Fibrofolliculoma is a benign, perifollicular, connective tissue tumor that usually arises in the form of multiple lesions; it is rarely seen as a solitary lesion. The lesions are clinically asymptomatic, 2 to 4 mm skin-colored, soft dome-shaped papules. Here, we report a patient who visited our hospital with a palpable lesion on the nasal septum. The lesion did not cause pain upon palpation, and nasal endoscopy confirmed an irregular wart-like lesion measuring 6 × 6 mm in the left anterior nasal septum near the columella. Other otolaryngology findings were normal, and there were no similar lesions in other parts of the body. None of the patient’s family members were known to have had such lesions. An excisional biopsy was performed on the mass for removal of the lesion, and histological examination confirmed the lesion as fibrofolliculoma. We report the first case of solitary fibrofolliculoma in the nasal septum in a healthy 62-year-old woman along with a review of the relevant literature.

Background and Objectives: Drug-induced sleep endoscopy (DISE) usefully determines the sites of airway obstruction in patients with sleep-disordered breathing. It is widely accepted that obesity increases obstructive sleep apnea. However, no study has explored how and where obesity causes obstructions. In this study, we described the patterns of upper airway obstruction revealed by DISE in patients of various body mass indices (BMIs) with sleep-disordered breathing.Subjects and Method All subjects had sleep-disordered breathing and underwent DISE. Endoscopic findings at the retropalatal (upper lateral, upper anteroposterior [AP]) and retrolingual (lower lateral, lower AP) levels were graded; obstruction was complete (2), partial (1), or none (0). Subjects with BMI <25 (<25 group), 25≤BMI<30 (25<30 group), and ≥30 kg/m2 (>30 group) were compared using a dummy variable; to this end, we employed R ver. 4.0.5. Results: For the total of 153 patients reviewed, the mean age was 43.1±12.2 years and the mean BMI was 26.0±3.4 kg/m2. At the retropalatal AP level, the DISE grade was significantly higher in the 25<30 group than in the <25 group (p=0.029) but not in the >30 group (p=0.248). At the retropalatal lateral level, significant increases were evident in both of the higher BMI groups (p=0.06 and p=0.024, respectively). No significant relationship was found at the retrolingual level. Conclusion In terms of the retropalatal AP and lateral diameters, a higher BMI is associated with a greater incidence of more severe obstruction.

Background and Objectives: The most common cause of snoring in children is enlarged tonsils and adenoids. However, there is insufficient evidence to determine whether the subjective measurement of tonsil hypertrophy, the most common prevailing method, reflects the actual tonsil size and volume. Therefore, we tried to determine whether the subjective grading of tonsil size and actual tonsil volume is related, and whether tonsil volume, weight, and adenoid index are correlated with the acoustic analysis of snoring.Subjects and Method The study was conducted on 21 children between the ages of 4 and 15 who came for tonsillectomy and adenoidectomy due to snoring symptoms. The degree of adenotonsillar hypertrophy was measured using the Brodsky grading scale and adenoid index. After tonsillectomy, the volume and weight of resected tonsil were measured. For acoustic analysis, the Praat software was used to determine formant frequency and sound intensity. A linear regression model and a dummy variable were used to determine the correlation between the quantitative values of tonsil, adenoid and the result of acoustic analysis. Results: The Brodsky tonsil grade tended to match the actual tonsil volume, but it was not statistically significant (p=0.073). There was no correlation between snoring intensity and actual tonsil volume, weight, and adenoid index. Formant frequency 1 and 2 were statistically negatively correlated with the actual tonsil volume (p=0.011, 0.002). Conclusion The study confirmed that the acoustic analysis of pediatric snoring could be a screening test to predict tonsil volume and changes in the vocal tract due to tonsil hypertrophy.

Background and Objectives: Snoring is the most common symptom of obstructive sleep apnea (OSA) and is caused by turbulent airflow due to narrowing of the upper airways. In patients with positional OSA, a change in sleep posture from supine to lateral is known to reduce snoring and sleep apnea. This study was performed to compare changes in snoring sound intensity and formant frequencies according to sleep position.Subjects and Method A total of 19 patients (male: 18; female: 1) diagnosed with positional OSA by polysomnography (PSG) were enrolled in this study. The snoring sounds recorded during PSG were analyzed acoustically and compared according to sleep position (i.e., supine vs. lateral). Results: Snoring disappeared on changing sleep position in five patients, all of whom had Apnea-Hypopnea Index (AHI) <15. In other patients, the snoring sounds tended to decrease with posture change, and the degree of decrease was inversely proportional to AHI (p=0.015) and respiratory disturbance index (RDI) (p=0.013). Formant frequencies 1, 3, and 4 (F1, F3, and F4, respectively) decreased when sleeping in the lateral position (p=0.02, 0.03, and 0.01, respectively). Conclusion In patients with positional OSA, a change in sleep posture from supine to lateral during sleep reduced the intensity and frequency of snoring sound.

BACKGROUND AND OBJECTIVES: Adenotonsillectomy is a commonly performed surgical procedure carried out by otolaryngologists for children. Anatomical changes to the vocal tract occur after the surgery and may alter the patient's voice. This study evaluated the effects of adenotonsillectomy on the voice in Korean children.SUBJECTS AND METHOD: total of 20 children who underwent adenotonsillectomy were enrolled. The speech of patients was recorded before and at one month of the surgery and acoustic features, especially the formant frequency, were analyzed. Perceptual analysis was also carried out and the Pediatric Voice Handicap Index (PVHI) questionnaire was used to assess subjective changes in the children's voice and the effects of these changes on social functions. RESULTS: Acoustic analysis revealed significant decreases in the vowel /i/ in the second formant, compact-diffuse, and grave-acute features of the voice (p=0.026, 0.022, and 0.031, respectively). A significant decrease was also observed in the intensity of the voice for the vowel /u/ (p=0.025). Perceptual analysis revealed that 86.6% of patients' voice recordings had post-operative changes. The mean preoperative PVHI score was 2.70±3.37, which decreased to 1.65±2.21 (p=0.011) after the surgery. CONCLUSION The results suggest that adenotonsillectomy affects Korean children's voices both acoustically and perceptually.

BACKGROUND AND OBJECTIVES: Adenotonsillectomy is a highly effective treatment for obstructive sleep apnea symptoms in children. In this study, to investigate the effects of adenotonsillectomy on snoring in children, we analyzed and compared snoring sounds recorded using a smartphone before and after adenotonsillectomy. We also determined whether it is possible to use acoustic analysis to monitor snoring in children. SUBJECTS AND METHOD: A total of 20 children diagnosed with snoring and had undergone adenotonsillectomy performed by the same surgeon were enrolled for the study. Snoring was recorded by patients' caregivers using smartphones before and after the surgery (mean of 8.5 days) and analyzed. Questionnaires were conducted by telephone survey at 3 months and 12 months after the surgery to determine snoring status. RESULTS: Snoring completely ceased in 25% of patients and decreased in the remaining 75% during the immediate follow-up period (mean of 8.5 days; from 58.07±9.35 dB to 42.59±7.89 dB, p<0.001), and disappeared in all of the patients by 3 months after adenotonsillectomy. Snoring recurred only in one patient after 1 year. A frequency analysis offered no evident statistically significant changes during the immediate follow-up period, indicating that although snoring volume had decreased, no anatomical change had developed in the patient. Spectrography was useful in investigating the snoring patterns before and after adenotonsillectomy. CONCLUSION: The results showed that acoustic analysis of snoring sounds obtained using a smartphone may be useful for monitoring snoring during follow-up after adenotonsillectomy in pediatric snoring patients.
Acoustics* ; Caregivers ; Child* ; Follow-Up Studies ; Humans ; Methods ; Sleep Apnea, Obstructive ; Smartphone* ; Snoring* ; Telephone ; Tonsillectomy

BACKGROUND AND OBJECTIVES: The present study evaluated the results of skin prick test using 55 allergens at 20 centers in the Republic of Korea in 2006, 2010, and 2014–2015. The aim was to assess changes in the positive rate of allergens according to temporal, regional, and environmental factors. MATERIALS AND METHODS: In total, 20 hospitals were selected based on the population distribution in the Republic of Korea. A skin prick test panel comprising 55 aeroallergens was distributed to 18 hospitals for this prospective study. The 2006 and 2010 skin prick test results were collected and analyzed retrospectively from 20 hospitals, while the 2014/2015 skin prick test results (from June 2014 to May 2015) were collected prospectively from 18 hospitals. RESULTS: A total of 14,897 SPT test results were analyzed: 4,319 in 2006, 7,431 in 2010, and 1,852 in 2014/2015. The overall rate of skin prick test positivity to more than two allergens was significantly higher in males than females. The positive rates of alder pollens and birch, oak and ragweed pollen positivity were increased in older patients. Several positive rates were increased according to the temperature in spring. The positive rates for beech pollen, birch pollen, hazel pollen, oak pollen, Tyrophagus putrescentiae, mugwort, cat, Acarus siro, Lepidoglyphus destructor and Tyrophagus putrescentiae were significantly increased, while those of Cult rye pollen and dandelion were significantly decreased over the three test periods. The overall positive rate for allergens in Jeju province varied significantly from Seoul and other cities. CONCLUSION: Change in the positive rate of multiple aeroallergens was evaluated in the Republic of Korea over time. Our findings can be used to recommend aeroallergens suitable for inclusion in skin prick test panels in the Republic of Korea and will facilitate further investigation of changes in the patterns of allergic diseases.
Allergens* ; Alnus ; Ambrosia ; Animals ; Artemisia ; Betula ; Cats ; Demography ; Fagus ; Female ; Humans ; Korea* ; Male ; Mites ; Pollen ; Prospective Studies ; Republic of Korea ; Retrospective Studies ; Secale ; Seoul ; Skin* ; Taraxacum

