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Spontaneous Tonsillar Hemorrhage and Post-Tonsillectomy Hemorrhage.

Yeon Soo KIM ; Seok Jin HONG ; June CHOI ; Seung Hoon LEE ; Soon Young KWON ; Ji Ho CHOI

Clinical and Experimental Otorhinolaryngology.2010;3(1):56-58.

Spontaneous tonsillar hemorrhage from infectious causes is extremely rare and post-tonsillectomy hemorrhage, although also relatively rare, is an unavoidable complication of the procedure. Hemorrhage in association with tonsillitis or tonsillectomy is potentially dangerous and can be life threatening. We report here the presentation and management of a 42-yr-old man with severe spontaneous hemorrhage from infected tonsils and post-tonsillectomy hemorrhage. We suggest that if attempts to control the bleeding are not successful or if severe spontaneous tonsillar hemorrhage occurs repeatedly or a malignancy is suspected, tonsillectomy and close postoperative follow up is recommended.
Hemorrhage ; Palatine Tonsil ; Tonsillectomy ; Tonsillitis

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Granular Cell Tumor on Larynx.

Jun Hee PARK ; Nam Yong DO ; Sung Il CHO ; Ji Yun CHOI

Clinical and Experimental Otorhinolaryngology.2010;3(1):52-55.

Granular cell tumors (GCTs) are uncommon neoplasm. They can originate in any part of the body. The most common sites of origin are in the head and neck, while the larynx is a relatively uncommon location. Patients affected with a laryngeal GCT typically present with persistent hoarseness, stridor, hemoptysis, dysphagia, and otalgia but, the tumor may be asymptomatic. Care must be taken to differentiate this lesion from others due to the presence of pseudo-epitheliomatous hyperplasia which overlies the GCT and may occasionally mimic squamous cell carcinoma. Therefore, a confirmative diagnosis should be made histopathologically and should be supported by immunohistochemical staining. These tumors are treated by complete surgical resection. Examining the complete removal of the tumor through securing a negative free margin is considered to be a consequential procedure. We experienced a 64-yr-old man with a laryngeal granular cell tumor involving the right true vocal cord. He was treated by surgical resection under a fine dissection laryngomicroscope. Here we present this case and a review of literature.
Carcinoma, Squamous Cell ; Deglutition Disorders ; Earache ; Granular Cell Tumor ; Head ; Hemoptysis ; Hoarseness ; Humans ; Hydrazines ; Hyperplasia ; Larynx ; Neck ; Respiratory Sounds ; Vocal Cords

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Excision of a Nasal Dermoid Sinus Cyst via Open Rhinoplasty Approach and Primary Reconstruction Using Tutoplast-Processed Fascia Lata.

Ji Heui KIM ; Jong Hwan WANG ; Yong Ju JANG

Clinical and Experimental Otorhinolaryngology.2010;3(1):48-51.

Nasal dermoid sinus cysts are the most common congenital midline nasal lesion, accounting for 1% to 3% of all dermoid cysts, and 4% to 12% of all head and neck dermoids. Selection of the appropriate reconstruction technique, after dermoid resection, is important for treatment. Here we describe the successful management of a case with a nasal dermoid sinus cyst using an open rhinoplasty approach, and primary reconstruction using Tutoplast-processed fascia lata and crushed septal cartilage.
Accounting ; Cartilage ; Dermoid Cyst ; Fascia ; Fascia Lata ; Head ; Neck ; Rhinoplasty

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XPD Polymorphisms and Risk of Squamous Cell Carcinoma of the Head and Neck in a Korean Sample.

Yong Bae JI ; Kyung TAE ; Yoon Seo LEE ; Seung Hwan LEE ; Kyung Rae KIM ; Chul Won PARK ; Byung Lae PARK ; Hyoung Doo SHIN

Clinical and Experimental Otorhinolaryngology.2010;3(1):42-47.

