Extracranial carotid artery aneurysm is an uncommon disease that otorhinolaryngologists may encounter only rarely. It usually presents as pulsatile neck mass or as other neurologic symptoms. We report a case of extracranial internal carotid artery aneurysm in an 81-year old female who presented with a fever and nonpulsatile oropharyngeal swelling mimicking a peritonsillar abscess. Incision and drainage of the swelling lesion could have resulted in catastrophic events such as aneurismal rupture or a stroke. We thus recommend radiologic evaluations of peritonsillar abscess before performing any procedure, even if it is clinically highly suspicious.

Background and Objectives: The aim of this study was to investigate the surgical outcomes of revision operation due to recurrence of non-cholesteatomatous chronic otitis media (COM) surgery cases.Subjects and Method From 1989 to 2018, 5197 cases of COM surgery were performed at Kangdong and Hallym University Sacred Heart Hospital. Among them, clinical data of 297 subjects who had undergone revision tympanoplasty and/or mastoidectomy for recurrent noncholesteatomatous COM were retrospectively collected from computerized database of middle ear surgery (Korean Otological Society program 2005). Each case was categorized by surgical approaches into canal wall down mastoidectomy (CWDM), canal wall up mastoidectomy (CWUM), or tympanoplasty only groups. Results: Tympanoplasty only was performed in 170 cases, CWDM in 74 cases, and CMUM in 53 cases. Postoperative perforation occurred in 9.4% of total cases, and less frequently in CMDM compared with tympanoplasty only (p=0.023), and CMUM (p=0.049), respectively, whereas no differences between tympanoplasty only and CMUM (p=0.930) were found. Postoperative infection rate was 1.0% and did not show any differences among the groups. Postoperative successful hearing was obtained in 66.7% of total cases, and the success rate of tympanoplasty only was better than that of CMDM (p=0.001), and CMUM (p=0.011). And, that of CMUM was better than that of CMDM (p=0.011). Conclusion The results showed that postoperative perforation occurred less frequently in CMDM than in tympanoplasty only and in CWUM; successful hearing was achieved more frequently in tympanoplasty alone than in the other surgical approaches in recurrent non-cholesteatomatous COM.

BACKGROUND AND OBJECTIVES: To investigate epidemiological features of patients with sialolithiasis and to evaluate the difference in outcomes depending on its location. SUBJECTS AND METHOD: We included in the test 472 patients, or 534 cases, who were admitted to the Hallym University Sacred Heart Hospital between February 2006 and May 2017 with the diagnosis of sialolithiasis. The diagnosis of sialolithiasis was established by CT images; all of the cases were classified by the location of stones (orifice to stone/orifice to hilum: 0–0.25, type I; 0.25–0.5, type II; 0.5–0.75, type III; 0.75–1, type IV). RESULTS: The average size of stone was 7.2±4.8 mm and the mean patient age was 36.1±17.4 years old. According to the method described above, 534 cases were classified into the following: type I consisted of 188 cases (35.2%), type II consisted of 55 cases (10.2%), type III consisted of 92 cases (17.2%) and type IV consisted of 199 (37.2%). When comparing these types, stones in Type I were significantly smaller than other groups. There was a significant difference in the surgical method depending on the location of stones. Different complications such as swelling, bleeding, tongue discomfort, ranula, recurrence, etc. have been reported and, together, they statistically show meaningful differences in the distribution depending on types. CONCLUSION: The position of stone in Wharton's duct is important factor that can determine the method of surgical procedure or postoperative prognosis. We recommend 4 types classification of sialolithiasis and it can provide more specific diagnosis of disease and facilitate approach for treatment.
Classification ; Diagnosis ; Heart ; Hemorrhage ; Humans ; Methods ; Prognosis ; Ranula ; Recurrence ; Retrospective Studies ; Salivary Ducts ; Salivary Gland Calculi ; Submandibular Gland ; Tongue

BACKGROUND AND OBJECTIVES: To investigate epidemiological features of patients with sialolithiasis and to evaluate the difference in outcomes depending on its location.SUBJECTS AND METHOD: We included in the test 472 patients, or 534 cases, who were admitted to the Hallym University Sacred Heart Hospital between February 2006 and May 2017 with the diagnosis of sialolithiasis. The diagnosis of sialolithiasis was established by CT images; all of the cases were classified by the location of stones (orifice to stone/orifice to hilum: 0–0.25, type I; 0.25–0.5, type II; 0.5–0.75, type III; 0.75–1, type IV). RESULTS: The average size of stone was 7.2±4.8 mm and the mean patient age was 36.1±17.4 years old. According to the method described above, 534 cases were classified into the following: type I consisted of 188 cases (35.2%), type II consisted of 55 cases (10.2%), type III consisted of 92 cases (17.2%) and type IV consisted of 199 (37.2%). When comparing these types, stones in Type I were significantly smaller than other groups. There was a significant difference in the surgical method depending on the location of stones. Different complications such as swelling, bleeding, tongue discomfort, ranula, recurrence, etc. have been reported and, together, they statistically show meaningful differences in the distribution depending on types. CONCLUSION The position of stone in Wharton's duct is important factor that can determine the method of surgical procedure or postoperative prognosis. We recommend 4 types classification of sialolithiasis and it can provide more specific diagnosis of disease and facilitate approach for treatment.

OBJECTIVE: This study aimed to analyze intracranial vessels using brain computed tomography angiography (CTA) and scoring systems to diagnose brain death and predict poor neurologic outcomes of postcardiac arrest patients.METHODS: Initial brain CTA images of postcardiac arrest patients were analyzed using scoring systems to determine a lack of opacification and diagnose brain death. The primary outcome was poor neurologic outcome, which was defined as cerebral performance category score 3 to 5. The frequency, sensitivity, specificity, positive predictive value, negative predictive value, and area under receiver operating characteristic curve for the lack of opacification of each vessel and for each scoring system used to predict poor neurologic outcomes were determined.RESULTS: Patients with poor neurologic outcomes lacked opacification of the intracranial vessels, most commonly in the vein of Galen, both internal cerebral veins, and the mid cerebral artery (M4). The 7-score results (P=0.04) and 10-score results were significantly different (P=0.04) between outcome groups, with an area under receiver operating characteristic of 0.61 (range, 0.48 to 0.72). The lack of opacification of each intracranial vessel and all scoring systems exhibited high specificity (100%) and positive predictive values (100%) for predicting poor neurologic outcomes.CONCLUSION: Lack of opacification of vessels on brain CTA exhibited high specificity for predicting poor neurologic outcomes of patients after cardiac arrest.
Angiography ; Brain Death ; Brain ; Cerebral Arteries ; Cerebral Veins ; Heart Arrest ; Humans ; Hypothermia ; ROC Curve ; Sensitivity and Specificity