1.Perimenstrual Epistaxis Caused by Nasal Septal Endometriosis: Very Rare Case Report
Journal of Rhinology 2022;29(3):182-184
We present a case of localized nasal endometriosis to contribute to the literature. A primiparous, primigravida, 37-year-old female was diagnosed with nasal septal endometriosis in the presence of history of periodic epistaxis, nasal pain, and nasal fullness. After a nasal biopsy for exclusion of malignancy, a comprehensive general screening was performed on the recommendation of a gynecologist, definitive endometriosis was diagnosed, and oral treatment was initiated. Significant relief was reported in her nasal symptoms during the 1-year follow-up period. We report this case to demonstrate the importance of clinical awareness of periodic cyclic perimenstrual epistaxis, nasal lesions, and nasal pain as a cause of nasal septal endometriosis.
2.Surgical Outcomes of Sigmoid Sinus Resurfacing for Pulsatile Tinnitus: The Predictive Value of the Water Occlusion Test and Imaging Studies
Ji Hyung LIM ; Jae Sang HAN ; Aynur ALIYEVA ; Jae-Hyun SEO ; So Young PARK ; Shi Nae PARK
Clinical and Experimental Otorhinolaryngology 2023;16(3):244-250
Objectives:
. Sigmoid sinus resurfacing (SS-R) is one of the most effective surgical treatments for patients with pulsatile tinnitus (PT) originating from anatomical variants of the vascular walls in the temporal bone. This study aimed to provide updated information on the clinical outcomes of SS-R and evaluate the efficacy of the water occlusion test (WOT) as an additional diagnostic modality.
Methods:
. We retrospectively reviewed medical records including tinnitus questionnaires, temporal bone computed tomography (TBCT) scans, audiologic tests, and preoperative WOT results from patients who underwent SS-R.
Results:
. In total, 26 patients were included in the study. The mean age was 44 years, and the mean symptom duration was 3 months. Fourteen patients (53.8%) were completely cured, seven (26.9%) significantly improved, and five (19.2%) remained stable. The mean visual analog scale loudness score decreased from 5.26 to 1.34 (P<0.001) and the mean Tinnitus Handicap Inventory score also improved from 50.23 to 5.5 (P<0.001) after SS-R surgery. In 10 patients with discrepancies between the preoperative TBCT and intraoperative findings, WOT showed a significant additive effect in predicting surgical outcomes. No patients experienced severe intraoperative or postoperative complications during the entire follow-up period.
Conclusion
. SS-R provides significant symptom improvement in patients with sigmoid sinus dehiscence who had a positive WOT without other sigmoid sinus variants. A combined diagnostic approach with TBCT, WOT, and intraoperative findings is crucial for achieving better surgical outcomes in patients with PT caused by sigmoid sinus variants.