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Malignant Melanoma of the Sphenoid Sinus.

Cheol Eon PARK ; Kun Hee LEE ; Su Jin KIM ; Seung Yup SHIN

Journal of Rhinology.2013;20(1):50-53.

Sinonasal malignant melanoma comprises 0.5% ~ 1.5% of all malignant melanomas. Malignant melanoma in the nasal cavity is relatively more predominant than in the paranasal sinus. The maxillary sinus is the most common sinus cavity affected by malignant melanoma, and the sphenoid sinus is a very rare site regardless of a primary or secondary origin. We encountered a patient with frequent epistaxis who was found to have malignant melanoma at the nasal septum and sphenoid sinus. She was treated successfully with endoscopic sinus surgery, and we report this case, along with the associated literature.
Epistaxis ; Humans ; Maxillary Sinus ; Melanoma* ; Nasal Cavity ; Nasal Septum ; Sphenoid Sinus*

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A Large Dentigerous Cyst Found in the Mandible.

Young Hyun KIM ; Jung Suk CHOI ; Bo Hyung KIM ; Sung Ho KANG ; Dae Jun LIM ; Myenog Sang YU

Journal of Rhinology.2013;20(1):46-49.

Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They are developmental epithelial-lined lesions which are formed from fluid accumulation in the space between the reduced enamel epithelium and the surface of crown. This may occure due to the obstructin of venous return caused by tooth impaction. The most prevalent location of dentigerous cysts are the third molar of mandible. While the single dentigerous cysts are the second most common odontogenic cysts following the radicular cysts of jaw, multiple cysts are observed in patients with some conditions such as mucopolysaccharidosis type IV, basal cell nevus syndrome, and cleidocranial dysplasia. They occur in young patients in the second or third decades of life, but it is a rare occurrence for children. A sixteen-year-old girl with painful swelling in the right mandible visited to our department. All routine laboratory test results were within normal limits. However, we were able to diagnose that she had facial asymmetry. Computed tomography showed a well-defined soft tissue mass obliterating right mandible ramus with an impacted tooth. We performed total enucleation of cyst and molar tooth. The pathology revealed a non-keratinized squamous epithelial lined cyst associated with an undamaged tooth.
Basal Cell Nevus Syndrome ; Child ; Cleidocranial Dysplasia ; Crowns ; Dental Enamel ; Dentigerous Cyst* ; Epithelium ; Facial Asymmetry ; Female ; Humans ; Jaw ; Mandible* ; Molar ; Molar, Third ; Mucopolysaccharidoses ; Odontogenic Cysts ; Pathology ; Radicular Cyst ; Tooth ; Tooth, Impacted

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Endoscopic Sinus Surgery and Septoplasty Performed Under Local Anesthesia: Comparative Analysis of Patient Discomfort.

Sung Jae HEO ; Ji Hye PARK ; Chang Mook PARK ; In Ji CHO ; Jung Soo KIM

Journal of Rhinology.2013;20(1):41-45.

OBJECTIVES: The goal of this study is to compare the degree of patient discomfort between endoscopic sinus surgery (ESS) and septoplasty under local anesthesia. MATERIAL AND METHODS: A total 95 patients that underwent ESS and septoplasty under local anesthesia between July 2009 and January 2010 were enrolled in this study. The patients estimated the parameters of their own discomfort (pain, position, noise, anxiety, and memory). The score of each of the parameters ranged from 0 to 4. We compared the scores of the parameters between the ESS and septoplasty groups. RESULTS: Of the 95 patients, 61 (64%) received ESS, 32 (34%) received septoplasty, and 2 (2%) received both. The scores of all the parameters were not greater than moderate in both groups. There were no significantly statistical differences between the two groups. However, the ESS group had lower scores than the septoplasty group in the parameters of pain, position, noise, and memory. No remarkable complications occurred. CONCLUSION: The patients in this study had modest discomfort and no noticeable complications during the surgeries under local anesthesia. Although no statistical difference existed between the two groups, the ESS group experienced relatively lower discomfort levels during the surgery under local anesthesia compared to the septoplasty group.
Anesthesia, Local* ; Anxiety ; Humans ; Memory ; Nasal Septum ; Nasal Surgical Procedures ; Noise ; Paranasal Sinuses

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A Clinical Analysis of Revision Endoscopic Sinus Surgery: Single-Center 10-Year Experience.

Boo Young KIM ; Min KIM ; Jung Mee PARK ; Hyun Bum KIM ; Sung Won KIM ; Byung Guk KIM ; Jin Hee CHO ; YongJin PARK ; Soo Whan KIM

Journal of Rhinology.2013;20(1):37-40.

