No abstract available.
Cholesteatoma* ; Otitis Media* ; Otitis* ; Temporal Bone*

BACKGROUND AND OBJECTIVES: Nasal polyps are a condition of uncertain etiology. Cytokines are thought to play a role in nasal polyps in vitro, but in vivo studies on the patterns of cytokine expression in nasal polyps have been limited. The aim of the present study is to gain a better understanding of the pathophysiology of nasal polyps by defining the patterns of expression of cytokine mRNA and p53 in the nasal mucosa of patients with nasal polyps. MATERIALS AND METHODS: This objective was supported by performing RT-PCR (reverse transcription-polymerase chain reaction) for IL-2, INF-gamma (T1 cytokine), IL-5, IL-8, IL-10, IL-13 (T2 cytokine), TNF-alpha, TGF-beta1, and p53. RESULTS: Observation of the nasal polyps indicated significant increases in mRNA for T2 cytokines and p53 over controls. The expressions of IL-10 and IL-13 mRNA in the nasal mucosa of non-allergic patients were stronger than in that of allergic patients. CONCLUSION: This result suggests that the pathogenesis of nasal polyps is associated with T2 cytokines and p53.
Cytokines* ; Humans ; Interleukin-10 ; Interleukin-13 ; Interleukin-2 ; Interleukin-5 ; Interleukin-8 ; Nasal Mucosa ; Nasal Polyps* ; Polyps ; RNA, Messenger ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery has become an effective tool for the treatment of chronic sinusitis. The success of this procedure can be best determined by a long-term evaluation of the surgery results from patients who are grouped according to the prepoerative severity of the disease. In this study we attempted to evaluate the results of endoscopic sinus surgery according to the severity of the disease and the length of the follow-up period. MATERIALS AND METHODS: Questionnaires were sent out to 313 patients with chronic sinusitis who underwent endoscopic sinus surgery at our department from April 1992 to October 1995. Replies from 118 patients (37.69%) were analyzed. All patients had taken preoperative ostiomeatal unit computed tomography (OMU-CT) and their results were graded according to the Levine and May's grading system. The follow-up periods ranged from 7 to 51 months, with the mean of 27 months. RESULTS: All nasal symptoms including nasal obstruction, rhinorrhea, postnasal drip, anosmia and headache significantly improved. The nasal obstruction symptom improved by 76.8%, rhinorrhea 62.1%, postnasal drip 64.4%, anosmia 50.0% and headache 80.0%. However, no statistical significance could be drawn between the improvement rate and the different lengths of the follow-up periods. CONCLUSION: The results suggest that endoscopic sinus surgery might improve nasal symptoms in patients with chronic sinusitis regardless of the severity of disease and the length of follow-up period.
Follow-Up Studies* ; Headache ; Humans ; Nasal Obstruction ; Olfaction Disorders ; Surveys and Questionnaires ; Sinusitis

BACKGROUND AND OBJECTIVES: Although sinusitis is commonly caused by nasal diseases that interfere with ostiomeatal unit, non-rhinogenic sinusitis, for example, post-traumatic or odontogenic, is often encountered. However, it remains unclear whether non-rhinogenic sinusitis affects the function and morphology of the nasal mucosa. The aim of the current study is to observe effects of experimentally induced maxillary sinusitis on ciliary beat frequency and histopathology of the nasal mucosa in rabbits. MATERIALS AND METHOD: Maxillary sinusitis was induced in the right sides of 10 rabbits by partially occluding the natural ostia and inoculating the maxillary sinus with P. aeruginosa. After 4 weeks, the nasal mucosa was obtained from the inferior turbinate and the septum in the right (experimental group) and the left side (control group A). Both sides of the nasal mucosa in another 5 normal rabbits were used as the control group B. Ciliary beat frequency (CBF) was measured by video-computerized analysis and degree of inflammation in histopathology was graded using a 100-point scale of inflammation score. CBF and inflammation score were compared between the three groups. RESULTS: CBFs of the experimental group were significantly lower than those of the control groups A and B. Inflammation scores of the experimental group were significantly higher than those of the control groups. In the experimental group, there were no correlations between CBFs of the maxillary and nasal mucosa, but weak correlations existed between inflammation scores of the maxillary and nasal mucosa. CONCLUSION: Primary maxillary sinusitis can locally induce dysfunction and inflammation of the nasal mucosa.
Inflammation ; Maxillary Sinus* ; Maxillary Sinusitis* ; Nasal Mucosa* ; Nose Diseases ; Rabbits* ; Sinusitis ; Turbinates

