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A Cervical Vagal Schwannoma Mimicking a Parathyroid Cyst.

Kyu Rin HWANG ; Jae Wook KIM ; Hee Kyung KIM ; Seung Won LEE

Clinical and Experimental Otorhinolaryngology.2014;7(2):153-156.

Cervical vagal schwannomas with cystic degeneration changes are extremely rare. These tumors are typically benign and slow growing. A 44-year-old woman underwent complete resection of a tumor measuring 4x3.5 cm in the right neck using the endoscopic approach, instead of the conventional transcervical approach. We applied the new scarless neck surgery technique with an endoscopic unilateral axillo-breast approach. The tumor originated from the right vagus nerve, and was confirmed to be a vagal schwannoma pathologically. The patient has been followed up for 18 months postoperatively with no evidence of tumor recurrence or neurological deficit. We report an extremely rare vagal schwannoma with cystic degeneration that was removed by an endoscopic approach, along with a review of the relevant literature.
Adult ; Female ; Humans ; Neck ; Neurilemmoma* ; Recurrence ; Vagus Nerve

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Oncocytic Sialolipoma of the Submandibular Gland.

Dongbin AHN ; Tae In PARK ; Junesik PARK ; Sung Jae HEO

Clinical and Experimental Otorhinolaryngology.2014;7(2):149-152.

Sialolipoma, a rare tumor of the salivary gland, is a recently described variant of salivary gland lipoma. Oncocytic sialolipoma was first described by Pusiol et al. in 2009. We report the case of an oncocytic sialolipoma of the submandibular gland in a 43-year-old female. Excision of the tumor was performed with preservation of the submandibular gland. The tumor had a thin, fibrous capsule and consisted of abundant adipose tissue, an oncocytic nodule, and scattered normal glandular structures surrounded by adipose tissue. Four cases of sialolipoma of the submandibular gland, including the present case, were reviewed. All 4 tumors were developed on the right submandibular glands, with a composition of adipose tissue as high as that of sialolipoma of the parotid gland; in contrast to previous reports, three cases were in females. As newly described tumor type, care should be taken to distinguish oncocytic sialolipoma from other salivary gland neoplasms such as simple lipoma, pleomorphic adenoma, or oncocytoma.
Adenoma ; Adenoma, Oxyphilic ; Adipose Tissue ; Adult ; Female ; Humans ; Lipoma ; Parotid Gland ; Salivary Gland Neoplasms ; Salivary Glands ; Submandibular Gland*

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Sinonasal Glomangiopericytoma Causing Oncogenic Osteomalacia.

Gang Gyu LEE ; Hun Jong DHONG ; Youn Soo PARK ; Young Hyeh KO

Clinical and Experimental Otorhinolaryngology.2014;7(2):145-148.

A 60-year-old woman suffered from recurrent femur neck fracture. Laboratory data showed serum hypophosphatemia, elevated alkaline phosphatase, normal serum calcium levels, and normal parathyroid hormone levels. Radiological examinations revealed a tumor in the right maxillary alveolar bone. The nasal cavity mass was removed, and the histological features were those of glomangiopericytoma. After removal of the tumor, some of the laboratory data normalized. Based on the clinical features, histopathological diagnosis and postoperative course of events, a diagnosis of glomangiopericytoma causing oncogenic osteomalacia was confirmed. We report a case of oncogenic osteomalacia caused by sinonasal glomangiopericytoma.
Alkaline Phosphatase ; Calcium ; Diagnosis ; Female ; Femoral Neck Fractures ; Hemangiopericytoma ; Humans ; Hypophosphatemia ; Middle Aged ; Nasal Cavity ; Osteomalacia* ; Parathyroid Hormone

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Reconstruction of a Columellar Defect With a Nasolabial Island Flap.

Il Gyu KANG ; Joo Hyun JUNG ; Seon Tae KIM ; Yu Jin KIM

Clinical and Experimental Otorhinolaryngology.2014;7(2):142-144.

Columellar skin defects may be caused by excision of cutaneous malignancy, trauma, or tissue necrosis associated with surgery. Although columellar skin necrosis rarely occurs following rhinoplasty, this condition might be more common when using an external approach than a closed approach. Columellar skin incision performed with exaggerated tip augmentation may cause columellar necrosis. The nasolabial island flap, used unilaterally to cover columellar skin defects, is used for a single-stage reconstruction procedure and is generally not associated with the need for secondary surgeries. This technique is well suited for repairing columellar skin defects. We experienced a patient with columellar skin necrosis occurring after rhinoplasty which was reconstructed using a unilateral single-stage nasolabial island flap.
Humans ; Necrosis ; Rhinoplasty ; Skin

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Persistent Direction-Fixed Nystagmus Following Canalith Repositioning Maneuver for Horizontal Canal BPPV: A Case of Canalith Jam.

Young Soo CHANG ; Jeesun CHOI ; Won Ho CHUNG

Clinical and Experimental Otorhinolaryngology.2014;7(2):138-141.