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS) has become a popular procedure for treating chronic sinusitis. Despite recent developments in medical and surgical techniques, primary ESS can still fail. Although revision ESS is one solution to the problem of recurrent sinusitis, revision surgery is stressful for patients and otolaryngologists. Therefore, we examined the causes of ESS failure and sought to find ways to prevent the failure of primary ESS. MATERIALS AND METHODS: All patients who underwent revision ESS in our department between April 2003 and March 2012 were studied retrospectively. RESULTS: During this period, revision ESS was performed 40 times to treat chronic sinusitis. We analyzed the preoperative computed tomographic (CT) findings of primary and revision ESS cases using the Lund-Mackay and Kennedy CT staging scores to compare disease severity. In our cases, the failure of ESS was not affected by the extent of disease, asthma, or allergy. Polyposis was the only useful predictor of revision ESS. CONCLUSION: Polyposis is an important predictor of revision ESS. We recommend that patients be followed frequently and carefully, especially those with polyps.
Asthma ; Humans ; Hypersensitivity ; Nasal Polyps ; Polyps ; Retrospective Studies ; Sinusitis

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Staloral(R) in Adult Patients with Allergic Rhinitis.

Il Ho PARK ; Sung Moon HONG ; Seong Woong CHOI ; Jae Min SHIN ; Heung Man LEE

Journal of Rhinology.2013;20(1):31-36.

BACKGROUND: Sublingual immunotherapy (SLIT) is currently accepted as a treatment of allergic rhinitis. SLIT has been demonstrated to be an effective and safe treatment in many studies; however, there have been few studies on Asian patients with allergic rhinitis. The goal of this study was to investigate the efficacy and safety of SLIT for Asian patients with allergic rhinitis to house-dust mites. METHODS: A total of 116 adult patients who had allergic rhinitis to Dermatophagoides pteronyssinus and Dermatophagoides farinae were included. All patients were treated with SLIT (Staloral(R)). Symptom scores and quality of life were evaluated by questionnaires for one year after SLIT. The medication score was also assessed monthly by a medication diary card. Adverse effects and compliance were also investigated. RESULTS: All nasal and non-nasal symptoms and quality of life were significantly improved after treatment except for itchy palate (p < 0.05). The total medication score was decreased significantly after SLIT (p < 0.05). Some minor adverse effects were reported, but no patient developed a systemic reaction. The drop-out rate was 19%. CONCLUSION: Staloral(R) for Asian patients with allergic rhinitis to house-dust mites is an efficient and safe therapeutic tool.
Adult* ; Asian Continental Ancestry Group ; Compliance ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Immunotherapy ; Mites ; Palate ; Pyroglyphidae ; Quality of Life ; Rhinitis* ; Rhinitis, Allergic, Perennial ; Surveys and Questionnaires

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Clinical Experience of Sinonasal Schwannomas.

Sung Moon HONG ; Jae Min SHIN ; Il Ho PARK ; Seung Hoon LEE ; Yong Dae KIM ; Heung Man LEE

Journal of Rhinology.2013;20(1):26-30.

BACKGROUND: Schwannomas are benign tumors of ectodermal origin derived from Schwann cells of the nerve sheath. Approximately less than 4% of these tumors are found in the paranasal sinuses and there has been little information reported concerning the presentation and surgical management of sinonasal schwannomas. The purpose of this study was to analyze the clinical data, management, and long-term outcomes of sinonasal schwannomas. METHODS: Retrospective chart review of patients with sinonasal schwannomas treated from January 2001 to March 2012 was performed. Clinical data and follow-up information were obtained from a review of the patients' charts and the operative, anesthesia, and pathology reports. RESULTS: There were 4 females and 4 males included in this study. The mean age was 37.5 years (range, 22-51 years). The mean tumor size was 3.1 cm (range 1.0-6.0 cm). The origin of the tumors included: nasal septum (n = 2), nasal vestibule (n = 2), pterygopalatine fossa (n = 2), ethmoid sinus (n = 1), and inferior turbinate (n = 1). Seven patients had endoscopic resections and one patient with a schwannoma in the nasal vestibule underwent a sublabial approach. The mean follow-up was 59 months. There were no tumor recurrences during the study period. CONCLUSIONS: Schwannomas in sinonasal cavity can be treated effectively with the endoscopic approach with minimal morbidity and long-term disease control.
Anesthesia ; Ectoderm ; Ethmoid Sinus ; Female ; Follow-Up Studies ; Humans ; Male ; Nasal Septum ; Neurilemmoma* ; Paranasal Sinuses ; Pathology ; Pterygopalatine Fossa ; Recurrence ; Retrospective Studies ; Schwann Cells ; Turbinates

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Therapeutic Effect of Combination Treatment of Antihistamine and Montelukast in Allergic Rhinitis.

Hye Ran SON ; Ki Il LEE ; Young Jun CHUNG ; Ji Hun MO

Journal of Rhinology.2013;20(1):20-25.

