Membrane-Specific Expression of Functional Purinergic Receptors in Normal Human Nasal Epithelial Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Extracellular purines and pyrimidines regulate various physiological responses via cell surface receptors known as purinoreceptors, and may exert autocrine or paracrine effects on ion transport, fluid transport, ciliary beat frequency and mucin secretion. This study aims to investigate the expression patterns of such purinoreceptors found in normal human nasal epithelial (NHNE) cells. MATERIALS AND METHOD: In RT-PCR, the mRNAs for several P2X (P2X3, P2X4, P2X7) and P2Y (P2Y1, P2Y2, P2Y4, P2Y6, P2Y11, P2Y12) receptors were identified in NHNE cells. Functional localizations of P2 receptors were investigated by measuring [Ca2+]i increases in a membrane-specific manner using a double-perfusion chamber. Absence of the responses of -Me ATP and 2MeS-ATP excluded functionally active P2X3, P2X4, and P2Y1 receptors as far as [Ca2+]i increase was concerned. RESULTS: Applications with ATP and UTP revealed that luminal membranes of NHNE cells express P2Y2 and P2Y6 receptors and basolateral membranes P2Y2 receptors. Expressions of P2Y2 and P2Y6 receptors in NHNE cells were further verified by the immunoblotting using specific antibodies. In addition, the results with BzATP indicated that the P2Y11 receptor may be present on the luminal side. CONCLUSION: The NHNE cells express functionally active P2Y2, P2Y6 and P2Y11 receptors in a membrane-specific pattern, which may play an important role in the control of mucin and fluid secretion in NHNE cells.

A Case of Isolated Neurofibroma Arising from the Epiglottis / 대한이비인후과학회지

Neurofibroma in the larynx is unusual and associated with von Recklinghausen's disease. A case of solitary endolaryngeal neurofibroma was first reported by Suchanek in 1925. Following the first report, there have been sporadic reports of solitary endolaryngeal neurofibroma. The aryepiglottic folds are the usual sites of occurrence for laryngeal neurofibroma, because the branch of the superior laryngeal nerve is involved. Rarely, a vocal cord is also concerned. We present here a case of neurofibroma in a 35 year-old male who complained of snoring, throat discomfort and hoarseness, all of which persisted for 5 months. This neurofibroma arose from the lingual surface of the epiglottis, thus making intubation difficult. We removed this tumor completely by transoral approach under the retrograde wire-guided endotracheal intubation. No evidence of recurrence was found for about two years. The solitary neurofibroma arising from the epiglottis has not been reported yet. So we present the first case of solitary neurofibroma of the epiglottis.

A Case of Osteoblastoma Arising from the Ethmoid Sinus / 대한이비인후과학회지

Osteoblastoma is a benign bone tumor which commonly occurs in the vertebral column and the long bone of extremities, although the paranasal sinus involvement is very rare. We are reporting a case of benign osteoblastoma of the ethmoid sinus extending maxillary sinus and nasal cavity in a 66-year-old man who presented with progressive exophthalmos and intractable epiphora. The tumor was successfully removed via extended medial maxillectomy through lateral rhinotomy approach. Histologic features showed the central zone of edematous vascular fibrous tissue with scattered trabeculae of osteoid surrounded by the outer layer of dense mature bone. A differential diagnosis is necessary for various kinds of fibro-osseous lesions such as osteoid osteoma, ossifying fibroma and fibrous dysplasia.

Surgical anatomy of natural ostium of the sphenoid sinus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is important for surgeons to identify the location of natural ostium of the sphenoid sinus during sphenoidotomy for sphenoiditis and transsphenoidal approach (TSA). But, it is not easy for a beginner to find it. This study aimed to investigate from a clinical aspect the location of natural ostium of the sphenoid sinus using korean adult cadaveric heads. Material and methods : One hundred sagittally-divided adult cadaveric heads were used. After removing the mucosa of anterior wall meticulously, they were carefully examined and documented serially by photography. The items analyzed were the distance from and the degree of nasal sill and limen nasi to the natural ostium of sphenoid sinus, and the distance from the posteroinferior end of the superior turbinate and the skull base to the natural ostium of the sphenoid sinus. In addition, we tried to investigate whether the natural ostium opens into the medial or lateral to the posterior end of the superior turbinate. RESULT: The natural ostium of the sphenoid sinus was located at 34.3 3.8o and 62.7 9.0 mm away from the nasal sill, and at 35.9 3.8o and 56.5 3.2 mm away from the limen nasi. It was located approximately in the middle of the anterior wall of the sphenoid sinus and medially to the posterior end of the superior turbinate in about 83%. CONCLUSION: By identifying the posteroinferior end of the superior turbinate, the location of natural ostium of the sphenoid sinus can be identified. We recommend that surgeons should look for the natural ostium in the middle of the anterior wall of the sphenoid sinus and medial to the posterior end of the superior turbinate.

Expression and regulation of MUC8 & MUC5AC by various cytokines in normal human nasal epithelial cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sinusitis is one of the most commonly reported diseases in the world. A network of inflammatory mediators is known to be involved in the pathogenesis of chronic sinusitis and nasal mucus secretion may also be under the control of an inflammatory mediator network. To date, 12 human mucin genes have been identified; however, the regulation of MUC8 has not yet been found out. In this study, we described the regulation of the MUC8 mRNA expression by inflammatory mediators and investigated its cellular location. MATERIALS AND METHOD: MUC8 mRNA and MUC5AC mRNA were detected in culture using passage-2 normal human nasal epithelial (NHNE) cells after the treatment with a mixture of following inflammatory mediators; TNF-alpha, IL-1beta, LPS, IL-4, PAF. The translocation of MUC8 mRNA from the nucleus to the cytoplasm was investigated by treating the inflammatory mediators with in situ hybridization. RESULTS: We found that a mixture of inflammatory mediators increased the MUC8 mRNA expression but decreased the MUC5AC mRNA expression in cultured normal human nasal epithelial cells. Among the inflammatory mediators, Interleukin-4 was responsible for the decrease in the MUC5AC mRNA expression and the MUC5AC mucin secretion. We also found that MUC8 mRNA resides in the nucleus of goblet cells and is transported into the cytoplasm following the treatment with inflammatory mediators. CONCLUSION: These results indicate that MUC8 may play an important role in the pathogenesis of mucus hypersecretion in chronic sinusitis.

Transoral Endoscopic Adenoidectomy with the Microdebrider / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Surgeons have tried various methods of adenoidectomy from the conventional transoral ad- enoidectomy using curettes or adenotomes to the newly developed transnasal endoscopic adenoidectomy using microdebriders. However, surgeons still face a great difficulty in achieving complete adenoidectomy due to the unfavorable anatomic structure and a narrow operating field. This study aims to introduce and try to establish a better way of performing transoral endoscopic adenoidectomy using microdebriders. MATERIALS AND METHODS: Thirty patients who underwent transoral endoscopic adenoidectomy using rnicrodebriders were prospectively randomized. Skull lateral radiographs and endoscopic photographs were obtained to analyze the surgical outcome of transoral endoscopic adenoidectomy using a microdebrider. RESULTS: There were no specific postoperative complications such as hemorrhage or infection. Nasal obstruction disappeared within 7 postoperative days, and mouth breathing and snoring were simultaneously improved. CONCLUSION: Transoral endoscopic adenoidectomy using a microdebrider can be considered as one of the most effective methods for more complete adenoidectomy to relieve nasal obstruction and to reduce mouth breathing and snoring.

Mucin and Lysozyme Expression in the Epithelium of Normal Human Nasal Inferior Turbinate and Polyps / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In chronic bronchitis, rhinitis or cystic fibrosis, the number of goblet cells increases along with hypertrophy of mucous cells in submucosal gland, resulting ineffective mucociliary clearance. But, it is still not fully understood what role each gene plays in producing airway secretions. This study aimed to figure out which mucin gene is expressed in the epithelium of normal human nasal mucosa and nasal polyps, and to verify whether the epithelium of nasal polyp itself contributes to the increased nasal secretion as in chronic sinusitis with nasal polyp. MATERIALS AND METHODS: Normal nasal epithelial cells were obt assay. And, RT-PCR was used for the detection of mucin mRNA and lysozyme mRNA. RESULTS: The level of intracellular mucin was 2.9 times higher in the epithelium of nasal polyp, and this was statistically significant. Among seven mucin genes (MUC1, 2, 4, 5AC, 5B, 7, 8) expressed in the epithelium of normal inferior turbinate and polyps, MUC2 and MUC8 were more strongly expressed in the epithelium of nasal polyp than those of normal inferior turbinate. CONCLUSION: This results suggest that the polyp epithelium itself is contributing to increased secretion in chronic sinusitis, and MUC2 and MUC8 are thought tbe responsible for this change. However, further study is required to uncover the full sequence of MUC8 mRNA and its exact function.

