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Two Cases of Nasolacrimal Duct Cyst Developed in Neonate.

Ja Hyun LEE ; Seung Sin LEE ; Kun Kyung CHO

Journal of Rhinology.2005;12(2):129-132.

Bilateral nasolacrimal duct cyst is an uncommon disease causing respiratory and feeding difficulty in neonates. It can either present pure intranasal cystic mass or be associated with dacryocystocele and/or dacryocystitis. Symptoms and signs of nasolacrimal duct cyst are different according to the patient's age and its bilaterality. Therefore, treatment should be individualized according to its presentation. The authors experienced one case of bilateral nasolacrimal duct cyst without dacryocystocele which caused respiratory difficulty and another case of nasolacrimal duct cyst associated with dacryocystocele. Both cases were treated by endoscopic marsupializaion of the cysts. We report these two cases with a brief review of the literature.
Dacryocystitis ; Humans ; Infant, Newborn* ; Nasolacrimal Duct*

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Two Cases of Organized Hematoma of Maxillary Sinus with Bone Erosion.

Kyung TAE ; Su Young KIM ; Jin Hyuk JUNG ; Kyung Rae KIM ; Young Ha OH ; Dong Woo PARK

Journal of Rhinology.2005;12(2):124-128.

An organized hematoma in the maxillary sinus can be formed by organizing procedure of hematoma in the unaerated maxillary sinus. It is a rare disorder of unknown etiology. Clinical symptoms, signs, and radiologic appearance of the hematoma mimick tumors at the initial diagnosis. An expansile organized hematoma in the maxillary sinus may induce erosion or destruction of the maxillary bony wall. Therefore, it may be difficult to distinguish such lesion from malignant tumors. We report two cases of an organized hematoma in the maxillary sinus presenting with erosion of the maxillary sinus wall with a brief review of the literature.
Diagnosis ; Hematoma* ; Maxillary Sinus*

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A Case of Blindness after Transsphenoid Approach for Pituitary Adenoma Removal: Revision Treatment Experience under Local Anesthesia.

Hyo Jin PARK ; Jin Woo LIM ; Young Han LIM ; Young Soo RHO

Journal of Rhinology.2005;12(2):120-123.

Pituitary adenoma accounts for 10% to 20% of intracranial tumors. Surgical approach to pituitary adenoma had been performed via craniotomy until the early 20th century, but transsphenoidal approach has been accepted as a primary procedure since 1910. However, there are frequent complications in the nose including nasal mucosal laceration, nasal septal perforation, and external nose deformities. Furthermore, cerebrospinal fluid leakage, visual field loss or blindness rarely occur. When blindness occurs by postoperative hematoma compression, revision operation is usually required for bleeding control and hematoma removal under general anesthesia. However, optic nerve decompression with postoperative hematoma removal via transsphenoidal approach can be adequately performed by endoscopic technique under local anesthesia, because there is no sensory nerve innervation in the pia mater and arachnoid membrane. We report a case of successful hematoma removal with bleeding control by endoscopic technique under local anesthesia in a patient who became blind due to postoperative hematoma after transphenoid approach for pituitary adenoma removal.
Anesthesia, General ; Anesthesia, Local* ; Arachnoid ; Blindness* ; Cerebrospinal Fluid ; Congenital Abnormalities ; Craniotomy ; Decompression ; Hematoma ; Hemorrhage ; Humans ; Lacerations ; Membranes ; Nasal Septal Perforation ; Nose ; Optic Nerve ; Pia Mater ; Pituitary Diseases ; Pituitary Neoplasms* ; Visual Fields

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Medpor(R)-using Reconstruction of the Orbital Floor Defect Caused by the Maxillary Sinus Mucocele: A Case Report.

Chan RHYOO

Journal of Rhinology.2005;12(2):116-119.

Mucoceles of the paranasal sinuses are benign, locally expansile cysts filled with mucus and lined by the mucoperiosteum of the involved sinus. Orbital symptoms are characteristic in symptomatic maxillary sinus mucoceles, and patients initially consulted ophthalmologists for eyeball displacement, diplopia, proptosis, enophthalmos, epiphora, and rarely decreased visual acuity. Recently, we experienced a case of maxillary sinus mucocele with the destruction of the orbital floor. The mucocele was treated by marsupialization via intranasal and transantral approach, and the large defect of orbital floor was successfully reconstructed using high-density porous polyethylene (Medpor(R), Porex Surgical Inc, College Park, GA). Accurately positioned Medpor implant was observed in the orbital floor after 48 months postoperatively.
Diplopia ; Enophthalmos ; Exophthalmos ; Humans ; Lacrimal Apparatus Diseases ; Maxillary Sinus* ; Mucocele* ; Mucus ; Orbit* ; Paranasal Sinuses ; Polyethylene ; Visual Acuity

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A Case of Frontal Mucocele with Paranasal Sinus Glass Foreign Body in Head Trauma Patient.

