A Mouse Model of Chronic Rhinosinusitis Induced by Streptococcus Pneumoniae / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A mouse has a great potential to be used in studying genetics and inflammatory process of the rhinosinusitis. The aim of this study was to observe effects of experimentally induced chronic rhinosinusitis on histopathology of the sinonasal mucosa in a mouse and to develop a chronic form of rhinosinusitis. MATERIALS AND METHOD: Thirty five, six-week old male C57BL/6 mice were used as follows: 7 normal controls without intervention, 7 Sham operated controls, 7 animals with ostial obstruction alone using Merocel, 7 animals implanted with Merocel plus 106 colony forming unit (CFU)/mL of Streptococcus pneumoniae and 7 animals implanted with Merocel plus 10(8) CFU/mL of S. pneumoniae. Six weeks after intervention, the animals were sacrificed and serially sectioned at 1 mm intervals and stained with Hematoxylin and Eosin. RESULTS: Increased epithelial thickness, goblet cell hyperplasia, epithelial disarray and inflammatory infiltration were observed in the experimental sinuses packed with Merocel alone or Merocel with bacterial inoculation, especially at the nasal septal area. However, there were no significant differences between the Merocel only inserted group and Merocel and bacteria inoculated group. CONCLUSION: Maxillary sinus ostial obstruction or ostial obstruction with S. pneumoniae inoculation induced chronic rhinosinusitis in C57BL/6 mice as indicated by the histologic change. This study could be used as a model of chronic rhinosinusitis for further study.

Delayed Facial Nerve Paralysis after Middle Ear and Mastoid Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to provide possible causes and post-treatment prognosis of delayed facial nerve palsy (DFP) following middle ear and mastoid surgery. SUBJECTS AND METHOD: The medical records of 3787 cases of middle ear and mastoid surgery from June, 1980 to August, 2003 were retrospectively reviewed. Nine cases developed ipsilateral facial nerve palsy after 72 hours of surgery. Their age ranged from 20 to 67 years (the mean of 40 years old and the male: female ratio of 1:1.25). For the review of the chart, we checked preoperative middle ear and mastoid state, intraoperative findings, clinical features of development and recovery of facial nerve palsy. To evaluate the degree and the possibility of recovery of facial nerve palsy, the House-Blackman grading system was used and electrophysiologic studies (Maximal stimulation test, Nerve excitability test and Nerve conduction velocity test) were performed. The steroid and vasodilator drugs were prescribed for the treatment. RESULTS: All of the nine patients had preoperative diagnosis of chronic otitis media and five of them also had cholesteatoma. Radical mastoidectomy was done in two cases, open cavity techniques in two cases and closed cavity techniques in five cases. There were postoperative wound infections in five cases. Facial palsy was developed between 5th and 16th postoperative day (mean 9th day) and the initial House-Blackman grade was II or III. The time for complete recovery ranged from 1 month to 6 months, with the fastest recovery time being 9 days after DFP. CONCLUSION: DFP following middle ear and mastoid surgery is an unpredictable complication. Postoperative wound infection may have been related to it and should be regarded as a risk factor of DFP.

The Relationship between Modified Mallampati Grade, Tonsillar Grade and Apnea-Hypopnea Index / 수면정신생리

OBJECTIVES: Obstructive sleep apnea (OSA) syndrome is diagnosed through history, physical examination, imaging studies and polysomnography. Clinical examination of this condition may point to hypertrophic tonsils and crowded oropharynx. The objective of this study is to investigate the usefulness of modified Mallampati grade (MMG) and tonsil grade (TG) in predicting the severity of obstructive sleep apnea. METHODS: MMG and TG were divided into 4 and 5 groups, respectively, according to their severity. Medical records were collected from 94 patients who had received polysomnography and otorhinolaryngologic examination for snoring and sleep apnea at Keimyung University Dongsan Medical Center from March 2002 through April 2004. Patients were divided into two groups according to the apnea-hypopnea index (AHI) : control (n=24), and patients with sleep apnea (n=70). RESULTS: Patients with higher MMG and TG had higher AHI, and MMG and TG proved to have a statistically significant correlation with AHI (p< 0.05) CONCLUSION: MMG and TG were reliable predictors of OSA and helpful parameters in deciding treatment method.