BACKGROUND: Montelukast is a type 1 cysteinyl-leukotrienes receptor antagonist that has been widely used in allergic disease. However, the effect of combination of leukotriene receptor antagonist and antihistamine is controversial. The aim of this study was to compare the effect of combination treatment of montelukast and antihistamine, fexofenadine, over antihistamine alone in patients with allergic rhinitis (AR). SUBJECTS AND METHODS: Retrospective chart review of 60 patients with AR was undertaken. Patients were classified into combination group (montelukast and fexofenadine, n=28) and antihistamine only group (fexofenadine, n=32) according to treatment modalities. Questionnaire survey was performed and allergic symptoms (VAS scale, 5pointscale), and SNOT (sinonasal outcome test)-20 score were obtained before and after the treatment. RESULTS: Mean follow-up duration was 6.7+/-4.6weeks. There was no significant difference in demographic data between two groups. Allergic symptoms and SNOT-20 score(nasal, QOL domain) were improved significantly in both groups after the treatment (all p < 0.001). Combination treatment group showed better improvement in nasal obstruction than antihistamine treatment group(p = 0.03). However, there were no significant differences in other allergic symptoms (rhinorrhea and sneezing) and SNOT-20 between two groups (all p > 0.05, respectively). CONCLUSION: A combination treatment of montelukast and fexofenadine showed more efficacies in nasal obstruction than single fexofenadine treatment in patients with AR. Therefore, montelukast could be used effectively with antihistamine in patients with AR complaining nasal congestion.
Acetates ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Humans ; Nasal Obstruction ; Quinolines ; Receptors, Leukotriene ; Retrospective Studies ; Rhinitis* ; Rhinitis, Allergic, Perennial ; Terfenadine ; Surveys and Questionnaires

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The Role of Epithelium in the Pathophysiology of Chronic Rhinosinusitis : An Update.

Jin Young MIN ; Hun Jong DHONG

Journal of Rhinology.2013;20(1):14-19.

Chronic rhinosinusitis (CRS) is characterized by persistent symptomatic inflammation of the nasal and paranasal sinus mucosa resulting from the interaction of multiple host and environmental factors. Although the etiology of CRS remains a matter of vigorous debate, research into CRS has implicated that the epithelium plays an important role as both a mediator and a regulator of innate and adaptive immune responses, as well as the transition from innate immunity to adaptive immunity. Recently, alterations of epithelial barrier functions, dysregulation of the innate immune system and inappropriate activation of the adaptive immune system have been identified as active processes in the pathogenesis of CRS. This review summarizes recent emerging evidence regarding the underlying pathogenic mechanism in CRS, which highlights the increasing recognition of the epithelium as a central factor in CRS etiology and pathogenesis.
Adaptive Immunity ; Epithelium* ; Immune System ; Immunity, Innate ; Inflammation ; Mucous Membrane

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Obstructive Sleep Apnea and Systemic Diseases.

Ji Hun MO

Journal of Rhinology.2013;20(1):8-13.

As society industrializes and develops, people become increasingly concerned about quality of life and sleep-related disorders. Sleep disordered breathing (SDB) includes obstructive sleep apnea (OSA) and upper airway resistance syndrome. Most of the patients that snore have OSA, and OSA can result in not only cardiovascular and neuro-cognitive diseases but also in severe morbidities and mortalities; therefore, its importance cannot be emphasized too strongly. The mechanism by which OSA induces such morbidities is related to sleep fragmentation and intermittent hypoxia, which result in sympathetic activation, endothelial dysfunction, and metabolic dysregulation. All of these conditions produce a humoral imbalance, a hypercoagulable state, and atherosclerosis, which finally result in multi-morbidities. These comorbidities include cardiovascular, respiratory, neurologic, metabolic, and genitourinary disorders. The clinical relevance of OSA is mainly due to its strong association with morbidities such as hypertension, metabolic syndrome, diabetes, heart failure, coronary artery disease, arrhythmias, stroke, pulmonary hypertension, and neurocognitive and mood disorders. A high mortality rate has also been associated with OSA. It is important to acknowledge the comorbidities of OSA to achieve a better understanding of the disease and for better treatment of patients with OSA. In this review, the comorbidities of OSA will be discussed in detail.
Airway Resistance ; Anoxia ; Arrhythmias, Cardiac ; Atherosclerosis ; Comorbidity ; Coronary Artery Disease ; Heart Failure ; Humans ; Hypertension ; Hypertension, Pulmonary ; Mood Disorders ; Mortality ; Quality of Life ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep Deprivation ; Stroke

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A Case of the Carotid-Cavernous Fistula Due to the Internal Carotid Artery Injury During Endoscopic Sinus Surgery.

Jae Ki KIM ; Seong Kyeong YANG ; Dan Bi SHIN ; Jung Gwon NAM

Journal of Rhinology.2015;22(2):116-120. doi:10.18787/jr.2015.22.2.116

Rupture of the internal carotid artery (ICA) during endoscopic sinus surgery is a rare complication. However, it can potentially result in death within minutes. In the event of a traumatic injury to the ICA during sphenoid sinus exploration, it is very difficult to control the bleeding. We present a case of carotid-cavernous fistula after an accidentally-developed ICA bleed during endoscopic sphenoidotomy. The patient was successfully treated with endovascular embolization techniques that included detachable microcoils.
Carotid Artery, Internal* ; Carotid-Cavernous Sinus Fistula ; Fistula* ; Hemorrhage ; Humans ; Rupture ; Sphenoid Sinus

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