Jae Ho JEONG ; Sea Yuong JEON ; Seong Ki AHN ; Han Gyu CHO

Journal of Rhinology.2005;12(2):112-115.

Foreign bodies in the paranasal sinuses are rare, but they may become more common with an increasing number of road traffic accidents. Foreign bodies in the paranasal sinuses cause vague symptoms. They are occasionally encountered either after occurrence of complications or after radiological workup for some other reasons. They may be missed if their presence is not suspected initially. Therefore, the presence of foreign bodies should be suspected even in seemingly trivial lacerations over the paranasal sinuses in cases of maxillofacial trauma. The suspicion of foreign bodies may prevent the development of intracranial and intrasinus complications. Although a wide variety of foreign bodies have been reported in the paranasal sinuses, glass were rare in the frontal sinus. We present a case of frontal mucocele with glass in the frontal sinus which occurred as a result of road traffic accident with a brief review of the literature.
Accidents, Traffic ; Craniocerebral Trauma* ; Foreign Bodies* ; Frontal Sinus ; Glass* ; Head* ; Humans ; Lacerations ; Mucocele* ; Paranasal Sinuses

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Clinical Study of Open Nasal Bone Fracture.

Chan Hum PARK ; Duk Young KIM ; Taek Gun KWAN ; Sung Ju HONG ; Ki Nam JUNG

Journal of Rhinology.2005;12(2):108-111.

BACKGROUND AND OBJECTIVES: Little is known about the treatment of open nasal bone fracture (ONF). The operative technique, timing, and management of ONF is still confusing. This study presents our treatment policy of ONF to help otolaryngologists decide proper management plan. MATERIALS AND METHODS: Of 380 consecutive patients who required surgical intervention, 57 patients underwent open nasal reduction. Of 57 patients, 15 had one-stage operation, and 42 had two- stage operation. Postoperative patients' satisfaction was evaluated using a visual analogue scale and the reasons of dissatisfaction were analyzed. RESULTS: ONF had poorer outcome than closed nasal bone fracture. Unsatisfactory cosmetic results such as scan of the external nose and change of the skin color were the most common problems associated with open nasal reduction. CONCLUSION: Operation timing and technique should be selectively applied to different types of nasal bone fracture and wound state. Meticulous wound care as well as accurate nasal bone reduction is mandatory for ONF.
Humans ; Nasal Bone* ; Nose ; Skin ; Wounds and Injuries

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Fungal Ball in Sinus: Multi-Center Study in Daegu.

Chang Ki YEO ; Byung Hoon AHN ; Jung Soo KIM ; Yong Dae KIM ; Seung Heon SHIN ; Mi Kyung YE

Journal of Rhinology.2005;12(2):105-107.

BACKGROUND AND OBJECTIVES: Fungal sinusitis has been reported increasingly in immunocompetent patients and the fungus ball is the most frequent and best recognized form of fungal sinusitis. Fungus ball is usually unresponsive to appropriate medical treatment and surgery is the treatment of choice. The aim of this study is to evaluate the incidence, clinical symptoms and signs, and CT findings, the proportion of the patients with fungus ball. MATERIALS AND METHODS: In retrospective study, we reviewed medical records and CT findings of 255 patients with fungus ball confirmed by histopathologically among 6,217 patients who had undergone endoscopic sinus surgery between 1995 and 2004 at five medical centers in Daegu. RESULTS: The symptoms of fungus ball were nasal obstruction (64.4%), rhinorrhea (56.7%), PND (49.2%), cheek pain (26.4%) and foul odor (25.1%). Fungus ball was mostly encountered in only one maxillary sinus (76.4%) of an otherwise healthy person and preoperative computerized tomography (CT) revealed mottled calcific densities within the involved sinus in 55.2% of cases. The success rate of fungus ball surgery by endoscopy was 98.4%. CONCLUSION: This is the retrospective study to evaluate the prevalence of fungus ball (nearly 5%) among the endoscopic sinus surgery. To make a diagnosis of fungus ball, a high index of suspicion to unilateral symptomatic chronic sinusitis, often painful, unresponsive to appropriate medical treatment is necessary and endoscopic sinus surgery is and should remain the mainstay of treatment.
Cheek ; Daegu* ; Diagnosis ; Endoscopy ; Fungi ; Humans ; Incidence ; Maxillary Sinus ; Medical Records ; Nasal Obstruction ; Odors ; Prevalence ; Retrospective Studies ; Sinusitis

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Comparison of Clinical Characteristics of B Cell Lymphoma and NK/T cell Lymphoma of the Nose and Paranasal Sinuses.

Kwang Woo HAN ; Se Jun CHOI ; Ki Hoon PAE ; Yoo Sam CHUNG ; Yong Ju JANG ; Bong Jae LEE

Journal of Rhinology.2005;12(2):101-104.

