BACKGROUND AND OBJECTIVES: This study is to find out whether laser tympanostomy (LT) with tympanostomy tube (TT) insertion has some potential role for the treatment of children with chronic otitis media with effusion (OME) under the topical anesthesia. SUBJECTIVES AND METHOD: We prospectively enrolled 89 OME children (2-7 yrs old, 139 ears) for LT with TT insertion under topical anesthesia. Following LT, TT insertion was done if the middle ear effusion was mucoid or if middle ear mucosa was inflammed, or if the child had poor prognostic factors. RESULTS: Ninety-four ears (68%) had mucoid effusion, 18 ears (13%) serous effusion, 11 ears (8%) purulent effusion, and 16 ears (12%) were dry. It was determined that TT insertion was not necessary in 26 ears (19%). TT insertion into the laser tympanostomy opening was tried on the other 113 ears. TT insertion had a success rate of 81% (91/113). After 3 months of follow-up, LT that did not need TT insertion showed 81% (21 ears) resolution rate. Therefore, the total efficacy of LT with TT insertion under topical anesthesia was 85%. CONCLUSION: Laser tympanostomy with TT insertion resulted in increased efficacy. Also, compared to knife myringotomy, it seems to have a potential role for lowering the age group of OME children whom can be managed under topical anesthesia.
Anesthesia* ; Child ; Ear ; Ear, Middle ; Follow-Up Studies ; Humans ; Middle Ear Ventilation* ; Mucous Membrane ; Otitis Media with Effusion ; Prospective Studies ; Treatment Outcome* ; Ventilation*

BACKGROUND AND OBJECTIVES: Until now, only a little is known about the mode of parotid involvement in external auditory canal (EAC) carcinoma. We examined the incidence of parotid node metastasis and direct parotid invasion in patients with EAC carcinoma. The purpose of this study was to evaluate the role of parotidectomy and to provide the guidelines for performance of parotidectomy when dealing with EAC carcinoma. MATERIALS AND METHOD: The study comprised of 11 patients with squamous cell carcinomas (SCC) and 10 patients with adenoid cystic carcinomas (ACC). A retrospective review of the surgical specimens was undertaken with specific reference to parotid node metastasis and parotid invasion. RESULTS: Parotid node metastasis was noted only in two cases of advanced staged SCC, whereas none of the ACC patients showed parotid node metastasis. Direct parotid invasion occurred only in advanced staged SCC;however, it did occur in early stage ACC. CONCLUSION: Our data indicated that elective parotidectomy for control of occult parotid node metastasis is necessary only in advanced SCC carcinoma, whereas parotid management to secure adequate safety margin is mandatory for advanced SCC and all cases of ACC.
Carcinoma, Adenoid Cystic ; Carcinoma, Squamous Cell ; Ear Canal* ; Humans ; Incidence ; Lymph Nodes* ; Neoplasm Metastasis* ; Parotid Gland ; Retrospective Studies

Tuberculous involvement of the esophagus is very rare even in the presence of extensive pulmonary tuberculosis or in the endemic area. This is resulted from local extension to the esophagus from contiguous tuberculosis organs or miliary spread. Such secondary involvement is more common than primary tuberculosis, in which there is no evidence of tuberculosis elsewhere. The diagnosis of esophageal tuberculosis may be difficult. So the radiologic, endoscopic, histologic findings and clinical feature including the response to chemotherapy may be needed to avoid misdiagnosis. Most cases can be treated successfully with antituberculosis medication. A 67-year-old man was admitted to our hospital complaining of swallowing difficulty for 2 months. On the gastrofibroscopic examination, 22 cm sized protruding mass with central deep ulceration was discovered at the mid-esophagus. The biopsy showed the ulcer with chronic granulomatous inflammation and multinucleated giant cells consistent with tuberculosis. After antituberculosis medication, the lesion of esophageal tuberculosis was healed completely remaining minimal ulcer scar.
Aged ; Biopsy ; Cicatrix ; Deglutition ; Diagnosis ; Diagnostic Errors ; Drug Therapy ; Esophageal Neoplasms* ; Esophagus ; Giant Cells ; Humans ; Inflammation ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer