Olfactory Evoked Potential for Objective Olfactory Function Evaluation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The exact diagnosis for olfactory dysfunction plays an indispensable complementary role to the proper management of olfactory dysfunction. But there is no confirmative objective method for olfactory function evaluation. Recently, olfactory evoked potential by jet steam method was introduced as an objective method for the evaluation of olfactory function. The purpose of this study is to evaluate clinical efficacy of olfactory evoked potential. SUBJECTS AND METHOD: Thirty two normal individuals were evaluated with olfactory evoked potential and their olfactory thresholds were within normal range when tested with T&T olfactometry. Odorant, skatole was introduced 1cm apart from the nostril by jet steam pulse. The results were averaged by Neuropack Four Computer. RESULTS: Twenty-nine individuals had typical positive waves with latency near 0.1ms, but three individuals had no typical positive wave. The threshold of twenty individuals in electro-olfactometry was E1 with E1 recognition or detection threshold in T&T olfactometry. The threshold of other nine individuals in electro-olfactometry was E2 with E1 recognition and detection threshold in T&T olfactometry. CONCLUSION: Olfactory evoked potential has good correlation with classic T&T olfactometry and could be used as an objective method for the evaluation of olfactory function.

Clinical Values of PET-CT Compared to Conventional Radiologic Imaging in Head & Neck Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES : In head & neck cancer, the conventional CT and MRI are useful methods in imaging the anatomical structures of cancer, but they have limits in estimating sensitivity and specificity. To overcome these limits, PET-CT, an imaging technique using metabolism emitting from cancer tissues, was introduced. This study was aimed to evaluate the clinical values of PET-CT by comparing the PET-CT of the conventional CT/MRI, with respect to imaging primary lesions, finding metastatic cervical lymph nodes, and discovering any tumor or recurrence. MATERIALS AND METHOD : Seventy patients, who were diagnosed with head and neck cancer, were selected from Inha Hospital from March, 2004 to July, 2005. For every patient selected, a retrospective analysis was done by medical record review. The studied patients were divided into group 1 and 2. Group 1 was composed of patients that had preoperative evaluation for staging, group 2 with follow-up patients after primary treatment. In group 1, the analysis was done by comparing pathohistologic results from PET-CT to CT/MRI findings and in group 2, radiologic imaging studies were compared by follow-up imaging or clinical manifestation after 6 months. RESULTS : For the primary sites, 22 cases were laryngeal cancers, and 17 cases were thyroid. For primary site cancers and metastatic lymph nodes in group 1 and 2, there were no statistical differences of sensitivity, specificity and predictability between CT/MRI and PET-CT imaging. CONCLUSION : We were not able to prove the clinical values of PET-CT, since PET-CT had no meaningful differences from the conventional methods in imaging primary lesions, finding metastatic cervical lymph nodes, and follow-up.

Preoperative Factors in Prediction of Postoperative Pulmonary Complication in Patients with Conservative Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To predict postoperative pulmonary complication in patients with conservative laryngectomy, variable factors such as pulmonary function test (PFT) have been reported. Therefore, we reviewed the relationships between postoperative pulmonary complications and preoperative risk factors including the parameters of PFT. PATIENTS AND METHOD: From 1997 Jun. to 2005 July., conservative laryngectomy was performed under diagnosis of laryngeal cancer in 36 patients. The factors related to age, history of lung diseases, the parameters of PFT (FEV1, FEV1/FVC and FVC), and the types of surgery were analyzed to evaluate the postoperative pulmonary complication. We used a retrospective analysis of medical records and Fisher exact method to verify the relationships between preoperative risk factors and the pulmonary complications. RESULTS: 8 patients had postoperative pulmonary complication. Age, history of lung diseases and PFT parameters had no statistical significance. Among them, 7 patients and 1 patient had takensupracricoid laryngectomy and supraglottic laryngectomy, respectively. Supracricoid laryngectomy cases had more significant postoperative pulmonary complications than vertical partial laryngectomy cases. CONCLUSION: Age, the history of lung diseases, and parameters of PFT had no predictable value for postoperative lung complications. In the comparison between the surgery types, only supracricoid laryngectomy cases had statistical increase of postoperative pulmonary complications.

