A Case of Neuromyelitis Optica Spectrum Disorder of a Patient Who Present for Fungal Sinusitis / 대한이비인후과학회지

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system, characterized by repeatedly invading the brain, optic nerve, or spinal cord. In 2004, when a disease-specific antibody (aquaporin-4-immunoglobulin G) was discovered in the serum of an optic neuromyelitis patient, it was thought to be a separated disease from multiple sclerosis. Since 2004, however, the concept of the disease has been expanded to include NMO spectrum disorder (NMOSD). We experienced a rare case of NMOSD in a patient who presented with left visual disturbance and underwent endoscopic sinus surgery because of acute fungal sinusitis. We report this case with a review of the literature.

Changes in Stress, Occupational Stress, and Subjective Health Problems of Novice Female Nurses: Secondary Data Analysis

Purpose@#This study aimed to examine the changes in stress, occupational stress, and subjective health problems of novice female nurses within the first 18 months of work. @*Methods@#This was a longitudinal study conducted with a secondary data analysis based on the Shift Work Nurse’s Health and Turnover (SWNHT) study. The participants were 178 female novice nurses who participated in all 3 data collection activities (on the first day of orientation before ward placement [T0], 6 months after work [T1], and 18 months after work [T2]). The stress, occupational stress, 8 subjective health problems (upper musculoskeletal pain, leg/foot discomfort, depression, anxiety or emotional disorder, sleep disturbance, headache, gastrointestinal disorder, menstrual disorder, and others), and the greatest health problem during the study period were measured, respectively. Data were analyzed using SPSS 26.0 to obtain descriptive statistics. @*Results@#The subjective health of novice female nurses were found to be poor at T1 compared to T0 on both physical (upper musculoskeletal pain, leg/foot discomfort, and sleep disturbance) and psychological health problems (depression and stress). However, the psychological health problems of the participants were alleviated at T2 whereas; physical health problems persisted until T2. @*Conclusion@#Novice nurses had poor health problems 6 months after work. Sleep disturbance and musculoskeletal pain persisted although other health problems such as depression and stress were alleviated over the period. Strategies to prevent and manage different health problems of novice female nurses at different work duration are urgently needed.

Clinical Outcome Study after External Approach Septoplasty / 대한이비인후과학회지

Background and Objectives@#This study aims to investigate the indications of external approach septoplasty and improvement in subjective symptoms and objective parameters in patients who underwent external approach septoplasty to correct septal deviation with various types of deformities. @*Subjects and Methods@#Thirty-one patients who underwent external approach septoplasty from October 2014 to January 2019 were classified by direction, location, and degree of nasal septal deviation, septal shape and surgical techniques. Through acoustic rhinometry, the minimum cross-sectional area and nasal volume were measured before and after surgery. To evaluate the improvement in symptoms, the Nasal Obstruction Symptom Evaluation (NOSE) survey and nasal congestion visual analogue scale (VAS) were also measured. @*Results@#We found significant correlations between: the direction and degree of nasal septal deviation; the location and degree of nasal septal deviation; septal shape and location of the nasal septal deviation; septal shape and surgical techniques; and the degree of nasal septal deviation and presence of spreader grafts. The NOSE scale following external approach septoplasty improved from 14.7±4.4 to 3.1±3.2 (p<0.001), while the VAS score improved from 7.2±2.3 to 1.2±1.4 (p<0.001). Also, acoustic rhinometry showed that the minimum cross-sectional area and nasal volume at the convex side of nasal cavity significantly increased after surgery. @*Conclusion@#The external approach septoplasty is a surgical technique that is effective not only in improving subjective symptoms, but also in improving objective parameters. External approach septoplasty could be used in case of caudal and/or dorsal nasal septal deviation.

