PURPOSE: To report the clinical course of refractive accommodative esotropia (AE) and to determine whether the strabismus resolves during the adolescent years in Korean patients. METHODS: A total of 32 adolescent patients with AE associated with hyperopia were retrospectively reviewed. Ocular alignments, amblyopia, stereopsis, changes in refractive error with time after glasses prescribed, and clinical characteristics were studied. RESULTS: The mean age and follow-up were 14.9 and 10.1 years, respectively at the final visit. The Initial and final refractive errors were 5.16 and 2.52 diopters (D), respectively. Spectacles were initiated at a mean age of 4.7 years, and intentional undercorrection initiated from a mean age of 6.3 years. Hyperopic reduction after prescribing glasses followed the formula: Diopter (D) = 5.23 - 0.02 (Time) - 0.03 (Time)**2. Initially, 16 out of 32 patients (50%) showed fully corrected hyperopia, and eventually, 71.9% wore partially corrected spectacles. The mean change of hyperopia per year was 0.26 D. Six out of 32 patients (18.8%) were successfully discontinued from hyperopic spectacles and the mean age of weaning was 14.7 years. Intentional initial undercorrection did not affect hyperopic reduction (p = 0.123). CONCLUSIONS: AE persists through adolescence for a majority of Korean patients. These patients need to be carefully monitored during follow-up periods because most do not outgrow their hyperopia and need to using spectacles.
Adolescent ; Amblyopia ; Depth Perception ; Esotropia ; Eyeglasses ; Follow-Up Studies ; Glass ; Humans ; Hyperopia ; Refractive Errors ; Retrospective Studies ; Strabismus ; Weaning

Actinomycosis is a rare anaerobic, gram-positive bacterial infection caused by Actinomyces. As an infection site for the disease, the cervicofacial area is common but the nasal cavity and the nasopharynx are rare. Actinomycosis causes chronic purulent granulomatous infection and is characterized by extensive infiltration, necrosis, and bone destruction on CT. Extranodal natural killer/T cell (NK/T cell) lymphoma, nasal type is more common in East Asia than elsewhere, comprising up to 7%-10% of all non-Hodgkin’s lymphoma. Early nasal symptoms are nonspecific and similar to chronic rhinosinusitis, such as nasal obstruction and nasal bleeding. With disease progression, inflammation and necrosis of the mucosa increase. We experienced a case of extranodal NK/T cell lymphoma in a 60-year-old female, who was diagnosed with opportunistic infection of actinomycosis. We report this case with a review of literature.

BACKGROUND AND OBJECTIVES: Tuberculous cervical lymphadenitis is not an uncommon inflammatory disorder in Korea. It often does not respond to the antituberculous medication, but grows up gradually making the cervical abscess. Authors aimed to find out the clinical features and the treatment modalities of tuberculous cervical abscess. SUBJECTS AND METHOD: From Jan. 2001 through Dec. 2005, 52 cases of the tuberculous cervical abscess (16 males, 36 females : age range 18-63 years, mean 30.4 years) were diagnosed and managed at the Department of Otolaryngology, Asan Medical Center. We reviewed medical records of patients to find out their presentations, diagnostic considerations, therapeutic options, and outcomes. Patients were followed up for sixteen months on the average after treatment. RESULTS: There was no difference in the duration of antituberculous chemotherapy according to the surgical methods. However, in the cases of mass excision (91.7%), cure rate (remnant mass size <5 mm) was higher, compared to incision and drainage (80.0%). Compared to excision (3/15, 25%, 39 days), incision and drainage needed more days for dressing for healing (4/5, 80%, 90 days). CONCLUSION: Therefore, we recommend, if possible, complete excision as a therapeutic modality in cases of tuberculous cervical abscess.
Abscess* ; Bandages ; Chungcheongnam-do ; Drainage ; Drug Therapy ; Female ; Humans ; Korea ; Lymph Nodes ; Lymphadenitis ; Male ; Medical Records ; Otolaryngology