Expression of Glucocorticoid Receptor in Nasal Polyps and Nasal Mucosa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Glucocorticoids are currently the most potent medication available for the treatment of nasal polyposis and allergic rhinitis, but exact mechanisms and cellular targets in the nasal mucosa are uncertain. Multifactorial effects of glucocorticoid are initiated by their binding to a specific cytoplasmic glucocorticoid receptor (GR). We performed this study to investigate the localization and distribution ot' human 4R and GR j3 isoform in nasal mucosa and to examine the influence of allergy and eosinophilic infiltration on GR and GR betaisoform expression in nasal polyps. MATERIALS AND METHODS: Nasal polyps (NP), middle turbinate mucosa (MT) and inferior turbinate (IT) mucosa were taken from 40 patients with chronic sinusitis and nasal polyps. We examined to have concomitant allergic rhinitis. Specimens were stained to quantify eosinophils and immunohistochemically stained to quantify GR and GR beta isaform in the unit area of tissues. RESULTS: Immunostaining of GR and GR betaisoform was predominantly localized in epithelial cell and infiltrating inflammatory cell in subepithelial layer, with lesser amounts in the endothelial cells and in the cells surrounding glands. Immunostaining of GR was mostly co-expressed with GR beta isoform. No correlation was found between Gk and GR beta isoform expression in subepithelial layer and the intensity of eosinophilic inflammation and allergy in NP. There was no significant differences in GR and GR beta isoform expression between NP, MT, and IT. CONCLUSION: Epithelial cells may be an important site of action for intranasal steroids, and the increased number of eosinophils infiltrating the mucosa and allergy did not amplify the number of immunostaining of GK and GR beta isoform.

A Case of Congenital Absence of the Epiglottis in an Adult / 대한이비인후과학회지

Congenital absence of the epiglottis is a rare anomaly of the larynx. We present a case in a young female adult who was identified incidentally as the first case of congenital absence of the epiglottiscase found in an adult. In her history, she had suffered from frequent upper respiratory infections and muffled voice. She had a herniated lumbar nucleus pulposus, and was scheduled to undergo a laminectomy. While inducing general anesthesia on the patient, the anesthesiologists had a great deal of difficulty in intubation of the endotracheal tube by routine procedure and consulted the department of ENT. The absence of the epiglottis was observed as a result of ENT consultation when examining the patient through a fiberoptic endoscope. fiberoptic laryngoscope and neck lateral plain X-ray. Using a fiberoptic laryngoscope and a neck lateral plain X-ray, v,e confirmed a congenital absence of the epiglottis, hypertrophy of aryepiglottic fold and arytenoid region, elongated larynx, a large false vocal cord.

Effect of Hot Steam Inhalation on Microcirculation of Nasal Mucosa

BACKGROUND AND OBJECTIVES: Nasal inhalation of hot humidified air may alleviate nasal symptoms associated with rhinologic disease. Thus, hot steam inhalation is often recommended as a home remedy for various nasal disorders such as the common cold and allergic rhinitis. But the mechanism of its effect is not fully known and correct guidelines for implementing hot steam inhalation have not been settled. We studied microcirculation of nasal mucosa using the nasal Laser Doppler Flowmetry (LDF) in ten healthy subjects in order to evaluate normal physiologic reactions to hot steam. MATERIALS AND METHODS: 10 healthy volunteers inhaled hot steam (about 42degrees C) 10 times, 20 times, 30 times, 50 times and 100 times respectively. Nasal LDF was then performed using a Peiflux 4001 (Perimed, Jartalla, Sweden) and the microcirculatory parameters perfusion, velocity, and concentration were each recorded at base line immediately, 15 minutes, 30 minutes, 60 minutes, 90 minutes and 120 minutes after hot steam inhalation. RESULT: Microcirculatory perfusion was highest at 15 minutes after hot steam inhalation regardless of how many times inhalation occurred. It was found that at 15 minutes, there was a significant increase of microcirculatory perfusion in subjects inhaling 50 times and 100 times (p<0.05). But, at 120 minutes, significant increase of microcirculatory perfusion was only seen in subjects inhaling 100 times (p<0.05). CONCLUSION: After inhalation of hot steam, an increased microcirculatory perfusion of nasal mucosa was registered. Up to inhaling of 100 times, it leads to effective increasement of microcirculation of nasal mucosa.

