Long-Term Outcome of the Voice Rehabilitation after Total Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The voice rehabilitation following total laryngectomy is very important for the quality of life of patients who are cured by cancer treatment. The purpose of this study is to investigate the success rate and complications of various procedures used in our clinics and to evaluate various factors that can affect the success rate of the voice rehabilitation. SUBJECTS AND METHOD: From March 1993 to November 2002, 77 medical charts of the patients who underwent total laryngectomy were reviewed retrospectively to determine the immediate and long-term success rates of voice rehabilitation. The statistic correlation between the variables (age, tumor stage, tumor site, radiotherapy) and the success rate was analysed. RESULTS: Good vocalization was achieved in 90.5% of patients after Provox insertion, 81% after Amatsu procedure, while esophageal voice was acquired by 11.1%. The long-term success rate in 39 patients was 75% in Provox group, 81.8% in Amatsu group and 30.5% in esophageal voice group. There were no statistically significant correlation between the variables and the success rate of vocie rehabilitation. CONCLUSION: The result of this study suggested that tracheoesophageal puncture with Provox prosthesis and Amatsu operation are very effective procedures for the long term voice rehabilitation following total laryngectomy.

The Efficacy of Stellate Ganglion Block in Olfactory Disorder Following Upper Respiratory Tract Infection / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: For patients with sudden hearing loss or retina arterial spasm, stellate ganglion block (SGB) has been used as a treatment method to increase the blood flow to the interested area. The aim of this study is to prospectively investigate the efficacy of SGB in patients with olfactory dysfunction following upper respiratory tract infection (URI). MATERIALS AND METHOD: Fifty one patients with anosmia or hyposmia following URI were included. The average duration of olfactory dysfunction was 3.5+/-8.4 years. Thirty eight patients were treated with SGB and compared with the untreated 13 patients. Buthanol threshold test and odor identification test with 16 natural fragrances were used to determine anosmia/hyposmia in these patients and to quantify the improvement of olfactory perception after SGB treatment or follow-up without treatment. RESULTS: Olfactory perception was improved significantly in the treated patients as shown by the buthanol threshold test (p<0.001) and by odor identification test (p<0.001). Subjective olfactory perception was improved in 27 of the 38 treated patients (p<0.001). No complications were observed after SGB and no one reported any worsening in olfactory perception during or after treatment. On the other hand, none of the untreated patients showed any improvement in neither of the tests or the subjective assessment. CONCLUSION: These results suggest that SGB may be a new treatment modality for olfactory dysfunction following URI.

A Case of Osteoma Originated from the Squama of Temporal Bone / 대한이비인후과학회지

Osteoma is a benign bone-forming tumor which is most frequently found in the fronto-ethmoidal area. Although commonly discovered in the external auditory canal of the temporal bone, few cases have been reported in the mastoid or squamous portion of the temporal bone. The authors experienced a case of large osteoma that originated from the squama of temporal bone. We report this rare case and its successful management with a review of the literatures.

Assessment of Olfactory Function after Endoscopic Sinus Surgery in Chronic Rhinosinusitis Patients and Clinical Validity of Cross-Cultrual Smell Identification Test / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS) improves olfactory dysfunction due to chronic rhinosinusitis. Cross-Cultural Smell Identification test (CC-SIT) is known to be one of the useful methods to assess the olfactory dysfunction. We assessed the influence of ESS on olfactory function by using symptom scores and CC-SIT, and determined the clinical validity of CC-SIT. MATERIALS AND METHODS: 151 patients with chronic rhinosinusitis who had received ESS were evaluated. Prior to and three months following the surgery, each patient was requested to mark a 5-point scale ranging from normosmia to anosmia. Preoperative and postoperative CC-SITs were performed for 20 patients who complained of olfactory dysfunction. To evaluate the clinical validity of CC-SIT, we assessed the correlations between CC-SIT scores, symptom scores and CT scores using the Lund-Mackay CT scoring system. RESULTS: There were a significant decrease in the symptom scores and an increase in the CC-SIT scores after ESS. However, normosmia was achieved in only 38.5% (25/65) of the patients determined by symptom scores and 23.5% (4/17) by CC-SITs. There were significant correlations between CC-SIT scores, symptom scores and CT scores (r=-0.416, r=-0.357, r=0.510, p<0.05). CONCLUSION: Although the average postoperative olfactory ability after ESS was in the hyposmic range, ESS could improve the olfactory ability in patients with chronic rhinosinusitis. The 5-point scale and the CC-SIT scores reflected well the severity of olfactory dysfunction in patients with chronic rhinosinusitis, and therefore, we recommend them as convenient and practical tools to assess olfactory ability before and after ESS.