We report herein the case of a 38-year-old woman with Cushings syndrome caused by bilateral adrenocortical adenomas. The adrenal tumor on the left side hypersecreted cortisol and no findings of cortisol hypersecretion from the adrenal tumor on the right side were observed on bilateral adrenal vein samplings. Both adrenal tumors were resected and histologically without any findings of nodular hyperplasia. The left adrenal tumor was histologically diagnosed as a so-called black adenoma. These data imply that the adrenal adenomas developed primarily from the adrenal gland itself, and that one of the tumors was well differentiated and secreted excess hormones, while the other remained in cell proliferation without hypersecretion.
Adenoma* ; Adrenal Glands ; Adrenocortical Adenoma* ; Adult ; Cell Proliferation ; Cushing Syndrome* ; Female ; Humans ; Hydrocortisone ; Hyperplasia ; Veins

Organizing hematomas are rare benign tumors and appear as forms of mass which is composed of neovascularization with organizing fibrous tissue in hematoma. There have been sporadic reports of the organizing hematoma not only in soft tissue but also in brain, spinal cord, lung, and maxillary sinus. We report a case of organizing hematoma that was restricted in the nasal cavity without inclusion of the paranasal sinus. This is the first article describing the organizing hematoma of the nasal septum. We present this case with a review of literature.
Brain ; Hematoma ; Lung ; Maxillary Sinus ; Nasal Cavity ; Nasal Septum ; Spinal Cord

Myxoid degeneration (MD) in the cartilage results from the accumulation of hyaluronic acid in the stroma. However, it is rarely found in the auricular cartilage, with only one published report to date. This article describes two histologically confirmed cases of MD of the auricle that was excised with favorable aesthetic results. Two men presented with auricular masses, with no history of trauma or tumors in the auricle. Laterally protruding masses were located around the helix and antihelix, which were similar in appearance to the normal auricular cartilage. We made an aesthetic skin incision under local anesthesia, and carved the mass from the normal cartilage for pathological and cosmetic reasons. Both excised masses showed MD of the auricular cartilage. We report these two cases with a review of the literature.
Anesthesia, Local ; Cartilage ; Ear ; Ear Cartilage* ; Humans ; Hyaluronic Acid ; Male ; Skin

BACKGROUND AND OBJECTIVES: Inverted papilloma (IP) is not infrequently associated with squamous cell carcinoma (SCCa). Preoperative punch biopsy for the nasal mass of patients with associated carcinoma often results only in an inverted papilloma, which is followed by an inadequate surgery. In this study, the authors aim to differentiate the inverted papilloma associated with carcinoma from the simple inverted papilloma in the preoperative CT scan. MATERIALS AND METHODS: Between January, 1997 and February, 2005, twelve cases of IP with carcinoma (IP+SCCa) were diagnosed and treated at the Department of Otolaryngology, Asan Medical Center. The control group, made up of twenty-six cases of IP, was selected randomly during the same period. We analyzed the paranasal sinus CT (PNS CT) findings and reviewed medical records of the patients. The CT characteristics such as calcification, bridging the antronasal border, heterogenous enhancement, tumor necrosis, bony thickening, choanal extension, bony remodeling, bony destruction and surrounding structures were compared between the two groups. RESULTS: Both the IP and the IP+SCCa had developed unilaterally. The most common site was the middle meatus in the IP and the ethmoid sinus in the IP+SCCa. On the PNS CT, the IP+SCCa had intraorbital and pterygopalatine fossa invasion were more frequent than in the IP. Bony thickening and bone destruction were the statistically significant findings that favor the IP+SCCa (p=0.049 & p=0.000). CONCLUSION: Bone destruction of the maxillary sinus wall in the preoperative PNS CT suggests the association of SCCa among the IP patients. Preoperative instruction for the patients and surgical planning for the possible SCCa should be strongly considered.
Biopsy ; Carcinoma, Squamous Cell* ; Chungcheongnam-do ; Ethmoid Sinus ; Humans ; Maxillary Sinus ; Medical Records ; Necrosis ; Otolaryngology ; Papilloma, Inverted* ; Pterygopalatine Fossa ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: For the documentation of nasopharyngeal adenoid tissue, various methods, including radiological, aerodynamic diagnostic modalities, have been utilized but were not practically efficient. The previous evaluation method of radiology was used to measure the shortest A-P diameter of nasopharyngeal air space (NPD min) in the preoperative skull lateral view or adenoidal-nasopharyngeal ratio (A/N ratio) related to the subjective symptoms. The authors attempted to compare the correlation between the narrowest, upper third, middle third, low third A-P diameter of nasopharyngeal air space, A/N ratio in the pre & postoperative skull lateral view and pre & postoperative subjective symptoms. MATERIALS AND METHODS: We evaluated the data from 100 children (61 males, 39 females: age range 2-14 years, mean 8.2 years), who received adenoidectomy and tonsillectomy from a single surgeon (senior author) from January 2004 to August 2004. RESULTS: There was no significance in the correlation between A/N ratio in the pre & postoperative skull lateral view and the most pre & postoperative subjective symptoms. However, the degree of postoperative nasal obstruction and cough were significantly related to the postoperative narrowest A-P diameter of nasopharyngeal air space, regardless of the location. The upper third, middle third and low third AP diameter of nasopharyngeal air space were also significantly related to the degree of postoperative cough. CONCLUSION: It is necessary to resolve the narrowest A-P diameter of nasopharyngeal air space on the skull lateral view for the improvement of the subjective symptom such as nasal obstruction and cough due to adenoid hypertrophy.
Adenoidectomy* ; Adenoids* ; Child ; Cough ; Female ; Humans ; Hypertrophy ; Male ; Nasal Obstruction ; Skull ; Tonsillectomy*