Inflammatory Myofibroblastic Tumor of Nasal Septum after Septoplasty: A Case Report

Inflammatory myofibroblastic tumor is an uncommon tumor composed of myoblasts and various types of inflammatory infiltrates. Inflammatory myofibroblastic tumor is most common in the lungs but can be rarely found in the nasal cavity. Inflammatory myofibroblastic tumor is a rare entity that represents a diverse histologic pattern that can mimic malignant tumors. We report a case of inflammatory myofibroblastic tumor of the nasal septum in a 45-year-old man who presented with a tumor-like lesion of the nasal septum after two rounds of septoplasty.

Repair of Nasal Septal Perforation Using Polycaprolactone Plate and Temporalis Fascia Graft

Management of the paralyzed face using temporalis tendon transfer via intraoral and transcutaneous approach / 대한악안면성형재건외과학회지

Temporalis tendon transfer is a technique for dynamic facial reanimation. Since its inception, nearly 80 years ago, it has undergone a wealth of innovation to produce the modern operation. Temporalis tendon transfer is a relatively minimally invasive technique for the dynamic reanimation of the paralyzed face. This technique can produce significant and appropriate movement of the lateral oral commissure, more closely mimicking the normal side. The aim of this article is to review the technique of temporalis tendon transfer involving transferring of the coronoid process of the mandible with the insertion of the temporalis tendon via intra-oral and transcutaneous approach.

Endoscopic Brow Lift / 대한이비인후과학회지

Eyebrows play a significant role in an individual's expression of emotions and nonverbal communications. Nonendoscopic approaches to brow lifting include the coronal, pretrichial, direct, midforehead, and transblepharoplasty approaches. Endoscopic brow lift has become widely accepted as a procedure for restoring a youthful brow, hardly noticeable incisions of the scalp are needed for this subperiosteal dissection and final repositioning of the brow. The choice of incision and approach is based on the patient's forehead height and hairline position, and the patient's desired effect and surgeon's comfort and experience with a given procedure. Endoscopic brow lift is a predictable procedure for rejuvenation of the upper third of the face with minimal complications and obtains satisfactory aesthetic results.

Surgical Reconstruction of Nasal Alar Deformities

Reconstruction of the nasal alar may be challenging due to the complex nature of multiple cosmetic units and functional considerations, including maintenance of valvular competency. Reconstructive options include various flaps or graft repairs, depending on the subunit involvement and the size of the defect. Linear closures may be suitable for small defects, while bilobed flaps, melolabial flaps, and forehead flaps may be considered for moderate to large defects involving partial and full-thickness defects of the ala.

A Case of Reconstruction of Surgical Defect after Removal of Intraosseous Hemangiomas on Nasal Dorsum / 대한이비인후과학회지

Intraosseous hemangioma arising from nasal bone is rare and has not been reported in the Korean literature. Hemangioma of the bone accounts for 0.7% of all bone tumors. The craniofacial region is a rare site of involvement, with mandible, zygoma, and maxilla being the most frequently affected areas. A 63-year-old male patient presented with complaints of a protruding mass on the nasal dorsum that began 10 years ago. Computed tomography demonstrated a round mass with honeycomb appearance involving the nasal bone. An en bloc excision of the mass and nasal reconstruction was performed. Histopathological examination showed increased number of large cystically-dilated vessels with thin wall lying between thin trabeculae of lamellar bone in marrow space. During a one-year follow-up, the patient had no recurrence and cosmetic results were excellent. A case report of an intraosseous hemangioma arising on the nasal bone is described, together with a discussion of the relevant literature.

Revision and Reconstructive Septoplasty / 대한이비인후과학회지

Nasal airway obstruction is one of the most common chronic complaints of patients seen in the day-today practice of the general otolaryngologist. While a variety of potential etiologies, both structural and nonstructural, must be considered when evaluating these patients, a deviated nasal septum is identified as the root source of unilateral or bilateral nasal obstruction in many. In the present study, we investigated the causes that underlie various problems in the revision septoplasty and reviewed treatment procedures. A total of 41 patients who had revision septoplasty due to nasal obstruction were studied retrospectively. Weakening of septal cartilage was observed in most cases during revision septoplasty. Excessive resection and scoring can cause weakening of septal cartilage and deviation. Various surgical procedures such as swing door technique, batten graft, caudal septal reconstruction, extracorporeal septoplasty and spreader graft were performed for the patients. Making a complete and correct diagnosis of the persistent obstruction is very important. Open approach and bilateral dissection gives excellent visualization and release external forces. Surgeons should be familiar with septal reconstruction and reinforcement for revision septoplasty. This will help to ensure a complete understanding of septal dynamics and, consequently, appropriate and effective surgical intervention.

