Desmoid fibromatosis is a very slowly growing benign fibroblast tumor. Locally aggressive and non-metastasizing, it is a well-differentiated, unencapsulated monoclonal myofibroblastic proliferation that has a tendency for local invasion and recurrence. About 15% of all desmoidtype fibromatosis develops within the head and neck. The majority of head and neck desmoid tumor is located in the neck, but less frequently in the face, scalp, oral cavity, mandible, paranasal sinuses, orbit, ear and other structures. We report a very rare case in a 55-year-old female of a desmoid fibromatosis arising from the lateral nasal wall of anterior portion of uncinated process. We discuss the clinicopathologic features and successful treatment of nasal desmoid tumor with a literature review.

High-grade B cell lymphoma not otherwise specified (HGBL, NOS) is a new diagnostic category of non-Hodgkin lymphoma (NHL) based on World Health Organization statement in 2016. Up to 40% of NHLs are located in the extra-nodal area, commonly involving the gastrointestinal tract, head and neck region, bone and skin. The diagnosis of NHL originating from the inferior turbinate (IT) is rare, and there have been no reported cases yet of HGBL, NOS in IT. In this study, we report on a 43-year-old female who had a nasal polyp in IT and was diagnosed with HGBL, NOS after surgery. Endoscopic polypectomy under general anesthesia was performed. A histopathological report confirmed the resected specimen as HGBL, NOS, with a clear resection margin. Nasal obstruction was improved immediately after surgery and the patient was followed up for 10 months without any recurrence or complications.

The etiologies of sudden sensorineural hearing loss (SSNHL) include idiopathic, viral infections, vascular occlusion, abnormal cellular stress responses within the cochlea, and a variety of immune-mediated mechanisms. Although idiopathic cause is most common, many studies have proposed a possible association between SSNHL and viral infections, including herpes simplex virus, human immunodeficiency virus (HIV), rubella, mumps, and so on. Particularly, various mechanisms underlying auditory dysfunction in the HIV/acquired immune deficiency syndrome have been proposed. Herein, we present the case of a 35-year-old male diagnosed with sudden hearing loss on both sides and left acute otitis media, presenting first in the left ear, in which subsequent serological examination revealed HIV infection. It is a case of HIV infection diagnosed after identifying the involvement of the 8th cranial nerve as the first symptom in the absence of any other HIV infection-associated symptoms.

Background and Objectives: The head and neck multidisciplinary team (MDT) approach plays a crucial role in bringing together the ideas of various medical professionals. This study aimed to evaluate the early characteristics of the MDT approach for head and neck cancer and analyzed patients’ satisfaction.Subjects and Method We analyzed 450 head and neck cancer patients who received MDT care from August 2014 to June 2022. Patient satisfaction with MDT care was evaluated by selfadministered questionnaires consisting of 9 questions. Results: Of 450, 298 (66.2%) were male and 152 (33.8%) were female. The mean age was 60.8±14.7 year. The most common primary site was the larynx (17.3%), followed by the oral cavity and oropharynx. A total of 726 cases of the MDT approach were performed in 266 MDT sessions, and the mean number of patients per MDT session was 2.74. The number of medical professionals participating in MDT ranged from a minimum of 3 to a maximum of 9, with a mean of 5.11. The mean running time of MDT meetings per case was 19.51 minutes. The time of the 2nd MDT was significantly shorter than that of the 1st or 3rd MDT. The mean score was close to very satisfactory in each of the 9 patient satisfaction questions. Conclusion We believe that the MDT approach is feasible and recommend its introduction for the treatment of head and neck cancer as most patients have shown very high satisfaction. Further studies on the role and efficacy of MDT care for head and neck cancer are necessary.

Background and Objectives: The purpose of this study was to examine the benefits of ultrasonography performed by a surgeon rather than a radiologist.Subjects and Method This retrospective study enrolled 122 cases of ultrasonography performed by a head and neck surgeon and 116 cases of the same examination performed by a radiologist before surgery. The time intervals between the first visit and surgery were compared in both groups. Results: The average waiting time for surgery after the first hospital visit was significantly reduced when a surgeon performed the ultrasound examination. Furthermore, there was no significant difference in sampling inadequacy rate on thyroid fine needle aspiration (FNA) between FNA performed by a head and neck surgeon and a radiologist. Conclusion Surgeons can utilize ultrasound as a diagnostic and therapeutic tool in an office-based setting. For patients, diagnosis and treatment provided by a single doctor will lead to more efficient outcomes.

