Two Cases of Rhinocerebral Mucormycosis in Diabetic Patients

Rhinocerebral mucormycosis is a rare fungal infection that involves the paranasal sinus and orbits and usually presents as acute invasive fungal sinusitis. It progresses rapidly, is often fatal, and occurs most commonly in patients with uncontrolled diabetes. If the condition is not treated, the fungal infection may disseminate into the brain and cause death within a week. We encountered two cases of rhinocerebral mucormycosis confirmed with histophathological examination. The cases were treated successfully with surgical debridement, a systematic application of amphotericin B, and irrigation and soakage with amphotericin B.

A Clinical, Radiologic Study of Tuberculous Otitis Media / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tuberculous otitis media is not commonly found nowadays, and therefore, the index of suspicion is often low. However, once contracted, it can cause significant morbidities, such as profound hearing loss, labyrinthitis, facial nerve palsy and so on, if early diagnosis and treatment are not performed. MATERIALS AND METHODS: In the chronic otitis media patients who visited Masan Samsung Hospital from Jan. 1993 to Jan. 1996, 37 cases of pathologically proven tuberculous otitis media were retrospectively reviewed. And temporal bone computerized tomography (TBCT) of 14 cases of tuberculous otitis media were compared to those of chronic suppurative otitis media and choronic otitis media with cholesteatoma. RESULTS: 1) Classic clinical findings of the disease such as multiple perforation, painless otorrhea, young age are not consistent with the clinical findings reviewed here. 2) Unexpectedly severe hearing loss, facial paralysis, eroded malleus handle, polypoid granulation or necrotic debris in middle ear cavity were significant clinical features. 3) In TBCT findings, soft tissue density in the entire middle ear cavity, soft tissue density extension to superior external auditory canal, poor sclerotic change of mastoid air cell were more common than other types of chronic otitis media. 4) Most of cases were confirmed by operative specimen pathologically. 5) Delayed healing of postoperative wound and formation of granulation tissue suggested tuberculous otitis media. 6) Antituberculous chemotherapy provided effective means of treatment. CONCLUSION: Early diagnosis by pathologic examination of biopsied tissue obtained at OPD was mandatory to avoid complication and postoperative morbidity. Postoperative specimen obtained from middle ear surgery must be confirmed pathologically.

Esophageal Foreign Body(Coin) Removal Using Foley's Catheter / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Esophageal foreign bodies are very common problems in the field of pediatric otolaryngology department. Of all, coins are the most common esophageal foreign bodies encoutnered. Management of the child with an esophageal coin is as follows: rigid esophagoscopic removal under general anesthesia, flexible endoscopic removal, Foley's catheter technique with or without fluoroscopy control, and advancement using bougination. This study is to evaluate the safety and efficiency of the procedure of removing coins from the esophagus in children using Foley's catheter without fluoroscopic control. MATERIALS AND METHODS: The subjects consisted of 101 children with coin lodgement in the first esophageal constrictor area who had been managed with Foley's catheter extraction method from April 1993 through February 1999 at Masan samsung hospital, Masan, Korea. A retrospective review of charts and radiological findings was performed. RESULTS: Of the 101 children who underwent Foley's catheter extraction method, 93 cases (92.1%) were successful without serious complications; but three attempts were unsuccessful and were subsequently removed by rigid esophagoscopy under general anesthesia. CONCLUSIONS: Foley's catheter extraction method may be used for removal of esophageal coins in selected cases, even without fluoroscopic control. The technique is effective, safe and avoids the risk of general anesthesia or radiation exposure.