The authors report a 64-year-old man who developed persistent direction fixed nystagmus after a canalith repositioning maneuver for horizontal canal benign paroxysmal positional vertigo (HC-BPPV). The patient was initially diagnosed with right HC-BPPV given that the Dix-Hallpike test showed geotropic horizontal nystagmus that was more pronounced on the right side, although the roll test did not show any positional nystagmus. The patient was treated with a canalith repositioning maneuver (Lempert maneuver). The next day, the patient experienced a different character of dizziness, and left-beating spontaneous nystagmus regardless of head position was observed. After a forced prolonged left decubitus and frequent head shaking, his symptoms and nystagmus resolved. This condition, referred to as canalith jam, can be a complication after the repositioning maneuver in patients with BPPV. Atypical positional tests suggest that abnormal canal anatomy could be the underlying cause of canalith jam.
Dizziness ; Head ; Humans ; Middle Aged ; Nystagmus, Pathologic ; Nystagmus, Physiologic ; Vertigo

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Characteristics of Deep Neck Infection in Children According to Weight Percentile.

Mehmet Fatih GARCA ; Ali BUDAK ; Nihat DEMIR ; Hakan CANKAYA ; Ahmet Faruk KIROGLU

Clinical and Experimental Otorhinolaryngology.2014;7(2):133-137.

OBJECTIVES: To evaluate the effect of weight percentile on deep neck infections in children. METHODS: A retrospective evaluation of 79 patients who were treated for deep neck infections. The patients were divided into six groups according to weight percentile. Patients who had systemic and/or congenital disease were excluded. Their demographics, etiology, localization, laboratory, and treatment results were reviewed. RESULTS: In total, 79 pediatric patients were recorded: 48.1% were females and 51.9% were males, with a mean age of 7.3 years. In total, 60 patients were under the 50th percentile according to their weight versus all children. The anteroposterior triangle (29.1%) and submandibular (26.5%) spaces were most commonly involved with deep neck infection. However, the anteroposterior triangle space was the highest in the group below the 3rd percentile (44.4%). In the blood analysis, white blood cell levels in patients with at percentile values of 75-50 were higher than other groups (P<0.05). Significant differences were found between C-reactive protein and hemoglobin levels and diameter of abscesses. The need for surgical drainage in patients in lower percentiles was higher. The patients who needed surgical drainage consisted of 56 patients (93.3%) below the 50th percentile and 9 patients (100%) below the 3rd percentile. CONCLUSION: Deep neck infection is more insidious and dangerous in low-weight-percentile children, especially those having low white blood cell counts, low hemoglobin levels, and high C-reactive protein in laboratory results.
Abscess ; C-Reactive Protein ; Child* ; Demography ; Drainage ; Female ; Humans ; Leukocyte Count ; Leukocytes ; Male ; Neck* ; Retrospective Studies

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Clinical History, Prognostic Factors, and Management of Facial Nerve in Malignant Tumors of the Parotid Gland.

Francesco BUSSU ; Mario RIGANTE ; Veronica GIGLIA ; Giovanni BASTANZA ; Eugenio DE CORSO ; Giovanni ALMADORI ; Gaetano PALUDETTI

Clinical and Experimental Otorhinolaryngology.2014;7(2):126-132.

OBJECTIVES: We analyzed the outcomes following clinical management of parotid masses that were determined to be malignant tumors after parotidectomy. METHODS: We evaluated data from 70 patients with parotid malignancies between November 1994 and December 2005. RESULTS: Among salivary histotypes (n=49), the most significant prognostic parameter was cT4 stage at diagnosis (P=0.0055, log-rank) both for clinical involvement of the facial nerve and for invasion of other structures. The main cause of cancer-related death was a distant metastasis. CONCLUSION: The present series confirms that the main prognostic parameter in salivary parotid malignancies was cT4 classification at diagnosis, often due to clinical involvement of the facial nerve. The oncological outcome of salivary malignancies was influenced by distant metastasis more than most other head and neck sites. We recommend dissecting and preserving the functioning VIIth cranial nerve during surgery for parotid malignancies.
Classification ; Cranial Nerves ; Diagnosis ; Facial Nerve* ; Head ; Humans ; Neck ; Neoplasm Metastasis ; Parotid Gland*

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The Role of Transnasal Esophagoscopy in ENT Office: A Prospective, Multicenter Study in Korea.

Eun Jae CHUNG ; Young Soo RHO ; Kwang Yoon JUNG ; Jae Wook KIM ; Seung Won LEE

Clinical and Experimental Otorhinolaryngology.2014;7(2):123-125.