OBJECTIVES: XPD is a major player in nucleotide excision repair, which is one of the basic pathways of DNA repair. The objective of this study was to investigate the association of XPD single nucleotide polymorphisms (SNPs) and the risk of squamous cell carcinoma of the head and neck (SCCHN) in Koreans. METHODS: We performed XPD +23591G>A and +35931A>C genotyping in 290 SCCHN patients and 358 controls. RESULTS: The frequencies of the XPD +23591G>A (GG/GA/AA) genotypes were 89.0%/11.0%/0% in the patients and 90.3%/8.8%/0.9% in the controls, respectively. The odds ratio (OR) of the XPD +23591 GA genotype was 1.94 (0.92 to 4.08) in reference to the GG genotype. The frequencies of the XPD +35931A>C (AA/AC/CC) genotypes were 86.9%/12.0%/1.1% in the patients and 85.6%/13.8%/0.6% in the controls, respectively. The OR of the XPD +35931 AC and CC genotypes were 0.98 (0.51 to 1.88) and 2.68 (0.71 to 10.1), respectively, in reference to the AA genotype. On the subgroup analyses according to the smoking and drinking statuses, the SNPs and haplotypes of XPD showed no statistically significant association with the risk of SCCHN. CONCLUSION: The results of this study suggest that the XPD +23591G>A and +35931A>C SNPs are not associated with the risk of SCCHN in Koreans; however, a further study with a larger number of subjects is necessary to verify this conclusion.
Carcinoma, Squamous Cell ; DNA Repair ; Drinking ; Genotype ; Haplotypes ; Head ; Head and Neck Neoplasms ; Humans ; Neck ; Odds Ratio ; Polymorphism, Single Nucleotide ; Smoke ; Smoking

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Comparative Analysis of Efficiency of Injection Laryngoplasty Technique for with or without Neck Treatment Patients: A Transcartilaginous Approach Versus the Cricothyroid Approach.

Seung Won LEE ; Jae Wook KIM ; Yoon Woo KOH ; Sung Shine SHIM ; Young Ik SON

Clinical and Experimental Otorhinolaryngology.2010;3(1):37-41.

OBJECTIVES: These days, the main injection laryngoplasty technique is cricothyroid (CT) approach. However, patients who have previously undergone other neck treatments, such as thyroidectomy or neck dissection have distorted anatomical landmark makes this approach more difficult. The aim of this study is to determined the efficiency of transcartilaginous (TC) approah as compared with CT approach for unilateral vocal fold paralysis patients, especially for previously neck treated patients. METHODS: From March 2005 to February 2008, 137 consecutive injection laryngoplasties were performed in patients with unilateral glottic insufficiency. Percutaneous injection was performed under local anesthesia into the vocalis muscle, using disposable 25 G 4 cm long needles through the cricothyroid membrane or directly through the thyroid cartilage. Of the 137 patients, 124 completed acoustic, perceptual, stroboscopic, and subjective evaluations prior to the injection and at 3 months after the injection. RESULTS: In the 124 patients, the CT and TC approaches were used in 94 and 30 patients, respectively. Acoustic and perceptual parameters (GRBAS, MPT, jitter, shimmer), voice handicap index, and grades of mucosal waves and glottic closure were significantly improved after the injection in both the CT and TC groups (P<0.05). Only two patients (6.6%) had penetration difficulties, because of ossification of the thyroid cartilage. The overall success rates of the CT and TC approaches were 86.2%, 93.3%, respectively. However, the success rate of the TC approach in patients who had previously undergone neck treatments was significantly higher than that of the CT approach (100% vs. 65% P<0.05). CONCLUSION: Based on the preliminary results of this trial, injection laryngoplasty using a TC approach was an effective alternative to the CT approach, especially in patients who had previously undergone neck surgeries.
Acoustics ; Anesthesia, Local ; Humans ; Laryngeal Muscles ; Laryngoplasty ; Membranes ; Neck ; Neck Dissection ; Needles ; Paralysis ; Thyroid Cartilage ; Thyroidectomy ; Vocal Cord Paralysis ; Vocal Cords ; Voice

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Assessment of Allergic Rhinitis Websites in Korea.

Moon Young CHANG ; Doo Hee HAN ; Il Joon MOON ; Seung Tae KIM ; Dong Young KIM ; Chul Hee LEE ; Yang Gi MIN ; Chae Seo RHEE

Clinical and Experimental Otorhinolaryngology.2010;3(1):32-36.