BACKGROUND/AIMS: Treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remains controversial. We compared the outcomes of hepatic resection (HR), transarterial chemoembolization (TACE), and sorafenib therapy as treatments for HCC with PVTT. METHODS: Patients diagnosed as HCC with PVTT between January 2000 and December 2011 who received treatment with sorafenib, HR, or TACE were included. Patients with main PVTT, superior mesenteric vein tumor thrombosis, or Child-Turcotte-Pugh (CTP) class C were excluded. The records of 172 patients were analyzed retrospectively. HR, TACE, and sorafenib treatment were performed is 40, 80, and 52 patients respectively. PVTT was classified as either involving the segmental branch (type I) or extending to involve the right or left portal vein (type II). RESULTS: The median survival time was significantly longer in the HR group (19.9 months) than in the TACE and sorafenib groups (6.6 and 6.2 months, respectively; both p<0.001), and did not differ significantly between the latter two groups (p=0.698). Among patients with CTP class A, type I PVTT or unilobar-involved HCC, the median survival time was longer in the HR group than in the TACE and sorafenib groups (p=0.006). In univariate analyses, the initial treatment method, tumor size, PVTT type, involved lobe, CTP class, and presence of cirrhosis or ascites were correlated with overall survival. The significant prognostic factors for overall survival in Cox proportional-hazards regression analysis were initial treatment method (HR vs. TACE: hazard ratio=1.750, p=0.036; HR vs. sorafenib: hazard ratio=2.262, p=0.006), involved lobe (hazard ratio=1.705, p=0.008), PVTT type (hazard ratio=1.617, p=0.013), and CTP class (hazard ratio=1.712, p=0.012). CONCLUSIONS: Compared with TACE or sorafenib, HR may prolong the survival of patients with HCC in cases of CTP class A, type I PVTT or unilobar-involved HCC.
Adult ; Aged ; Antineoplastic Agents/*therapeutic use ; Carcinoma, Hepatocellular/complications/drug therapy/*therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms/complications/drug therapy/*therapy ; Male ; Middle Aged ; Niacinamide/*analogs & derivatives/therapeutic use ; Phenylurea Compounds/*therapeutic use ; Portal Vein ; Proportional Hazards Models ; Retrospective Studies ; Severity of Illness Index ; Survival Rate ; Treatment Outcome ; Venous Thrombosis/*complications

The "nasal swell body" (NSB) or septal turbinate is a distinct structure of the anterior nasal septum that is observed on endoscopic and radiographic examination. It is primarily a glandular rather than a venous formation that is comprised of septal cartilage, bone, and thick mucosal lining. It is commonly found in patients with symptoms of chronic sinusitis and allergic rhinitis, and is linked to septal deviation. Space occupying lesions of the septum such as tumors, mucoceles, and pneumatization of the septum can lead to anatomical and functional disorders such as nasal obstruction and sinusitis, while more serious clinical conditions can develop when these lesions are combined with the NSB. Recently, there has been emphasis on the functional aspects of the NSB. It is especially being emphasized for clinicians to pay attention to the NSB and its connection with the stuffy nose. We report an interesting case of the NSB combined with pneumatization of the perpendicular plate of the ethmoid bone causing severe nasal obstruction and repetitive sinusitis along with a literature review.
Cartilage ; Ethmoid Bone* ; Humans ; Mucocele ; Nasal Obstruction ; Nasal Septum ; Nose ; Rhinitis, Allergic ; Sinusitis ; Turbinates

BACKGROUND AND OBJECTIVES: Septoplasty with turbinoplasty has the potential to affect voice because it alters the vocal tract. We conducted a study to evaluate the postoperative voice changes and aid using subjective and objective data regarding the effect of surgery. SUBJECTS AND METHOD: To rule out gender bias, only 23 male patients were enrolled. Voice change was analyzed by a subjective test through a questionnaire and an objective test through acoustic analysis. During each recording session, the subject uttered the words [^m ma: the Korean word for "mother"] and [Nu Na: the Korean word for "sister"]. We then analyzed the nasal consonant ([m] in [^m ma]), the nasalized vowel ([a] in [^m ma] and [a] in [Nu Na]), and the intensity of nasal sound. RESULTS: In the subjective study, 73.9% of patients reported an improvement in the quality of voice after surgery. Most of the patients reported a reduction in twang. In the objective study, there was a tendency for increased formant frequencies in the nasal consonant, and F1 of [m] in [^m ma] was increased significantly (p=0.003). There was also a tendency for decreased formant frequencies in the nasalized vowel, F2 of [a] in [^m ma] and F1 of [a] in [Nu Na] were decreased significantly (p<0.001), and there was an increase in the intensity of nasal sound, [^m ma] (p=0.009) and [Nu Na] (p=0.013). CONCLUSION: Nasal sound became clearer with reduced twang after surgery. It is important to keep the phonetic aspect in mind when patients are undergoing septoplasty with turbinoplasty.
Acoustics ; Humans ; Male ; Methods ; Nasal Cavity ; Nasal Obstruction ; Sexism ; Voice*