age both in the better-ear and worse-ear groups. Younger participants tended to overestimate their hearing impairment, while older participants tended to underestimate it. Subjectively perceived normal hearing thresholds increased with age and they were very close to the MATs for each age group. @*Conclusion@#Results can be useful for devising different age-group specific pure tone audi-ometry-based diagnostic criteria for self-reported hearing loss, which can be used to determine the need for hearing aid in a timely manner.

Current Update of Local Allergic Rhinitis / 대한이비인후과학회지

Local allergic rhinitis (LAR) is a localized nasal allergic response in the absence of systemic atopy. The symptoms, duration, severity, and comorbidities of LAR are similar to those of allergic rhinitis. Although pathophysiology of LAR is not fully understood, in some patients specific IgE can be demonstrated in the nasal secretions. The diagnosis currently relies on the positive results of nasal provocation test. Nasal provocation test has shown high sensitivity and specificity with safety, and is considered as the gold standard. LAR patients benefit from the same therapeutic strategies as allergic rhinitis patients, including the avoidance of allergen exposure and the pharmacotherapy. Effectiveness and safety of allergen immunotherapy open a window of treatment opportunity in LAR. This review provides a current update on LAR.

Extensive Adenomatoid Odontogenic Tumor of the Maxilla: A Case Report of Conservative Surgical Excision and Orthodontic Alignment of Impacted Canine / 대한악안면성형재건외과학회지

The present report describe the surgical therapy, clinical course, orthodontic treatment and morphological characteristics of an adenomatoid odontogenic tumor in the maxilla of an 11-year-old patient. The cystic tumor filled the maxillary sinus and involved a tooth. Marsupialization was accompanied by partial enucleation and applied traction to the affected tooth by a fixed orthodontic appliance. Healing was uneventful and no local recurrence was observed during a 1-year period of follow-up control.

Multicenter clinical study on the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique

OBJECTIVES: This study was to evaluate the effect of vertical bone gain and success rate and analyze the failure cases using the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique. MATERIALS AND METHODS: Patients who had been operated in the three centers including Daegu Catholic University Medical Center were selected for this study. The mucoperiosteal flap was elevated, and the sinus floor was then broken by specially designed piezoelectric insert, with hydraulic pressure applied to the sinus membrane for even elevation. Afterward, implants were placed. Panoramic radiogram or computed tomogram was taken before and after surgery and at the second operation and prosthesis placement. Later, changes in vertical height were measured and compared. The survival rate was based on the criteria of Buser et al. and Cochran et al. RESULTS: In this study, 8 implants failed out of a total of 169 implants, resulting a success rate of 95.3%. These failure cases were due to insufficient initial stability or sinus membrane perforation. The mean of radiographic vertical height change at prosthesis placement was 5.7 mm (0.5-10.5 mm). CONCLUSION: In this study, HPISE technique was found to be a predictable treatment for atrophic maxilla and an alternative technique to the lateral approach.

A Correlation between Mandibular Angle Fracture and the Mandibular Third Molar

Comparative study of removal torque of 3 different hydroxyapatite coated implants in the femur of rabbits

INTRODUCTION: This study compared the strength of osseointegration as determined by the resistance to reverse torque rotation of three different hydroxyapatite coated implants in the rabbit femur model. MATERIALS AND METHODS: Three hydroxyapatite coated implants (HAPTITE), Tapered Screw-Vent (TSV) and BioTite-H - were used. A total of 40 implants were placed in the femur of 20 adult male rabbits. The animals were divided into two groups. In group A (n=10); one HAPTITE was placed into each right femur and one TSV was placed into each left femur. In group B (n=10); one HAPTITE was placed into each right femur and one BioTite-H was placed into each left femur. Five rabbits of each group were sacrificed at 4 and 8 weeks. The implants were removed by reverse torque rotation using a digital torque-measuring device. A total of 40 implants in 20 rabbits were used for the removal torque measurements. RESULTS: In the Group A, 4 weeks after implant placement, the mean removal torque for the HAPTITE and TSV was 70.7+/-31.6 N cm and 28.9+/-15.1 N cm, respectively. Eight weeks after implant placement, the mean removal torque for the HAPTITE and TSV was 87.9+/-26.2 N cm and 54.9+/-22.4 N cm, respectively. In the Group B, 4 weeks after implant placement, the mean removal torque for the HAPTITE and BioTite-H was 58.0+/-29.6 N cm and 37.7+/-14.1 N cm, respectively. Eight weeks after implant placement, the mean removal torque for the HAPTITE and BioTite-H was 91.4+/-47.1 N cm and 30.8+/-9.8 N cm. HAPTITE showed a higher removal torque than the other implants. CONCLUSION: These results suggest that HAPTITE increases the strength of osseointegration significantly as determined by the resistance to reverse torque rotation.