In patients with sinusitis, nasal obstruction and purulent discharge from the maxillary sinus are frequently observed. Mostly, it responds to antibiotic treatment. But in case of not responding, although fungal infection is a rare entity, we have to consider fungal sinusitis. We recently experienced a case of acute aggravation of fungal maxillary sinusitis after zygomaplasty. Endoscopic sinus surgery was performed and foreign materials were observed inside the right maxillary sinus. They were gauzes, which had been used during previous surgery. Intraoperative examination demonstrated a dark brown, cheese-like material in the sinus. After surgery, the patient's symptoms disappeared gradually. The culture examination identified the surgical sample to be Trichosporon asahii. So we reported with a review of literature.
Humans ; Maxillary Sinus ; Maxillary Sinusitis ; Nasal Obstruction ; Sinusitis ; Trichosporon

Benign paroxysmal positional vertigo (BPPV) is one of the most common diseases that cause dizziness. It can be resolved relatively easily using canalith-repositioning maneuvers. However, some patients suffer from dizziness even after successful canalith-repositioning. This is an atypical dizziness felt in the absence of typical nystagmus after resolution of BPPV and named residual dizziness. Otolithic organ disorder, anxiety and persistence of debris in the canal have been reported to be associated with residual dizziness. Although 31-61% of BPPV patients suffer from residual dizziness, residual dizziness has not yet been clearly known not only the treatment but also the pathophysiology. This article investigate the factors associated with residual dizziness and treatment and prediction methods for residual dizziness.

Background and Objectives: This study aimed to investigate whether benign paroxysmal positional vertigo (BPPV) accompanied by temporal bone fracture would be more resistant to canalith repositioning procedures (CRPs) than idiopathic BPPV.Subjects and Method Seventy-eight patients with BPPV were included in this study. Among them, 13 patients had temporal bone fractures and 65 had no temporal bone fractures. To identify the factors related to the number of CRPs performed until the remission of BPPV, sex, age, the presence of temporal bone fracture, hypertension, diabetes, dyslipidemia or osteopenia, BPPV affected side, and the type of affected semicircular canal were analyzed using the univariable regression analysis. Thereafter, the multivariable regression analysis was performed using only the variables that had a p-value of 0.2 or less in the univariable analysis. Results: In the univariable analysis, temporal bone fracture, diabetes mellitus, and BPPV side showed relatively significant association with the number of CRPs (p<0.2). In the multivariable analysis, only temporal bone fracture showed a significant association with the number of CRPs (p=0.043, β=0.532, 95% CI: 0.017-1.046). Conclusion The major finding of this study is that BPPV, accompanied by temporal bone fracture, precipitated more resistance to CRPs than idiopathic BPPV did. Thus, patients with temporal bone fracture might need more intensive examination and treatment for BPPV than those without temporal bone fracture.

Although brain infusion cannula is a good method to deliver compounds directly into the brain, fixation of the brain infusion cannula is essential for successful delivery. Dental cements and adhesive gel are the commonly used materials for fixation of the infusion cannula. However, these materials take time to harden and occasionally, fixation may fail. Therefore, we developed a novel method to fix the brain infusion cannula. Brain infusion cannulas were implanted into seven Wistar rats using the novel tie method. One, three, and seven days after the surgery, displacement of the brain infusion cannula and cerebrospinal fluid (CSF) leakage were evaluated in all the rats. None of the animals showed displacement of the brain infusion cannula or leakage of CSF at any point of time. In this study, we showed the successful results of the novel tie method for fixation of the brain infusion cannula, which needs no additional materials. It only requires a thread which is used for skin sutures.

