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A Case of Periorbital Necrotizing Fasciitis Occurred in Patient with Fungal Sinusitis

Dong Hwan KIM ; Min Song KIM ; Han Seok YOO ; Jin Hyeok JEONG

Korean Journal of Otolaryngology - Head and Neck Surgery.2018;61(1):56-60. doi:10.3342/kjorl-hns.2016.17181

Orbital complications due to sinusitis usually occur in children and spread from the ethmoid or frontal sinusitis. Periorbital necrotizing fasciitis, which is an aggressive infection characterized by extensive necrosis and gas formation in the fascia and subcutaneous tissue, is uncommon as an orbital complication due to sinusitis. Because most of orbital complications of the fungal sinusitis occur from invasive fungal infection in immunocompromised patients, orbital complications due to non-invasive maxillary fungal ball in healthy patients are extremely rare, especially if the complication is periorbital necrotizing fasciitis. We report a case of periorbital necrotizing fasciitis that occurred in a healthy 44-year-old male patient with non-invasive fungal sinusitis, which was treated with a combination of intravenous antibiotics and endoscopic sinus surgery and ophthalmologic surgical treatment.
Adult ; Anti-Bacterial Agents ; Child ; Fascia ; Fasciitis, Necrotizing ; Frontal Sinus ; Frontal Sinusitis ; Humans ; Immunocompromised Host ; Male ; Necrosis ; Orbit ; Sinusitis ; Subcutaneous Tissue

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Angioleiomyoma Originating from the Auricle

Ji Hwan PARK ; Soo Keun KONG ; Eui Kyung GOH ; Se Joon OH

Korean Journal of Otolaryngology - Head and Neck Surgery.2018;61(1):52-55. doi:10.3342/kjorl-hns.2016.16859

Angioleiomyoma is a benign tumor which arises from vascular smooth muscle. It originates primarily in the upper and lower extremities, but several isolated cases have been described. Although angioleiomyoma has a benign nature, there is a potential risk of malignant change and recurrence in case of incomplete resection. We acknowledge that venous type angioleiomyoma on the posterior surface of auricle has not been reported in the Korean literature. We report a rare case of 49-year-old male who had angioleiomyoma originating from the auricle along with a literature review.
Angiomyoma ; Humans ; Lower Extremity ; Male ; Middle Aged ; Muscle, Smooth, Vascular ; Recurrence

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A Case of Dermatofibrosarcoma Protuberans was Misdiagnosed as Keloid of the Anterior Neck

Jin Hyun SEO ; Jin Pyeong KIM ; Seung Hoon WOO

Korean Journal of Otolaryngology - Head and Neck Surgery.2018;61(1):47-51. doi:10.3342/kjorl-hns.2016.16635

Dermatofibrosarcoma protuberans is a rare type of cancer, a soft tissue sarcoma that develops in the deep layers of skin. It is a locally aggressive tumor with a high recurrence rate but the metastasis rarely occurs. The first sign of dermatofibrosarcoma protuberans is often a small bump on the skin. It may resemble a deep-seated pimple of rough patch of skin. The tumor typically grows slowly and can become a raised nodule. Therefore, it is likely to be misdiagnosed as keloid, basal cell carcinoma and scleroderma. We recently experienced a case of dermatofibrosarcoma protuberans in a 63-year-old man, who presented with anterior lower neck mass. We present this case with a review of the literature.
Carcinoma, Basal Cell ; Dermatofibrosarcoma ; Humans ; Keloid ; Middle Aged ; Neck ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Skin

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Partial Superficial Parotidectomy via Retroauricular Hairline Incision

Yu Jin JUNG ; Gil Joon LEE ; Jin Ho SOHN ; Dongbin AHN

Korean Journal of Otolaryngology - Head and Neck Surgery.2018;61(1):42-46. doi:10.3342/kjorl-hns.2017.00682

