A Case of Schwannoma Originated from the Posterior Nasal Septum / 대한이비인후과학회지

Schwannomas are slow-growing, benign neurogenic tumors arising from the sheath of myelinated nerve fibers. They usually occur in the head and neck region. Only 4% of schwannomas found in the head and neck region originate in the sinonasal tract. Schwannoma of the nasal septum is rarer, and only few cases have been previously reported in the literature. We experienced a rare case of the schwannoma of the posterior nasal septum in a 71-year-old woman. She was treated successfully by transnasal endoscopic surgery. No recurrence was detected within 18 months follow-up period.

A Case of Metastatic Malignant Melanoma Presenting as Subcutaneous Posterior Neck Mass / 대한이비인후과학회지

Malignant melanoma can be classified as both cutaneous and mucosal types. The former comprises more than 98% of all melanomas and is related to ultraviolet exposure, whereas the latter occupies only 1.3%. More than half of mucosal melanoma arises in the head and neck region, and the sinonasal tract is also one of its predilection sites. On the other hand, the metastatic melanoma of head and neck is lower incidence than primary lesion and the unknown primary site is about two to five percent. Moreover, a lymphatic metastasis to the posterior neck is a more unusual clinical pattern. A 71-year-old man with a solitary subcutaneous posterior neck mass visited our clinic. He was confirmed with metastatic melanoma in the lymph node through excisional biopsy. However, the primary site was not found with whole radiologic examinations. We report a very rare disease entity with a brief literature review.

A Case of Schwannoma Originated from the Posterior Nasal Septum / 대한이비인후과학회지

Schwannomas are slow-growing, benign neurogenic tumors arising from the sheath of myelinated nerve fibers. They usually occur in the head and neck region. Only 4% of schwannomas found in the head and neck region originate in the sinonasal tract. Schwannoma of the nasal septum is rarer, and only few cases have been previously reported in the literature. We experienced a rare case of the schwannoma of the posterior nasal septum in a 71-year-old woman. She was treated successfully by transnasal endoscopic surgery. No recurrence was detected within 18 months follow-up period.

A Case of Metastatic Malignant Melanoma Presenting as Subcutaneous Posterior Neck Mass / 대한이비인후과학회지

Malignant melanoma can be classified as both cutaneous and mucosal types. The former comprises more than 98% of all melanomas and is related to ultraviolet exposure, whereas the latter occupies only 1.3%. More than half of mucosal melanoma arises in the head and neck region, and the sinonasal tract is also one of its predilection sites. On the other hand, the metastatic melanoma of head and neck is lower incidence than primary lesion and the unknown primary site is about two to five percent. Moreover, a lymphatic metastasis to the posterior neck is a more unusual clinical pattern. A 71-year-old man with a solitary subcutaneous posterior neck mass visited our clinic. He was confirmed with metastatic melanoma in the lymph node through excisional biopsy. However, the primary site was not found with whole radiologic examinations. We report a very rare disease entity with a brief literature review.

A Case of Parotid Abscess and Chest Wall Inflammation Induced by Giant Warthin's Tumor / 대한두경부종양학회지

Warthin's tumor (WT) is second most common neoplasm in the parotid gland and it can be accompanied by inflammation and necrosis. The chest wall inflammation may present a rapid and fatal clinical course and secondary to parotid abscess is extremely rare. An 81-year-old man came to emergency room complained of rapidly enlarged left parotid mass and inflammatory symptoms and signs around the upper lateral neck. We performed incision and drainage with adequate infection control. He was pathologically diagnosed as abscess. We report the unique and instructive clinical case with a literature review.

A Case of Multiple Posterior Cervical Ganglioneuromas in Elderly Patient / 대한두경부종양학회지

Ganglioneuroma (GN) is benign neurogenic tumor arising from ganglia of the sympathetic nervous system. They are mostly found at posterior mediastinum, retroperitoneum, and adrenal gland, whereas only 1–5% occurred in the cervical region. GN usually present as a single, painless and slow-growing mass, but multiple cervical occurrences are extremely rare. An 80-year-old woman came to our clinic complained of posterior neck mass for three years. We performed surgical excision, and it was finally diagnosed as GN. We report the unique and rare disease entity with a brief literature review.

