A new year's greeting message

No abstract available.

A new year's greeting message

No abstract available.

A new year's greeting message

No abstract available.

A new year's greeting message

No abstract available.

World Medical Association Guidelines on Promotional Mass Media Appearances by Physicians: Starting Campaigns for Ethics

No abstract available.

Diagnosis of Cervical Tuberculous Lymphadenitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although the incidence of tuberculosis has decreased recently, cervical tuberculous lymphadenitis is one of the most common causes of neck mass in Korea. Its confirmative diagnosis is not common, especially when the presence of acid-bacilli is not proven. So, the treatment of cervical tuberculous lymphadenitis is generally carried out by clinical diagnosis, not by confirmative diagnosis. In this study, we designed to verify theusefulness of fine needle aspiration cytology (FNAC), AFB stain, Mycobacterium tuberculosis polymerase chain reaction (PCR) and excisional biopsy prospectively. MATERIALS AND METHODS: We underwent FNAC, AFB stain and PCR as a first stage work-up through fine needle aspiration in forty-eight patients who were suspected of cervical tuberculous lymphadenits. In patients with positive results on the first stage work-up, we treated the patients with antituberculosis chemotherapy under clinical diagnosis of tuberculosis. In patients with negative test results, we performed excisional biopsy. Also in patients who revealed positive results with no response to the antituberculosis chemotherapy, we performed an excisional biopsy too. RESULTS: The sensitivity and specificity of first stage work-up were 64.9% and 81.8%, respectively. The sensitivity of FNAC, AFB stain and PCR were 8.1%, 13.5% and 56.8 %, respectively. The specificity of PCR was 81.8%. Thirteen (59.1%) of 22 patients who revealed negative results in their first stage work-up were proven to have cervical tuberculous lymphadentis through excisional biopsy, and two of the positive results in PCR were false positive. CONCLUSION: In clinical diagnosis of cervical tuberculous lymphadentis, the first stage work-up used in this study is found to be useful methods which resulted 64.9% sensitivity and 81.8% specificity. Especially, PCR is the most useful tool among them and suggest that, if its result is negative, excisional biopsy should be considered positively.

Diagnostic Criteria of Internal Jugular Phlebectasia in Korean Children

Internal jugular phlebectasia (IJP) is a fusiform dilatation of the internal jugular vein (IJV), usually presented as a neck mass in children. Accurate diagnosis from carefully directed history, physical examination, and radiological study could result in lifesaving therapy. We performed our study to suggest possible clinical diagnostic criteria for IJP in Korean children. We reviewed three cases of IJP (patients group) and compared the diameter of the internal jugular phlebectasias with diameters of IJVs in ten normal children (control group) using ultrasonography (USG). There were no significant differences in the range of diameters in the resting state between the two groups. The diameters on the right side, compared with those on the left side, showed no statistical significance (p < 0.05). Te range of expanding diameter and average expanding ratios (resting state to Valsalva maneuver X 100%) showed a statistical difference between the two groups (p < 0.05).

A Case of Second Branchial Cleft Cyst with Oropharyngeal Presentation

Second branchial cleft cysts are the most common type of branchial abnormalities and usually found high in the neck. Oropharyngeal presence of branchial cleft cyst is very rare. We report a case of oropharyngeal branchial cleft cyst in 2-yr-old girl with about 1x1 cm sized cystic mass, which had not any specific symptom. It was removed completely under impression of mucocele and did not have tract-like structure. However, cyst had a squamous epithelium-lined wall with lymphoid aggregation in histopathologic study, which was characteristic finding of branchial cleft cyst. Patient discharged without any complication and there was no evidence of recurrence for 18 months follow-up. We review reported oropharyngeal or nasopharyngeal presentation of these cases in English literature and embryological explanation.

Non-traumatic Subcutaneous Emphysema in the Head and Neck / 대한이비인후과학회지

Subcutaneous emphysema often occurs as a result of surgery, trauma of the aerodigestive tract, and increased alveolar pressure. Generally, spontaneous emphysema is rare, because "spontaneous" is only used to describe emphysema that has no obvious etiology. We reviewed six cases of non-traumatic subcutaneous emphysema occurring in the head and neck. Among them, four cases were associated with pneumomediastinum. Two occurred without obvious etiology, another two were due to heavy lifting events, one due to severe vomiting, and the last one due to severe blowing. Most cases occurred in young males. Clinical symptoms, commonly involved sites, treatments and results of these cases of spontaneous emphysema were analysed.

Osteochondroma of the Atlas Presenting as an Oropharyngeal Mass / 대한이비인후과학회지

Osteochondroma, also known as osteocartilaginous exostosis, or just exostosis, is the most common benign bone tumor. Most of osteochondromas are solitary lesions and affect long bones; however, about 12% of osteochondromas are multiple lesions with the autosomal dominant inheritance. Only 1~4% of solitary osteochondromas originate in the spine. Symptoms vary depending on its location. We experienced a case of osteochondroma of the atlas presenting as an oropharyngeal mass. We report the case with a review of literatures.

