No abstract available.
Epithelial Cells* ; Maxillary Sinus* ; Mucous Membrane*

We report a rare case of pleomorphic adenoma arising from heterotopic salivary gland tissue in the upper neck. Although it is difficult to differentiate this condition from lymph node diseases-including metastasis- on the basis of radiologic findings alone, it should be included in the differential diagnosis of a solitary unilateral solid cervical mass, particularly one in the upper neck.
Adenoma, Pleomorphic* ; Diagnosis, Differential ; Lymph Nodes ; Neck* ; Salivary Glands*

No abstract available.
Sinusitis*

PURPOSE: The purpose of this study was to evaluate computed tomographic (CT) findings of deep neck space infection(DNSI) with particular attention to the differences in the spaces involved and in complications between odontogenic and nonodontogenic groups. MATERIALS AND METHODS: Forty-four patients(21 odontogenic and 23 nonodontogenic) were included in this study. Among odontogenic DNSls, 15 had the dental infection in the second or third mandibular molar. We compared the CT features between odontogenic and nonodontogenic DNSIs with special emphasis on the differences in the spaces involved and in the rate and type of complications. RESULTS: In all patients, CT clearly differentiated abscess from cellulitis. The most common spaces involved in 21 patients with odontogenic DNSl were the parapharyngeal(n=18), the submandibular(n=18), the anterior visceral(n=13), the masticator(n=9), and the sublingual(n=7) spaces. In contrast, in 23 patients with nonodontogenic DNSI, the anterior visceral space(n=14) was most frequently involved. The parapharyngeal, the submandibular, and the masticator spaces were statistically more frequently involved in odontogenic than in nonodontogenic DNSI(p<.05). Twenty-two patients had one or more complications shown by CT, of which airway compromise was more frequent and severe in odontogenicthan in nonodontogenic DNSI. CONCLUSION: We conclude that the parapharyngeal, the submandibular, and the masticator spaces are more significantly vulnerable in odontogenic DNSl than in nonodontogenic DNSl. The predilection for certain spaces of the neck in odontogenic DNSl seems to originate from the intimate relationship of the mandibular molars to the adjacent deep neck spaces.
Abscess ; Cellulitis ; Humans ; Molar ; Neck*

PURPOSE: The purpose of this study was to evaluate computed tomographic (CT) findings of deep neck space infection(DNSI) with particular attention to the differences in the spaces involved and in complications between odontogenic and nonodontogenic groups. MATERIALS AND METHODS: Forty-four patients(21 odontogenic and 23 nonodontogenic) were included in this study. Among odontogenic DNSls, 15 had the dental infection in the second or third mandibular molar. We compared the CT features between odontogenic and nonodontogenic DNSIs with special emphasis on the differences in the spaces involved and in the rate and type of complications. RESULTS: In all patients, CT clearly differentiated abscess from cellulitis. The most common spaces involved in 21 patients with odontogenic DNSl were the parapharyngeal(n=18), the submandibular(n=18), the anterior visceral(n=13), the masticator(n=9), and the sublingual(n=7) spaces. In contrast, in 23 patients with nonodontogenic DNSI, the anterior visceral space(n=14) was most frequently involved. The parapharyngeal, the submandibular, and the masticator spaces were statistically more frequently involved in odontogenic than in nonodontogenic DNSI(p<.05). Twenty-two patients had one or more complications shown by CT, of which airway compromise was more frequent and severe in odontogenicthan in nonodontogenic DNSI. CONCLUSION: We conclude that the parapharyngeal, the submandibular, and the masticator spaces are more significantly vulnerable in odontogenic DNSl than in nonodontogenic DNSl. The predilection for certain spaces of the neck in odontogenic DNSl seems to originate from the intimate relationship of the mandibular molars to the adjacent deep neck spaces.
Abscess ; Cellulitis ; Humans ; Molar ; Neck*

BACKGROUND AND OBJECTIVES: Traumatic optic neuropathy (TON) is a relatively rare complication associated with closed head injury. However, it represents an extremely poor prognosis, and its management remains controversial. We present the treatment results of 15 patients with immediate and complete TON who were treated with megadose steroids (MDS), and, in cases where MDS produced no response, intranasal optic nerve decompression (OND). PATIENTS AND METHODS: The diagnosis of TON was based on evidence of the following : complete loss of vision, absence of direct pupillary light reflex and intact consensual response. All of the patients underwent high resolution CT scans of the orbit and received a complete neuro-opthalmologic examination. MDS was started immediately after the diagnosis. If no response occurred by 48 hours, an intranasal OND was conducted. RESULTS: Two of the 15 patients exhibited improved vision after treatment with MDS, and six of the remaining 13 patients who were unresponsive to MDS demonstrated improved vision after OND. Overall, eight out of the 15 patients experienced improved vision. CONCLUSION: This study is uncontrolled, but suggests that our protocol of MDS and, in cases where this produced no response, OND may be an effective and valid treatment modality for patients with immediate complete TON, which is generally believed to represent an extremely poor prognosis regardless of treatment.
Decompression* ; Diagnosis ; Head Injuries, Closed ; Humans ; Optic Nerve Injuries* ; Optic Nerve* ; Orbit ; Prognosis ; Reflex ; Steroids* ; Tomography, X-Ray Computed

