Intraoral Approach in Plunging Ranula / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The plunging ranula is a relatively uncommon phenomenon which represents a mucus escaping reaction due to the disruption of the sublingual gland. We recommend that plunging ranula be treated by surgery via an intraoral approach rather than cervical approach. MATERIALS AND METHODS: We present the cases of 15 patients managed at Ghil hospital over the period of a year. A retrospective review of 15 patients with this condition was undertaken. All patients underwent removal of the sublingual gland combined with the evacuation of the ranula via an intraoral approach. Information was collected on age, sex, origin, history of onset, predisposing factors, treatment, and outcome of treatment. RESULTS: Pain and temporary submaxillary swelling were observed during postoperative 3 days. But, neither complication nor recurrence was observed in any patient. Histological observation revealed no epithelial lining in any of the examined specimens. CONCLUSION: Removal of the sublingual gland combined with the evacuation of the ranula via an intraoral approach was the reliable method.

Glutathione S-Transferase P1 Polymorphism in Patients with Allergic Rhinitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Genetic factors play a role in the etiology of allergic rhinitis. The glutathione S-transferase (GSTP1) is one of the detoxifying enzymes for oxidative stress. The purpose of this study is to examine Polymorphisms of whether there is an association between some alleles of GSTP1 genes and allergic rhinitis. SUBJECTS AND METHOD: Patients with allergic rhinitis were selected on the basis of the following criteria: 1) watery rhinorrhea, sneezing, nasal obstruction and/or itching for longer 3months and 2) positive reaction at the allergic skin prick test for DP, DF allergen and 3) positive reaction at specific IgE RAST for DP, DF allergen. GSTP1 gene polymorphisms in exon5 (Ile105Val) were analyzed by polymerase chain reaction (PCR) with restriction fragment length polymorphisms (RFLP) in 149 patients with allergic rhinitis and 156 healthy control subjects. RESULTS: In allergic rhinitis, Ile105/Ile105 were 106 cases (71.1%), Ile105/Val105 were 42 cases (28.2%), Val105/Val105 were 1 case (0.7%) and in normal controls, Ile105/Ile105 were 100 cases (64.1%), Ile105/Val105 were 45 cases (28.8%), Val105/Val105 were 11 cases (7.1%)(p=0.004). CONCLUSION: Genetic polymorphism of Val105/Val105 in GSTP1 may be protective genotypes in allergic rhinitis.

Vestibuloneuritis Developed Concurrently in Ipsilateral Site with Herpes-Zoster Oticus Syndrome

BACKGROUND:Acute vestibular neuronitis is the disease of which the etiology and pathophysiology are largely unknown . But the viral infection and ischemia of the labyrinth and the vestibular nerve are considered as general etiology. This study was performed to support the viral infection rather than the ischemic theory. MATERIALS & METHODS:We studied seventy years old female patient who showed painful vesicles on left auricle and vertigo with spontaneous nystagmus to the right side. We performed physical examination, serologic test, ENG test, pure tone audiogram, brain magnetic resonance imaging and polymerase chain reaction. RESULTS:We found small vesicles and vascular injection in left EAC, herpes zoster IgG positive, spontaneous right beating in electronystagmograpy, 54% left canal paresis in Caloric test , decreasing left side Tc in velocity step rotatory test, decresed gain, deviation to left in symmetry and phase lead in sinusoidal harmonic acceleration test, normal range hearing in pure tone audiogram, microangiopathy on cortex in brain MRI and negative PCR. CONCLUSION:This case supports viral infection etiology rather than ischemia in vestibular neuritis. But more studies to find the etiology of vestibular neuronitis are required.

Evaluation of Vestibular Function in Ramsay Hunt Syndrome

BACKGROUND AND OBJECTIVES: Ramsay Hunt syndrome is herpes zoster of the facial nerve, frequently associated with VIII cranial nerve involvement, but on rare occasions other cranial nerves are affected as well. We tried to show that Ramsay Hunt symdrome should be recognized as a cranial polyneuropathy characterized by damage to cranial nerves, especially the facial nerve and the auditory-vestibular nerve. MATERIALS AND METHOD: 11patients suffered from auricular vesicles, otalgia, facial palsy, and vertigo. Group A included 8 patients of acute peripheral vestibulopathy with Ramsay Hunt syndrome. Group B included only 3patients of Ramsay Hunt syndrome. Each patient received a battery of tests, including neurological examination, audiometry, vestibular function test. RESULTS: The lesion site of Ramsay HHhhunt syndrome was right in 5cases and left in 6cases. Electronystagmography showed 3cases of right acute peripheral vestibulopathy, 5cases of left, and 3cases of disequilibrium. Site of Ramsay hunt syndrome and that of vestibulopathy was same in 8cases of Group A. 3cases was observed in Ramsay Hunt syndrome patients that hearing loss and vestibulopathy was same site. Facail nerve palsy improved without recovery of vestibular function. Cranial examination and imaging study like brain CT or temporal MRI showed no abnormal finding. CONCLUSION: Although Ramsay Hunt syndrome usually presents with the classical triad of pain, vesicles and facial nerve paralysis, it must be kept in mind that it is a cranial polyneuropathy. In our study, there was few association between facial nerve palsy recovery and acute peripheral vestibulopathy.