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the feasibility and safety of a retroauricular hairline incision in partial superficial parotidectomy. SUBJECTS AND METHOD: Twenty-three patients who underwent partial superficial parotidectomy via retroauricular hairline incision from 2014 to 2016 were enrolled in the study. Patient's characteristics, surgical outcomes and postoperative complications were assessed. Subjective cosmetic satisfaction was assessed using a visual analog scale 3 months after surgery. RESULTS: In all 23 cases, parotid tumors were removed successfully via retroauricular hairline incision alone without any exposure failure. The mean operating time and the amount of postoperative drainage was 117.6 min (range, 75–163 min) and 51.5 mL (range, 25–91), respectively. Major complications such as permanent facial nerve paralysis and hematoma were not reported. The mean visual analogue scale score for subjective satisfaction with the incision scar was 9.0 (range, 6–10). CONCLUSION: We conclude that partial superficial parotidectomy via retroauricular hairline incision for the treatment of benign parotid tumor is technically feasible and it provides excellent cosmetic outcomes without an increase in complications.
Cicatrix ; Drainage ; Facial Nerve ; Hematoma ; Humans ; Methods ; Paralysis ; Parotid Gland ; Postoperative Complications ; Visual Analog Scale

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Usefulness of Centor Score to Diagnosis of Group a Streptococcal Pharyngitis and Decision Making of Antibiotics Use

Hye Ran LEE ; Jeong Tae KIM ; Jae Yong LEE ; Jae Min SHIN ; Jae Wook KIM ; Byung Don LEE ; Kyurin HWANG

Korean Journal of Otolaryngology - Head and Neck Surgery.2018;61(1):35-41. doi:10.3342/kjorl-hns.2017.00640

BACKGROUND AND OBJECTIVES: This study aims to verify the usefulness of Centor scores to diagnose the Group A Streptococcal pharyngitis. SUBJECTS AND METHOD: The subjects of this study were 379 patients who had been examined by the rapid antigen detection test (RADT) for Group A Streptococcus. We analyzed their medical records and laboratory test results retrospectively and compared the results of Centor symptom scores with those of RADT. Then we analyzed the association of RADT, the Centor score and the laboratory test results statistically. RESULTS: There were no correlation between the RADT results and fever, cough, tonsillar enlargement, nasal symptoms, myalgia or chilling (p>0.05). In the RADT positive group, there were more patients with tonsillar exudate, neck lymph node enlargement, tenderness and pharyngeal abscess formation significantly (p<0.05). The Centor score and C-reactive protein were significantly higher in the RADT positive group (p<0.05). CONCLUSION: The results of this study suggest that Centor symptom scores can be used to determine which antibiotics to use. The Centor score system can help reduce medical costs and detect the problematic Group A Streptococcal pharyngitis.
Abscess ; Anti-Bacterial Agents ; C-Reactive Protein ; Cough ; Decision Making ; Diagnosis ; Exudates and Transudates ; Fever ; Humans ; Lymph Nodes ; Medical Records ; Methods ; Myalgia ; Neck ; Pharyngitis ; Retrospective Studies ; Streptococcus ; Streptococcus pyogenes

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Comparison of Multiple Allergen Simultaneous Test and ImmunoCAP for the Diagnosis of Allergic Rhinitis

Do Youn KIM ; So Young PARK ; Soon Be HONG ; Oh Hyeong LEE ; Gyeong Cheol CHOI ; Jin Hee CHO

Korean Journal of Otolaryngology - Head and Neck Surgery.2018;61(1):29-34. doi:10.3342/kjorl-hns.2017.00381