Radiologic Laryngeal Parameters in Acute Supraglottitis in Korean Adults

Soft-tissue lateral neck radiography is important for diagnosing acute supraglottitis. This study aimed to determine the objective criteria for a diagnosis of acute supraglottitis from soft-tissue lateral neck radiographs in Korean adults. The parameters in 30 adult patients with acute supraglottitis were compared with those of age- and sex-matched normal 30 Korean adults. The mean of epiglottis width (EW) and aryepiglottic fold width (AEW) in the control group were 4.37 +/- 0.93 mm, 2.45 +/- 0.71 mm, respectively and in the patient group they were 15.87 +/- 3.60 mm, 6.4 +/- 2.55 mm, respectively. The sensitivity and specificity of an EW greater than 7mm were 100%, and 100% respectively. The sensitivity and specificity of an AEW greater than 4.5 mm were 83%, and 100% respectively.

A Case of Recurrent Primary Cervical Neuroblastoma: Case Report / 대한이비인후과학회지

Neuroblastoma is a soft tissue malignant tumor in the early childhood originating from the sympathetic nervous system, and usually occurs in the abdomen, thorax, and pelvis. It is rare in the head and neck region and primary cervical neuroblastoma (PCN) is very rare. We present 13-month old boy with slowly growing right neck mass confirmed neuroblastoma. The mass was excised with surrounding enlarged lymph nodes. Postoperative adjuvant chemotherapy was done. During chemotherapy enlarged lymph nodes were found and removed surgically. These nodes showed metastatic well differenciated neuroblastoma. Radiation therapy was added. The patient had total 15 times chemotherapy and 1500 cGy radiation, and there was no evidence after the second operation.

Histochemical Staining of PetaNADPH Diaphorase in Mongolian Gerbil and CJU/A Mouse Cochleae / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) is an inorganic, gaseous free radical that carries a variety of messages between cells. The histochemical demonstration of neuronal betaNADPH-d is the demonstration of the presence of NOS. The purpose of this study was to identify the existence of NOS and the difference of the expression of betaNADPH-d in mouse and gerbil cochleae. MATERIALS AND METHODS: Each of the eight cochleae of Mongolian gerbil (Meriones unguiculatus) and mice (CJU/A) were fixed by cardiac perfusion with 4% paraformaldehyde in 0.1M phosphate buffer solution. The en-bloc cochleae were incubated after decalcification, and stained with betaNADPH-d and counterstained with acid fuchsin. The relative intensity of staining was decided in the same location of cochlea. RESULTS: Most supporting cells were strongly stained except Claudius cells and Boettcher's cells in gerbil. However, Boettcher's cells were strongly stained in mice. Outer hair cells, inner hair cells, basial membrane and lining cells of spiral limbus were strongly stained. Interdental cells of spiral limbus, inner border cells and intermediate cells of stria vascularis were moderately stained. Tectorial membrane and amorphous layer of basial membrane were not stained. CONCLUSION: Using betaNADPH-d staining, this study documents the presence of nitric oxide synthase in mice and gerbil cochleae and the difference of staining between two species.

Cryptococcal Infection Combined with Cholesteatoma / 대한이비인후과학회지

Cryptococcus neoformans is a yeast-like organism causing opportunistic infection in the immunocompromized host. Men-ingitis is the most frequent manifestation and causes serious morbidity and mortality. Other sites are less commonly involved. There have been a few cases presenting hearing loss and vertigo as a result of the extension of meningitis through the internal auditory canal. Authors report a case of cryptococcal infection combined with cholesteatoma that developed in a 54-year-old woman who did not have either evidence of immunocompromised state or pathological signs of cryptococcal infection. Cryptococcus neoformans was incidentally found in the keratinized layer of cholesteatoma.

Endonasal Endoscopic Reduction of Blowout Fractures of the Medial Orbital Walls / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Until recently, blowout fractures (BOFs) of the medial orbital walls were treated using external approach. With recent advances in endoscopy, many cases of BOFs of the medial orbital walls are now treated endonasaly using an endoscope. This article describes endonasal endoscopic reduction (EER) of BOFs of the medial orbital walls and reports the clinical results. MATERIALS AND METHODS: Twelve patients with BOFs of the medial orbital walls underwent EER. Their records were reviewed for surgical indications, operative techniques, operative results, and postoperative complications. RESULTS: Surgical indications were persistent diplopia, limitation of eye movement, and significant enophthalmos. Ten patients showed complete resolution of symptoms after the operation. One patient underwent medial wall reconstruction with transorbital approach after failure of EER, and is now free of symptoms. Another patient with both zygomatic fracture and BOF of the orbital floor remained enophthalmic after EER. There were no other significant complications postoperatively. CONCLUSION: The results indicate that EER is a safe and effective method of treating BOFs of the medial orbital walls.

