Clinical Evaluation of Cholesteatoma Using Computerized Tomogram / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Computerized tomography (CT) is the method of choice in radiologic diagnostic evaluation of cholesteatoma, since it reveals the presence of soft tissue mass and erosion of bony structure. Also CT enable us to predict the route of cholesteatoma extension, so we hope to hypothesize the unknown pathogenesis of cholesteatoma indirectly. MATERIALS AND METHODS: Preoperative CT and surgical treatment were performed on 80 patients with acquired cholesteatoma from 1996 to 1998 at otolaryngology department in Hanyang University Hospital. The charts and CT findings of the patients were retrospectively reviewed and analyzed according to types of cholesteatoma and its location and extension route. RESULTS: Pars flaccida cholesteatoma is the highest incidence of cholesteatoma and it is possible to predict the direction of progression of cholesteatoma using CT in most cases. Sensitivity of destruction of ossicles and semicircular canal in CT is over 96%. Incidence of obstruction of tympanic isthmus and eustachian tube is higher in pars flaccida cholesteatoma than in pars tensa cholesteatoma. CONCLUSION: Temporal bone CT is a very useful tool to evaluate the clinical characteristics and predict the pathogenesis of cholesteatoma by evaluating of extension route of it.

Patency of Internal Jugular Vein after Modified Neck Dissection / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Preservation of the internal jugular vein is beneficial in bilateral neck dissection where sacrifice of both jugular veins (IJV) have been associated with death, cerebral damage, blindness, or permanent facial distortion. The benefit of preservation of the IJV in unilateral neck dissection is less clear. Potential benefits may include decreased edema, and reduced morbidity. This study was performed to define the postoperative patency rate of the IJV and to analyze the risk factors associated with occlusion of the IJV. MATERIALS & METHODS: Thirty-one patients, and fourty-one cases of modified neck dissection were evaulated postoperatively with Duplex pulsed ultrasonogram for patency of the internal jugular vein. RESULTS: The patency rate of internal jugular vein was 97.7%. IJV was narrowed in 4 patients who had been irradiated in their neck, postoperatively. Occlusion of the IJV was revealed in only one patient who underwent reconstruction with a pectoralis major myocutaneous flap. CONCLUSION: The patency rate of internal jugular vein following a modified neck dissection was extremely high in this study. Postoperative irradiation and bulky myocutaneous flap reconstruction method may present as risk factors contributing to the occlusion or narrowing of the IJV.