Background and Objectives: There are several diagnostic and therapeutic modalities for chronic rhinosinusitis (CRS), but specific guidelines have not been developed for Koreans. This study sought to evaluate and report CRS practice patterns of members of the Korean Rhinologic Society.Materials and Method: An anonymous survey including 32 items was conducted from August to September 2015. The survey items were categorized into three parts: general information, diagnosis and treatment of CRS, and endoscopic sinus surgery. Results: A total of 267 members participated in this survey. Almost half of the respondents (41.9%) were in their 40s and 42.7% had 10-20 years of experience. A total of 61.8% were private practitioners, while the rest worked in hospitals (38.2%). The prevalence rate of acute rhinosinusitis was higher in private clinics compared to hospitals (p<0.001). Intranasal steroids and saline irrigation were more commonly prescribed among hospital doctors compared to private practitioners (p<0.001). Amoxicillin/clavulanic acid was the drug of choice for adult and pediatric CRS patients among private practitioners. However, hospital doctors preferred macrolides for adult CRS patients and third-generation cephalosporins for pediatric CRS patients. Most private clinics performed surgery under local anesthesia (90.8%), while those in a hospital setting preferred general anesthesia (78.4%). Revision surgery rates were higher in hospitals compared to private clinics (p<0.001). Conclusion There were significant variations in CRS practice patterns between private clinics and hospitals. For effective and standardized diagnosis and management of CRS, appropriate local guidelines are needed.

BACKGROUND AND OBJECTIVES: It is difficult to correct anterior nasal septal dislocation and subluxation. This study reviewed our surgical technique for correcting septal dislocation and subluxation. SUBJECTS AND METHOD: This retrospective study reviewed the medical records of 20 patients who underwent septal reconstructive suturing of the cartilage to the premaxilla. Acoustic rhinometry, endoscopic pictures, visual analogue scale (VAS) scores, and patient satisfaction were evaluated. RESULTS: The results of acoustic rhinometry showed that there was significant (p<0.05) improvement in the minimum cross-sectional area on both sides of the nasal cavity. The nasal cavity volume was also increased bilaterally, although not significantly on the convex side (convex side, p=0.108; concave side, p=0.007). Thirteen patients had complete correction of the septal deformity on the endoscopic pictures and seven had incomplete correction. The VAS score for nasal obstruction was decreased significantly (p<0.05). Most patients (85%) felt satisfied with the surgery. Only one patient complained about a mild deformity of the external nose. No other major complications were encountered. CONCLUSION: The correction of caudal septal dislocation or subluxation with the excision of excessive septal cartilage and suturing the cartilage to the premaxilla are both successful methods for treating septal deformities.
Cartilage* ; Congenital Abnormalities ; Dislocations* ; Humans ; Medical Records ; Nasal Cavity ; Nasal Obstruction ; Nose ; Patient Satisfaction ; Retrospective Studies ; Rhinometry, Acoustic

BACKGROUND AND OBJECTIVES: Inverted papillomas (IPs) are rare benign tumors of nasal epithelium with high recurrence rates and malignant transformation potential. Tumor development results from imbalance between cell proliferation and "programmed cell death", also named apoptosis. The purpose of this study was to compare cell proliferation, apoptosis, and apoptosis inhibition in hyperplastic epithelium from IPs and nasal polyps (NPs), and also to understand the mechanism of growth and malignant transformation of IPs. MATERIALS AND METHODS: IP samples were obtained after surgical removal of tumor in 15 patients, and NPs were sampled during endoscopic sinus surgery in 7 patients as a control. IP samples were classified in three groups: group I (n=9) -IP without dysplasia or carcinoma, group II (n=3) -IP with dysplasia, group III (n=3) -IP with carcinoma. Cell proliferation and apoptosis inhibition, respectively, were assessed by immunohistochemical identification of the Ki-67 and the oncoprotein Bcl-2. Apoptosis was evaluated by analyzing the DNA fragmentation using TUNEL method. RESULTS: Ki-67 index was increased in IPs compared to NPs (p=0.001). Of the IPs, Ki-67 index was increased progressively from IP without dysplasia or caccinoma, through IP with dysplasia, to reach the highest level in IP with carcinoma. Apoptotic index was also increased in IPs (p=0.002) with the highest level in IP without dysplasia or carcinoma. Of the IPs, apoptotic index was decreased as the tumor progress. Bcl-2 index was decreased in IPs (p=0.004), but, of the IPs, as the tumor progress, bcl-2 index was more decreased. CONCLUSION: Tumor development of IPs could result from the imbalance between hugely increasing epithelial cell proliferation and slightly increasing apoptosis, and the inhibition of apoptosis via bcl-2 oncoprotein seems to be involved in the growing process of IPs. Although we can not exactly mention due to limited number of cases, these imbalance may be involved in dysplastic or malignant transformation of IPs, but may be independent of the expression of bcl-2.
Apoptosis* ; Cell Proliferation ; DNA Fragmentation ; Epithelial Cells* ; Epithelium ; Humans ; In Situ Nick-End Labeling ; Nasal Mucosa ; Nasal Polyps ; Papilloma, Inverted* ; Recurrence

