Effect of a Chitosan Gel on Hemostasis and Prevention of Adhesion After Endoscopic Sinus Surgery

OBJECTIVES: Postoperative bleeding and adhesion formation are the two most common complications after endoscopic sinus surgery (ESS). The former sometimes can be life threatening and the latter is the most common reason requiring revision surgery. This study was designed to evaluate the effect of newly developed chitosan gel (8% carboxymethyl chitosan, Surgi shield) on hemostasis and wound healing after ESS. METHODS: A prospective, randomized, double-blind controlled trial was conducted in 33 patients undergoing symmetric ESS. At the conclusion of the operation, Surgi shield was randomly applied on one side of the nasal cavity, with the opposite side acting as control and the bleeding quantity of the surgical field was evaluated every 2 minutes. And then, Merocel was placed in the ethmoidectomized areas of the both sides. Five milliliters of Surgi shield was applied to the Merocel of intervention side and saline was applied to the other side. Merocel in both nasal cavities was removed and 5 mL of Surgi shield was applied again to the intervention side on the second day after surgery. The nasal cavity was examined using a nasal endoscope and the degree of adhesion, crusting, mucosal edema, infection, and granulations were graded at 1, 2, and 4 weeks after surgery. RESULTS: Complete hemostasis was rapidly achieved in the Surgi shield applied side compared with the control side at 2, 4, 6, 8, and 10 minutes after application of Surgi shield (P#x0003d;0.007, P#x0003d;0.004, P0.05). No adverse effects were noted in the patient series. CONCLUSION: Surgi shield containing chitosan can be used safely to achieve rapid hemostasis immediately after ESS and to prevent adhesion formation.

Delayed Electrode Extrusion after Cochlear Implant Repositioning / 대한이비인후과학회지

It is well known that cochlear implant device repositioned in the posterosuperior direction will cause intracochlear electrode extrusion. We have recently repositioned a cochlear implant device due to infection and device exposure. The device repositioning was performed under C-arm assisted fluoroscopic monitoring. The exposed device was covered with a local scalp flap. During and immediately after the repositioning operation, electrodes seemed to be well positioned in place. Mapping and neural response imaging were performed 4 days after the operation, and the results were quite similar to the preoperative results. But when the same tests were performed one month after repositioning operation, we found that the number 15 and 16 electrodes were not responsive. The transorbital view also revealed a slight extrusion of the intracochlear electrode. In the present article, we discuss the possible cause of delayed electrode extrusion and its clinical implication.

A Case of Alveolar Soft Part Sarcoma in Floor of Mouth Mimicking Ranula / 대한이비인후과학회지

Alveolar soft part sarcoma (ASPS) is a rare, aggressive mesenchymal malignancy that comprises of approximately 1% of all soft tissue sarcomas. About 60 cases of ASPS arising in the head and neck have been reported, with most of them occuring in the orbit and tongue. An ASPS found in the mouth floor is extremely rare, with only one single case reported in english literature. Because of its rarity and slow growing feature, it can be misdiagnosed as a benign oral cavity mass or a vascular neoplasm. We herein report a new case of mouth floor ASPS, which mimicked a ranula in a child. In our patient of 12 year-old girl, tumor was located at the floor of mouth. She was successfully treated with surgical excision without adjuvant radiation or chemotherapy.

Gender Difference of Clinical Characteristics in Meniere's Disease / 대한평형의학회지

BACKGROUND AND OBJECTIVES: Meniere's disease (MD) is a clinical cluster of common symptoms by various causes rather than a single disease entity. Many causes such as autoimmune, allergy, vascular insufficiency have been thought to be related with Meniere's disease. We assumed that different pathologic mechanisms have contribution in each gender. With this premise, we compared clinical characteristics between male and female patients to determine if there is any difference indicating heterogeneous underlying pathology. MATERIALS AND METHODS: We reviewed medical records of 61 patients (43 female, 18 male) who were diagnosed as unilateral definite MD and underwent vestibular function test and audiologic evaluation (more than two times of pure tone audiometry during the follow-up period) from October 2005 to December 2011. RESULTS: The average duration of dizziness in females was longer than in males. In the worst ipsilateral pure tone audiometry, low frequency thresholds were lower in females than in males. Female had lesser hearing difference at all frequencies between the sides and showed more hearing fluctuation than male. There was no significant difference between male and female in the vestibular function test. CONCLUSION: These results are insufficient to suggest that the pathogenesis of MD differs between the genders. However, some differences between the genders prompt a need for future studies involving more patients.