BACKGROUND AND OBJECTIVES: Adenoid cystic carcinoma is occasionally found, second to the squamous cell carcinoma, in the sinonasal tracts. The purpose of this study is to find out the clinical features, treatment outcome, and prognostic factors of adenoid cystic carcinoma in the sinonasal tracts. MATERIALS AND METHODS: Between September 1993 and December 2005, 16 cases of adenoid cystic carcinoma of the sinonasal tracts (6 males, 10 females, ages ranging between 35-70 years; a mean age of 49 years) were selected. We reviewed medical records of the patients to examine their clinical presentations, treatment options, and their outcomes. RESULT: The most common site of affliction was the nasal cavity (37.5%) followed by the maxillary sinus (31.3%). Patients displayed various symptoms such as nasal obstruction, facial pain, and epistaxis. Nine out of 16 patients (56%) were diagnosed to be in stage IV (AJCC staging system). Histopathological examination revealed cribriform type (13 patients: 81%) and solid type (3 patients:19%). In 3 patients, perineural invasion was observed. Surgery with or without postoperative radiation therapy (RT) was applied for 8 patients (stage I, II, III, IV), RT only for 7 patients (stage III, IV), and RT and chemotherapy for 1 patient (stage IV). Total recurrence rate was 43.8% (7 out of 16 patients) and the recurrence rate of the patients followed up over 5 years was 62.5% (5 out of 8 patients). CONCLUSION: Adenoid cystic carcinoma of the sinonasal tract develops more frequently among women and is usually discovered in the advanced stage. Surgery and postoperative RT are the main stay of the treatment.
Adenoids ; Carcinoma, Adenoid Cystic ; Carcinoma, Squamous Cell ; Epistaxis ; Facial Pain ; Female ; Humans ; Male ; Maxillary Sinus ; Medical Records ; Nasal Cavity ; Nasal Obstruction ; Recurrence ; Treatment Outcome

Vegetable granuloma or pulse granuloma results from the implantation of food particles of vegetable origin. Pulse granulomas have mainly been reported in association with lung aspirations, the oral cavity with a history of oral procedures and less frequently in gastrointestinal tracks. We report a 31-year-old woman who presented with right nasal obstruction and was found to have a firm mass in the right nasal cavity. Paranasal sinus computerized tomography scans identified a calcified ring lesion in her right nasal cavity. Endoscopic sinus surgery was performed, and pathology examination revealed a lesion consistent with a pulse granuloma that contains starch granules with cellulose envelopes appearing as hyaline rings surrounded by inflammation cells and concentrically arranged delicate connective tissue. Pulse granuloma is a well described entity with distinct histopathology. However, pulse granulomas are rare, and especially extraoral pulse granulomas are extremely rare. We found that pulse granuloma can be occurred in the nasal cavity through regurgitation.
Adult ; Aspirations (Psychology) ; Cellulose ; Connective Tissue ; Female ; Granuloma* ; Humans ; Hyalin ; Inflammation ; Lung ; Mouth ; Nasal Cavity* ; Nasal Obstruction ; Nose ; Pathology ; Starch ; Vegetables*