Background and Objectives: Carotid body paraganglioma is the common type of carotid body tumor for which angiography, carotid artery balloon occlusion test (BOT) and tumor embolization could be considered before the surgery. We analyzed cases in a single institute and reviewed related literature to investigate the necessity of these preoperative examinations.Subjects and Method Medical records of patients who were diagnosed with paraganglioma were retrospectively analyzed from 2000 to 2019. Results: Sixteen patients were identified. Of the total, 14 patients underwent surgery at this institute, and 13 underwent angiography. Of the 13 patients who underwent angiography, 6 patients underwent carotid artery BOT, and 12 patients underwent tumor embolization. The average tumor size of 6 patients who underwent carotid artery BOT was 28.7 mm, and 8 patients who did not undergo carotid artery BOT was 30.1 mm. The average tumor size of 12 patients who underwent tumor embolization was 29.4 mm. Two patients did not undergo tumor embolization, and their average tumor size was 30 mm. In 1 patient, both preoperative angiography and carotid artery BOT were performed, but tumor embolization was not performed due to spasm of tumor vessels. Conclusion Preoperative carotid artery BOT can be performed to reduce side effects in patients with the potential for carotid resection. In addition, tumor embolization is performed regardless of tumor size. By reducing the amount of bleeding during surgery and reducing the size of the tumor, it is possible to secure an appropriate surgical field of view to facilitate operation during surgery; however, its effectiveness needs to be clearly identified.

Background and Objectives: Traditionally, transoral laser microsurgery (TLM) is commonly used to treat early glottic cancer. However, the long-term oncologic results have not been thoroughly investigated. Therefore, this study aimed to analyze long-term oncologic outcomes of TLM for early glottic cancer.Subjects and Method We retrospectively studied 132 patients who underwent TLM for early glottis cancer from January 2001 to August 2020. We assessed overall and disease-free survival according to the T classification and types of cordectomy proposed by the European Laryngological Society in 2007. Results: Of the 132 patients, 125 were male and 7 female. The mean age was 61.6±9.3 years. We found 5 (3.8%), 112 (84.8%), and 15 (11.3%) patients staged as CIS, T1, and T2, respectively. For the cordectomy types, there were 6 in type I, 22 in type II, 83 in type III, 6 in type IV, 13 in type V, and 2 in type VI. Ten-year overall and disease-free survival rates were 99.2% and 87.1%, respectively. Overall and disease-free survival curves were not different according to different T classification and cordectomy types. Conclusion TLM is an excellent treatment modality for the long-term oncologic control of early glottic cancer.

Background and Objectives: The aim of this study was to evaluate the effect of sleep position and nasal cavity dimension according to minimal cross-sectional area (MCA) on the severity of obstructive sleep apnea (OSA).Subjects and Method This study enrolled 528 consecutive patients who completed overnight polysomnography (PSG) and acoustic rhinometry. Positional sleep time and apnea-hypopnea index (AHI) were compared between the right and left lateral sleep positions (RLSP vs. LLSP), and between the wide and narrow lateral side sleep position (WLSP vs. NLSP) according to MCA. Results: The sleep time was longer for LSP than for WLSP (20.35%±19.69% and 15.92%±16.35%, respectively) with a statistically significant difference (p=0.001). However, the AHI was not significantly different between the two groups. The sleep time was longer for RLSP than for LLSP (20.65%±19.31% and 15.39%±16.05%, respectively) with a statistically significant difference (p<0.001). In the RLSP-dominant group, there were fewer left nasal cavity narrowed patients than right nasal cavity narrowed patients (91 vs. 129, respectively). Furthermore, in the LLSP-dominant group, there were fewer right nasal cavity narrowed patients than left nasal cavity narrowed patients (60 vs. 85, respectively, p=0.001). However, we found that the AHI value was not significantly different according to sleep posture and nasal cavity dimension. Conclusion Snoring patients preferred RLSP to LLSP, and preferred to sleep on the lateral side of the narrow nasal cavity. The OSA severity was not different according to sleep position and nasal cavity dimension.