Bilateral Hearing Loss in Wernicke Encephalopathy

Wernicke encephalopathy is a syndrome caused by thiamine deficiency whose three typical symptoms are ophthalomoplegia, ataxia, and confusion. There are also rare reports of bilateral hearing loss, which can be caused by damage to the bilateral inferior colliculus or thalamic lesions, or by energy failure of the cochlea. This case suggests that thiamine should be administered based on the possibility of Wernicke encephalopathy occurring in malnourished or alcoholic patients with sudden bilateral hearing loss.

A Case of Soft Tissue Metastasis in Contralateral Submandibular Space by Regional Recurrence of Lower Lip Cancer / 대한이비인후과학회지

The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I–III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.

A Case of Epidermal Cyst Occurred in the Bony External Auditory Canal Misdiagnosed as External Auditory Canal Carcinoma / 대한이비인후과학회지

Epidermal cysts are generally benign tumors that usually originate from the skin caused by inflammation of hair cortex and proliferation of epidermal cells within the dermis; however, for these cysts to occur in the bony external auditory canal (EAC) is rare. They are often present as a solitary, painless lesion and usually asymptomatic and the diagnosis depends on the results of the histological examination. In treatment, the cyst wall must be completely removed surgically. We recently encountered a 82-year-old male with a mass in the right EAC. An otoscopic examination showed a polypoid mass on the bony EAC, which was finally diagnosed as epidermal cyst after an initial misdiagnosis as EAC carcinoma. We report the rare, unique case with literature review.

A Case of Protrusion of False Vocal Fold Resulting from the Deformed Thyroid Cartilage

Trauma, congenital malformation and aging process can be a cause of the deviation of laryngeal prominence in the thyroid cartilage. Among these, the senility is the most common cause. Usually, ossification in the thyroid cartilage has occurred symmetrically, but the asymmetrical event leads to the shift of laryngeal prominence. Also, such deformity can provoke protrusion of false vocal fold. A 75-year-old man with hoarseness and globus sense in throat visited our clinic. Five years ago, he experienced a blunt trauma on left midline neck and had a concave deformity in the left thyroid cartilage lamina. Laryngoscopic findings revealed a marked protrusion in the left false vocal fold. We performed the laryngeal microsurgery to discriminate the tumorous condition. The pathology revealed non-pathologic mucosa. We report a unique and didactic case with a brief literature review.

A Case of Glottic Mucoepidermoid Carcinoma Presenting as Submucosal Mass / 대한이비인후과학회지

Mucoepidermoid carcinoma (MEC) is the most common malignant tumor originated from salivary gland. However, it rarely occurs in the larynx, which is approximately less than 0.35% of all laryngeal neoplasm. In the literature, the laryngeal MEC often appears as submucosal mass with intact mucosa. As a result, most patients are diagnosed in the advanced stage due to difficulty of early detection. There is no standard treatment option because of the rarity of the disease and the prognosis varies by histological features. We recently encountered a 85-yearold male with progressive hoarseness, and he was finally diagnosed as high grade glottic MEC. We report this rare and unique case with a literature review.

A Case of Unusual Type of Branchial Cleft Cyst Presenting as Superficial Midline Neck Mass / 대한이비인후과학회지

The most widely accepted hypothesis about the origin of branchial cleft cysts (BCC) is developmental theory. The second most accepted is acquired inflammatory theory. A 57-year-old woman visited our department, presenting with a soft and well-margined round superficial mass in the lower midline neck. We performed an excisional biopsy to confirm the disease. The mass was located superficial to the sternohyoid without severe adhesion and abnormal communication. The pathology was proven to be BCC. We presumed that this is irrelevant to the established developmental theory, and a recurrent pharyngeal inflammation might lead to the transformation of aberrant epithelium into a cervical lymph node. We report rare and unusual type of BCC with a literature review. To the best of our knowledge, there have been two similar clinical cases that have been reported earlier.