Intratympanic injection has emerged as a novel approach to bypass the blood-labyrinth barrier and effectively deliver drugs into the inner ear. This technique is used for treatment of various inner ear diseases and overcomes the limitations of systemic drug therapy. In this paper, we provide an overview of the application of intratympanic injection using steroids and gentamicin and highlight the major diseases and summarize the reported efficacy of this approach.Current Concepts: Intratympanic steroid injections have been used for treatment of various inner ear diseases, including sudden sensorineural hearing loss, Ménière disease, and tinnitus. Therapeutic effects of steroids include reducing inflammation, modulating the immune response, improving cochlear blood flow, and maintaining ion homeostasis. Intratympanic gentamicin injections are primarily used to minimize hearing loss and control vertigo symptoms in patients with Ménière disease. Gentamicin selectively injures vestibular hair cells with minimal ototoxicity compared with other aminoglycoside antibiotics.Discussion and Conclusion: Intratympanic injections offer several advantages, including targeted drug delivery, minimal systemic adverse effects, and rapid action. Reportedly, intratympanic steroid injections used as primary or salvage treatment are associated with positive outcomes in patients with sudden sensorineural hearing loss. Ménière disease also shows positive outcomes following intratympanic steroid and gentamicin injections. However, studies have reported conflicting results, and further research is required to standardize dosing and administration protocols. Intratympanic injections are a promising therapeutic option, and ongoing research is essential to optimize their efficacy and safety.

Subdural hematoma is a common disease of intracranial hemorrhage that accounts for 11-21% of all head trauma patients. It is defined as a hematoma that develops between dura mater and subarachnoid space. In elder patients, mild trauma may not always be accurately recognized and symptoms may not develop slowly due to the large area of subdural space. Headache is the most common symptom of subdural hematoma and may be associated with hemiplegia, dysarthria, sensation disorder, conscious disorder, and etc. We present, with a literature review, a case of a patient who developed subacute subdural hematoma after performing Brandt-Daroff habituation exercise to treat benign paroxysmal positional vertigo.
Benign Paroxysmal Positional Vertigo ; Craniocerebral Trauma ; Dura Mater ; Dysarthria ; Headache ; Hematoma ; Hematoma, Subdural* ; Hemiplegia ; Humans ; Intracranial Hemorrhages ; Sensation Disorders ; Subarachnoid Space ; Subdural Space

A 57-year-old man presented to the outpatient department with sudden bilateral hearing loss. The otological examination suggested bilateral severe sensorineural hearing loss. After several hours, the patient complained of a headache and became drowsy. The brain computed tomography showed a 3 x 4 cm intracerebral hemorrhage (ICH) of the left temporal lobe. Surgery was performed and 34 days after the procedure the patient was discharged from the hospital with severe bilateral sensorineural hearing loss (SNHL). Temporal lobe ICH should be considered in the differential diagnosis of patients with sudden bilateral hearing loss, regardless of the other neurological symptoms.
Brain ; Cerebral Hemorrhage ; Diagnosis, Differential ; Headache ; Hearing Loss, Bilateral ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Middle Aged ; Outpatients ; Temporal Lobe

The maxillary sinus is the most commonly affected in the fungal infection of the sinus, but sphenoid sinus is only occasionally occurred. Because of the adjacent structures in sphenoid sinus, however, its complication may cause fatal outcome. Visual loss due to optic neuritis, which is defined as an inflammatory neuropathy of the optic nerve, is extremely rare, which may occur via direct spread of fungus. We experienced a case of fungal sphenoid sinusitis, which damaged the optic nerve and led to visual loss in a 74 year-old male. It was treated by endoscopic sinus surgery with steroid therapy. We present this case with a brief review of these disease's entities.
Fatal Outcome ; Fungi ; Humans ; Male ; Maxillary Sinus ; Optic Nerve ; Optic Neuritis ; Sphenoid Sinus ; Sphenoid Sinusitis

Gastric cancer is one of the most common causes of cancer-related death in Asian countries, including Korea. We experienced a case of leptomeningeal carcinomatosis (LC) from gastric cancer that was originally misdiagnosed as vestibular schwannoma based on the similar radiological characteristics. To our knowledge, LC from gastric cancer is very rare. In conclusion, our experience with this case suggests that clinicians should consider the possibility of delayed leptomeningeal metastasis when treating patients with gastric cancer.
Asian Continental Ancestry Group ; Carcinoma, Signet Ring Cell ; Humans ; Korea ; Meningeal Carcinomatosis* ; Neoplasm Metastasis ; Neurofibromatoses ; Neuroma, Acoustic* ; Stomach Neoplasms*

No abstract available.
Forehead* ; Hyaluronic Acid* ; Imaging, Three-Dimensional* ; Pilot Projects*