A paranasal sinus mucocele is an epithelial-lined, mucus-containing sac that completely fills the sinus and forms an expandable cystic structure. It most commonly affects the frontal and ethmoidal sinuses, and rarely the maxillary and sphenoid sinuses. Orbital displacement or external disfigurement resulting from the expansion of the frontal or ethmoid sinuses is common; however, facial asymmetry caused by maxillary bone remodeling is rare. We describe a case of large maxillary sinus mucocele that destroyed the maxillary sinus bony wall, resulting in notable left cheek swelling and disfigurement, and review the relevant literature.

Herniation of the temporomandibular joint (TMJ) into the external auditory canal is rare as TMJ and external auditory canal are separated by an anterior bony wall of external auditory canal. The bony defect of the anterior external auditory canal can be caused by trauma, otologic procedure, neoplasm, inflammation and a rare congenital bony defect. Conservative treatment is available if the severity of the symptom is mild or asymptomatic. However, surgical procedure is considered if the patient experiences severe distress. There have been no reported cases of surgical-related complications and recurrence during postoperative follow-up period. Herein we report the very first case of foreign body prolapse involving herniation from TMJ extending into the external auditory canal.

Background/Aims: Functional dyspepsia (FD) is a chronic upper gastrointestinal symptom complex that routine diagnostic work-up, such as endoscopy, blood laboratory analysis, or radiological examination, fails to identify a cause for. It is highly prevalent in the Korean population, and its response to the various available therapeutic strategies is only modest because of the heterogeneous nature of its pathogenesis. We constituted a guidelines development committee to review the existing guidelines on the management of FD. Methods: This committee drafted statements and conducted a systematic review and meta- analysis of various studies, guidelines, and randomized control trials. External review was also conducted by selected experts. These clinical practice guidelines for FD were developed based on evidence recently accumulated with the revised version of FD guidelines released in 2011 by the Korean Society of Neurogastroenterology and Motility. Results: These guidelines apply to adults with chronic symptoms of FD and include the diagnostic role of endoscopy, Helicobacter pylori screening, and systematic review and meta-analyses of the various treatment options for FD (proton pump inhibitors, Helicobacter pylori eradication, and tricyclic antidepressants), especially according to the FD subtype. Conclusions The purpose of these new guidelines is to aid understanding, diagnosis, and treatment of FD, and the targets of the guidelines are clinicians, healthcare workers at the forefront of patient care, patients, and medical students. The guidelines will continue to be revised and updated periodically.

Background/Aims: Functional dyspepsia (FD) is a chronic upper gastrointestinal symptom complex that routine diagnostic work-up, such as endoscopy, blood laboratory analysis, or radiological examination, fails to identify a cause for. It is highly prevalent in the Korean population, and its response to the various available therapeutic strategies is only modest because of the heterogeneous nature of its pathogenesis. We constituted a guidelines development committee to review the existing guidelines on the management of FD. Methods: This committee drafted statements and conducted a systematic review and meta- analysis of various studies, guidelines, and randomized control trials. External review was also conducted by selected experts. These clinical practice guidelines for FD were developed based on evidence recently accumulated with the revised version of FD guidelines released in 2011 by the Korean Society of Neurogastroenterology and Motility. Results: These guidelines apply to adults with chronic symptoms of FD and include the diagnostic role of endoscopy, Helicobacter pylori screening, and systematic review and meta-analyses of the various treatment options for FD (proton pump inhibitors, Helicobacter pylori eradication, and tricyclic antidepressants), especially according to the FD subtype. Conclusions The purpose of these new guidelines is to aid understanding, diagnosis, and treatment of FD, and the targets of the guidelines are clinicians, healthcare workers at the forefront of patient care, patients, and medical students. The guidelines will continue to be revised and updated periodically.

Primary malignant lesions in the external auditory canal are rare. While squamous cell carcinoma is the most common of these lesions, there are also basal cell carcinoma, malignant melanoma and adenocarcinoma, etc. However, squamous cell carcinoma in situ of the external auditory canal is extremely rare since its first report in the English literature in 1953 and has not been reported in Korea. Its clinical manifestations are very similar to chronic ear disease. For treatment, local wide resection of the lesions is preferred. We recently encountered a 54-year-old female, who presented with intermittent irritating sensation in the external auditory canal. Otoscopic examination showed a scaly plaque with the irregular surface on the anteroinferior portion of the left external auditory canal. Excisional biopsy revealed a squamous cell carcinoma in situ. We report this very rare and unique case with a literature review.

Community-based preconception care for men and women of childbearing age has been introduced in Seoul. The program aims to focus on problem areas such as low birth rate, fertility issues potentially due to late marriages, preterm or premature births, and low-birthweight in newborn babies. The district administration officials of Seoul, as well as, academics from the Korean Society of Maternal and Child Health, developed a protocol by using a questionnaire and laboratory test for screening risk factors in pregnancy. The protocol was tested on a trial basis in four local districts in Seoul from July 2017 to 2018, extended to 12 local districts in 2019, and all 25 districts in Seoul in 2020. The protocol includes AntiMullerian Hormone tests to assess women’s ovarian reserve and male health checkups that include semen analysis and physical examinations of genitalia. These tests are conducted for early detection and treatment of infertility, especially in cases of late marriages. In order to prevent women being abandoned during pregnancy (leading them to single-parenting), the protocol also emphasizes building a gender-sen sitive environment by encouraging more male participation. A monitoring group comprised of Seoul city district officials and academics from the Korean Society of Maternal and Child Health, regularly visited the local districts to observe improvements and keep the program officials up to date. In addition, the group also conducted a mobile phone survey for feedback on the program. The interest and support of the resi dents in Seoul city, and positive results and development in pregnancy care and childbirth, are needed to stabilize and extend this protocol.