Comparison of the Effects of Middle Ear Implants and Conventional Hearing Aids on Cognitive Function / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The association between hearing impairment and cognitive function has been established in previous studies. The aim of this study was to compare the effects of conventional hearing aids and middle ear implants on cognitive function. SUBJECTS AND METHOD: This study included 22 participants who underwent middle ear implantation between October 2013 and September 2016. Their mean age at surgery was 70 years. Using Pure tone audiometry (PTA), the Speech discrimination test (SDT), and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, we compared audiologic benefits of three conditions [without hearing aids, with conventional hearing aids, or with Vibrant Sound bridge (VSB)]. Cognitive ability was evaluated using neuropsychological testings (Seoul Neuropsychological Screening Battery) at intervals of approximately eight weeks. RESULTS: The results of PTA showed a 7.96 dB HL gain with conventional hearing aids and a 10.00 dB HL gain with the use of VSB. SDT results showed a 4.10% gain with conventional hearing aids and a 10% gain with the use of VSB. Results of the APHAB questionnaire showed a significant increase with the use of VSB compared to conventional hearing aids. In the Korean Mini-Mental State Examination, a slight improvement was observed after middle ear implantation. In the Digit Span Test and Korean-Boston Naming Test, a significant improvement was seen with the use of VSB compared to conventional hearing aids. CONCLUSION: The use of middle ear implants in rehabilitation of hearing communication in patients showed improvements in cognitive abilities, compared to the use of conventional hearing aids.

Isolated Trochlear Palsy Due to Pilocytic Astrocytoma Involving the Pineal Gland

No abstract available.

Cerebral Paragonimiasis Presenting as Recurrent Hemorrhagic Stroke without Pulmonary Symptoms

No abstract available.

A Case of Embolic Cerebral Infarction Following Disulfiram Poisoning

A 29 year old man without any noticeable past or familial history presented with left ACA and MCA territorial hemorrhagic infarction after consuming an overdose of disulfiram in a drunken state. This hemorrhagic infarction was thought to be caused by cardiac embolism, which developed following cardiac arrhythmia and cardiac injury induced by O form acceptor reductase associated with disulfiram poisoning. (J Korean Neurol Assoc 19(3):294~297, 2001)

Diagnostic Sensitivity of Several Muscles in Repetitive Nerve Stimulation Test for Myasthenia Gravis / 영남의대학술지

BACKGROUND: This study was undertaken to evaluate the diagnostic sensitivity of several muscles in repetitive nerve stimulation test (RNST) for myasthenia gravis (MG) patients. MATERIALS AND METHODS: The study population consisted of 39 MG patients classified by modified Ossermann's classification. Using Stalberg's method, RNST was systematically performed in facial (orbicularis oculi and nasalis) and upper extremity (flexor carpi ulnaris, abductor digiti quinti and anconeus) muscles. RESULTS: The significant electrodecremental response of RNST were noted in orbicularis oculi (58.9%), nasalis (51.3%), flexor carpi ulnaris (42%), anconeus (41%) and abductor digiti quinti muscles (27%). Among the 3 muscles of upper extremity (abductor digiti quinti, flexor carpi ulnaris and anconeus), the positive electrodecremental response of anconeus muscles was significantly higher than other two muscles (p<0.05) in type IIa, IIb and there were no statistical differences of the positive electrodecremental response between orbicularis oculi and nasalis muscles. The facial muscles showed more prominent decremental responses than upper extremity muscles in type I MG(p<0.05). In type IIa MG patients, there were no significant statistical differences between facial and upper extremity muscles but significant statistical differences among upper extremity muscles. In type IIb MG patients, there were no significant statistical differences in all tested muscles in spite of the increased positive electrodecremental response of RNST. CONCLUSION: On the basis of this study, RNST would be initially performed for the orbicularis or nasalis in type I MG and for the anconeus in type IIa or IIb MG.

A case of primary antiphospholipid antibody syndrome showing vegetation on the mitral valve through echocardiography / 영남의대학술지

Antiphospholipid antibody syndrome(APS) is a well-known clinical syndrome characterized by recurrent arterial or venous thromboses, recurrent fetal loss, thrombocytopenia, together with high titers of sustained anticardiolipin antibody(aCL) or lupus anticoagulant(LA). Although systemic lupus erythematosus(SLE) and APS may coexist, a high proportion of patients manifesting the APS do not suffer from classical lupus or other connective tissue disease. The patient has been defined as having a primary antiphospholipid antibody syndrome. We experienced one case of primary APS with recurrent fetal loss, recurrent cerebral infarctions, positive anticardiolipin antibody IgG and fluttering vegetation on the mitral valve, without other connective tissue diseases including SLE. Forty-three old female had 2 out of 11 criteria for the diagnosis of SLE, such as thrombocytopenia and positive antinuclear antibody, but did not meet whole criteria. The patient was treated with ticlopidine, and anticoagulant therapy was recommended.