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Effectiveness of Suppressive Therapy with Levothyroxine in Benign Thyroid Nodules.

Yun Jeong KIM ; Kyung TAE ; Seok Young KANG ; Yong Seop LEE ; Dong Sun KIM ; Tae Hwa KIM ; You Hern AHN

Korean Journal of Otolaryngology - Head and Neck Surgery.2009;52(8):674-678. doi:10.3342/kjorl-hns.2009.52.8.674

BACKGROUND AND OBJECTIVES: The effectiveness of suppressive therapy with Levothyroxine in benign thyroid nodule is controversial. The favorable response varies between 9-68%. The aim of this study was to evaluate the effect of Levothyroxine suppressive therapy on benign thyroid nodules in comparison with untreated patients. SUBJECTS AND METHOD: A total 98 patients diagnosed with benign thyroid nodules by high resolution ultrasonography and fine needle aspiration cytology from January 2001 to June 2007 was evaluated retrospectively. The case group included 55 patients who received Levothyroxine suppressive therapy for longer than 6 months with documentation of thyroid stimulating hormone (TSH) suppression level. The control group included 43 patients who were followed up without any treatment. We measured TSH, free T4, and thyroid nodule volume by ultrasound every 6 months. RESULTS: In 13 patients (23.6%) of the case group, nodule volume decreased more than 50% after the Levothyroxine suppressive therapy. In 10 (23.2%) of the control group, nodule volume decreased more than 50 % after the follow-up of 6 months. There was no significant difference between the two groups. The change of nodule volume was not related to the TSH suppression level, the number of nodule or the type of nodule. CONCLUSION: We concluded that Levothyroxine suppressive therapy was not effective in volume reduction of benign thyroid nodules.
Biopsy, Fine-Needle ; Follow-Up Studies ; Humans ; Retrospective Studies ; Thyroid Gland ; Thyroid Nodule ; Thyrotropin ; Thyroxine

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A Case of Inflammatory Myofibroblastic Tumor of the Maxillary Sinus.

Nam Yong DO ; Jun Han LEE ; Seong Yeol KIM

Korean Journal of Otolaryngology - Head and Neck Surgery.2005;48(3):418-422.

Inflammatory myofibroblastic tumor (inflammatory pseudotumor) is a term used to describe the space occupying the neoplastic lesion rather than the inflammatory lesion. Its occurrence in the maxillary sinus is rare. The etiology and pathophysiology of the maxillary inflammatory myofibroblastic tumor is unknown. The diagnosis must be based on histological evidence to exclude other disease. We report a case of a 72-year-old patient with maxillary and nasal cavity inflammatory myofibroblastic tumor that simulated an invasive neoplasm in its clinical presentation, Radiologic findings showed near total coagulation necrosis histopathologically.
Aged ; Diagnosis ; Granuloma, Plasma Cell ; Humans ; Maxillary Sinus* ; Myofibroblasts* ; Nasal Cavity ; Necrosis

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A Case of Arteriovenous Fistula between Common Carotid Artery and Internal Jugular Vein.

Kyung TAE ; Yong Bae JI ; In Bum PARK ; Chul Bum LEE

Korean Journal of Otolaryngology - Head and Neck Surgery.2005;48(3):410-413.

Traumatic arteriovenous fistula between common carotid artery and internal jugular vein is extremely rare. Major cervical vascular injury may present as vigorous external bleeding, an expanding or stable cervical hematoma, or a hemispheric neurologic deficit. A rapidly expanding hematoma is immediate to the patient's airway and severe ongoing hemorrhage may lead to exanguination. The authors have experienced a case of traumatic pseudoaneurysm and arteriovenous fistula between common carotid artery and internal jugular vein. We treated this case successfully with exploration and vascular autograft, and so, we report it with a review of the literature.
Aneurysm, False ; Arteriovenous Fistula* ; Autografts ; Carotid Artery Injuries ; Carotid Artery, Common* ; Hematoma ; Hemorrhage ; Jugular Veins* ; Neurologic Manifestations ; Vascular System Injuries ; Wounds, Penetrating

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A Case of Post-Traumatic Pseudomeningocele Presenting as a Cyst of External Auditory Canal.