BACKGROUND AND OBJECTIVES: Specific IgE assays are important in the diagnosis and treatment of allergic rhinitis (AR). Among the diagnostic tests of AR, multiple allergen simultaneous test (MAST) and ImmunoCAP have been frequently used as simple, safe, and economical methods. In this study, we compared the diagnostic outcomes of MAST and ImmunoCAP in patients with AR. SUBJECTS AND METHOD: Seventy-eight patients (52 men, 26 women, mean age 34.5 years: range 6–80 years), who have nasal symptoms of allergy and no clinical factors to influence the test results, underwent routine skin prick test (SPT) and MAST, and ImmunoCAP for eight major allergens. The diagnosis of AR was based on the criteria of SPT. The class 1 responses or more were regarded as positive for both MAST and ImmunoCAP. The agreements, sensitivities, and specificities of MAST and ImmunoCAP were evaluated along with the correlation between the two tests. RESULTS: Total agreement rates of MAST and ImmunoCAP amounted to 91.5 and 92.1%, respectively. The overall sensitivity and specificity of MAST were 73.4 and 95.3%, respectively, and those of ImmunoCAP were 81.4 and 94.5%, respectively. The correlations between MAST and ImmunoCAP showed statistical significance for Dermatophagoides pteronyssinus/Dermatophagoides farinae. CONCLUSION: Our study demonstrated the diagnostic usefulness of both MAST and ImmunoCAP in AR, especially for the most prevalent allergens of house dust mites. Moreover, ImmunoCAP, which showed higher sensitivity than MAST, can be effectively used in rhinology clinics.
Allergens ; Diagnosis ; Diagnostic Tests, Routine ; Female ; Humans ; Hypersensitivity ; Immunoglobulin E ; Male ; Methods ; Pyroglyphidae ; Rhinitis, Allergic ; Sensitivity and Specificity ; Skin

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Association of Dietary Factors with Presence and Severity of Septal Deviation: Results of the Korean National Health and Nutrition Survey 2010–2012

Chun HAN ; Sang Man PARK ; Ju Shin LIM ; Jang Woo KWON

Korean Journal of Otolaryngology - Head and Neck Surgery.2018;61(1):24-28. doi:10.3342/kjorl-hns.2017.00059

BACKGROUND AND OBJECTIVES: The data of Korean National Health Survey from 2010 to 2012 were used to analyze the correlation between the westernized dietary style with the incidence of septal deviation in the Korean population. SUBJECTS AND METHOD: A total of 25532 candidates between the ages of 13–97 was analyzed with their nutrition uptake, body characteristic differences, and the incidence of septal deviation. Inclusion criteria for the candidate were normal values for the smell test, no rhinological abnormalities, and patients who underwent all of the otolaryngologic examinations. Nutrition uptake of the following was examined: total energy uptake per day (kcal), total daily uptake of food, carbohydrate, protein, fat, water (g), total daily uptake of fiber, potassium, calcium, phosphate, iron, and sodium (mg). Each category was examined, compared, and analyzed to investigate a possible relationship with the incidence of septal deviation. RESULTS: When height, waist, and body mass index (BMI) were categorized according to sex and analyzed for relationship with the incidence of disease, the male group showed a positive correlation with the incidence of septal deviation in all three factors. BMI, an important clinical predictive factor for physical growth, showed a positive relationship for obesity rate and septal deviation with the males aged between 10 and 20. CONCLUSION: Males in their 10's and 20's are the most affected by the westernized diet change; therefore, we believe that this is the reason for this age group's association with a higher septal deviation incidence rate compared to other age group.
Body Mass Index ; Calcium ; Diet ; Health Surveys ; Humans ; Incidence ; Iron ; Male ; Methods ; Nasal Septum ; Nutrition Surveys ; Obesity ; Potassium ; Reference Values ; Smell ; Sodium ; Water

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Behavioral Perception and Neural Correlates of Categorical Perception in Cochlear Implant Users

Jeong Hye PARK ; Ji Hye HAN

Korean Journal of Otolaryngology - Head and Neck Surgery.2018;61(1):15-23. doi:10.3342/kjorl-hns.2017.00703