Iatrogenic cerebrospinal fluid(CSF) rhinorrhea, rarely occuring, is one of the major complications, and should be managed immediately if it occurs during operation. CSF leakage can be repaired intracranially or extracranially. Extracranial approaches are subdivided into extranasal and intranasal. Recent advance in nasal endoscopy and its advantage of low morbidity allow more surgeons to perform the intranasal approach using endoscope. As graft materials, free or rotational flaps of temporalis muscle fascia, muscle, fat, and mucosa or mucoperiosteum in the nasal septum or turbinates have widely been used. Sometimes composite graft such as osteomucoperiosteal(OMP) free flap was also used. By intranal endoscopic approach using OMP free flap obtained from the middle Turbinate(MT), we successfully repaired CSF leakage from a defect, 5~7mm in size, which had occured in the right ethmoid roof near the lamina cribrosa during endoscopic sinus surgery on a patient with chronic paranasal sinusitis. Repair of CSF rhinorrhea using MT OMP free flap may be an useful technique for immediate intraoperative management of the defect, if it is not so large, because of availability and easy handling of this flap in the same surgical field.
Cerebrospinal Fluid Rhinorrhea* ; Cerebrospinal Fluid* ; Endoscopes ; Endoscopy ; Fascia ; Free Tissue Flaps* ; Humans ; Mucous Membrane ; Nasal Septum ; Sinusitis ; Transplants ; Turbinates*

The aim of this study is to develop an animal model of polyps that is more suitable for further polyp studies by semiquantitatively analyzing the effects of Pseudomonas aeruginosa infection and/or mechanical trauma to the sinus mucosa, based on the epithelial rupture theory, on polyp formation in the rabbit maxillary sinuses. The natural ostia were occluded in 30 Pasturellafree New Zealand white rabbits. All rabbits were divided into three groups according to the following modes of manipulation on the right maxillary sinus: inoculation with P. aeruginosa (group A), brushing of the sinus mucosa (group B), and inoculation with P. aeruginosa accompanied by brushing of the mucosa (group C). The left maxillary sinuses were used as the control. After four weeks, macroscopic polyps and light microscopic polyps and/or polypoid mucosa were semiquantitatively analyzed. The number of macroscopic polyps per sinus was significantly larger in groups A (1.0 polyps) and C (1.3 polyps) than in group B (0.0 polyps). Microscopic examination revealed significantly higher levels of polyps and/or polypoid mucosa in groups A and C than in group B. The results of this study suggest that a rabbit model of polyps using P. aeruginosa is suitable for further polyp studies and that induction of this type of model needs no mechanical trauma to the sinus mucosa.
Maxillary Sinus* ; Models, Animal ; Mucous Membrane* ; Polyps* ; Pseudomonas aeruginosa* ; Pseudomonas* ; Rabbits ; Rupture

BACKGROUND: Based on the work of Messerklinger, endoscopic sinus surgery(ESS) has become popular during recent years. Many reports on the technique of, indications for, and results of ESS have been published. Few reports are devoted exclusively to the complications of ESS in Korea. OBJECTIVES: In this paper, the complications of ESS in Korea and the findings and prevention of complications are discussed through early recognition and appropriate management. MATERIALS AND METHODS: A retrospective study about the complications of ESS was done on 42 hospitals from 1988 to 1995 in Korea. The incidence of complications of ESS in Korea(total 31,012 cases) is compared to complications in three other series of patients(total 2,165 cases) who underwent ESS in foreign contries and three series of patients(total 2,454 cases) who underwent conventional endonasal sinus surgery. RESULTS: Major complications occurred in 0.04% and major bleeding was the commonest. Minor complications occurred in 22.54% and were related to recurrent inflammatory symptom and midddle turbinate adhesions. CONCLUSIONS: There are some differences in incidence of each complications according to surgical approach. In major complications, the incidence of intracranial and orbital complication with the conventional endonasal sinus surgery approach was higher than that of endoscopic approach. Another difference is that adhesions do not occur with the conventional approach because middle turbinate is routinely removed. The incidence of recurrent symptoms was highest with ESS in Korea. We discuss complications of the procedures and the related factors to complications.
Hemorrhage ; Incidence ; Korea* ; Orbit ; Retrospective Studies ; Turbinates