Jae Ho JEONG ; Seong Ki AHN ; Sea Yuong JEON ; In Sung PARK

Korean Journal of Otolaryngology - Head and Neck Surgery.2005;48(3):414-417.

Pseudomeningoceles are formed by extravasation of cerebrospinal fluid through a dural defect into soft tissue. Although post-traumatic pseudomeningocele rarely occurs in the head and neck, this case demonstrates a traumatic pseudomeningocele in an adult. A 32-year old woman presented a ten-year history of right ear stuffiness and muffled hearing after the head trauma. A soft, nonpulsatile and cystic mass was noted in the right external auditory canal. The MRI scan demonstrated the connection between subarachnoid space and cyst of the right external auditory canal. The right ear was explored and mastoid antrum was partiallyfilled with a cyst connected to the dural defect. The extradural portion of the mass was removed, and the dural defect was repaired with a temporalis fascia-cartilage graft. We report a case of the post-traumatic pseudomeningocle presenting as a cyst of the external auditory canal with a review of the related literature.
Adult ; Cerebrospinal Fluid ; Craniocerebral Trauma ; Ear ; Ear Canal* ; Female ; Head ; Hearing ; Humans ; Magnetic Resonance Imaging ; Mastoid ; Meningocele ; Neck ; Subarachnoid Space ; Transplants

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A Case of Reduction of Frontal Sinus Anterior Wall Fracture Using Bioabsorbable Plate.

Min Sang KWON ; Jung Hwan MOON ; Jae Hwan KWON ; Joong Hwan CHO

Korean Journal of Otolaryngology - Head and Neck Surgery.2005;48(3):406-409.

Frontal sinus fractures are relatively uncommon maxillofacial injuries, making up only 5% to 12% of all facial fractures. Management of the fracture depends on the type and severity of the fracture and the presence of associated injuries. The use of a metalic plate as a reduction material for facial bone fracture has vastly grown; however, in infants, metal implants induce growth restriction of facial bone and the plate needs to be removed after approximately 3-6 months. Due to these weakness, the use of it as a bioabsorbable plate has thus taken over the large proportion of all its uses. A 15-year-old man was admitted to our hospital with a depression fracture of the frontal sinus anterior wall after trauma to the frontal area. Seven days after the trauma, the patient got open reduction. After exposing the fracture site with a butterfly incision, and placing the fractured bony fragments back in original place, the bioabsorbable plates were fixed on them. Postoperatively, depressed frontal area was restored normally. There is no evidence of complication after 28 months from the operation. We report a successful reduction of the frontal sinus anterior wall fracture using bioabsorbable plates.
Adolescent ; Butterflies ; Depression ; Facial Bones ; Frontal Sinus* ; Humans ; Infant ; Maxillofacial Injuries

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Two Cases of Ramsay Hunt Syndrome Complicated with Multiple Cranial Nerve Palsy and Aseptic Meningitis.

Jong Bin KIM ; Jae Yong BYUN ; Sung Wan KIM ; Chang Il CHA

Korean Journal of Otolaryngology - Head and Neck Surgery.2005;48(3):398-401.

Herpes zoster oticus or Ramsay Hunt syndrome occurs in about one percent of all cases of herpes zoster and represents 12 percent of all facial palsies. The typical clinical presentation includes otalgia, facial palsy, herpetic lesions of the auricle and external auditory canal, but is frequently accompanied with sensorineural hearing loss, vertigo and tinnitus. Rarely, it may be associated with the involvement of V, VI, IX, X, XI and XII cranial nerves, aseptic meningitis, and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). With a review of literature, we report two cases. The first case is a 64-year-old male with Ramsay Hunt syndrome complicated with cranial nerve VIII palsy and aseptic meningitis. The second case is a 30-year-old female with Ramsay Hunt syndrome complicated with the cranial nerve III, IV, V, VI and VIII palsies and aseptic meningitis.
Adult ; Cranial Nerve Diseases* ; Cranial Nerves* ; Ear Canal ; Earache ; Facial Paralysis ; Female ; Hearing Loss, Sensorineural ; Herpes Zoster ; Herpes Zoster Oticus* ; Humans ; Male ; Meningitis ; Meningitis, Aseptic* ; Middle Aged ; Oculomotor Nerve ; Paralysis ; Tinnitus ; Vertigo ; Vestibulocochlear Nerve

