Comparison Study of Epithelial Cell Proliferation in Nasal Polyp and Nasal Mucosa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVE: Nasal polyposis is a chronic inflammatory disease with structural modification of the mucosal epithelium and the lamina propria. In one of recent studies related to the lamina propria, the myofibroblast, which is a potent inducer of extracellular matrix (ECM) synthesis, was found to increase the pedicle area of the nasal polyp. In this study, we intended to quantify epithelial cell proliferation of the polyp. We also tried to identify the active area of epithelial proliferation within nasal polyp and to compare it with the active area of ECM synthesis. MATERIALS AND METHODS: During the endoscopic surgery of nasal polyposis patients, anatomically intact polyp, uncinate process, inferior turbinate and middle turbinate were sampled. The normal nasal mucosa of the inferior turbinate and the septum were obtained from patients who underwent septoplasty. The proliferation cell nuclear antigen (PCNA) expression in the samples were quantified by immunohistochemistry. The PCNA index of the two groups were compared. RESULTS: Epithelial proliferation of the nasal polyp was found to be more active than the normal nasal mucosa. The active area of epithelial proliferation within the nasal polyp was the body area. CONCLUSION: The active area of epithelial proliferation was different from the pedicle area, which is the active area of ECM production.

A Case of Giant Intradiploic Epidermoid Cyst of the Temporal Bone / 대한이비인후과학회지

Intradiploic epidermoid cysts are extradural and very uncommon lesions that may occur in all flat bones of the calvarium. The very slow growth rate and the benign histological nature of these tumors explain their long preoperative evolution and the mild neurological signs. We report a giant intradiploic epidermoid cyst of the temporal bone with an intracranial extension into the posterior fossa which was probably responsible for the destruction of the endolymphatic sac and presenting intermittent vertigo and profound hearing loss. It was discovered incidentally during the evaluation of chronic otitis media. Plain film, CT and MRI all demonstrated the characteristic appearances of intradiploic epidermoid cyst. The tumor was totally removed and cranioplasty was performed.

Three Cases of Fibrous Dysplasia Involving the Paranasal Sinuses / 대한이비인후과학회지

Fibrous dysplasia is a developmental disease of bone in which there is replacement of normal spongiosa and filling of the medullary cavity of affected bones by an abnormal fibrous tissue that contains trabeculae of poorly calcified primitive bone formed by osseous metaplasia. Fibrous dysplasia arising in the paranasal sinus is rare and often presents a diagnostic challenge. It is usually secondary to extension of disease from adjacent bones and is rarely limited to the sinuses. We have described two cases of fibrous dysplasia involving the sphenoid sinus and a case of fibrous dysplasia involving the sphenoethmoid sinus with narrowed orbital apex. A brief update of the clinical aspects, radiolographic appearance, diagnosis, and management of craniofacial fibrous dysplasia is proved.

The Prognostic Factors of Uvulopalatopharyngoplasty in Obstructive Sleep Apnea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Uvulopalatopharyngoplasty (UPPP) is one of the surgical methods used to cure obstructive sleep apnea (OSA). It is designed to relieve of oropharyngeal obstruction and to enlarge the potential air space in the oropharynx by removing the excessive soft tissues involved in the free margin of the soft palate, uvula, tonsils and the pharyngeal wall. Although laser-assisted uvulopalatoplasty (LAUP) has been recently popular for the treatment of snoring and some OSA, UPPP remains the best choice of treatment for moderate to severe OSA. The criteria for selecting patients for this procedure, however, are obscure and factors that can predict successful responses are not well established. The purpose of this study was to evaluate the success rate of UPPP and to determine the factors that can predict the response to UPPP. MATERIALS AND METHODS: We report our experience on 27 OSA patients who underwent UPPP. We evaluated their preoperative cephalometric radiograph readings as well as body mass index (BMI). Each patient also underwent polysomnography before and after UPPP. RESULTS: Defining surgery to be successful when the postoperative apnea index (AI) was reduced by more than 50%, the success rate of the surgery was 74%. The mean AI decreased from 32 to 4, and the mean lowest oxygen saturation increased from 79% to 89% in good responders. Snoring was reduced in 67% of the patients. However, no single parameter could be used to predict good responses to UPPP. CONCLUSION: We found that UPPP is an effective treatment for OSA, but we could not identify a single parameter which can invariably predict the success of the operation.