A Case of Vascular Leiomyoma in Nasal Cavity: Case Report and Literature Review / 대한이비인후과학회지

Vascular leiomyoma may arise from the muscular layer of blood vessel wall, which is extremely rare in the nasal cavity or paranasal sinuses. According to the online search on pubmed and koreamed, only 62 cases with vascular leiomyoma arising from nasal cavity or paranasal sinuses, including 13 cases of the nasal septum, have been reported since the first case was reported in 1966. The authors experienced a case of vascular leiomyoma arising in the left side of nasal septum in a patient. It was successfully removed by trans-nasal approach. In addition, we conducted a literature review of clinical features of the 62 cases of vascular leiomyoma in the nasal cavity.

A Case of Multiple Lobular Capillary Hemangiomas of the Nasal Septum / 대한이비인후과학회지

Lobular capillary hemangioma (LCH) is a benign lesion of unknown etiology. LCH is a rapidly growing lesion usually affecting skin and oral mucosa. It is known to be relatively rare in the nasal cavity or sinuses. LCH bleeds easily even with a little irritation because of its excessive vascularity. Hormonal imbalance and microtrauma are known as the major etiologic factors in the development of LCH. The authors experienced a case of multiple LCH in the nasal cavity, which was completely removed with endoscopic approach. According to the literature review, there has been no case report on multiple lobular capillary hemangioma occurring in the nasal cavity. Therefore, the authors report a case with a review of literatures.

A Case of Vidian Nerve Schwannoma: Resection by Endoscopic Sinus Surgery / 대한이비인후과학회지

Schwannoma is a benign tumor arising from the sheath of myelinated nerve fibers and may occur in any part of the body. However, a vidian nerve schwannoma is extremely rare. A 41 year-old man has experienced an occipital area headache and posterior neck stiffness for 2 weeks. Brain computed tomography (CT) angiography, magnetic resonance image revealed lobulated soft tissue density mass in left sphenoid sinus with upward displacement of sphenoid sinus floor and pressure erosion of sphenoid sinus and petrous apex. Ostiomeatal unit CT scan showed a 28x16 mm sized mass filling the left pterygoid canal. The mass was resected using endoscopic sinus surgery. The mass was confirmed as schwannoma. We report a case of vidian nerve schwan-noma that was treated by endoscopic sinus surgery.

A Case of Acute Bilateral Retrocochlear Hearing Loss as an Initial Symptom of Unilateral Thalamic Hemorrhage

A speech discrimination test is a test using a list of 25 phonetically balanced monosyllables. It is often overlooked but significant enough for pure tone audiometry. Many physicians have performed pure tone audiometry but without a speech discrimination test. A 73-year-old woman visited our clinic complaining of sudden bilateral hearing loss. Pure tone audiometry showed only bilateral high frequency loss. However, speech discrimination had decreased markedly. We decided to follow-up after 1 week of Ginexin-F(R) (ginkgo leaf extract) and Nafril(R) (nafronyl oxalate). She felt a gait disturbance within 2 days. Magnetic resonance imaging revealed a left thalamic hemorrhage. After a 1 month hospitalization, the hematoma subsided, and speech discrimination recovered 3 months later. Acute hearing loss due to thalamic hemorrhage that recovered has never been reported. We report the first case of retrocochlear hearing loss that occurred with a thalamic hemorrhage in a patient who recovered.

Early Endoscopic Electrocoagulation of the Sphenopalatine Artery for Refractory Posterior Epistaxis: Preliminary Study

BACKGROUND AND OBJECTIVES: Intractable epistaxis is a challenging problem associated with clinical morbidity and high costs due to prolonged hospitalization. Early endoscopic electrocoagulation of the sphenopalatine artery can be a good alternative management. SUBJECTS AND METHODS: This study is a retrospective review of 6 patients with uncontrolled epistaxis between January 2013 and January 2014. A decision to surgically intervene was made within 24 hours of hospitalization in all cases. Endoscopic electrocoagulation of the sphenopalatine artery was conducted under general anesthesia. Clinical and hematologic information, preoperative and surgical care, postoperative complications and surgical outcome, and duration of preoperative and postoperative hospital stay were evaluated. RESULTS: Epistaxis was effectively controlled in all cases. Four patients (66.7%) complained of nasal dryness and one of them endured nasal crusting for 9 months after surgery. Recurrent posterior epistaxis occurred after 5 postoperative months in one case, which was successfully controlled without surgery. The average length of postoperative hospital stay was 2.5+/-0.5 days. The average total length of hospital stay was 4.8+/-0.8 days. CONCLUSIONS: Early endoscopic electrocoagulation of the sphenopalatine artery seems effective for controlling intractable epistaxis.