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Two Cases of Parotid Lymphadenitis by Toxoplasmosis.

Jae Won KIM ; Tae Youn KIM ; Byung Han CHO ; Young Mo KIM

Korean Journal of Otolaryngology - Head and Neck Surgery.2005;48(3):394-397.

Toxoplasma gondii, a coccidian protozoon, infects various animal species and humans. Toxoplasma lymphadenitis is the most common clinical manifestation of toxoplasmosis in an immunocompetent host, but still more rare in Korea than in other countries. We report two cases of toxoplasma lymphadenitis in intraparotid lymph node in an immunocompetent host. Serological results supported a diagnosis of toxoplasmosis correlated with histological findings. In Korea, travels to and from other countries and consumption of meat are increasing, possibly increasing the incidence of toxoplasma lymphadenitis. This report emphasizes the need for clinicians to consider the diagnosis of unexplained lymphadenitis at all sites.
Animals ; Diagnosis ; Humans ; Incidence ; Korea ; Lymph Nodes ; Lymphadenitis* ; Meat ; Toxoplasma ; Toxoplasmosis*

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Sialendoscopy: Endoscopic Diagnosis and Treatment of the Salivary Gland Disease.

Jae Won KIM ; Dae Hyung KIM ; Kyung Tae KIM ; Tae Youn KIM ; Kook Jin KO ; Jeong Seok CHOI ; Young Mo KIM

Korean Journal of Otolaryngology - Head and Neck Surgery.2005;48(3):373-379.

BACKGROUND AND OBJECTIVES: Obstructive lesion of salivary glands by salivary duct calculi and stenosis is the main inflammatory disease of major salivary glands. Recently, the sialendoscopy has been introduced for the diagnosis and intervention of salivary ductal disease. The purpose of this study is to assess the efficacy of the sialendoscopy for the treatment of inflammatory salivary gland diseases. SUBJECTS AND METHOD: Diagnostic and interventional sialendoscopy were performed in 19 patients (7 parotid glands, 12 submandibular glands), who had salivary duct calculi or recurrent sialadenitis without calculi from 2003 Sep. to 2004 Jun. Diagnostic sialendoscopy was performed for obstructive lesions and evaluation of ductal status. Interventional sialendoscopy was performed for the removal of salivary duct calculi and dilatation of duct stenosis in cases with calculi and stenosis. RESULTS: Diagnostic sialendoscopy was performed in all cases successfully. Sixteen glands had obstructive lesions and 3 glands had sialadenitis with no evidence of obstruction. Only one case with salivary duct calculi was failed. The remaining 10 calculi were removed with microforceps and basket with or without laser fragmentation. The average size of sialoliths was 5.2 mm and multiple stones were found in 2 cases. Five cases with stenosis of parotid and submandibular gland duct were dilated with balloon catheter or endoscopy sheath successfully. In the remaining 3 glands with no obstruction, the finding of ductal inflammation was identified. No major complications were noted. CONCLUSIONS: Diagnostic sialendoscopy is a new and minimal invasive technique for complete exploration of ductal system and evaluating salivary duct disease. Interventional sialendoscopy allows the extraction of salivary duct calculi in most cases and the dilatation of stenotic duct. This technique might be useful in preventing open gland surgery in well indicated cases.
Calculi ; Catheters ; Constriction, Pathologic ; Diagnosis* ; Dilatation ; Endoscopy ; Humans ; Inflammation ; Parotid Gland ; Salivary Duct Calculi ; Salivary Ducts ; Salivary Gland Calculi ; Salivary Gland Diseases* ; Salivary Glands* ; Sialadenitis ; Sialography ; Submandibular Gland

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A Case of Chondroma Originated from the Nasal Septum.