Reconstruction of Traumatic Orbital Defects Using Porous Polyethylene Sheet / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Among the various alloplastic materials which are used in reconstruction of the traumatic orbital defects, porous polyethylene sheets (PPSs) are increasingly used due to their improved biocompatibility, easy malleability, and minimal complication. We report our experience with PPSs in reconstruction of the traumatic orbital defects. MATERIALS AND METHODS: PPSs (0.85 mm or 1.5 mm) were used in 23 patients with significant traumatic orbital defects. Twenty patients were treated for orbital floor defects, 2 for medial wall defects, and 1 for both floor and medial wall defects. Their surgical results and postoperative complications were studied. Their mean follow-up period was 18 months. RESULTS: Postoperatively, diplopia or limitation of eye movements were resolved in 11 of 17 patients and enophthalmos in 6 of 9 patients. No patients had induced diplopia or exacerbation of preoperative symptoms. There were no complications like graft extrusion, infection, clinically detectable graft distortion, or resorption. CONCLUSION: PPS appears to be an excellent material for reconstruction of the traumatic orbital defects.

Relationship between the Extent of Fracture and the Degree of Enophthalmos in Isolated Blowout Fracture of the Medial Orbital Wall / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In blowout fracture (BOF) of the medial orbital wall, the presence of significant enophthalmos indicates a need for surgery. In early post-traumatic period, it is usually difficult to measure the degree of enophthalmos due to orbital edema. So, in order to decide on the correct treatment method, it will be useful if we can predict the degree of enophthalmos according to the extent of fracture observed in computed tomography (CT). We studied the relationship between the extent of fracture measured in CT scans and the degree of enophthalmos in BOF of the medial orbital wall. MATERIALS AND METHODS: Nine patients with isolated BOF of the medial orbital wall confirmed by CT scans were studied. The severity of enophthalmos was measured by exophthalmometry. The area of fracture site and the volume of herniated orbital tissue were measured in CT scans. The statistical significance was analyzed using linear regression method. RESULTS: The degree of enophthalmos increased as the area of fracture site or the volume of herniated orbital tissue increased. The area of the fracture site and the volume of the herniated orbital tissue that caused enophthalmos of 2 mm were 1.9 cm2 and 0.9 ml, respectively. CONCLUSION: In BOF of the medial orbital wall, surgical intervention may be recommended to prevent significant enophthalmos when the area of fracture site is 1.9 cm2 or more, or the volume of herniated orbital tissue is 0.9 ml or more.

A traumatic pseudoaneurysm of the superficial temporal artery

Pseudoaneurysm arising from the superficial temporal artery (STA) is very rare and is most commonly caused by blunt trauma. Most pseudoaneurysms of the STA usually present as a painless pulsating mass, with concomitant symptoms according to location, and their size may rapidly increase. The treatment of choice is ligation and resection. We present a case of pseudoaneurysm arising from STA after a penetrating injury caused by broken glass. We describe the history, findings of physical examination, Doppler sonography, angiography, histopathology, and the outcome of treatment. We also include a brief review of this condition.

Efficacy of Computed Tomography for Diagnosis and Treatment of the Deep Neck Infection / 대한이비인후과학회지

BACKGROUND: Deep neck infection is an inflammatory disease process within the deep cervical fascia of the head and neck. Although the frequency has declined dramatically with development of antibiotics, the morbidity is still high because the diagnosis is delayed in the course of the disease. OBJECTIVES: To determine the diagnostic value of neck computed tomography (CT) and treatment modality according to the disease severity. MATERIALS AND METHODS: Forty-three patients with deep neck infection admitted and treated from January 1992 to December 1996 were analysed retrospectively. CT was checked at the initial state and checked again at the seven to ten days later for evaluation of treatment. RESULTS: CT was valuable for early diagnosis when this disease was suspected and follow-up evaluation of treatment results. Hospital days were longer in patients with underlying disease. The size of abscess and the involved regions of cellulitis were used guides for the decision of treatment modality. In cases of cellulitis and small abscess less than 3cm, intravenous antibiotic therapy and CT-guided aspiration was efficient. Combined therapy with intervention and antibiotics was needed in patients with abscesses larger than 3cm and progressive disease. CONCLUSION: CT was an excellent diagnostic method and valuable for the evaluation of treatment. Treatment modality was decided according to the size of abscess and the presence of underlying disease.

Dacryocystitis associated with nasolacrimal duct cyst

An infant presented with persistent epiphora after successful probing of the lacrimal system. Examination of the nose showed a cystic structure occluding lower portion of the lacrimal drainage system. In cases of recurrent obstruction, nasal examination and endoscopic marsupialization may help guide the clinician towards the most appropriate treatment.