BACKGROUND AND OBJECTIVES: Although many cochlear implant (CI) recipients receive significant benefits from using the implants, speech perception ability is still known to vary among CI users, and the variability is closely related to the ability of users to process temporal information. As one of the important temporal cues for speech perception in CI users, voice onset time (VOT) can be used to examine behavioral perception and neural correlates of temporal processing. In this study, we measured categorical perception and N1-P2 cortical auditory evoked potentials (CAEPs) using a /ba/-/pa/ VOT continuum in CI users as well as in normal-hearing (NH) listeners. SUBJECTS AND METHOD: Ten CI subjects and 11 NH controls participated in syllable identification tasks and in electroencephalography recording. CI subjects were divided into two groups, which were ‘good’ and ‘poor’ performers based on their speech perception scores. The stimuli used in both experiments were a synthetic /ba/-/pa/ VOT continuum. The identification boundary and N1-P2 peak-to-peak amplitude were measured for each subject group. RESULTS: Behavioral results revealed that poor CI performers had a delayed identification boundary compared to NH listeners and good CI performers. However, N1-P2 peak-to-peak amplitudes in both good and poor CI performers were significantly smaller than those in NH group. CONCLUSION: N1-P2 amplitudes reflected decreased auditory cortical activity of temporal cues in CI users. The categorical perception of good CI performers was similar to that of NH listeners, whereas their cortical responses were decreased to the level similar to that of poor CI performers. This finding indicates that CAEPs would be more sensitive to altered temporal processing of CI users than to behavioral measures.
Cochlear Implants ; Cues ; Electroencephalography ; Evoked Potentials, Auditory ; Methods ; Speech Perception ; Voice

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Computed Tomography and Magnetic Resonance Imaging Evaluation in Pediatric Unilateral Sensorineural Hearing Loss

Se A LEE ; Sang Kuk LEE ; Sang Woo SUN ; Jae Hyun JUNG ; Jong Dae LEE ; Bo Gyung KIM

Korean Journal of Otolaryngology - Head and Neck Surgery.2018;61(1):9-14. doi:10.3342/kjorl-hns.2017.00283

BACKGROUND AND OBJECTIVES: Children with unilateral sensorineural hearing loss (USNHL) are not actively evaluated by physicians. The diagnostic tool for evaluation of USNHL is also controversial, and no strategy for diagnosing USNHL through imaging studies has been established. We examined the results of temporal bone computed tomography (TBCT) imaging and magnetic resonance imaging (MRI) studies on children with USNHL. SUBJECTS AND METHOD: Eighty-nine patients with USNHL were reviewed. Of these patients, 21 underwent both TBCT and MRI, 51 underwent temporal MRI only, and 17 underwent TBCT only. RESULTS: The etiology of USNHL were determined through imaging studies in 20 patients. The most common abnormal finding (65%) was a narrow internal auditory canal identified on TBCT and cochlear nerve aplasia on temporal MRI. Incomplete partition (20%), common cavity (10%), and labyrinthitis ossificans (5%) were also observed in imaging studies. The hearing threshold was lower in USNHL patients with normal findings (76.1±28.7 dB) than in USNHL patients with abnormal findings on TBCT or temporal MRI (100.1±22.3 dB). CONCLUSION: Cochlear and cochlear nerve abnormalities can be detected through imaging studies in approximately 25% of patients with USNHL. Therefore, we suggest that children should undergo TBCT when USNHL is confirmed through audiologic evaluation.
Child ; Cochlear Nerve ; Ear, Inner ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Labyrinthitis ; Magnetic Resonance Imaging ; Methods ; Temporal Bone

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Definition and Clinical Implication of Temporal Fine Structure

Young Soo CHANG ; Il Joon MOON

Korean Journal of Otolaryngology - Head and Neck Surgery.2018;61(1):1-8. doi:10.3342/kjorl-hns.2017.00794

Perception of sound is associated with the use of multiple acoustic cues in the human auditory system. These acoustic cues can be classified by their temporal and spectral properties. Temporal information can be considered as a slowly varying envelope (ENV) superimposed on a more rapid temporal fine structure (TFS). Various sound-processing techniques have been developed to assess the role of acoustic information carried by temporal ENV and TFS information. Previous studies demonstrated that ENV cues are associated with speech recognition in quiet, while TFS cues have a role to melody/pitch perception and listening to speech in a competing background noise. Besides, a number of studies have shown that the relative insensitivity of hearing-impaired subjects to TFS information. Although current technologies used in cochlear implants are not efficient in delivering the TFS cues, new speech processing strategies have been proposed to deliver TFS information. We herein review the cutting edge of TFS related studies and discuss the clinical implication of TFS.
Acoustics ; Cochlear Implants ; Cues ; Hearing Loss ; Humans ; Noise ; Speech Perception

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