Impacts of Recurrent Tonsillitis on the Outcome of Powered Intracapsular Tonsillectomy in Children

Background and Objectives@#To investigate the effects of recurrent tonsillitis on postoperative outcomes after powered intracapsular tonsillectomy and adenoidectomy (PITA) in children with obstructive sleep-disordered breathing (oSDB). @*Materials and Methods@#Children who underwent PITA in Kyung Hee University Hospital at Gangdong from 2016 to 2018 were classified into two oSDB groups according to comorbid chronic/recurrent acute tonsillitis (CHT). To evaluate the efficacy of the PITA technique, quality of life (QoL) was measured using the obstructive sleep apnea questionnaire (OSA-18) for 3 months after surgery. To evaluate the disadvantages of the PITA technique, we followed complications such as throat pain, otalgia, nausea, vomiting, and postoperative bleeding for 1 week after surgery. Finally, we compared the pre- and postoperative QoL and analyzed the incidence of postoperative complications in the oSDB with CHT (SDBwCHT) and oSDB without CHT (SDBsCHT) groups. @*Results@#Of the 802 enrolled patients, 135 were classified as SDBwCHT and 667 as SDBsCHT. Both groups exhibited marked improvements in QoL after PITA. The SDBwCHT group showed a change of OSA-18 score from 70.7±17.0 to 31.2±11.4. The SDBsCHT group showed a change of OSA-18 score from 70.0±17.1 to 31.0±9.9. The groups did not demonstrate statistical differences in complication rates and severity of symptoms during the first postoperative week. @*Conclusion@#Although comorbid CHT delayed improvement in postoperative symptoms, PITA is a useful technique to treat children with oSDB, regardless of CHT.

Association Between High Neutrophil to Lymphocyte Ratio and Delayed Recovery From Bell's Palsy

OBJECTIVES: Factors predictive of the severity of and recovery from Bell's palsy remain unclear. This study evaluated the association between neutrophil to lymphocyte ratio (NLR) and the severity of and recovery from Bell's palsy. METHODS: This retrospective study included 51 patients who were hospitalized with Bell's palsy from 2015 to 2017. Degree of paralysis was assessed by House-Brackmann (H-B) grade. Patients with H-B grades 2–4 were classified as having mild to moderate palsy and patients with H-B grade 5 or 6 were classified as having severe palsy. Patients were evaluated for obesity, hypertension and diabetes mellitus, and blood tests were performed to determine NLR and platelet to lymphocyte ratio. Patients were treated with steroids and antiviral agents. H-B grade was assessed 1 week, 1 month, and 3 months after treatment. RESULTS: NLR was significantly higher in patients with severe than with mild to moderate palsy (P=0.048). Recovery time was significantly longer in patients with high NLR than low NLR (P=0.045). CONCLUSION: Higher NLR in patients with Bell's palsy was associated with longer recovery time. NLR may be prognostic of recovery time in patients with Bell's palsy.

Difference according to Interpretation Methods in Allergic Skin Test

BACKGROUND AND OBJECTIVES: The skin prick test is a widely used test that uses three methods (allergen/histamine ratio method, erythema size method, and wheal size method) to interpret the results. However, there has been no comparison of these methods. The aim of this study is to compare the three different interpretation methods and define the relationship among them. SUBJECTS AND METHOD: A total of 139 patients who visited our allergy clinic complaining of nasal symptoms were enrolled. Three interpretation methods were used for defining positivity in the skin prick test, and their results were compared. The validity of each interpretation method was evaluated by total nasal symptom score. RESULTS: Positivity in the skin prick test was reported in 48.2% of patients according to the allergen/histamine ratio method and in 64.0% of patients according to the wheal size method and erythema size method. The proportion of subjects who showed a negative result with the allergen/histamine ratio method but positive results with the wheal size method or erythema size method was 15.8%. This group had a significantly higher total nasal symptom score, especially rhinorrhea and nasal obstruction, than subjects who showed negative results on all three methods. CONCLUSION: When diagnosing allergic rhinitis patients using the skin prick test, the wheal size method and erythema size method should be considered rather than the allergen/histamine ratio method.

Intravascular Papillary Endothelial Hyperplasia of the Nasopharynx: A Case Report and Review of the Literature / 대한이비인후과학회지

Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign proliferation of intravascular endothelial cells. However, IPEH can be easily mistaken for an angiosarcoma, thus differential diagnosis is very important to avoid over-treatment. We report the case of a 22-year-old man who presented with small lobulating mass in nasopharynx. Computed tomography showed about 4 cm homogenous mass in the nasopharynx without extension into soft tissues. Complete surgical excision was done and biopsy during operation showed distended vessels and numerous papillae consist of endothelial cells lining a hyaline core. At follow up, no other complications were observed. Thus we present the case and a review of the literature.