The clinical staging systems for laryngeal cancer is limited as a prognostic indicator because of different biological characteristics of cancer in this region. To determine biological characteristics of laryngeal cancer and whether the matrix metalloproteinase-2(MMP-2), tissue inhibitor of metalloproteinase-2(TIMP-2) and angiogenesis can be used as prognostic indicators, the authors performed immunohistochemical staining of MMP-2, TIMP-2 and factor VIII related antigen in 20 cases of surgically treated squamous cell carcinoma of the larynx. The results are as follows: (1) The positive rates of MMP-2 and TIMP-2 expression in laryngeal squamous cell carcinoma were 55% and 95% respectively.(2) As the clinical stage was advanced, the expression of MMP-2 and TIMP-2 increased significantly(p=0.043, p=0.014).(3) The microvessel count(MVC) did not correlate with the clinical stage and histopathologic grading.(4) As the MVC increased, the expression of MMP-2 and TIMP-2 increased significantly(p=0.0004, p=0.0025). In conclusion, MMP-2 and TIMP-2 can be used as a prognostic indicator of laryngeal squamous cell carcinoma. As MMP-2 increases, so does neovascularization. And as neovascularization increases TIMP-2 does also in order to inhibit it. Since TIMP is an expression of the host response to a tumor and this response is different in each tumor, studies on MMP, TIMP and angiogenesis in other tumors should also be encouraged.
Carcinoma, Squamous Cell* ; Humans* ; Laryngeal Neoplasms ; Larynx ; Matrix Metalloproteinase 2* ; Microvessels ; Population Characteristics ; Tissue Inhibitor of Metalloproteinase-2* ; von Willebrand Factor

BACKGROUND AND OBJECTIVES: Although CO2 laser turbinate surgery is known to be an effective method in reducing the nasal symptoms of perennial allergic rhinitis, the long term effects have not yet been evaluated. Therefore, the purpose of this study was to assess the subjective and objective long term results of CO2 laser surgery. MATERIALS AND METHODS: The charts and questionnaires of 49 patients who received laser surgery at our department from January 1994 to December 1999 were reviewed. Preoperative and postoperative nasal volume of 20 randomly selected patients were measured by acoustic rhinometry. Nasal mucosa of 10 patients before and after laser surgery yearly for 6 years were examined under light and electron microscopy. RESULTS: Watery nasal discharge, nasal obstruction and sneezing had improved significantly after laser surgery. Postoperative nasal volumes also increased significantly. Histological findings 6 years after laser surgery revealed focal squamous epithelium and regenerating ciliated columnar epithelium. Decreased goblet cells, fibrous proliferation and scarce vessels and glands were also observed. CONCLUSIONS: CO2 laser surgery proves to be an effective method in reducing the symptoms of perennial allergic rhinitis for short and long periods.
Epithelium ; Goblet Cells ; Humans ; Laser Therapy ; Lasers, Gas* ; Microscopy, Electron ; Nasal Mucosa ; Nasal Obstruction ; Rhinitis* ; Rhinometry, Acoustic ; Sneezing ; Turbinates* ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: Although CO2 laser turbinate surgery is known to be an effective method in reducing the nasal symptoms of perennial allergic rhinitis, the long term effects have not yet been evaluated. Therefore, the purpose of this study was to assess the subjective and objective long term results of CO2 laser surgery. MATERIALS AND METHODS: The charts and questionnaires of 49 patients who received laser surgery at our department from January 1994 to December 1999 were reviewed. Preoperative and postoperative nasal volume of 20 randomly selected patients were measured by acoustic rhinometry. Nasal mucosa of 10 patients before and after laser surgery yearly for 6 years were examined under light and electron microscopy. RESULTS: Watery nasal discharge, nasal obstruction and sneezing had improved significantly after laser surgery. Postoperative nasal volumes also increased significantly. Histological findings 6 years after laser surgery revealed focal squamous epithelium and regenerating ciliated columnar epithelium. Decreased goblet cells, fibrous proliferation and scarce vessels and glands were also observed. CONCLUSIONS: CO2 laser surgery proves to be an effective method in reducing the symptoms of perennial allergic rhinitis for short and long periods.
Epithelium ; Goblet Cells ; Humans ; Laser Therapy ; Lasers, Gas* ; Microscopy, Electron ; Nasal Mucosa ; Nasal Obstruction ; Rhinitis* ; Rhinometry, Acoustic ; Sneezing ; Turbinates* ; Surveys and Questionnaires