A Case of Hereditary Hemorrhagic Telangiectasia: Surgical Treatment with Modified Septodermoplasty / 대한이비인후과학회지

Hereditary hemorrhagic telangiectasia (HTT) or Rendu-Osler-Weber disease, identified nearly a century ago, is a familiar syndrome inherited by an autosomal dominant mode. It is characterized by recurrent epistaxis with multiple telangiectatic lesions on the mucosa and skin, basically capable of involving blood vessels in any part of the body. HTT is an important disease for otolaryngologists to familiarize with, because 90 percent of patients who experience epistaxis are referred to the department of otorhinolaryngology for its evaluation and treatment. Its occurence is not unusual in the western countries, but relatively rare in many Asian countries. We report a recent case of a 64-year-old male patient who had been suffering from GI bleeding, and experiencing recurrent epistaxsis for more than 30 years. His epistaxis was successfully treated with modified septodermoplasty.

Effect of Retinoic Acid on the Differentiation and Lysozyme Expression in Human Airway Epithelial Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Retinoic acid (RA)-deprived cultures of normal human tracheobronchial epithelial (NHTBE) cells became squamous metaplastic, failed to produce mucin and instead secreted or released large amounts of lysozyme (LZ). The purpose of this study was to elucidate the relationship between RA-deficiency induced squamous metaplasia and increased LZ as a function of time. MATERIALS AND METHOD:The change of lysozyme protein and lysozyme mRNA was investigated over time in cultures using passage-2 normal human tracheobronchial epithelial (NHTBE) cells and passage-2 normal human keratinocytes (NHK). The amount of lysozyme and mucin was measured with dot blot, message of lysozyme with RT-PCR, and cornifin mRNA with Northern blot. RESULTS: Lysozyme message levels were consistently higher in RA-sufficient than RA-deficient cultures. Intracellular and extracellular LZ increased to a peak on the day 16 and thereafter decreased in the RA-deficient cultures. LZ gene expression in the RA-deficient cultures was barely detectable on the day 7 but was clearly expressed between days 10 and 14, but thereafter message levels decreased markedly. On day 12, large numbers of cells began to exfoliate in the RA-deficient cultures. Extracellular LZ appeared simultaneously at the apical surface, presumably released from the exfoliated cells, which contained high concentrations of LZ. Intracellular LZ levels were more than 11 fold less in NHK cells compared to NHTBE cells. CONCLUSION: This study suggests that cellular accumulation of lysozyme protein is a unique feature of metaplastic squamous differentiation. Further studies are needed to find out what mechanisms are involved.

Comparison of Mucin and Lysozyme Expression between Human in vivo Nasal Epithelial Cells and Cultured Nasal Epithelial Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare the expression of mucin and lysozyme in passage-2 normal human nasal epithelial (NHNE) cells with those in human in vivo nasal epithelium and human tracheal RNA. MATERIALS AND METHODS: Cell lysates and total RNA from passage-2 NHNE cells, and human in vivo nasal epithelial cells were obtained. The amount of mucin and lysozyme protein was measured by immunoblotting. and qualitative RT-PCR was done to investigate the expression of mucin mRNAs and lysozyme mRNA. RESULTS: Passage-2 NHNE cells contained 16% of mucin and 76% of lysozyme when compared to the amount of intracellular mucin and lysozyme of normal in vivo nasal epithelial cells. MUC4, MUC5AC, MUC7, MUC8 and lysozyme mRNAs were expressed in passage-2 NHNE cells. However, MUC2 and MUC5B mRNAs were not expressed. CONCLUSION: Passage-2 NHNE cells contain enough amount of mucin and lysozyme protein and express most mRNAs of secretory genes which are known to be expressed in the human airway. Thus, we find passage-2 NHNE cells to be suitable for conducting studies on secretions in the human upper airway.

