Malignancy of the middle ear is rare and its estimated incidence is 0.18 cases per million people in the US, with its most common type being squamous cell carcinoma. Squamous cell carcinoma in situ is thought to be a precursor to squamous cell carcinoma, which is extremely rare in the middle ear. The pathology reports of squamous cell carcinoma have not been well-characterized as it has not been reported to date in Korea. Here, we report a case of squamous cell carcinoma in situ of the middle ear in a 66-year-old man, who presented with otorrhea and tympanic membrane perforation.
Aged ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Ear, Middle ; Epithelial Cells ; Humans ; Incidence ; Korea ; Pathology ; Tympanic Membrane Perforation

Malignancy of the middle ear is rare and its estimated incidence is 0.18 cases per million people in the US, with its most common type being squamous cell carcinoma. Squamous cell carcinoma in situ is thought to be a precursor to squamous cell carcinoma, which is extremely rare in the middle ear. The pathology reports of squamous cell carcinoma have not been well-characterized as it has not been reported to date in Korea. Here, we report a case of squamous cell carcinoma in situ of the middle ear in a 66-year-old man, who presented with otorrhea and tympanic membrane perforation.

Essential thrombocythemia is a kind of myeloproliferative disorder characterized by primary elevation in the number of platelet and by multiple episodes of bleeding or thrombotic complications. Rarely, thrombocythemia itself causes coronary arterial occlusion and leads to ischemic heart disease. Fewer than twenty cases of coronary artery occlusive disease in thrombocythemia have been reported since Cheitlin et al had included thrombocythemia in their review of rare causes of myocardial infarction. We experienced a case of coronary artery disease in a 53-year-old woman with thrombocythemia, who had not coronary artery disese risk factors at all. Presence of multiple thrombus in the coronary artery was suggested in coronary angiography.
Angina, Unstable* ; Blood Platelets ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Female ; Hemorrhage ; Humans ; Middle Aged ; Myeloproliferative Disorders ; Myocardial Infarction* ; Myocardial Ischemia ; Risk Factors ; Thrombocythemia, Essential ; Thrombocytosis* ; Thrombosis

BACKGROUND AND OBJECTIVES: Various surgical approaches have been employed for the complete resection of inverted papilloma (IP) of the nose and paranasal sinus. Sacrificing the inferior turbinate (IT) and nasolacrimal duct (NLD) is often unavoidable due to the anatomy of maxillary sinus. However, the prelacrimal recess approach (PLRA) provides a wider entrance to the maxillary sinus without the ablation of NLD and IT. We present seven cases of IP successfully treated by the PLRA. SUBJECTS AND METHOD: We collected data from seven different cases involving patients who underwent resection of IP by means of the PLRA from 2016 to 2017. If the lesion could not be removed first via middle meatal antrostomy (MMA), then PLRA was attempted. The surgical specimens were all confirmed to be IP. RESULTS: Preoperative imaging studies demonstrated that the lesions of IP were located mainly in the maxillary sinus. All of the seven patients had unilateral lesions and all tumors were completely resected via PLRA. The follow-up ranged from 3 to 24 months, during which no recurrence or complications were observed in any of the seven patients. CONCLUSION: PLRA provides an adequate operation field without unfavorable scars. It allows the preservation of sinus structure and function. PLRA is feasible and can be used for the diffuse maxillary sinus IP.
Cicatrix ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Methods ; Nasolacrimal Duct ; Nose ; Papilloma, Inverted ; Recurrence ; Turbinates

BACKGROUND AND OBJECTIVES: Various surgical approaches have been employed for the complete resection of inverted papilloma (IP) of the nose and paranasal sinus. Sacrificing the inferior turbinate (IT) and nasolacrimal duct (NLD) is often unavoidable due to the anatomy of maxillary sinus. However, the prelacrimal recess approach (PLRA) provides a wider entrance to the maxillary sinus without the ablation of NLD and IT. We present seven cases of IP successfully treated by the PLRA.SUBJECTS AND METHOD: We collected data from seven different cases involving patients who underwent resection of IP by means of the PLRA from 2016 to 2017. If the lesion could not be removed first via middle meatal antrostomy (MMA), then PLRA was attempted. The surgical specimens were all confirmed to be IP. RESULTS: Preoperative imaging studies demonstrated that the lesions of IP were located mainly in the maxillary sinus. All of the seven patients had unilateral lesions and all tumors were completely resected via PLRA. The follow-up ranged from 3 to 24 months, during which no recurrence or complications were observed in any of the seven patients. CONCLUSION PLRA provides an adequate operation field without unfavorable scars. It allows the preservation of sinus structure and function. PLRA is feasible and can be used for the diffuse maxillary sinus IP.

Background and Objectives: Endoscopic prelacrimal recess approach (PLRA) was introduced to treat maxillary sinus inverted papilloma (IP) without sacrificing the inferior turbinate and nasolacrimal duct. This study aimed to compare surgical outcomes of prelacrimal recess approach with the conventional Caldwell-Luc approach (CLA) to remove IP of maxillary sinus and to evaluate the usefulness of the PLRA.Subjects and Method We retrospectively reviewed medical records of 51 patients who were treated in our institution for IP of nasal cavity and sinuses between March 2010 and June 2019. Twenty patients had maxillary sinus IP. Sixteen patients underwent endoscopic sinus surgery combined with either CLA (n=8) or PLRA (n=8). Demographic data, surgical technique, site of IP origin, intra- and postoperative complications, duration of follow-up, recurrence rate and pathologic diagnosis were reviewed. Results: IP was the pathologic diagnosis for all 16 cases. Gross total removal was achieved in all cases. The mean follow-up period was 20.1 months in CLA group and 12.5 months in PLRA group. There was one case of massive bleeding during operation requiring transfusion and postoperative ICU care in CLA group. On postoperative follow-up, two patients from the CLA group had recurrence during the follow-up period. One patient had numbness around the gingival area, another patient had transient wound dehiscence, and another had persistent oro-antral fistula. In PLRA group, one patient had periorbital swelling after blowing nose; otherwise, no other patient from the PLRA group developed subjective complaints after surgery. Conclusion Endoscopic prelacrimal recess approach showed lower complication rates and recurrence rates compared to CLA. PLRA is a safe and effective method for the excision of primary maxillary sinus IP.