Diagnosis and Treatment of Alar Rim Deformities / 대한이비인후과학회지

Alar rim deformity is one of the most challenging problems to correct in nasal surgery. It is difficult to correct, recurs easily, and needs delicate handling. The technique to correct a hanging alar includes excision a vestibular skin, direct skin excision, and/or excision of the lateral crus. The technique to correct the minimal-to-mild alar retraction includes scar contracture release, alar rim grafts, V-Y advancement flap and composite grafts. In case of severely retracted alar, several techniques such as lateral crural strut graft, alar spreader graft, inter-cartilaginous graft, and island pedicled advancement flap of the nasal dorsum can help to correct the deformities. Alar rotation flap, septal extension graft, alar base surgery, and derotation graft also have some benefit.

The Relationship of Intra-Annual Distribution of Sudden Sensorineural Hearing Loss versus Meteorological Parameters / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The influence of specific meteorological conditions, such as temperature, wind velocity, fine dust and their co-variation on the incidence of idiopathic sudden sensorineural hearing loss (ISSHL) has been rarely investigated. Aiming at better predictions of the seasonal variation of ISSHL, we investigated variations in the monthly incidence of ISSHL and meteorological parameters. SUBJECTS AND METHOD: One-hundred-five patients who had been diagnosed with ISSHL were analyzed. Monthly incidence counts were analyzed for incidence distributions throughout the year. The incidence counts were investigated according to age groups and hearing recovery. The relationship between intra-annual distribution of ISSHL and meteorological parameters was compared. RESULTS: The highest of monthly incidence was found in March and April. Intra-annual distribution of ISSHL was well correlated with daily temperature range, wind velocity and fine dust. The incidence of ISSHL was significantly correlated to fine dust. The distribution of age group and hearing recovery of ISSHL in March and April were not different with the rest of the year. CONCLUSION: We concluded that ISSHL incidences are significantly related to seasonal variation and the highest is found in March and April. This provides valuable information for clinicians, creating an awareness of periods of potentially increased risk.

A Case of Benign Fibrous Histiocytoma of the Nasal Dorsum

Benign fibrous histiocytoma is a mesenchymal tumor that has been described as a benign neoplasm composed of fibroblasts and histiocytes. The occurrence of this lesion of the head and neck has been rarely reported. We experienced a case of benign fibrous histiocytoma on the nasal dorsum in a 53-year-old female. During physical examination, we found 1x1-cm-sized bilateral mass on the nasal dorsum. Excision and Z-plasty were performed, and recurrence was not observed for 12 months after operation. We present this rare case with review of the clinical and pathological features.

Nasal Hemangiopericytoma Causing Oncogenic Osteomalacia

Oncogenic osteomalacia is a rare cause that makes abnormalities of bone metabolism. Our case arose in a 47-year-old woman presenting a nasal mass associated with osteomalacia. We excised the mass carefully. After surgery, it was diagnosed as hemangiopericytoma and her symptoms related with osteomalacia were relieved and biochemical abnormalities were restored to normal range. We report and review a rare case of nasal hemangiopericytoma that caused osteomalacia.

