The 3rd Cranial Nerve Palsy due to Posterior Communicating Artery Aneurism Mimicking Acute Vestibulopathy (Vestbular Neuritis) / 대한이비인후과학회지

We present a 66-year old woman complaining of dizziness and vomiting for the previous three days. Her symptoms were quite similar to vestibular neuritis except for mild headache. Spontaneous nystagmus recording, head shake test, and slow harmonic acceleration results were also similar to vestibular neuritis. But the caloric test was not consistent with the chair test results. During the neurologic examination, ptosis, mydriasis, and the diplopia in the left eye were detected, which was indicative of central organic pathology. Bilateral posterior communicating artery aneurysm that was compressing the left oculomotor nerve was detected by CT angiography. A careful and precise neurologic examination should never be neglected when examining a dizzy patient. It was also noticeable that, acute third nerve palsy may present as intermittent saccades which mimic spontaneous nystagmus in vestibular neuritis.

A Case of Massive Skull Base Erosion by Fungus Ball in the Sphenoid Sinus / 대한이비인후과학회지

Isolated sphenoid fungal sinusitis is rare and difficult to diagnose because the presenting symptoms are often vague and nonspecific. In addition, cases with skull base erosion are extremely rare. In this paper, we describe a rare case of destructive, but non-invasive isolated sphenoid fungus ball with massive skull base erosion causing recalcitrant headache and hypertension.

Incidence of Actinomycosis in the Tonsils and Its Clinical Significance / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The relationship between actinomycosis and chronic tonsillar diseases, such as chronic recurrent tonsillitis or tonsillar hypertrophy, has been reported several times; but there seems to remain some controversy. The aim of this study was to find out the incidence of actinomycosis in the tonsil and its clinical significance. SUBJECTS AND METHOD: A histologic evaluation with tonsil specimen for actinomycosis was done for 300 patients who had undergone tonsillectomy from July 2005 to February 2006. Other clinical features such as age, sex, chief complaints, tonsil size, frequency of recurrent tonsillitis, and laboratory findings were also analyzed. RESULTS: The incidence of actinomycosis in tonsil was significantly high in adult group. There was no significantly statistical difference in the rate of actinomycosis according to sex, chief complaints, tonsil size, frequency of recurrent tonsillitis, number of leukocytes, and hemoglobin. CONCLUSION: Actinomycosis seems to have no causal role in recurrent tonsillitis or tonsillar hypertrophy. However, the possibility of actinomycosis should be considered in unusual tonsillar hypertrophy patients.