Kimura's Disease as Unusual Cause of Head and Neck Masses / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Kimura's disease is a rare, allergic, inflammatory disorder of unknown cause. Patients often present nontender subcutaneous swelling in the head and neck region. Lymphadenopathy, peripheral eosinophilia, and an elevated serum IgE are also present. Kimura's disease is easily mistaken for malignant tumor, and has been confused with angiolymphoid hyperplasia with eosinophilia (ALHE). The diagnosis is confirmed by a biopsy. Treatment options range from observation to surgical excision, steroid therapy, and radiotherapy. We summarize characteristics of clinical feature, laboratory results in six cases of Kimura's disease and report the results of treatment, including surgery and steroid therapy. SUBJECTS AND METHOD: Between May 1999 and August 2003, six cases were diagnosized as Kimura's disease at the Department of Otorhinolaryngology Head and Neck Surgery at the Inha University. Six cases included four males and two females, with the mean age of 47.3 years. Preoperative evaluation included CT or MRI, CBC, and urine analysis. The study was done retrospectively. RESULT: Primary sites were two parotid glands, one submandibular gland, two neck lymph nodes, one scalp and cheek. Complete excision with steroid therapy was done in all cases. Five cases had peripheral eosinophilia. All cases reveal renal involvement, postsurgical complication or recurrence. CONCLUSION: Steroid therapy following surgical excision is the treatment of choice for definitive diagnosis and initial management. Kimura's disease must be included in the differential diagnosis of unusual head and neck mass because Kimura's disease is an unusual condition and it imitates the neoplastic or imflammatory condition in the head and neck.

Sialendoscopy: Endoscopic Diagnosis and Treatment of the Salivary Gland Disease / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Obstructive lesion of salivary glands by salivary duct calculi and stenosis is the main inflammatory disease of major salivary glands. Recently, the sialendoscopy has been introduced for the diagnosis and intervention of salivary ductal disease. The purpose of this study is to assess the efficacy of the sialendoscopy for the treatment of inflammatory salivary gland diseases. SUBJECTS AND METHOD: Diagnostic and interventional sialendoscopy were performed in 19 patients (7 parotid glands, 12 submandibular glands), who had salivary duct calculi or recurrent sialadenitis without calculi from 2003 Sep. to 2004 Jun. Diagnostic sialendoscopy was performed for obstructive lesions and evaluation of ductal status. Interventional sialendoscopy was performed for the removal of salivary duct calculi and dilatation of duct stenosis in cases with calculi and stenosis. RESULTS: Diagnostic sialendoscopy was performed in all cases successfully. Sixteen glands had obstructive lesions and 3 glands had sialadenitis with no evidence of obstruction. Only one case with salivary duct calculi was failed. The remaining 10 calculi were removed with microforceps and basket with or without laser fragmentation. The average size of sialoliths was 5.2 mm and multiple stones were found in 2 cases. Five cases with stenosis of parotid and submandibular gland duct were dilated with balloon catheter or endoscopy sheath successfully. In the remaining 3 glands with no obstruction, the finding of ductal inflammation was identified. No major complications were noted. CONCLUSIONS: Diagnostic sialendoscopy is a new and minimal invasive technique for complete exploration of ductal system and evaluating salivary duct disease. Interventional sialendoscopy allows the extraction of salivary duct calculi in most cases and the dilatation of stenotic duct. This technique might be useful in preventing open gland surgery in well indicated cases.

Effects of Peroxynitrite on HSP 70 Expression in Cultured Normal Human Nasal Epithelial Cell

BACKGROUND AND OBJECTIVES: Nitric Oxide (NO) is an endogenous mediator first characterized as an endothelium-derived relaxing factor. It is now recognized as a key mediator in many physiological process such as vasodilatation, neurotransmission, host defense, and iron metabolism. However, much remains to be determined about the pathophysiological role of NO in the airway. Peroxynitrite, which is synthesized by NO, is the diret cause of cellular toxicity in inflammatory reaction. In this study, we investigated the cellular toxcity of peroxynitrite by the expression of Heat-shock proteins 70 (HSP 70) in normal human nasal epithelium (NHNE) at the inflammatory conditions MATERIALS AND METHODS: 3-Morpholinosydronimone clorhydrate which is a peroxynitrite donor was mixed in the media of cultured NHNE cell. RESULTS: HSP 70 was expressed at the peroxynitrite environment of cultured NHNE cells and HSP 70 mRNA was detected with a time-dependent increasing pattern. CONCLUSION: Peroxynitrite may have a cytotoxic effect, and inhibition of peroxynitrite synthesis may have an important role for controlling the cytotoxic and inflammatory conditions of rhinitis and sinusitis.