A Case of Pneumorrhachis Associated with Spontaneous Pneumomediastinum and Subcutaneous Emphysema / 대한이비인후과학회지

Pneumorrhachis or epidural emphysema is an uncommon finding observed in the spinal epidural space. Pneumorrhachis could be occasionally associated with pneumomediastinum or pneumothorax or subcutaneous emphysema. Probably this results from air that leaks from the mediastinum, which traverses through the fascial planes and intervertebral neural foramina. In particular, without any causes, these conditions rarely appear simultaneously with trauma, surgery, malignancy, anesthesiological interventions, or Valsalva maneuvers. We report a case of pneumorrhachis accompanied by spontaneous pneumomediastinum and subcutaneous emphysema that was resolved after conservative treatment.

Nasal Bone 3 Dimentional Computer Tomography Guided Tailored Osteotomy of the Bony Deviated Nose / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Correction of deviated nose is considered one of the most difficult and serious surgical operations in rhinoplasty. The correction of bony deviation, in particular, requires osteotomy. Although there are individual differences in the shapes or features of bony deviations of each patient, the techniques of osteotomy are limited. Therefore, for proper correction of bony deviation, it is necessary to set up a precise pre-surgical plan. SUBJECTS AND METHOD: We categorized 187 patients with bony deviated nose into 5 types based on the analysis of preoperative nasal bone 3D computer tomography, and studied surgical method for each type. RESULTS: Of 187 patients, 92 (49%) patients are categorized into type I, 62 (36%) patients into type II, 12 (6%) patients into type III, 2 (1%) patients into type IVa, 7 (4%) patients into type IVb and 7 (4%) patients into type V. Only did eight patients (5%) undergo revision surgery due to unsuccessful outcomes. Major complications like infection, abscess, arteriovenous fistula, epiphora, and saddle deformation did not occur at all. CONCLUSION: Preoperative planning under the analysis and categorization using 3D CT is considered helpful for the precise and individualized surgery in corrective rhinoplasty.