The Long Term Efficacy of Microdebrider Assisted versus Coblation Assisted Inferior Turbinoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The study aimed to evaluate the long term efficacy of micro-debrider assisted inferior turbinoplasty (MAIT) compared to coblation assisted inferior turbinoplasty (CAIT) for hypertrophic inferior turbinates. SUBJECTS AND METHOD: From January 2008 to December 2008 inclusively, 96 patients with persistent hypertrophic inferior turbinates mucosa refractory to medical therapy were enrolled into this study. All patients were suffering from nasal obstruction and related symptoms. Overall, 56 patients were treated with microdebrider assisted inferior turbinoplasty (MAIT group) and 40 patients were treated with coblation assisted inferior turbinoplasty (CAIT group). Postoperative changes in degree of nasal obstruction, sneezing, rhinorrhea, minimal cross sectional area (MCA), and nasal volume from the nostril to 7 cm posteriorly (V7), operation time, duration of crust formation, intraoperative bleeding and delayed bleeding were compared between the two surgical methods prospectively in the 1st and 6 months, and in the 1st and 2nd years after the procedure. Also patient's satisfaction with procedure was evaluated. RESULTS: The nasal obstruction and related nasal symptoms improved significantly in MAIT group and persisted within the periods of 2 years after surgery, while in CAIT group the significant improvements took place in the 1st and 6th months after surgery but no significant improvements from 1 to 2 years after were noted. Nasal patency (MCA and V7) also showed more improvement and persistence in MAIT group than CAIT group. There were no significant differences in operation time and intraoperative bleeding and delayed bleeding but the duration of crust formation was significantly shorter in MAIT group. And patient satisfaction in the MAIT group was higher than that in the CAIT group. CONCLUSION: From the analysis of this study, it can be said that MAIT is more effective and satisfactory for the long term relief of nasal obstruction, related nasal symptoms and reduction of hypertrophic inferior turbinate mucosa than CAIT.

A Case of Chondroid Syringoma of the External Auditory Canal / 대한이비인후과학회지

Chondroid syringoma is a benign sweat gland tumor composed of a mixture of epithelial cells and mesenchymal tissue. It is most frequently located on the head and neck. Chondroid syringoma is usually present as a firm intradermal or subcutaneous nodule. Histologically, the epithelial component consists of tubulocystic structures and aggregates of epithelial cells as well as single scattered epithelial cells throughout the stroma. The treatment of choice is complete local excision. We report a case of chondroid syringoma presenting as a external auditory canal mass in 54 year old man with a brief review of literature.

A Case of Pleomorphic Adenoma in Cheek / 대한이비인후과학회지

Pleomorphic adenoma are benign neoplasms that typically occur in the major salivary glands. Uncommonly, they arise in minor salivary glands, which account for only 10% of all reported salivary gland pleomorphic adenomas. Minor salivary gland tumors are clinico-histopathological curiosities and arise from glands scattered throughout the oral and pharyngeal mucosa. The cheeks, lips and gingiva are rare sites of occurrence. We experienced a case of a 68-year-old woman who presented a 45-years history of a left cheek mass. The pathologic diagnosis was pleomorphic adenoma. We removed the mass intraorally and obtained good postoperative results. We report this case with a review of literature.

A Case of Epidural Abscess in Middle Cranial Fossa Secondary to Acute Sphenoid Sinusitis

Acute or chronic sinusitis is common disease of ENT. Most cases usually respond to appropriate treatment; however, some cases occasionally progress to the development of serious complication and poor prognosis. The orbital complications are most common complication fallowed by intracranial complications. The incidence of sinogenic intracranial complications is about 3.7-11.0% and these complications are progressively decreasing however the complications occur due to incorrect use of antibiotics, antibiotics resistant pathogens, decreasing host immunity, improper diagnosis and delayed surgical treatment. Therefore the case of epidural abscess in anterior portion of middle cranial fossa secondary to acute sphenoid sinusitis, which was treated with transnasal endoscopic sphenoidotomy and intravenous antibiotics, is being reported.

Two Case of Acute Pulmonary Edema due to Local Epinephrine Injection during Tonsillectomy / 대한이비인후과학회지

Epinephrine is used to control bleeding and clear operative field during tonsillectomy procedure by local and general anesthesia. But epinephrine also has many adverse effects, such as palpitation, headache, hypertension, arrhythmia, tachycardia, anxiety and some significantly more dangerous conditions including intracranial hemorrhage, pulmonary edema, cardiac arrest, etc. We have experienced two acute pulmonary edema owing to infiltration of epinephrine during tonsillectomy, where the condition of patients rapidly became more serious. We performed intensive care and ventilation therapy. In all cases, patients were recovered after intensive care and additional postoperative complication has not been detected until now. We report these cases with literature.

A Case of Cavernous Hemangioma Originated from the Middle Turbinate / 대한이비인후과학회지

Hemangiomas are common benign soft tissue tumors in the head and neck, but they occur infrequently in the sinonasal cavity. Most of nasal hemangiomas arise from the nasal septum or vestibule and are of capillary type. Only a few arise from the lateral wall of the nose, and these usually are cavernous. Chief symptoms are recurrent epistaxis and nasal obstruction; if the tumor becomes large, it may cause adjacent bony erosion. Cavernous hemangioma shows essentially little tendency to regress, and in adults, it is more common than capillary hemangioma. Consequently, the majority of cavernous hemangiomas require surgery in contrast to their capillary counterparts. We report a case of cavernous hemangioma of middle turbinate in an adult female, together with a review of the literature.

A Case of Neurilemmoma of the Lateral Wall of the Hypopharynx Treated with Endoscopic Removal / 대한이비인후과학회지

Neurilemmoma is a relatively rare benign tumor originating from the Schwann cells of all nerve fibers outside the central nervous system, with the sole exception being the optic and olfactory nerves. About 25-40% of neurilemmoma occurs in the head and neck region and the acoustic nerve is most frequently involved. But the tumor rarely affect the hypopharynx. In this paper, authors report a case of neurilemmoma of the lateral wall of the hypopharynx in a 61-year old female patient. The tumor was successfully removed via endoscopic approach. So, we report the case with literature.