BACKGROUND AND OBJECTIVES: Sphenoid sinus is surrounded by several important structures and this can make sphenoid sinus surgeries difficult. The aim of this study was to clarify the anatomical features of the sphenoid sinus with its surrounding structures based on 3-dimensional multidetector computed tomography. SUBJECTS AND METHOD: We obtained the sagittal reconstruction images of the sphenoid sinus from of 110 participants and measured various distances in the sphenoid sinus. In addition, we analyzed the impact of anatomical variation on the results of measured distances, such as presence of Onodi cell (Onodi type vs. non-Onodi type) and the location of sphenoid ostium corresponding to the level of sella floor (superior type vs. inferior type). RESULTS: In the Onodi type, the mean distance from the sphenoid ostium to the roof of sphenoid sinus (5.81+/-1.12 mm vs. 10.31+/-2.90 mm, p=0.001) and the mean length of sphenoid sinus roof (4.52+/-1.00 mm vs. 9.89+/-4.17 mm, p=0.001) were significantly shorter than those in the non-Onodi type. In superior type, the mean distance from the sphenoid ostium to the floor of sphenoid sinus (12.44+/-2.63 mm vs. 9.90+/-2.31 mm, p<0.001) and that from sphenoid ostium to the posterior wall of sphenoid sinus (13.44+/-3.27 mm vs. 20.38+/-7.63 mm, p<0.001) were significantly longer compared with those in the inferior type. However, the mean distance from the sphenoid ostium to the roof of sphenoid sinus was shorter (7.49+/-1.86 mm vs. 10.51+/-3.03 mm, p<0.001). CONCLUSION: The present study provides anatomical information about sphenoid sinus with important surgical distance measured between the sphenoid ostium and the surrounding structures, which is essential to avoid the complications during sphenoid surgery.
Anatomic Landmarks ; Floors and Floorcoverings ; Multidetector Computed Tomography ; Sphenoid Sinus

Optic neuritis (ON) is an acute or subacute inflammatory or demyelination process affecting the optic nerve. ON can be classified ophthalmologically as retrobulbar neuritis, papillitis, neuroretinitis. Retrobulbar neuritis, in which the optic disc appearance is normal, is the most common type of ON in adults. Multiple sclerosis is the most common cause of ON, but in many cases no apparent etiology is found. Paranasal sinusitis as a cause of ON is rare. Management of retrobulbar neuritis which is combined with paranasal sinusitis is controversial. Recently, we experienced a case of retrobulbar neuritis which was combined with paranasal sinusitis without orbital complication. It was treated by endoscopic sinus surgery and endoscopic optic nerve decompression in addition to intravenous antibiotics and corticosteroids. Visual acuity was improved nearly to a normal state after the treatment. The most possible pathophysiologic mechanism of retrobulbar neuritis may be the direct spread of infection of the sphenoid sinus to the optic nerve.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Decompression* ; Demyelinating Diseases ; Humans ; Multiple Sclerosis ; Optic Nerve* ; Optic Neuritis* ; Orbit ; Papilledema ; Retinitis ; Sinusitis* ; Sphenoid Sinus ; Visual Acuity

Peripheral T cell neoplasms (PTCNs) comprise a group of uncommon and heterogenous lymphoid malignancies. They are more difficult to diagnose and treat and have a worse prognosis than B cell lymphomas. NK/T cell lymphoma is the most common histologic subtype in the head and neck. Unspecified type is the most common subtype of PTCNs but is not reportedin oral cavity or nasal cavity. We report a case of a perforating palatal ulceras a rare presentation of peripheral T cell lymphoma with a review of literature.
Actinomycosis ; Head ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, T-Cell, Peripheral ; Mouth ; Nasal Cavity ; Neck ; Palate, Hard ; Prognosis ; Ulcer

OBJECTIVE: The purpose of this study was to estimate the prevalence of metabolic syndrome, as defined by the ATP III report, in some Korean adults and use the Asian-Pacific proposed waist circumference to investigate waist circumference in some Korean adults using ROC curves. METHODS: Study subjects were seventy-five thousands and ninety one persons (47, 979 men and 27, 111 women) who were selected among the patients who visited hospital for health evaluation from January 2000 to December 2001. All subjects were measured by height, weight, waist and hip circumferences, blood pressure and blood chemistry (lipid profile). RESULTS: The mean age was 41.6+/-8.5 years in men, 41.1+/-10.4 years in women (p< 0.05). Body mass index was in the normal range in 35.3% of men, and 55.9% of women. In both men and women, blood pressure, blood sugar, total cholesterol and triglyceride were positively correlated with BMI. waist circumference, and Broca's index (p< 0.01). However HDL. choloesterol was correlated negatively (p< 0.01). Using ROC curve, the calculated waist circumferences were 84 cm in men (sensitivity 61.4% and specificity 64.1%) and 74 cm in women (sensitivity 65.0% and specificity 73.2%). The age adjusted prevalences of the metabolic syndrome as defined by NCEP ATP III were different for men (6.4%) and women (14.6%). The prevalence increased from 1.2% among participants aged 20 through 29years to 15.0% among participants aged over 60years in men (p< 0.05) and from 1.6% to 27.4% respectively, in women. The age adjusted prevalences, as defined by using the waist circumference that was recommended by WHO's regional office for the western Pacific, were 10.6% in men and 18.5% in women. The age adjusted prevalences, as defined by using the waist circumference that was calculated by the ROC curves, were 17.1% in men and 22.4% in women. And All prevalences were increased following increased BMI and Broca's index. CONCLUSIONS: The prevalence of metabolic syndrome in some Korean adults was lower than that in western adults. Nevertheless because waist circumference was differed among race and region, application of the same criteria was not proper. Morcover, a higher awareness was required in women, because the prevalence of metabolic syndrome was rapidly increased with increment of age.
Adenosine Triphosphate ; Adult* ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Chemistry ; Cholesterol ; Continental Population Groups ; Female ; Hip ; Humans ; Male ; Obesity ; Prevalence* ; Reference Values ; ROC Curve ; Sensitivity and Specificity ; Triglycerides ; Waist Circumference*

OBJECTIVES: To evaluate the surgical outcomes of endoscopic dacryocystorhinostomy followed by canalicular trephination and silicone stenting in patients with distal or common canalicular obstructions. METHODS: The medical records of 29 patients (31 eyes) from January 2001 to December 2009 who underwent endoscopic dacryocystorhinostomy followed by canalicular trephination and silicone tube insertion for the treatment of distal or common canalicular obstructions were retrospectively reviewed. The level of obstruction was confirmed by intraoperative probing. The outcome of the surgery was categorized as a complete success, partial success, or failure according to the functional and anatomic patency. RESULTS: The average age of the patients was 52 years. The duration of silicone intubation ranged from 4 to 11 months with an average of 5.7+/-1.6 months. The follow-up period after stent removal ranged from 4 to 15 months with an average of 8.2+/-3.3 months. Complete success was achieved in 25 out of 31 eyes (80.6%), partial success in 4 out of 31 eyes (12.9%), and failure in 2 out of 31 eyes (6.5%). CONCLUSION: Endoscopic dacryocystorhinostomy followed by canalicular trephination and silicone stent intubation may be safe and considered as an initial treatment of patients with distal or common canalicular obstructions.
Dacryocystorhinostomy ; Endoscopes ; Eye ; Follow-Up Studies ; Humans ; Intubation ; Lacrimal Apparatus Diseases ; Medical Records ; Retrospective Studies ; Silicones ; Stents

Electrocardiographic abnormalities commonly associated with hypopituitarism are low QRS voltage, ST-segment depression, inverted T waves and a prolonged QT interval. Although the mechanism remains unclear, glucocorticoid therapy, an intracelluar-extracellular electrolyte imbalance of myocytes, and histopathological changes in the myocardium are thought to play a role in this disorder. We discribe a 64 year old woman with recurrent ventricular tachycardia associated with QT prolongation in Sheehan's syndrome. Ventricualr tachycardia was treated by lidocain and direct current cardioversion. Sheehan's syndrome was confirmed by past history, anterior pituirary stimulation test and brain MRI showed empty sella. After hormone replacement treatment, inverted T waves and prolonged QT interval was normalized and ventricular tachycardia did not recur.
Brain ; Depression ; Electric Countershock ; Electrocardiography ; Female ; Humans ; Hypopituitarism* ; Magnetic Resonance Imaging ; Middle Aged ; Muscle Cells ; Myocardium ; Tachycardia ; Tachycardia, Ventricular*