OBJECTIVES: The internet has become an important source of medical information and a great amount of information related to allergic rhinitis (AR) is available on the internet. However, the quality of this information is still a matter of debate. Therefore, this study was conducted to assess the AR-related information on Korean websites. METHODS: The key word "allergic rhinitis" was entered into 4 popular search engines, and this led to identifying 40 websites. After being categorized according to authorship, the informational value of these websites was evaluated using 4 different assessment tools such as the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire, the Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update and the Health On the Net (HON) code. RESULTS: The 40 websites containing AR-related information were categorized according to their authorship as Western physician: 20, Oriental physician: 14, commercial: 1, and others: 5. The mean citation frequencies of the JAMA benchmarks and the ARIA 2008 Update concepts was 1.23 out of 4 and 4.33 out of 8, respectively, while the mean DISCERN score was 1.92 out of 5. When the websites were evaluated based on the type of authorship, the mean citation frequencies of the ARIA 2008 Update concepts were Western physician: 5.35, Oriental physician: 2.64. Additionally, three websites authored by Western physicians and 13 authored by Oriental physicians contained unreliable information. Among these 16 websites, only 3 websites met the requirements for the HON code "Justification". CONCLUSION: AR-related information available on Korean websites is of variable quality and not all of the information provided is justifiable. Thus, performing surveillance of the medical information on these websites is necessary. Furthermore, common criteria that can be used to evaluate the websites created by both Western and Oriental physicians are also needed.
American Medical Association ; Asthma ; Authorship ; Internet ; Korea ; Rhinitis ; Rhinitis, Allergic, Perennial ; Search Engine ; Surveys and Questionnaires

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Sex Differences in a Cross Sectional Study of Age-related Hearing Loss in Korean.

SungHee KIM ; Eun Jung LIM ; Hak Soo KIM ; Jun Ho PARK ; Soon Suck JARNG ; Sang Heun LEE

Clinical and Experimental Otorhinolaryngology.2010;3(1):27-31.

OBJECTIVES: The purpose of this study was to obtain sex- and age-specific reference level for hearing threshold of normal aging in Korean and to determine if the rate of change in pure-tone hearing thresholds differed by sex. METHODS: Subjects were clients who visited the Health Promotion Center, Daegu Fatima Hospital, Daegu, Korea, from January 2004 to September 2005. Pure-tone audiometric measures were obtained from 3,470 subjects who also completed a hearing questionnaire. The slope of a linear regression was used to estimate the rate of change in pure-tone thresholds at 0.25 to 8 kHz for each ear in 214 men and 902 women without past history of otorrhea, usage of ototoxic drugs, head injury, job in noisy environment, and military service. RESULTS: Hearing thresholds were elevated with age in all test frequencies. Significant sex differences were found in pure-tone thresholds at 4 and 8 kHz after adjusting for age using analysis of covariance. In those high frequencies, hearing was worse in men than in women. The average rate of change in threshold was 0.28 and 0.24 dB per year at 0.25 kHz, increasing gradually to 1.27 and 1.05 dB per year at 8 kHz for men and women, respectively. Men had significantly faster rates of threshold increase at 4 and 8 kHz than women. CONCLUSION: These cross-sectional measures of hearing levels and rate of threshold increases at 4 and 8 kHz showed significant sex differences in Korean men and women with little evidence of noise-induced hearing loss.
Aging ; Auditory Threshold ; Craniocerebral Trauma ; Ear ; Female ; Health Promotion ; Hearing ; Hearing Loss ; Hearing Loss, Noise-Induced ; Humans ; Korea ; Linear Models ; Male ; Military Personnel ; Sex Characteristics ; Surveys and Questionnaires

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Classification of External Auditory Canal Cholesteatoma by Computed Tomography.

Seung Ho SHIN ; Jae Han SHIM ; Ho Ki LEE

Clinical and Experimental Otorhinolaryngology.2010;3(1):24-26.

OBJECTIVES: We propose here a classification system for external auditory canal cholesteatoma (EACC). We classified the EACC by the computed tomography findings and clinical findings of the patients, and we evaluated the EACC characteristics by the proposed staging system. METHODS: Stage classification was done according to the results of temporal bone computed tomography and the clinical findings of the patients. Stage I indicates that the EACC lesion is limited to the external auditory canal. Stage II indicates that the EACC lesion invades the tympanic membrane and middle ear. Stage III indicates that the EACC lesion creates a defect of the external auditory canal and it involves the air cells in the mastoid bone. Stage IV indicates that the EACC lesion is beyond the temporal bone. Between 1996 and 2006, 29 patients with EACC and who underwent surgery were prospectively collected. This study was comprised of 16 males and 13 females with a mean age of 22.8+/-15.0 yr. We reviewed the characteristics and results of surgery by our proposed staging system. RESULTS: A total of 29 patients who underwent operation due to EACC were classified by this system, and the number of stage I, II, III, and IV cases was 14, 3, 10, and 2, respectively. Symptoms such as otorrhea, hearing impairment and otalgia occurred in 12, 17, and 17 cases, respectively. The most common wall invaded by EACC was the inferior wall. The number of cases that had a spontaneous, congenital, post-traumatic, post-inflammatory or tumorous origin was 14, 9, 2, 2, and 1, respectively. Cholesteatoma recurred in 2 patients after surgery. Both cases were stage 1 and both were caused by congenital disease. There were 3 cases with meatal stenosis after surgery, and their primary disease was congenital. CONCLUSION: This proposed staging is simple and easily applicable for use when deciding the treatment plan for patients with EACC.
Cholesteatoma ; Constriction, Pathologic ; Ear Canal ; Ear, Middle ; Earache ; Female ; Hearing Loss ; Humans ; Male ; Mastoid ; Prospective Studies ; Temporal Bone ; Tympanic Membrane

