Long Term Results after CO2 Laser Turbinate Surgery for Perennial Allergic Rhinitis

BACKGROUND AND OBJECTIVES: Although CO2 laser turbinate surgery is known to be an effective method in reducing the nasal symptoms of perennial allergic rhinitis, the long term effects have not yet been evaluated. Therefore, the purpose of this study was to assess the subjective and objective long term results of CO2 laser surgery. MATERIALS AND METHODS: The charts and questionnaires of 49 patients who received laser surgery at our department from January 1994 to December 1999 were reviewed. Preoperative and postoperative nasal volume of 20 randomly selected patients were measured by acoustic rhinometry. Nasal mucosa of 10 patients before and after laser surgery yearly for 6 years were examined under light and electron microscopy. RESULTS: Watery nasal discharge, nasal obstruction and sneezing had improved significantly after laser surgery. Postoperative nasal volumes also increased significantly. Histological findings 6 years after laser surgery revealed focal squamous epithelium and regenerating ciliated columnar epithelium. Decreased goblet cells, fibrous proliferation and scarce vessels and glands were also observed. CONCLUSIONS: CO2 laser surgery proves to be an effective method in reducing the symptoms of perennial allergic rhinitis for short and long periods.

Long Term Results after CO2 Laser Turbinate Surgery for Perennial Allergic Rhinitis

BACKGROUND AND OBJECTIVES: Although CO2 laser turbinate surgery is known to be an effective method in reducing the nasal symptoms of perennial allergic rhinitis, the long term effects have not yet been evaluated. Therefore, the purpose of this study was to assess the subjective and objective long term results of CO2 laser surgery. MATERIALS AND METHODS: The charts and questionnaires of 49 patients who received laser surgery at our department from January 1994 to December 1999 were reviewed. Preoperative and postoperative nasal volume of 20 randomly selected patients were measured by acoustic rhinometry. Nasal mucosa of 10 patients before and after laser surgery yearly for 6 years were examined under light and electron microscopy. RESULTS: Watery nasal discharge, nasal obstruction and sneezing had improved significantly after laser surgery. Postoperative nasal volumes also increased significantly. Histological findings 6 years after laser surgery revealed focal squamous epithelium and regenerating ciliated columnar epithelium. Decreased goblet cells, fibrous proliferation and scarce vessels and glands were also observed. CONCLUSIONS: CO2 laser surgery proves to be an effective method in reducing the symptoms of perennial allergic rhinitis for short and long periods.

Anatomical Relationship of the Anterior Ethmoid Canal to the Anterior Skull Base: A Computed Tomographic Analysis on the Types of the Fovea Ethmoidalis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: As the anterior ethmoid canal (AEC) provides a good surgical landmark and its injury may result in serious complications, the anatomical relationship of the AEC to the anterior skull base (ASB) should be evaluated preoperatively. Despite some studies on the ASB, studies analyzing this anatomical relationship and the types of the fovea ethmoidalis (FE) on computed tomography (CT) are rare. The aim of this study is to better understand this anatomical relationship by determining the frequency of each type of the FE and distances between anatomical structures on the CT scans with our new classification. MATERIALS AND METHOD: Four hundred sides of the FE were analyzed from the preoperative coronal CT scans of 200 chronic sinusitis patients (100 males and 100 females, aged 20 to 59 years). The FE was classified into 4 types (I: non-separated type, II: partially separated type, III: completely separated type, IV: unidentifiable type) and 2 subtypes (A: developed medial cranial wall, B: undeveloped medial cranial wall). Heights of the medial cranial wall (a), the AEC (b), and the ethmoid roof (c) were measured on the CT image. RESULTS: Frequencies of the types I-IV were 48.0% (IA: 25.2%, IB: 22.8%), 19.3% (IIA: 4.3%, IIB: 15.0%), 29.5% (IIIA: 29.5%, IIIB: 0%), and 3.2%, respectively. The medial cranial wall of type IIIA was significantly longer than those of the other types, and the AEC of type IIIA was in a significantly lower position than those of the other types. CONCLUSION: On the CT scans, we found the AEC in 96.8% and type IIIA in nearly 30% of all types of the FE. Sinus surgery should be performed only after preoperative evaluation of these anatomical relationship on the CT scans under close scrutiny. For the type IIIA, surgery should be performed with utmost care due to high risk of injury to the AEC and the medial cranial wall.

Significance of Caloric Test in Reversed Position / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Caloric nystagmus has been known since a century ago, and the thermal convection theory proposed by Barany has been widely accepted. Gravity plays an important role in thermal convection. In 1984, caloric nystagmus was reported in weightless space environments and although the response was weak, the nystagmus was found to occur in the same direction as the earth. This implies that factors other than thermal convection might participate in the caloric nystagmus. MATERIALS AND METHODS: Using 50 normal ears as subjects, this study compared the responses of conventional caloric test and reversed caloric test, which places the plane of the lateral semicircular canal upside down. RESULTS: The direction of the nystagmus was reversed, and the maximal slow phase velocity was decreased compared to that of the normal caloric test. CONCLUSION: The reversed direction of the nystagmus observed in this study basically supports the theory by Barany, however, the differences that are noted implicate that other factors with a certain direction maybe involved.