A Novel Powered Nasal Irrigation After Endoscopic Sinus Surgery in Patients With Chronic Rhinosinusitis: A Preliminary Study / 대한이비인후과학회지

Background and Objectives@#We aimed to compare the efficacy of a novel powered irrigation system with that of the manual bottle-squeeze method for postoperative healing after endoscopic sinonasal surgery (ESS).Subjects and Method In this prospective randomized clinical trial, 29 patients were enrolled for nasal irrigation (NI) with either NOSSHA® (Womens Care Co., Ltd.) powered irrigation system (NOSSHA® group, n=14) or manual irrigation (control group, n=15). Objective findings were evaluated using the modified Lund-Kennedy scores. Subjective outcomes were assessed using the total nasal endoscopic score (TNES), total nasal symptom score (TNSS), visual analog scale (VAS), and quality of life (QOL) questionnaires in each group at baseline, and 1, 2, 4, 6, and 8 weeks after ESS. We compared the postoperative changes between both groups. @*Results@#The mean TNES of patients were significantly higher in the NOSSHA® group than in the control group (p=0.015); however, the improvement in TNES was achieved 2 weeks earlier in the NOSSHA® group. The improvement in TNES (p<0.001) and TNSS (p<0.001) was statistically significant in both groups. The improvement in QOL was statistically significant in the NOSSHA® (p<0.001) and control group (p=0.007). The improvement in the TNSS and QOL was earlier in the NOSSHA® group by 4 and 7 weeks, respectively; no early improvement occurred in the NOSSHA® group for the VAS score. @*Conclusion@#We validated the usefulness of postoperative NI using a powered device, which may be useful for patients who cannot tolerate manual NI.

Vascular Leiomyoma of the Nasal Floor: The Risk of Misdiagnosis

A Case of Saddle Nose Deformity Caused by Electrocautery of Nasal Septum / 대한이비인후과학회지

Electrocautery of nasal septum is a very common treatment of epistaxis in Otorhinolaryngology. However, serious complications of electrocautery are rare. We encountered a 52-year-old female patient who presented with nosebleeds. A definite focus of bleeding was identified by nasal endoscopy, thus electrocautery by bipolar diathermy was performed in the area of Kisselbach's plexus of nasal septum. There were no abnormal findings in the nasal septum during the three weeks of outpatient visit. However, the patient noticed a depression near the tip of her nose 12 weeks later. Saddle nose deformity after electrocautery has not yet reported in the literature. Therefore, we present this case with a brief review of literature.

Extranodal NK/T Cell Lymphoma, Nasal Type that Occurred in Patients with Atrophic Rhinitis / 대한이비인후과학회지

Extranodal NK/T cell lymphoma, nasal type, is a rare non-Hodgkin lymphoma originating in the nasal cavity or in the paranasal sinuses. Atrophic rhinitis is a debilitating chronic nasal mucosal disease of unknown etiology. However, there have not been any reports on the occurrence of nasal NK/T cell lymphoma in patients with atrophic rhinitis. We experienced a case of the extranodal NK/T cell lymphoma in the left nasal cavity, which had been misdiagnosed as atrophic rhinitis in a 39-year-old female. Thus, we report this rare case with a review of the literature.

The Feasibility of Using Automated Distortion Product Otoacoustic Emission (DPOAE) as a Screening Auditory Function Test of Workers in a Noisy Environment / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Automated DPOAE (Distortion product otoacoustic emission) was tested on workers exposed to a noisy environmnent to determine its feasibility as a screening test for noise-induced hearing loss. SUBJECTS AND METHOD: Sensitivity and specificity were analyzed for in both automated DPOAE and Pure tone audiometry conducted on 300 subjects working in a noisy environment. Of these subjects, a subgroup of 40 workers who were available for a follow-up study underwent the same experiment again a year later, and the results were compared with the first one. RESULTS: In terms of the frequency of automated DPOAE, it was noted that it showed 91% sensitivity with a 9% false negative rate. The pass rate according to the period of service indicated statistical significance, although the results of a 1 year follow-up experiment did not indicate statistical significance. CONCLUSION: The automated DPOAE seems feasible to use as a screening test when frequency and adjusted reference criteria are considered.

Histologic Change of the Septal Cartilage with the Respect to Trauma History and Age at the Trauma in Nasal Septal Deviation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The histologic difference of the traumatic nasal septal cartilage from that of non-traumatic has not been extensively studied. The aim of this study was to identify histologic difference in the nasal septal cartilage between traumatic and non-traumatic nasal septal deviation and to find its implication for surgical intervention. SUBJECTS AND METHOD: Nasal septal cartilage was obtained from 23 patients who had undergone septoplasty or septorhinoplasty for the nasal septal deviation. The septal cartilage without trauma (7 patients, Group I) and with the history of the trauma at the age under 10-15 years old (8 patients, Group II), and over 25 years old (8 patients, Group III) between May 2003 to February 2005 were included in this study. An approximately 1 x 1 cm sized piece of the septal cartilage was harvested from the site deviated the most. The histologic difference of the septal cartilage by hematoxylineosin staining under a light microscope was performed. RESULTS: The chondrocyte densities were significantly higher in the convex side than in the concave side of the septal cartilage in Group I, II, III. Especially, the increased chondrocyte ratio (convex/concave) were more evident in the septal cartilage traumatized at the age of 10 to 15 years, and the cartilage plate was thicker than the other groups (p<0.001). Also, dystrophic changes of the chondrocytes as representing the chondrocyte differentiation and chondroblast ratio (convex/concave) were significantly higher in the group II than in the other groups (p<0.005). CONCLUSION: This study demonstrated that age dependent changes in septal cartilage with nasal trauma showed distinctive histologic characteristics. We suggest that these observations will help determine surgical treatment modality for cases of nasal septal deviations with and without trauma.

A Case of Empty Sella Syndrome with Cerebrospinal Fluid Rhinorrhea / 대한이비인후과학회지

The empty sella syndrome is defined as the intrasella herniation of the chiasmal cistern resulting from a congenitally incompetent diaphragma sellae. In idiopathic or primary empty sella syndrome, sella remodelling occurs as a result of an anatomical variation in the diaphragma sella. The secondary empty sella syndrome occurs following surgery or irradiation of an intrasellar lesion. Empty sella syndrome is known to be rarely associated with Cerebrospinal fluid (CSF) rhinorrhea. We experienced a case of secondary empty sella symdrome with CSF rhinorrhea in a 56-year old female who complained of persistent rhinorrhea through the roof of the sphenoid sinus after brain surgery due to meningioma. The CSF rhinorrhea was treated successfully with transseptal trans-sphenoidal approach.

A Case of Collagen Graft for Patulous Eustachian Tube / 대한이비인후과학회지

The patulous eustachian tube is not a common otorhinolaryngological disease, for which a standard therapy is not established yet. It is considered benign, but symptoms affecting the patient should not be overlooked or ignored. Using an acellular dermal graft (Collagen), we gained positive results in treating a patient, and thus report this case with a review of the literature.