Common Bleeding Sites of Posterior Epistaxis: Nasal Endoscopic Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Typically, posterior epistaxis means that the bleeding point cannot be visualized with anterior rhinoscopy, and it is difficult to find a localized bleeding point. Although bleeding point identification is the key to efficient management, debate and uncertainty remain around the actual location and distribution of the bleeding sites in posterior epistaxis. SUBJECTS AND METHOD: This study was designed to clarify bleeding points of the posterior epistaxis using nasal endoscopy. In 121 of the total 150 (80.7%) cases, we could see the posterior nasal cavity in more detail and find the bleeding point precisely. RESULTS: The most common sites of the bleeding were the posterior portion of the inferior meatus, the posterior portion of middle meatus, and the posterior septum medial to the middle turbinate in order of frequency. A total of 113 cases, corresponding to 93.4% (113/121), showed that epistaxis could be controlled very efficiently by electrocauterization and localized small packing with the help of endoscopes. In the majority of cases, non-surgical interventions were sufficient. CONCLUSION: Bleeding could be stopped more rapidly and with less discomfort if checking the 3 most common sites early.

Effect of Fibrin Glue on Post-Tonsillectomy Pain / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Post-tonsillectomy pain is unavoidable and related to the dysphagia, dehydration and loss of time in returning to normal activities. This study was performed to investigate whether fibrin glue (Tissucol(R) Duo Quick, Baxter AG, Wien, Austria) applied to tonsillar bed after the completion of tonsillectomy reduced pain. SUBJECTS AND METHOD: Twenty-five adults scheduled for an elective tonsillectomy were included in this prospective double-blind study. After removal of both tonsils electrocauterization was done on both tonsillar bed for adequate hemostasis. And then, one side of tonsillar bed randomly selected by operating surgeon was coated with the fibrin glue and the other side was left without coating. Pain scores were measured at the first (postoperative day, POD1), third (POD3) and tenth (POD10) day of the operation by using visual analogue scale (VAS). RESULTS: The VAS scores of the side treated with fibrin glue and the non-coated side were 3.67+/-1.16/3.14+/-0.96/1.52+/-0.81 (POD1/POD3/POD10) and 5.33+/-1.28/4.19+/-1.21/1.71+/- 0.96 (POD1/POD3/POD10), respectively. The VAS score difference between both sides were 1.67+/-0.58/1.05+/-0.59/0.19+/-0.40 (POD1/PO3/POD10). CONCLUSION: This study shows that the application of fibrin glue on tonsillectomy site was effective for postoperative pain control. Moreover, the efficacy was prominent at early postoperative days known as period of severe pain.

A Case of Isolated Frontal Fungal Sinusitis with Orbital Complication / 대한이비인후과학회지

The most commonly involved sinus of fungal infections is maxillary sinus, followed by sphenoid sinus and ethmoid sinus. On the other hand, the frontal sinus is only occasionally affected. Common pathogenic organisms related to fungal sinusitis are species of Aspergillus, dematiaceous fungi or zygomycetes; however, species of candida are rarely reported. In the invasive fungal sinusitis, orbital invasion, invasion and destruction of the skull base with a fungal meningitis, and fungal osteomyelitis with complete destruction of the maxilla have all been reported. Although these occurrences can not be explained, orbital complications have been reported in the noninvasive paranasal sinus mycosis. The treatment of paranasal fungus ball is primarily by surgical removal. In the past, fungus ball of frontal sinus was approached externally; however, this has been largely replaced with the endonasal endoscopic technique. We experienced a case of frontal fungal sinusitis with orbital complication, which was successfully treated by endonasal endoscopic frontal sinusotomy. In this paper, we report this case with a review of literature.

Adenoidectomy with the Suction Electrocoagulator / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The traditional adenoidectomy using adenotome and adenoid curette could not guarantee a clear operative field due to bleeding. Also the traditional transoral adenoidectomy was not always effective in the complete removal of adenoid tissues obstructing the choana and surrounding the eustachian tube. This study was performed to evaluate the effectiveness of using the electric suction coagulator for adenoidectomy. MATERIALS AND METHOD: This study was completed by 60 patients who underwent adenoidectomy or adenoidectomy with ventilation tube insertion. For adenoidectomy, 30 cases were performed using the variable sized suction coagulator via nasal cavity and the other 30 were performed using the adenotome and adenoid curette with oral approach. The amount of intraoperative bleeding and the duration of surgery were recorded. A preoperative and a at least one-month post operative nasal endoscopic photograph and lateral skull radiograph were obtained. RESULTS: Intraoperative bleeding amount was less and less time was needed in suction coagulator method (p<0.05). There was no statistical difference in the postoperative endoscopic grade, adenoid nasopharyngeal ratio, and the shortest nasopharyngeal diameter between two groups. The postoperative improvement of subjective symptoms was not different. CONCLUSION: Adenoidectomy using transnasal suction coagulator is an effective method for complete removal of adenoid with the advantages of excellent visualization and complete hemostasis. Especially, the authors think that this method is useful for the removal of superior part of adenoid and peritubal adenoid tissue.

The Relationship between Clinical Patterns of Sinusitis and Anatomical Variation / 대한이비인후과학회지

BACKGROUND: With the advent of functional endoscopic sinus surgery, the importance of the ostiomeatal unit(OMU) has been known. Anatomic abnormalities, irreversible inflammatory changes, or obstruction of ostiomeatal unit lead to sinus ostial obstruction and subsequent chronic or recurrent sinusitis. For these reasons, septal deviation, concha bullosa and paradoxical middile turbinate may compress the uncinate process and occlude the infundibulum and then they may induce anterior paranasal sinusitis. OBJECTIVES: This study was conducted to evaluate the relationship between the existence of anatomical variations of sinonasal regions and Babbel's five patterns of chronic sinusitis based on coronal plane CT and to be helpful in treatment of chronic sinusitis. MATERIALS AND METHOD: From february 1994 to February 1996, Coronal plane CT scans of 150 patients with bilateral sinonasal disease were retrospectively reviewed. We examined anatomical variations-paradoxical middle turbinate, concha bullosa, and septal deviation-using PNS CT and analyzed the finding of PNS CT based on Babbel's five patterns of chronic sinusitis. One patient with bilateral sinonasal disease was considered as two different cases. RESULTS: In consequence of this study, the existence of anatomical variations don't show any influence on the paranasal sinusitis patterns. CONCLUSION: This study suggests that the existence of anatomical variations may not be significantly associated with respective incidence of the paranasal sinusitis patterns and may similarly influence in each patterns of chronic sinusitis.

8 cases of congenital ossicular anomalies / 대한이비인후과학회지

No abstract available.

Clinical analysis of 644 cases of chronic otitis media / 대한이비인후과학회지

No abstract available.