Vasoactive intestinal polypeptide(VIP), 28-amino acid peptide extracted from porcine duodenum first, has been known as a potent vasodilator. And, VIP is also one of the important neurotransmitters in autonomic pathways affecting secretion and vascular tone of the airway. The purpose of present study is to localize the VIP-containing nerve endings in the nasal gland of the guinea pig at ultrastructural level. For immunoelectron microscopy, adult guinea pigs(300-400g B.W.) were perfused with Zamboni fixative through the aorta and the nasal septum were removed. 20nm cryosections were made for immunocytochemistry using rabbit anti-VIP and ABC methods. After DAB reaction, sections were processed for pre-embedding method, and 70nm ultrathin sections were cut. Routine uranyl acetate and lead citrate staining were employed, and immunoreactivity was observed under transmission electron microscope. VIP-containing nerve endings were located in cytoplasmic interdigitation between acinar cells, and also found along the basal surface of the acini, excretory ducts, and myoepithelial cells as well. These findings imply that VIP might be involved in secretory activity of the nasal gland of the guinea pig.
Acinar Cells ; Adult ; Animals ; Aorta ; Autonomic Pathways ; Citric Acid ; Cytoplasm ; Duodenum ; Guinea Pigs* ; Guinea* ; Humans ; Immunohistochemistry ; Microscopy, Electron, Transmission* ; Microscopy, Immunoelectron ; Nasal Septum ; Nerve Endings* ; Neurotransmitter Agents ; Vasoactive Intestinal Peptide

BACKGROUND AND OBJECTIVES: Acute laryngeal trauma is a very rare injury. Controversy still exists in regards to its proper management. The aim of this study was to present clinical findings and management of acute laryngeal trauma. MATERIALS AND METHODS:We analyzed medical records of 15 patients with acute laryngeal trauma from 1987 to 1997 retrospectively. RESULTS: The most common cause of injury was traffic accident. Hoarseness (93.3 %), odynophagia (86.7 %), subcutaneous emphysema (60.0 %) were the common presenting symptoms and thyroid cartilage was the most common site of fracture. The correlation between dyspnea (p=0.03) and subcutaneous emphysema (p=0.08) and major injury was high. Esophageal examination was performed on 11 patients and revealed no injury. All four patients with vocal cord palsy and minor injury findings improved. Patients with major injury showed bad results of airway and voice, and result of voice was worse that of airway. CONCLUSION: If presenting symptoms are emphysema and dyspnea, major injury should be considered. Routine esophageal examination may be skipped in blunt minor injury. Vocal cord palsy with minor injury finding may not be an operative indication in blunt injury.
Accidents, Traffic ; Dyspnea ; Emphysema ; Hoarseness ; Humans ; Medical Records ; Retrospective Studies* ; Subcutaneous Emphysema ; Thyroid Cartilage ; Vocal Cord Paralysis ; Voice ; Wounds, Nonpenetrating

BACKGROUND: As treatment of head and neck cancer has improved, the trend showed that distant metastases(DMs) have become an increasingly common cause of death. Knowing about the presence of DMs is important for deciding treatment protocol. OBJECTIVES: The purpose of this study was to identify tumor characteristics(site of primary tumor, TNM staging, tumor differentiation) of head and neck squamous cell carcinoma related to higher incidence of DMs and determine the accuracy of blood test(alkaline phosphatase, calcium, LFT) in detection of DMs. MATERIALS AND METHODS: A retrospective review was carried out on 74 patients of 134 patients admitted to department of Otolaryngology, Gyeongsang National University Hospital from January 1987 to June 1994. RESULTS: The review revealed 21 DMs in 18 patients. DMs occurred in 18(24.3%) of 74 patients. Lung(47.6%) and bone(42.9%) were common DM site. As site of primary tumor, pharynx increased the incidence of DMs more than larynx, PNS & nasal cavity and oral caity. The incidence of DMs was increased in patients who had tumors of advanced T stage, N stage, Stage(statistically significant, p<0.05) and poor histologic differentiation(statistically insignificant, p=0.11). CONCLUSION: Abnormal alkaline phosphatase and hypercalcemia showed low sensitivity(56% and 0%) for detection of bone metastases. So blood tests(alkaline phosphatase, calcium) may be not useful for screening test for bone metastases. But the sensitivity of abnormal LFT was insignificant due to only one case of liver metastases in our study.
Alkaline Phosphatase ; Calcium ; Carcinoma, Squamous Cell* ; Cause of Death ; Clinical Protocols ; Head and Neck Neoplasms ; Head* ; Humans ; Hypercalcemia ; Incidence ; Larynx ; Liver ; Mass Screening* ; Nasal Cavity ; Neck* ; Neoplasm Metastasis* ; Neoplasm Staging ; Otolaryngology ; Pharynx ; Retrospective Studies

Semicircular canal aplasia is rare congenital inner ear anomaly. During embryogenesis, congenital malformation of vestibular labyrinth usually associates with cochlear anomalies. Two cases of semicircular canal aplasia with normal or near-normal cochlear development was reported in the English literature. We present three patients with computed tomographic findings of bilateral total semicircular canal aplasia with normal cochlear development in the same family member. Two patients had significant conductive hearing loss due to congenital stapedial anomalies and the other was congenital deafmute. Temporal bone CT scan revealed total absence of the semicircular canals bilaterally and both cochleas were normal in three cases.
Cochlea ; Ear, Inner ; Embryonic Development ; Female ; Hearing Loss, Conductive ; Humans ; Pregnancy ; Semicircular Canals* ; Temporal Bone ; Tomography, X-Ray Computed ; Vestibule, Labyrinth