Objective: : The use of oblique lateral interbody fusion at the L5–S1 level (OLIF51) is increasing, but no study has directly compared OLIF51 and transforaminal lumbar interbody fusion (TLIF) at the L5–S1 level. We evaluated the usefulness of OLIF51 by comparing clinical and radiologic outcomes with those of TLIF at the same L5–S1 level. Methods: : We retrospectively reviewed and compared 74 patients who underwent OLIF51 (OLIF51 group) and 74 who underwent TLIF at the L5–S1 level (TLIF51 group). Clinical outcomes were assessed with the visual analogue scale for back pain and leg pain and the Oswestry Disability Index. Mean disc height (MDH), foraminal height (FH), disc angle (DA), fusion rate, and subsidence rate were measured for radiologic outcomes. Results: : The OLIF51 group used significantly higher, wider, and larger-angled cages than the TLIF51 group (p<0.001). The postoperative MDH and FH were significantly greater in the OLIF51 group than in the TLIF51 group (p<0.001). The postoperative DA was significantly larger in the OLIF51 group than in the TLIF51 group by more than 10º (p<0.001). The fusion rate was 81.1% and 87.8% at postoperative 6 months in the OLIF51 and TLIF51 groups, respectively, and the TLIF51 group showed a higher fusion rate (p<0.05). The subsidence rate was 16.2% and 25.3% in the OLIF51 and TLIF51 groups, respectively, and the OLIF51 group showed a lower subsidence rate (p<0.05). Conclusion : OLIF51 was more effective for the indirect decompression of foraminal stenosis, providing strong mechanical support with a larger cage, and making a greater lordotic angle with a high-angle cage than with TLIF.

Functional dyspepsia (FD) is a chronic upper gastrointestinal (GI) symptom complex that routine diagnostic work-up, such as endoscopy, blood laboratory analysis, or radiological examination, fails to identify a cause. It is highly prevalent in the World population, and its response to the various available therapeutic strategies is only modest because of the heterogenous nature of its pathogenesis. Therefore, FD represents a heavy medical burden for healthcare systems. We constituted a guideline development committee to review the existing guidelines on the management of functional dyspepsia. This committee drafted statements and conducted a systematic review and meta-analysis of various studies, guidelines, and randomized control trials. External review was also conducted by selected experts. These clinical practice guidelines for FD were developed based on evidence recently accumulated with the revised version of FD guidelines released in 2011 by the Korean Society of Neurogastroenterology and Motility. These guidelines apply to adults with chronic symptoms of FD and include the diagnostic role of endoscopy, Helicobacter pylori screening, and systematic review and meta-analyses of the various treatment options for FD (proton pump inhibitors, H. pylori eradication, and tricyclic antidepressants), especially according to the FD subtype. The purpose of these new guidelines is to aid the understanding, diagnosis, and treatment of FD, and the targets of the guidelines are clinicians, healthcare workers at the forefront of patient care, patients, and medical students. The guidelines will continue to be revised and updated periodically.

Warthin's tumor (WT) is second most common neoplasm in the parotid gland and it can be accompanied by inflammation and necrosis. The chest wall inflammation may present a rapid and fatal clinical course and secondary to parotid abscess is extremely rare. An 81-year-old man came to emergency room complained of rapidly enlarged left parotid mass and inflammatory symptoms and signs around the upper lateral neck. We performed incision and drainage with adequate infection control. He was pathologically diagnosed as abscess. We report the unique and instructive clinical case with a literature review.
Abscess ; Aged, 80 and over ; Drainage ; Emergency Service, Hospital ; Humans ; Infection Control ; Inflammation ; Neck ; Necrosis ; Parotid Gland ; Thoracic Wall ; Thorax

OBJECTIVE: Few studies have reported direct comparative data of lumbar spine angles between direct lateral interbody fusion (DLIF) and oblique lateral interbody fusion (OLIF). The purpose of this study was to investigate the clinical and radiological outcomes of DLIF and OLIF, and determine influential factors.METHODS: The same surgeon performed DLIF from May 2011 to August 2014 (n=201) and OLIF from September 2014 to September 2016 (n=142). Radiological parameters, cage height, cage angle (CA), cage width (CW), and cage location were assessed. We checked the cage location as the distance (mm) from the anterior margin of the disc space to the anterior metallic indicator of the cage in lateral images.RESULTS: There were significant differences in intervertebral foramen height (FH; 22.0±2.4 vs. 21.0±2.1 mm, p<0.001) and sagittal disc angle (SDA; 8.7±3.3 vs. 11.3±3.2˚, p<0.001) between the DLIF and OLIF groups at 7 days postoperatively. CA (9.6±3.0 vs. 8.1±2.9˚, p<0.001) and CW (21.2±1.6 vs. 19.2±1.9 mm, p<0.001) were significantly larger in the OLIF group compared to the DLIF group. The cage location of the OLIF group was significantly more anterior than the DLIF group (6.7±3.0 vs. 9.1±3.6 mm, p<0.001). Cage subsidence at 1 year postoperatively was significantly worse in the DLIF group compared to the OLIF group (1.0±1.5 vs. 0.4±1.1 mm, p=0.001). Cage location was significantly correlated with postoperative FH (β=0.273, p<0.001) and postoperative SDA (β=-0.358, p<0.001). CA was significantly correlated with postoperative FH (β=-0.139, p=0.044) and postoperative SDA (β=0.236, p=0.001). Cage location (β=0.293, p<0.001) and CW (β=-0.225, p<0.001) were significantly correlated with cage subsidence.CONCLUSION: The cage location, CA, and CW seem to be important factors which result in the different-radiological outcomes between DLIF and OLIF.
Lumbar Vertebrae ; Spinal Fusion ; Spine