An oval-shaped mass with a smooth surface was found in the ear canal of a 22-month-old male infant. Although the mass appeared to be almost entirely blocking the ear canal, it was successfully removed under a surgical microscope without general anesthesia at the outpatient department. Under an optical microscope with hematoxylin and eosin staining, the specimen was observed to have a cuticle with a serrated surface and a pore canal, as well as parts of the capitulum, salivary glands, muscles, midgut, and the legs. The specimen was identified as a hard tick of the family Ixodidae, based on gross and histological findings. This paper is the first report in Korea on the diagnosis and treatment of a tick bite in the ear canal.
Anesthesia, General ; Diagnosis ; Ear Canal* ; Eosine Yellowish-(YS) ; Female* ; Hematoxylin ; Humans ; Infant* ; Ixodidae* ; Korea ; Leg ; Male ; Muscles ; Outpatients ; Salivary Glands ; Tick Bites ; Ticks

BACKGROUND AND OBJECTIVES: Zinc has antioxidant effect, anti-inflammatory effect and neuromodulative function. The purpose of this study was to investigate whether treatment with zinc can improve the outcome of sudden sensorineural hearing loss (SSNHL). SUBJECTS AND METHOD: The study group consisted of 143 patients diagnosed as SSNHL. Of the patients, 82 were given corticosteroid treatment (group Ct) and 61 were given oral zinc plus corticosteroid treatment (group Zn). In group Zn, serum zinc level was checked before treatment and the patients with normal serum zinc level were included. Hearing was assessed before therapy and at 2 weeks, 1 month and 2 months after the initiation of therapy. RESULTS: A significantly larger hearing gain in pure tone average (group Ct vs. group Zn=26.40 dB HL vs. 34.28 dB HL) and at 2000 Hz (group Ct vs. group Zn=24.93 dB HL vs. 33.60 dB HL) and 8000 Hz (group Ct vs. group Zn=11.64 dB HL vs. 20.66 dB HL) were seen in group Zn compared with the group Ct. CONCLUSION: Oral zinc supplementation may have beneficial effects in the treatment of SSNHL, especially at 2000 and 8000 Hz.
Antioxidants ; Hearing ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Zinc*

Intratympanic membrane congenital cholesteatoma (ITMCC) is extremely rare in patients without previous trauma or surgery of the ear. There are multiple theories to the pathogenesis of middle ear congenital cholesteatoma but none are applicable for ITMCC. When the size of ITMCC is small, there are usually no ear symptoms. However, surgery is needed early, as in any other type of cholesteatoma, because early treatment before middle ear involvement enables enucleation without the need for other procedures such as myringoplasty. We report an incidental finding of a small pearl at the umbo in a 2-year-old boy. The cholesteatoma involved only the outer epidermic layer of the tympanic membrane (TM). A transcanal approach was performed and the cholesteatoma was enucleated from TM.
Cholesteatoma ; Ear ; Ear, Middle ; Humans ; Incidental Findings ; Membranes ; Myringoplasty ; Preschool Child ; Tympanic Membrane

Benign paroxysmal positional vertigo is the most common disease of the peripheral vestibular disorder. A 51-year-old man showed geotropic horizontal nystagmus in the head roll test. After head-bending posture, the nystagmus of the patient was changed to apogeotropic horizontal nystagmus in the head roll test. We concluded that transition of canalolithiasis into cupulolithiasis happened during head-bending posture. The cupulolithiasis was returned to canalolithiasis by using side-lying position with the affected ear downward for approximately 45 minutes.
Ear ; Head ; Humans ; Middle Aged ; Nystagmus, Pathologic ; Posture ; Semicircular Canals ; Vertigo

Labyrinthine fistula refers to a condition caused by an abnormal connection between the inner ear and surrounding structures. Most cases of that occur as a result of a complication brought about by cholesteatoma. It may also be generated by long repeated infections of a mastoid cavity that has been exposed to the outside after canal wall down mastoidectomy (CWDM). The infection is usually repeated for several years or decades after surgery. Therefore, labyrinthine fistula after CWDM is known as a late complication. In this case, labyrinthine fistula occurred in two months after surgery due to postoperative infection. Although cholesteatoma was removed after CWDM and the horizontal semicircular canal (HSCC) was not damaged during the operation, this labyrinthine fistula was thought to develop very early after surgery. Two months after surgery, the patient complained of dizziness, we identified the opened bony labyrinth and damaged endosteum of the HSCC in the patient.
Cholesteatoma ; Dizziness ; Ear, Inner ; Fistula ; Humans ; Mastoid ; Semicircular Canals

BACKGROUND: Otomycosis is a fungal infection that comprises 7~10% of outer ear infections. Although the occurrence is higher in humid climates, relatively few studies have investigated otomycosis occurrences in humid environments. While recurrent chronic otitis media discharge in the ear creates a milieu in which otomycosis is likely to occur, investigations of otomycosis co-occurring with chronic otitis media have been rare. OBJECTIVE: To examine the characteristics of patients with otomycosis co-occurring with chronic otitis media and identify causative fungi. METHODS: The study included 60 patients with chronic otitis media who presented typical otomycosis findings in the outer ear canal and the presence of fungi. Patients were treated in the department of otolaryngology, Daegu Catholic University Medical Center, between July 2011 and June 2018. RESULTS: The mean patient age was 57.77 years, and our study included 20 men and 40 women (p=0.010). The lesion was on the right in 39 patients and on the left in 21 (p=0.020). Ear discharge was the most common chief complaint at diagnosis. Of the 54 patients over age 19, 10 had diabetes (18.5%). Aspergillus was causative in 29 patients and Candida in 31. Aspergillus niger was identified in 15 patients, Aspergillus sp. in 14, Candida parapsilosis in 12, Candida sp. in six, and Candida albicans in five. CONCLUSION Otomycosis and chronic otitis media co-occurrences increase with age. The Aspergillus and Candida genera were similar in proportion. A. niger was the most common Aspergillus species, while C. parapsilosis was the most common Candida.