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Expression of HSP70 and Its Relation with Other Cytokines in Human Middle Ear Effusion.

Shi Nae PARK ; Kyoung Ho PARK ; Hyeog Gi CHOI ; Ji Hyun SHIN ; Dong Hee LEE ; Ki Hong CHANG ; Sang Won YEO

Clinical and Experimental Otorhinolaryngology.2010;3(1):18-23.

OBJECTIVES: While other cytokines are known to be associated with otitis media with effusion (OME), the involvement of heat shock protein 70 (HSP70) in middle ear effusion (MEE) is unknown. This study was undertaken to investigate the possibility of there being a HSP70 expression in human MEE and to determine its potential role as a cytokine in OME. METHODS: The levels of HSP70, tumor necrosis factor-alpha and interleukin-1beta were measured by enzyme-linked immunosorbent assay in the effusion of different groups of OME patient following collection of the MEE using our new collection system. The clinical characteristics of the OME patients and the MEE status were analyzed. RESULTS: HSP70 was expressed in all the types of MEE. The mucous and seromucous effusions showed higher HSP70 levels than that of the serous effusion. The HSP70 level was correlated with the levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta in the effusions. The positive correlations between HSP70, TNF-alpha and IL-1beta were statistically significant (P<0.05). CONCLUSION: The highly elevated level of HSP70 in the seromucous and mucous effusions implicates this protein in the chronicity of OME.
Cytokines ; Ear, Middle ; Enzyme-Linked Immunosorbent Assay ; Heat-Shock Proteins ; HSP70 Heat-Shock Proteins ; Humans ; Interleukin-1beta ; Interleukins ; Otitis Media with Effusion ; Tumor Necrosis Factor-alpha

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Effect of Nebulized Bovine Surfactant for Experimental Otitis Media with Effusion.

Chul Ho JANG ; Yong Bum CHO ; Seung Eun OH ; Jeong Uk CHOI ; Haekyun PARK ; Cheol Hee CHOI

Clinical and Experimental Otorhinolaryngology.2010;3(1):13-17.

OBJECTIVES: In this study, we evaluated the efficacy of nebulized bovine pulmonary surfactant on experimentally induced otitis media with effusion (OME) in guinea pigs. METHODS: Twenty guinea pigs were divided into three groups. Four untreated animals served as normal controls. Experimental OME was established in both ears of the remaining 16 animals by a transbullar injection of 10 microL of Pseudomonas aeruginosa lipopolysaccharide in saline. Thereafter, the guinea pigs received nebulized phosphate buffered saline (n=8) or nebulized bovine pulmonary surfactant (n=8). Nebulization was given daily for 7 days. On day 8, all the animals' passive opening pressure (POP) of the Eustachian tube was measured and histopathological observations of the bulla were made by light microscopy. RESULTS: Nebulized bovine pulmonary surfactant significantly reduced the POP compared to that of saline nebulization. The bovine pulmonary surfactant improved the tubal patency and produced less histopathologcally-evident edematous bullar mucosa. CONCLUSION: Nebulization of bovine pulmonary surfactant plays an important role in treating otitis media with effusion in guinea pigs. Our results suggest that the chosen nebulized bovine pulmonary surfactant can be of good clinical benefit for treating OME in the future.
Animals ; Blister ; Ear ; Eustachian Tube ; Guinea ; Guinea Pigs ; Light ; Microscopy ; Mucous Membrane ; Otitis ; Otitis Media ; Otitis Media with Effusion ; Pseudomonas aeruginosa ; Pulmonary Surfactants

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