A Case of Epidural Abscess in Middle Cranial Fossa Secondary to Acute Sphenoid Sinusitis

Acute or chronic sinusitis is common disease of ENT. Most cases usually respond to appropriate treatment; however, some cases occasionally progress to the development of serious complication and poor prognosis. The orbital complications are most common complication fallowed by intracranial complications. The incidence of sinogenic intracranial complications is about 3.7-11.0% and these complications are progressively decreasing however the complications occur due to incorrect use of antibiotics, antibiotics resistant pathogens, decreasing host immunity, improper diagnosis and delayed surgical treatment. Therefore the case of epidural abscess in anterior portion of middle cranial fossa secondary to acute sphenoid sinusitis, which was treated with transnasal endoscopic sphenoidotomy and intravenous antibiotics, is being reported.

A Case of Cavernous Hemangioma Originated from the Middle Turbinate / 대한이비인후과학회지

Hemangiomas are common benign soft tissue tumors in the head and neck, but they occur infrequently in the sinonasal cavity. Most of nasal hemangiomas arise from the nasal septum or vestibule and are of capillary type. Only a few arise from the lateral wall of the nose, and these usually are cavernous. Chief symptoms are recurrent epistaxis and nasal obstruction; if the tumor becomes large, it may cause adjacent bony erosion. Cavernous hemangioma shows essentially little tendency to regress, and in adults, it is more common than capillary hemangioma. Consequently, the majority of cavernous hemangiomas require surgery in contrast to their capillary counterparts. We report a case of cavernous hemangioma of middle turbinate in an adult female, together with a review of the literature.

A Case of C1 Inhibitor Deficiency Syndrome / 대한이비인후과학회지

C1 inhibitor (C1 INH) deficiency is characterized by recurrent attacks of angioedema. The disorder may be inherited or acquired, with both types presenting a similar phenotypic picture. The angioedema most frequently affects the extremities, gastrointestinal, genital, facial and, airway swelling. The laryngeal angioedema can compromise the integrity of the upper airway, so its early diagonsis is crucial. Acquired angioedema by C1 deficiency is a rare disorder characterized by adult onset and lack of inheritance of the disease. We experienced a case of angioedema in a 37-year old man. He had no family history of angioedema and laboratory data showed depressed C1 inhibitor levels. With a review of literature, authors report a case of acquired angioedema by C1 inhibitor deficiency who had a history of the recurrent swelling of tongue, lip and, oral buccal mucosa.

A Case Report of Correction of Cryptotia / 대한이비인후과학회지

Cryptotia is a congenital auricular anomaly found more commonly in orientals than whites. It is characterizaed by the invagination of the upper part of the auricle under the temporal skin and deformity of the auricular cartilage. Surgeries to correct cryptotia principally involves addition of skin to the deficient retroauricular sulcus and cartilage plasty. We have developed a surgical method using modified retroauricular flap and have obtained good result without complication. We hereby report a surgical case with discussion and review of literatures.

Fine Needle Aspiration Biopsy and Histopathologic Diagnosis in the Head and Neck Mass / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Fine needle aspiration cytology (FNAC) is a safe and economical biospy technique which is widely applicable to palpable masses as a first-line procedure. Successful FNAC, however, demands high specimen quality and experience on the part of both the aspirator and the pathologist. We compared cytological diagnosis with histopathological diagnosis in the head and neck region, in order to increase accuracy and solve any discrepancy in the two types of diagnoses. MATERIALS AND METHODS: From July 1996 through to July 1998, FNAC were carried out in 830 cases in palpable mass of the head and neck region in the Department of Pathology, Chonnam University Hospital. The major target sites were lymph nodes (61.4%), soft tissues (22.2%), and salivary glands (16.4%). Histopathological diagnoses were performed in 267 cases by surgical methods. Cytological reports were classified into the following diagnostic categories: non-tumor, tumor (benign, malignant: primary or metastatic). RESULTS: In a series of 267 cases, there were 70 non-tumor lesions (26.2%), 197 tumor lesions (73.8%), (benign: 77, malignant: 120). Lymph nodes were the most common anatomic sites for FNAC. The overall diagnostic accuracy, sensitivity and specificity of FNAC were 95.5%, 98.8%, and 94.2% allowed an correct diagnosis between FNAC and histopathology. CONCLUSION: FNAC of the head and neck region is a sensitive and specific diagnostic tool, especially when diagnosing metastatic carcinomas. Four major causes of error were identified: material adequacy criteria, sampling technique, cytological interpretation and limitations in the procedure. In particular, attention must be paid to subtle morphological changes when making detailed clinical pathological observations; this may help avoid discrepancies and achieve the right diagnosis.