Vascular leiomyoma (Angiomyoma) is a benign tumor composed of smooth muscle cell and vascular endothelium. Most of them occur at the skin of the lower leg. Cases of vascular leiomyomas developing in the nasal cavity and paranasal sinuses are extremely rare. Most common symptoms are nasal obstruction, epistaxis and nasal pain but none are specific for diagnosis. Complete surgical excision is the treatment of choice and was used in all cases reported. Local recurrence rate is very low. We experienced a case of vascular leiomyoma in the inferior turbinate of a 70-year-old woman who complained of intermittent epistaxis. The tumor was successfully removed via an endoscopic approach. It displayed the characteristic histological findings of abundant thick-walled blood vessels blending with proliferative smooth muscle tissue.
Aged ; Angiomyoma ; Blood Vessels ; Endothelium, Vascular ; Epistaxis ; Female ; Humans ; Leg ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Nasal Cavity ; Nasal Obstruction ; Paranasal Sinuses ; Recurrence ; Skin ; Turbinates

PURPOSE: There is no effective treatment for patients with advanced gastric cancer having failed to respond to first line chemotherapy. The aim of this study was to evaluate the therapeutic activity, and safety, of a FEP regimen in patients with a recurrence of, or metastatic, gastric cancer that had been unresponsive to primary chemotherapy. MATERIALS AND METHODS: Recurred or metastatic gastric cancer patients that did not respond to a 5-fluorouracil based regimen were entered into this trial. The patients were treated with FEP (5-FU, etoposide and cisplatin) as salvage chemotherapy. The treatment regimen was 5-FU (900 mg/m2/day) by continuous infusion for 3 days, etoposide (90 mg/m2/day) on days 1, 2 and 3, and cisplatin (60 mg/m2/day) on day 2. This treatment was repeated every 3 weeks. RESULTS: Between December 1997 and October 2001, 28 patients were enrolled to the study. The response rate was 32.1% (95% CI 15.5~57.8%). The median times to progression and survival duration were 23~33 weeks, respectively. Among a total of 187 cycles of chemotherapy, the grade 3 and 4 hematological toxicities were leukopenia (6.4%), thrombocytopenia (1.6%), and grade 3 non-hematological side effects of nausea/vomiting (17.9%). CONCLUSION: FEP combination chemotherapy seems to be an effective treatment regimen for gastric cancer as salvage chemotherapy. To confirm these results, large scale of clinical trials will be required.
Cisplatin ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Fluorouracil ; Humans ; Leukopenia ; Polytetrafluoroethylene* ; Recurrence ; Salvage Therapy ; Stomach Neoplasms* ; Thrombocytopenia

PURPOSE: There are few therapeutic options in patients with colorectal cancer that have progressed or recurred following 5-fluorouracil (5-FU) based therapy. We evaluated the efficacy and toxicity of oxaliplatin, 5-FU, leucovorin (Mayo clinic regimen) in 5-FU pretreated advanced colorectal cancer patients. MATERIALS AND METGODS: Twenty-eight patients were enrolled in this study between January 1999 and May 2001. Patients were treated with oxaliplatin 150 mg/m2 on day 1 as a 2-hr infusion and 5-FU 425 mg/m2, leucovorin 20 mg/m2, bolus for 5 days. Treatment courses were repeated in 4-week intervals. RESULTS: The objective response rate was 25% for 28 assessable patients, all cases registered a partial response. Eleven patients (39%) demonstrated stable disease, and ten (36%) progressed. The median response duration was 5.5 months, and the median time to progression was 6.3 months. The median overall survival time was 13.5 months from the start of the chemotherapy. From the 120 cycles analyzed, grade 3,4 hematologic toxicities included neutropenia: 1.6%, and thrombocytopenia: 1.6%. The frequent grade 3.4 non-hematologic adverse reactions were nausea/vomiting (25.0%), diarrhea (14.3%), stomititis (3.6%), and neuropathy (3.6%). There were no treatment-related deaths. CONCLUSION: This phase II study had relatively higher toxicity than previous studies, and did not show an increased significant response rate. These high levels of toxicity suggest that the study treatment combination of oxaliplatin with a full dose Mayo clinic regimen arm is no feasible. Therefore, this regimen will be discontinued and a safer regimen will be adopted.
Arm ; Colorectal Neoplasms* ; Diarrhea ; Drug Therapy ; Drug Therapy, Combination ; Fluorouracil* ; Humans ; Leucovorin* ; Neutropenia ; Thrombocytopenia

Angiofibromas originate predominantly from the posterolateral wall of the nasopharynx and are typically seen in adolescent males, but they may also exist outside of the nasopharynx. Nine patients with extranasopharyngeal angiofibromas have been reported in Korea. The inferior turbinate was the most commonly affected site, and patients reported experiencing various nasal symptoms, such as epistaxis and nasal obstruction. Extranasopharyngeal angiofibroma arising from the superior turbinate is extremely rare and has not been reported to date. Recently we experienced a case of angiofibroma of the left superior turbinate in a 68-year-old male that was successfully treated with endoscopic surgery.
Adolescent ; Aged ; Angiofibroma* ; Epistaxis ; Humans ; Korea ; Male ; Nasal Obstruction ; Nasopharynx ; Turbinates*