Background and Objectives: Tinnitus, although being a common chronic disease, can be an intractable disease that causes depression and insomnia. This study aimed to analyze the results of the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI) questionnaire surveys before and after clonazepam therapy. In addition, we analyzed the association of three pre-treatment questionnaires and evaluated whether pre-treatment factors could predict the post-treatment THI index.Subjects and Method Patients were selected from those who visited a tertiary hospital from 2019 to 2021 for the treatment of chronic tinnitus they had for more than 3 months and who were over 20 years old. Patients were excluded from the study if they were diagnosed with acute sudden hearing loss, Meniere’s disease, brain/internal auditory canal tumors, or muscular/vascular tinnitus. The questionnaire surveys of THI, BDI, PSQI were conducted before and after 3 months of clonazepam therapy (Rivotril [Roche Inc.] 0.25 or 0.5 mg). Questionnaire scores were compared using the paired t-test. Multiple regression analysis was used to determine the relationships among the three questionnaires. Results: A total of 76 patients (38 males and 38 females) with the mean age of 57.2±9.01 years was analyzed. The average hearing threshold was 30.4±20.67 dB HL on the right and 31.7±17.06 dB HL on the left. The pre-treatment THI, BDI, and PSQI scores were 44.3±23.4, 7.96±2.36, and 6.85±4.68, respectively. The relationships between the THI and BDI and the THI and PSQI were significant (p=0.0027 and p<0.0001, respectively). The pre-THI score showed no significant association with age, sex, or hearing threshold (p=0.91, 0.85, and 0.23, respectively). The post-treatment THI score was 33.6±17.1, which was significantly lower than the pre-THI scores (p<0.0001). Post-BDI and post-PSQI were 7.38±2.25 and 4.04±3.20, respectively. Post-PSQI also significantly decreased compared with pre-PSQI (p=0.0002), but post-BDI did not significantly decrease (p=0.1231). In the THI survey, Question 7 (sleep disturbance) showed decrease the most, followed by Question 25 (unstable mood). The post-treatment THI could be predicted by using the formula, 0.7673+0.6947×pre-THI+0.3572×pre-PSQI. Conclusion The appropriate/optional use of clonazepam at low doses (0.25-0.5 mg) can significantly improve chronic tinnitus and sleep quality. Tinnitus was significantly associated with the scores of THI, BDI, PSQI and the usage of Clonazepam significantly reduced the THI and PSQI scores. However, clonazepam did not affect the BDI score.

Background and Objectives: With the growing acknowledgment of age-related vestibular impairments, consensus diagnostic criteria for presbyvestibulopathy (PVP) have been recently published. The PVP criteria retains its objectivity with video head impulse test (vHIT), rotatory chair test (RCT) and caloric test. These objective tests share testing principles, but targeted frequencies vary across the tests. The PVP criteria are applicable for subjects of age over 60. However, there are different age cut-offs for older male in different areas. The purpose of the present study was to explore whether the PVP diagnostic criteria were appropriate for early elderly (Eel) patients and to identify the most sensitive test for age-related loss of vestibular function.Subjects and Method Eligible patients, aged 60 years or older, complained of dizziness for at least 3 weeks, and have undergone at least one of the followings: vHIT, RCT, or caloric test. We selected two groups based on age: the Eel group (aged >60 years but <65 years) and the late elderly (Lel) group (aged ≥75 years). Results: The vestibulo-ocular reflex (VOR) gains differed significantly between the Eel and Lel groups for vHIT and caloric gain test. No Eel patient met the PVP criteria but 26.1% of Lel patients met the criteria for vHIT, and the proportions of such patients in the two groups differed significantly. Conclusion Eel subjects could be considered to differ from Lel subjects. Given the significance of both averages, VOR difference and the proportional difference in terms of meeting the PVP criteria and vHIT may be optimal when evaluating age-related changes.