Byung Guk KIM ; So Young PARK ; Dae Gun JUNG ; Young Hoon JOO

Korean Journal of Otolaryngology - Head and Neck Surgery.2005;48(3):390-393.

Chondroma is a benign tumor characterized by the formation of mature cartilage. Chondromas occur infrequently in nasal area, but are found more commonly in metaphyseal area of the phalanges and metacarpals of the hands, pelvis, sternum, and scapula. Since it was first described by Morgan in 1842, about 150 cases of nasal chondroma have been recorded in the world literature. The authors present an unusual case of histologically proven benign nasal chondroma arising from the nasal septum. Diagnostic studies included intranasal endoscopy and CT scanning and MRI of the nose. An intranasal endoscopic tumor removal with an adequate margin of normal tissue was performed. After six months of treatment, there was no evidence of recurrence.
Cartilage ; Chondroma* ; Endoscopy ; Hand ; Magnetic Resonance Imaging ; Metacarpal Bones ; Nasal Septum* ; Nose ; Pelvis ; Recurrence ; Scapula ; Sternum ; Tomography, X-Ray Computed

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Comparison of the Results of Voice Handicap Index and Computer-Assisted Voice Analysis in Patients with Benign Vocal Cord Lesions before and after Microlaryngeal Surgery.

Jong Hwan WANG ; Soo Kyung PARK ; Suk Kee LEE ; Seung Ho CHOI ; Sang Yoon KIM ; Soon Yuhl NAM

Korean Journal of Otolaryngology - Head and Neck Surgery.2005;48(3):380-386.

BACKGROUND AND OBJECTIVES: The Voice Handicap Index (VHI) subjectively evaluates the severity of voice disorders. On the other hand, computer-assisted voice analysis objectively evaluates the severity of voice disorders. The purpose of this study was to compare the results of these two different tests in patients with benign vocal cord lesions and to measure the correlation between parameters of these two tests. MATERIALS AND METHODS: From January 2002 to December 2003, 76 patients who underwent microlaryngeal surgery for benign vocal cord lesions in the Asan Medical Center were included in this study. They all filled out the VHI questionnaires, which were composed of 30 questions about before and after surgery. For 32 out of 76 patients, we also performed preoperative and postoperative acoustic analysis (jitter, shimmer, noise to harmonic ratio) and aerodynamic analysis (maximum phonation time, mean flow rate, mean subglottic pressure). All VHI and voice analysis parameters were entered into a statistical program and analyzed using a Pearson correlation. RESULTS: All the parameters of VHI showed significant improvement after surgery. The values of jitter, shimmer, noise to harmonic ratio, and maximal phonation time showed a significant change after surgery, but the mean flow rate and the mean subglottic pressure didn't. Each VHI parameter provided a significant level of reliability (p<0.01) when compared with other VHI parameters before and after the surgery. Three voice analysis parameters (jitter, shimmer, noise to harmonic ratio) also showed significant reliability (p<0.01) in comparison with other parameters except maximum phonation time, mean flow rate and mean subglottic pressure before and after the surgery. Reliability of VHI and voice analysis showed to be strong (p<0.01) for the maximum phonation time and the mean flow rate before surgery but poor (p>0.05) after surgery. CONCLUSION: The VHI provides a measure of self-perception on the severity of the voice disorders that cannot be assessed through objective acoustic and aerodynamic measures. No objective parameters show strong correlation with VHI parameters when compared across other testing methods after surgery. This discrepancy indicates that no objective parameters can yet be regarded as a prognostic factor to evaluate subjective perception.
Acoustics ; Chungcheongnam-do ; Hand ; Humans ; Noise ; Phonation ; Surveys and Questionnaires ; Self Concept ; Vocal Cords* ; Voice Disorders ; Voice*

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