A Case of Extranasopharyngeal Angiofibroma of the Inferior Turbinate / 대한이비인후과학회지

Juvenile nasopharyngeal angiofibroma is a well-documented tumor occurring almost exclusively in adolescent boys. However, enough cases have now been reported in the age range of 1 to 60 years. Although angiofibromas extend beyond the nasopharynx commonly, they rarely originate outside the nasopharynx. Reports of primary extranasopharyngeal angiofibromas have appeared sporadically in the literature. The inferior turbinate is a very rare site of extranasopharyngeal angiofibroma, with only three cases reported in the medical literature. We present an unusual case of an angiofibroma arising from the inferior turbinate. The tumor occurred in a 57-year-old man and was excised by endoscopic dissection. Histopathology confirmed it to be a case of angiofibroma. The likely theory of the origin of the tumor and the management is also discussed.

A Case of Masson's Hemangioma of the Buccal Mucosa / 대한이비인후과학회지

Masson's hemangioma, which is also called intravascular papillary endothelial hyperplasia (IPEH), is a benign, vascular lesion that is characterized histologically by papillary fronds lined by proliferating endothelium. It is thought to represent an unusual form of organizing thrombus. It may deveolop in a distended vessel or in association with other vascular lesions. The main singnificance of Masson's hemangioma is its microscopic resemblance to angiosarcoma and possible misinterpretation as such. We report the case of a 42-year-old woman who had such a lesion in the left buccal mucosa and discuss the management of this lesion, with an emphasis on radiologic and histologic assessment and the differential diagnosis.

Treatment of Acute Mastoiditis with Subperiosteal Abscess;Is the Mastoidectomy Necessary? / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Subperiosteal abscess, the most common complication of acute mastoiditis, has traditionally been treated with mastoidectomy. We aimed in this study to investigate the effectiveness of mastoidectomy in the management of acute mastoiditis with subperiosteal abscess. SUBJECTS AND METHOD: We reviewed restrospectively the charts of 19 patients who had been admitted to our hospitals with acute mastoiditis complicated with subperiosteal abscess during the years 1994-2004. RESULTS: All patients received intravenous antibiotics. While the mastoidectomy with ventilation tube insertion was done in 13 cases, 5 cases received incision and drainage of the abscess with ventilation tube insertion. In one patient who developed a subperiosteal abscess after the resolution of acute mastoiditis, only incision and drainage of the abscess was done. All cases showed complete recovery. CONCLUSION: Incision and drainage of the abscess accompanied by application of intravenous anti-biotics and ventilation tube would be an appropriate treatment for acute mastoiditis with subperiosteal abscess instead of routine mastoidectomy. or in cases with no evidence of facial nerve palsy, cholesteatoma and intracranial complications such as meningitis, cerebral abscess and sigmoid sinus thrombophlebitis etc.

Effect of Rofecoxib on Pain and Hemorrhage after Tonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nonsteroidal anti-inflammatory durgs (NSAIDs) are now widely accepted analgesics for posttonsillectomy patients, but their ability to inhibit platelet cyclooxygenase (COX) may be associated with a risk of increased bleeding after tonsillectomy. Rofecoxib, the recently introduced selective COX-2 inhibitor, may have advantages for analgesics in tonsillectomy in that they produce minimal effects on platelet aggregation. But the analgesic efficacy of rofecoxib in tonsillectomy has not been made known yet. The aim of our randomized prospective study was to compare the analgesic efficacy of rofecoxib, the selective COX-2 inhibitor, and ibuprofen, the classic NSAID, for the posttonsillectomy pain management. We also evaluated the influence of both drugs on the posttonsillectomy bleeding. SUBJECTS AND METHOD: Thirty-eight adult patients undergoing tonsillectomy were randomly divided into either ibuprofen or rofecoxib group. Patients received either oral ibuprofen (600 mg, three times a day) or oral rofecoxib (25 mg, twice a day). Patients recorded pain levels twice daily for 7 days using a visual analogue scale. Posttonsillectomy hemorrhage was recorded in each groups. RESULTS: Pain scores for the 7 days were not significantly different between two groups, but the rofecoxib group reported less pain. Rofecoxib group felt more satisfactorily about early control of postoperative pain. There was no significant difference in the incidence of postoperative hemorrhage between two groups. CONCLUSION: Rofecoxib is as effective as ibuprofen for postoperative pain control in adult tonsillectomy, which might be beneficial for avoiding the adverse effects of NSAIDs.