Treatment Outcomes of Olfactory Neuroblastoma: A Report of 5 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Several strategies have been reported for the treatment of olfactory neuroblastoma such as radiation therapy, chemotherapy, craniofacial resection, or their combination. However, a consensus regarding the optimal management has not been obtained. In this study, we examined the outcomes of different treatment modalities in five patients with olfactory neuroblastoma. MATERIAL AND METHOD: Five patients diagnosed as olfactory neuroblastoma during the past 10 years were retrospectively analyzed. RESULTS: Five patients were categorized by the modified Kadish's staging system. Three patients underwent surgery. Radiotherapy was given concurrently with chemotherapy for two patients. Distant metastases were observed in two cases, one in the heart and the other in the cervical lymph node. After a median follow-up of 34 (12-87) months, two patients who underwent craniofacial resection only and another two patients who received combined radiotherapy and chemotherapy are still alive. One patient who underwent Denker's operation with postoperative radiotherapy had died of heart failure as a result of cardiac metastasis. CONCLUSION: We suggest a complete surgical resection as a primary treatment modality, however, a multi-drug chemotherapy with radiotherapy could be the choice of treatment in cases of children or one with distant metastasis.

Epidemiological Study for Allergic Disease of School Aged Children and Adolescence in Rural Area of Korea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Basic epidemiologic investigations are important given the need for prevention and proper treatment of the patient with allergic disease. However, basic epidemiologic data of allergic disease in Korea are rarely found. Especially, data about school children in the rural areas of Korea are not found in the review of literature. We attempted to obtain epidemiological data of allergic diseases, such as prevalence rate, skin test results and family history, in school children living in the rural area of Korea. MATERIALS AND METHODS: We performed statistical analysis of 13,160 students who responded to the questionnaire concerning several allergic symptoms and family history. Of these 13,160 students, 171 students were given skin tests, and their results were also statistically analyzed. RESULTS AND SUMMARY: The percentage of students who had ever suffered from allergic diseases were as follows: atopic dermatitis (11.2%), urticaria (31.3%), asthma (11.1%), and allergic rhinitis (28.5%). The prevalence rate of allergic disease at the point of study performed were as follows: atopic dermatitis (1.5%), urticaria (4.7%), asthma (2.2%), and allergic rhinitis (5.3%). Students with allergic symptoms showed positive skin test results (64.7%). The most common allergen causing the allergic symptoms were Dermatophagoides pteronyssinus and Dermatophagoides farinae. Seasonal predominance was prominent in the winter (33.8%) for students who have allergic rhinitis.

Types of Nasal Septal Deformities Related to Nasal Symptoms: A Preliminary Report / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nasal septal deformity (NSD) is one of the most common cause of nasal obstructions. However, many patients with NSD complain various symptoms besides nasal obstruction such as rhinorrhea, sneezing, nasal discomfort, etc. This study aims to investigate the frequencies of various types of NSD, and to analyze the relationship between types of NSD with nasal symptoms. MATERIALS AND METHOD: We prospectively analyzed the relationship between the patients with different types of NSD and their various nasal symptoms in 693 cases visited Severance Health Center from March to May 1997. We thoroughly evaluated them with careful history taking for their symptoms and meticulous physical examination for classifying the types of NSD using the anterior rhinoscope, nasal endoscope as well as palpation with cotton applicators. RESULTS: 273 cases (39.4%) had a certain type of NSD and 176 cases (25.3%) were suffering from nasal symptoms. According to the Mladina's Classification, the most common type was type I, and the overall prevalence of the nasal symtoms in NSD group was higher than the control group. The most common symptom was nasal obstruction, and its degree and other symptoms were positively correlated with the types of NSD. CONCLUSION: The NSD showed a positive correlation with various nasal symptoms and, therefore, the surgical treatment of NSD will not only improve nasal obstruction but also other various nasal symptoms.

The Clinical Effects of Laser Surgery in Simple Snorers on Polysomnography / 대한이비인후과학회지