A Case of Endoscopic Management of Dacryocystocele in an Adult / 대한이비인후과학회지

Dacryocystocele presents as a distended lacrimal sac and it is often considered to have a congenital etiology. However, dacryocystocele is an uncommon disease in adults. The clinical feature associated with a dacryocystocele is painless swelling at the site of the lacrimal sac, and this is usually found inferior to the medial canthal ligament. The lacrimal excretion test, endoscopy, CT scans and MRI are used to make the diagnosis of dacryocystocele. The management of a congenital dacryocystocele is conservative treatment that involves the use eye drops, lacrimal sac massage, lacrimal probing and surgery in some cases. However, for a dacryocystocele that develops in an adult, the dilated lacrimal sac does not decrease in size, so a nasal drainage procedure is the treatment of choice. We encountered an adult patient who presented with a dacryocystocele with an intranasal cystic mass, which we treated by endoscopic marsupialization. We report on this case along with a review of the related literature.

Granular Cell Tumor on Larynx

Granular cell tumors (GCTs) are uncommon neoplasm. They can originate in any part of the body. The most common sites of origin are in the head and neck, while the larynx is a relatively uncommon location. Patients affected with a laryngeal GCT typically present with persistent hoarseness, stridor, hemoptysis, dysphagia, and otalgia but, the tumor may be asymptomatic. Care must be taken to differentiate this lesion from others due to the presence of pseudo-epitheliomatous hyperplasia which overlies the GCT and may occasionally mimic squamous cell carcinoma. Therefore, a confirmative diagnosis should be made histopathologically and should be supported by immunohistochemical staining. These tumors are treated by complete surgical resection. Examining the complete removal of the tumor through securing a negative free margin is considered to be a consequential procedure. We experienced a 64-yr-old man with a laryngeal granular cell tumor involving the right true vocal cord. He was treated by surgical resection under a fine dissection laryngomicroscope. Here we present this case and a review of literature.

Acute Optic Neuropathy due to Compression by Posterior Ethomoidal Cell (an Onodi cell) Mucocele

Acute optic neuropathy occurs commonly as a result of ischemia and inflammation, but paranasal sinus disease without infection is generally dismissed. We report a rare case of acute optic neuropathy caused by compression of a mucocele in an Onodi cell, which is an uncommon anatomical variation of the ethmoid sinus. The mucocele was confirmed by imaging and endoscopic sinus surgery. An Onodi-cell lesion should be considered in the differential diagnosis of acute optic neuropathy.

Galectin-8 Expression in Laryngeal Squamous Cell Carcinoma

OBJECTIVES: Despite the ongoing development of treatment protocols for laryngeal squamous cell carcinoma (LSCC), the patients suffering with this malady have shown only a modestly improved outcome. This poor outcome has been attributed to the lack of therapy that's individualized to the tumor's biological properties. Various studies have showed that galectin-8 is widely expressed in tumor tissues as well as in normal tissues, and the level of the galectin-8 expression may correlate with the malignancy of human squamous cell carcinoma. The purpose of this study is to evaluate the expression of galectin-8 and to investigate its correlations with the primary stage, the nodal involvement, the clinical stage and the histologic grade of squamous cell carcinoma of the larynx. METHODS: The paraffin-embedded tissue specimens from 77 patients who were diagnosed as LSCC between 1993 and 2007 were immunohistochemically stained for galectin-8. RESULTS: Immunohistochemical analysis showed that a strong positive expression of galectin-8 was correlated with the T-stages, the nodal stages and the clinical stages. However, the histopathologic grades were not correlated with the galectin-8 expression in LSCC. CONCLUSION: The expression of galectin-8 protein can be used as a prognostic factor for patients with LSCC.

Cavernous Lymphangioma in the Nasal Cavity / 대한이비인후과학회지

Cavernous lymphangioma is a benign congenital malformation that usually appears in the early childhood. It may arise in any anatomical location, including the head and neck, but is rarely found in the nasal cavity. Recently, we experienced a case of a cavernous lymphangioma originating from the nasal cavity, which was successfully treated by endoscopic approach without recurrence. Cavernous lymphangioma can occur in the nasal cavity, and therefore, it should be included in the differential diagnosis of mass on the nasal cavity and paranasal sinuses. In this paper, we present and discuss this rare case with a review of the literature.