The Determination of Thyroid Dimension by Routine Neck Computed Tomography and Its Relationship to Age, Sex, and Body Size in Korean Adults / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to establish a "normal" range of dimensions of the thyroid glands on routine neck computed tomography in the Korean population. Also, this study investigated the possible influence of some physical factors. MATERIALS AND METHOD: Neck computed tomography scans of 100 adults were reviewed retrospectively to measure the size of the thyroid gland and to evaluate its relationship to the trachea and cervical vertebra. The width, thickness, and length of each thyroid lobes, as well as the estimated volume of the thyroid gland were measured. The cross-sectional areas of the trachea and cervical vertebra were utilized as two parameters of standard in measuring the size of thyroid glands according to different body size. RESULTS: The mean widths were 15.7 mm (right) and 15.2 mm (left). The mean thicknesses were 20.9 mm (right) and 18.9 mm (left). The mean lengths were 61.8 mm (right) and 58.5 mm (left). The mean estimated volumes of each lobe were 8.8 cm3 (right) and 7.6 cm3 (left). The mean volume of total thyroid glands (including isthmus) was 17.5 cm3. There was no significant difference between the total study group and normal thyroid function group. The dimensions of right lobe was significantly larger that of the left. There was no significant difference between males and females. The results of the multiple regression analysis supported the likelihood that the influence of the body weight was most pronounced. CONCLUSION: Our study presents initial data for assessing the thyroid gland on neck computed tomography scans in Koreans, providing the limit values of normal thyroid glands.

The Expression of Bcl-xL and Bax in Nasal Polyps / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The etiology and the pathophysiology of nasal polyps are still not definitely known and recently, it is suggested that inflammatory responses involving eosinophils may play a major role. The process of the infiltration of eosinophils in tissues is explained by the increase of the movement of eosinophils to the inflammatory area and the delay of apoptosis which results in the longer survival of eosinophils. Recently, there have been studies showing how eosinophils extracted from blood expressed their anti-apoptotic Bcl-xL genes and pro-apoptotic Bax genes when put in a delayed apoptotic condition. The purpose of this study is to investigate Bcl-xL and Bax expressions of eosinophils in nasal polyps and how allergic rhinitis affect their expressions. MATERIALS AND METHOD: Nasal polyps were obtained from patients with chronic paranasal sinusitis (30 cases) and nasal polyps were divided into two groups, one obtained from the patient with allergic rhinitis (15 cases) and the other obtained from the patient without allergic rhinitis (15 cases). The normal control group consisted of 5 cases of normal nasal mucosa in the inferior turbinate. The immunohistochemical stain was used to detect eosinophils and the cells expressing Bcl-xL and Bax. RESULTS: In nasal polyps, a significant statistical correlation between eosinophil numbers and Bcl-xL positive cell numbers was detected. But there was no correlation between them in the normal control. The Bax positive cell numbers had a correlation to eosinophil numbers in both the normal control and nasal polyps. And allergic rhinitis did not affect the expression of Bcl-xL and Bax of eosinophils in nasal polyps. CONCLUSION: The authors propose that in eosinophils of nasal polyps, Bcl-xL plays an important role in delayed apoptosis and allergic rhinitis has no effect on the expression of Bcl-xL and Bax.

Expression of E-Cadherin and beta-Catenin in Human Squamous Cell Carcinoma of the Tongue / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has been suggested that inactivation of the cadherin-mediated cell to cell adhesion system plays a role in the initial steps of cancer invasion and metastasis. We investigated the relationship between the expressions of E-cadherin and beta-catenin to the clinicopathologic findings in squamous cell carcinoma of the tongue. MATERIALS AND METHOD: The expression of the E-cadherin and beta-catenin was examined immunohistochemically in 39 squamous cell carcinomas of the tongue and 5 cases of normal tissue. RESULTS: The expression of the E-cadherin and beta-catenin was reduced or absent in 15/39 (39%), 20/39 (51%) cases of the tumors examined, respectively. The reduced expression of the E-cadherin was associated with decreased histologic differentiation (p=0.001) and lymph node metastasis (p=0.006) and the reduced expression of the beta-catenin with decreased histologic differentiation (p=0.001). There were significant correlation between E-cadherin and beta-catenin expression (p=0.001). CONCLUSION: The present study demonstrates a significant down-regulation of E-cadherin, and that the beta-catenin expression in squamous cell carcinoma of the tongue is specifically associated with decreased histologic differentiation and lymph node metastasis. These results suggest that E-cadherin and beta-catenin may be useful markers of lymph node metastatic potential and valuable prognostic markers in the early stage of the disease.

A Case of Extraskeletal Chondroma of External Auditory Canal / 대한이비인후과학회지

Chondroma is a relatively common tumor that occurs in any areas of the body and is characterized by the formation of abundant hyaline cartilage. However, benign extraosseous cartilaginous lesions are uncommon and extraskeletal chondroma of the bony external auditory canal (EAC) is extremely rare. We recently experienced a case of extraskeletal chondroma of the bony EAC in a young female who was treated with simple excision. This case is reported along with a brief review of the literature.