OBJECTIVES: We aimed to evaluate the clinical effects of the recently developed laser surgery in patients who were diagnosed by polysomnography as simple snorers. MATERIALS AND METHODS: We operated on 35 patients with apena index of below 5, using CO 2 laser, from June, 1993 through May, 1994 at Yongdong Severance Hospital. For these patients, we carried out before and after assessments of three different kind: first, a follow-up assessment of subjective symptoms, such as snoring, daytime somnolence, nocturnal arousal, and headache; second, a psychodynamic analysis done by a psychiatrist on insomnia and depression: and third, an assessment of subjective atisfaction for 24 weeks following the surgery. RESULTS: Snoring improved in 74.2% of the patients, and daytime somnolence improved in 80.0% of the patients. Nocturnal arousal showed improvement in all the subjects whereas headache showed improvement in 66. 7% of the patients. In the psychodynamic analysis, insomnia as observed in 22.9% of the subjects, showing significant improvemnt. However, depression didn't improve significantly. Subjecive satisfaction of the surgery was noted to be the greatest at the fouth week of the operation but it gradually decreased thereafter. The most common postoperative complication was foreign body sensation (31.4%), which disappeared spontaneously within 3 to 6-months of the operation. CONCLUSION: Laser snoring surgery in simple snorers is found to be an effective method to lessen snoring. However, patients should be informed beforehand that this method of surgery may not fully meet their expectations.

Secretory Differentiation of Serially Passaged Normal Human Nasal Epithelial (NHNE) Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to subculture normal human nasal epithelial (NHNE)cells without compromising their ability to differentiate into secretory and ciliated cells and to study the effect of retinoic acid (RA)on mucous and serous secretions in each passaged cells. MATERIALS AND METHOD: Freshly isolated nasal epithelial cells from normal inferior turbinates were subcultured repeatedly in serum-free medium on plastic tissue culture dishes. The subcultured cells were tested after every passage for secretory differentiation in air-liquid interface (ALI) cultures. The apical secretion of cultured NHNE cells was characterized by immunoblotting and Western blotting. RESULTS: Cultured NHNE cells secreted mucin and lysozyme. RA was essential for mucociliary and secretory differentiation. The epithelium became squamous and mucin secretion decreased when RA was deleted from the culture media. Cells from passage 1(P-1) through passage-2 (P-2) remained competent to differentiate into mucous and squamous cells when grown in air-liquid interface culture. CONCLUSION: P-2 NHNE cell cultures retained many important features of normal epithelium and were suitable for conducting many studies of upper airway cell biology with an expanded cell pool.

Effects of Preoperative Midazolam and Ketorolac Tromethamin Treatment in Septoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study was to investigate the effect of preoperative administration of midazolam and ketorolac for postoperative pain and antegrade amnesia in septoplasty under local anesthesia. MATERIALS AND METHODS: We studied 40 patients who underwent septoplasty under local anesthesia. The patients were divided into four groups, each consisting 10 patients (N=40). The groups received different treatment, with the first group receiving ketorolac, the second group ketorolac and diazepam, and the third group ketorolac and midazolam. The fourth group received midazolam only. Postoperative pain was evaluated according to Verbal Rating Pain Scores (VRP), and Visual Analogue Pain Scores (VAS) at 2, 4, 6, 12, 24 and 48 hours after operation. Antegrade amnesia was evaluated also. RESULTS: Postoperative pain was decreased at 6, 12, 24 hours in the third and fourth group. Antegrade amnesia was noted in the third and fourth group. The third group showed strong antegrade amnesia. CONCLUSION: Preoperative administration of ketorolac and midazolam were effective for postoperative pain and antegrade amnesia in septoplasty.

Clinical Characteristics of Primary Paranasal Sinus Mucoceles and Their Surgical Treatment Outcome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVE: Paranasal sinus mucocele is a slowly expanding benign lesion which can occur as a result of trauma, spontaneous obstruction of sinus ostium or ostial tract. Since it may destruct the adjacent bony structures by pressure, early diagnosis and proper treatment are necessary. This study aims to analyze the clinical characteristics of primary paranasal sinus mucoceles, and to compare the treatment results of external and transnasal approaches based on the rates of complications and recurrences. MATERIALS AND METHODS: Thirty one cases of primary paranasal sinus mucocele diagnosed at Severance Hospital from January 1988 to September 1997 were retrospectively reviewed. RESULTS: Twenty one cases were approached transnasally, 7 cases by external approach and 3 cases by sublabial approach. The most common site of origin was ethmoid sinus and proptosis was the most common presenting feature. Among the mucoceles of frontal and frontoethmoid sinuses, there was no difference in the rates of recurrences or complications between the two different approach methods. CONCLUSION: Primary paranasal sinus mucocele occurs most commonly in the ethmoid sinus, and the endonasal approach is considered to be effective for the initial treatment of primary paranasal sinus mucoceles.