BACKGROUND AND OBJECTIVES: There are various subtypes in lymphoma of the nasal cavity and paranasal sinuses. This study aimed to compare the clinical differences between NK/T cell lymphoma and B cell lymphoma in the nose and paranasal sinuses. MATERIALS AND METHODS: From 1991 through 2003, 18 patients were diagnosed with lymphoma by histopathologic biopsy (NK/T cell 13 : B cell 5). We reviewed the medical records retrospectively regarding subjective symptoms, physical findings, and PNS CT findings. RESULTS: The most common symptom of NK/T cell lymphoma was nasal obstruction (8/13), and the main endoscopic finding was ulcerative small lesion. The PNS CT finding of NK/T cell lymphoma was homogenous, poorly enhanced, small mass. In contrast, the most common symptom of B cell lymphoma was periorbital swelling (2/5), and the main endoscopic finding was fungating mass. The PNS CT finding of B cell lymphoma was heterogenous, well-enhanced, large mass with bone destruction. The location of NK/T cell lymphoma was the inferior or middle turbinate in the nasal cavity, whereas the location of B cell lymphoma was the ethmoid or maxillary sinus. CONCLUSION: It is suggested that there may be significant clinical differences between NK/T cell lymphoma and B cell lymphoma in the sinonasal cavity.
Biopsy ; Humans ; Lymphoma* ; Lymphoma, B-Cell* ; Maxillary Sinus ; Medical Records ; Nasal Cavity ; Nasal Obstruction ; Nose Neoplasms ; Nose* ; Paranasal Sinus Neoplasms ; Paranasal Sinuses* ; Retrospective Studies ; Turbinates ; Ulcer

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Clinical Analysis of Isolated Sphenoid Sinus Leision.

Byung Gi SUNG ; Sea Yuong JEON ; Jin Pyeong KIM ; Seong Ki AHN ; Jung Je PARK ; Jae Ho JEONG

Journal of Rhinology.2005;12(2):97-100.

BACKGROUND AND OBJECTIVES: Isolated sphenoid lesion (ISL) is rare due to its anatomic location in the nasal cavity. The recent advances in the diagnosis with CT and MRI make it easier to diagnose ISL. We experienced 15 cases of ISL and reviewed their clinical characteristics. MATERIALS AND METHODS: Patients with ISL admitted from January 1998 through April 2004 were retrospectively reviewed. Patients' clinical symptoms, endoscopic and radiologic findings, treatment modalities, postoperative diagnosis, and the outcomes were analyzed. RESULTS: The most common symptom was headache presented in 9 patients, followed by nasal symptoms in 4 patients. Five of 15 cases were acute sphenoiditis which was improved with antibiotic trials. The other 10 cases were treated by endoscopic sphenoidotomy. Postoperative pathology showed 4 cases of fungal ball, and 3 cases of mucocele, 3 cases of chronic sphenoiditis. CONCLUSION: Headache and orbital symptom were the most common presentation in patients with ISL. Endoscopic and radiologic findings were not pathognomonic to diagnose ISL in most cases. Antibiotic trials should be preceded, and then followed by endoscopic sphenoidotomy in the refractory cases. Loss of vision or light reflex may predict a poor rognosis.
Diagnosis ; Endoscopy ; Headache ; Humans ; Magnetic Resonance Imaging ; Mucocele ; Nasal Cavity ; Orbit ; Pathology ; Reflex ; Retrospective Studies ; Sphenoid Sinus*

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15-Lipoxygenase-1 Mediates Mucociliary Differentiation in Normal Human Nasal Epithelial Cells.

Jung Hyun CHANG ; Jeong Hong KIM ; Joo Heon YOON ; Jeung Gweon LEE ; Hyung Seok SEO ; Kyung Su KIM

Journal of Rhinology.2005;12(2):92-96.

BACKGROUND AND OBJECTIVES: 15-lipoxygenase-1 (15-LO-1) is involved in the differentiation of human tracheobronchial epithelial cells. Here we investigated the relation between 15-LO-1 expression and the differentiation of normal human nasal epithelial (NHNE) cells. MATERIALS AND METHODS: NHNE cells, RT-PCR, Western blot analysis, and scanning electron microscopy (SEM) were used. RESULTS: In retinoic acid (RA)-sufficient culture media, 15-LO-1 expression in NHNE cells increased time-dependently, but its expression was undetectable in RA-deficient culture media. Moreover, in RA-deficient culture media, IL-4 time-dependently induced 15-LO-1 expression at a concentration of 1 ng/mL. In addition, MUC8 gene expression, a marker of mucociliary differentiation, was up-regulated by 15-LO-1, which was itself induced by IL-4. In SEM, the ciliated epithelium was observed with the treatment of IL-4. CONCLUSION: Our findings suggest that 15-LO-1 may be related to the differentiation of human nasal epithelium, and that it may mediate the mucociliary differentiation of NHNE cells.
Blotting, Western ; Cell Differentiation ; Cilia ; Culture Media ; Epithelial Cells* ; Epithelium ; Gene Expression ; Humans* ; Interleukin-4 ; Microscopy, Electron, Scanning ; Nasal Mucosa ; Tretinoin

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