OBJECTIVES: The purpose of study was to report the current role of transnasal esophagoscopy (TNE) in Korea. METHODS: One hundred thirty-seven patients who underwent TNE at Soonchunhyang University Bucheon Hospital (n=69) and Korea University Anam Hospital (n=68) from July 2007 to February 2009 were prospectively analyzed. Laryngopharyngeal reflux disease (LPRD) patients without any response to proton-pump inhibitor (n=102), and patients with complaints that require esophagoscopy as part of their evaluation (n=35) were included in this study; investigation of metachronous lesions or routine follow-up screening of head and neck cancer patients, n=17; dysphagia, n=9; blood tinged saliva, n=4; to determine the cause of vocal fold paralysis as screening tool, n=4; suspicious esophageal foreign body, n=1. RESULTS: Fifty-three patients (38.7%) had positive findings on TNE. Positive finding ratio was highest in group of dysphagia (7 among 9 patients, 78%). Forty-two patients (41.1%) were found to have pathology (esophagitis, n=41; esophageal diverticulum, n=1) during the screening examination for LPRD. There were no significant complications in any of the patients. CONCLUSION: TNE is a high-yield diagnostic and therapeutic modality available to otolaryngologists for use on awake patients in the office setting.
Deglutition Disorders ; Diverticulum, Esophageal ; Esophagoscopy* ; Esophagus ; Follow-Up Studies ; Foreign Bodies ; Gyeonggi-do ; Head and Neck Neoplasms ; Humans ; Korea ; Laryngopharyngeal Reflux ; Mass Screening ; Paralysis ; Pathology ; Prospective Studies* ; Saliva ; Tolnaftate ; Vocal Cords

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Partial Superficial Parotidectomy via Retroauricular Hairline Incision.

Do Youn KIM ; Gi Cheol PARK ; Young Wook CHO ; Seung Ho CHOI

Clinical and Experimental Otorhinolaryngology.2014;7(2):119-122.

OBJECTIVES: The purpose of this study was to evaluate the usefulness of retroauricular hair line incision (RAHI) in partial superficial parotidectomy by comparison with modified Blair incision or facelift incision. METHODS: Medical records of 73 patients with benign parotid tumor who underwent partial superficial parotidectomy were retrospectively reviewed. Size and location of tumors, operative time, occurrence of facial nerve paralysis and Frey's syndrome, and cosmetic outcomes were compared among RAHI, facelift incision (FLI), modified Blair incision (MBI) groups. RESULTS: RAHI group showed better cosmetic results than FLI group or MBI group compared with other type of incisions (P<0.001, P<0.001, respectively). Among the 3 groups, there were no significant differences of operative time and location of tumor (P=0.377), size of tumor (P>0.999), occurrence of temporary or permanent facial nerve paralysis (P=0.745) and Frey's syndrome (P=0.940). CONCLUSION: Partial superficial parotidectomy can be done safely by RAHI in most cases of benign parotid tumor. Compared with MBI or FLI, RAHI has better cosmetic outcome with no increase of operative time or postoperative complications.
Facial Nerve ; Hair ; Humans ; Medical Records ; Operative Time ; Paralysis ; Parotid Gland ; Postoperative Complications ; Retrospective Studies ; Rhytidoplasty ; Sweating, Gustatory

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Dexamethasone Induces Apoptosis of Nasal Polyp-Derived Tissue Cultures Through JNK and p38 MAPK Activation.

Tae Hoon LEE ; Jung Gwon NAM ; Ho Min LEE ; Bo Young KIM ; Myung Koo KANG ; Woo Yong BAE ; Dae Young HUR ; Seong Kook PARK

Clinical and Experimental Otorhinolaryngology.2014;7(2):112-118.

OBJECTIVES: Glucocorticoids, such as dexamethasone (DEX), increase apoptosis in a variety of white cells in nasal polyps and apoptosis is an important factor in the resolution of inflammation. However, the mechanism of glucocorticoids induced apoptosis in nasal polyp remains unclear. In this study the authors evaluated which pathways were engaged in apoptosis induced by DEX in an ex vivo model of nasal polyps. METHODS: Nasal polyp tissues were cultured using an air-liquid interface method. Cultures were maintained in the absence or presence of DEX (10 or 100 microM) for 24 hours. To investigate the involvement of the apoptotic signaling pathways in nasal polyp, such as caspase cascades, Fas-FasL signaling pathway, mitochondrial pathway and p38 mitogen-activated protein kinase (MAPK)/JNK pathway, the authors performed reverse transcription-polymerase chain reaction and Western blotting. RESULTS: The expression ratios of FasL, activated form of caspase-8, caspase-9, and caspase-3 were significantly higher in DEX-treated polyps (P<0.01). In the Bcl-2 family expression, the anti-apoptotic molecules, Bcl-2 and Bcl-XL decreased, but pro-apoptotic molecules, Bax increased, and Bid and Bad were activated. In the conventional MAPKs, JNK, and the phospho-p38 MAPK were significantly higher, but phospho-extracellular signal-regulated kinase (ERK)1/2 was significantly lower in DEX-treated polyps (P<0.01). CONCLUSION: DEX induces apoptosis of nasal polyp via caspase cascades, Fas-FasL signaling pathway, mitochondrial pathway and p38 MAPK/JNK pathway.
Apoptosis* ; Blotting, Western ; Caspase 3 ; Caspase 8 ; Caspase 9 ; Dexamethasone* ; Glucocorticoids ; Humans ; Inflammation ; Nasal Polyps ; Organ Culture Techniques ; p38 Mitogen-Activated Protein Kinases* ; Phosphotransferases ; Polyps ; Protein Kinases

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