The laryngeal framework surgery (LFS) is an operation to correct the position and tension of the vocal cords by changing the laryngeal cartilage and muscles. LFS such as type 1 thyroplasty, arytenoid adduction, and arytenopexy is performed to improve the voice of patients with unilateral vocal cord paralysis. It is known that the voice improvement effect of LFS in patients with unilateral vocal cord paralysis is excellent and lasts for a long time. LFS can also be operated under local anesthesia. Complications are not common, however, severe complications like airway obstruction could occur after the operation. Recently, several other attempts to modify the traditional surgical method have been reported. This review is intended to be helpful in understanding the characteristics and changes in laryngeal framework surgery.

Rhino-orbito-cerebral mucormycosis (ROCM) is an invasive fungal infection that usually occurs in immunocompromised patients. It is aggressive and has a high risk of mortality. With unclear guidelines, ROCM is treated in various ways. We present a patient who underwent kidney transplant and who treated for ROCM without major complications.

Objectives: . Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular disorder characterized by recurrent epistaxis, telangiectasia, and visceral arteriovenous malformations (AVMs). Activin A receptor-like type 1 (ACVRL1/ALK1) and endoglin (ENG) are the principal genes whose mutations cause HHT. No multicenter study has yet investigated correlations between genetic variations and clinical outcomes in Korean HHT patients. Methods: . Seventy-two members from 40 families suspected to have HHT based on symptoms were genetically screened for pathogenic variants of ACVRL1 and ENG. Patients with genetically diagnosed HHT were also evaluated. Results: . In the HHT genetic screening, 42 patients from 24 of the 40 families had genetic variants that met the pathogenic criteria (pathogenic very strong, pathogenic strong, pathogenic moderate, or pathogenic supporting) based on the American College of Medical Genetics and Genomics Standards and Guidelines for either ENG or ACVRL1: 26 from 12 families (50%) for ENG, and 16 from 12 families (50%) for ACVRL1. Diagnostic screening of 42 genetically positive HHT patients based on the Curaçao criteria revealed that 24 patients (57%) were classified as having definite HHT, 17 (41%) as having probable HHT, and 1 (2%) as unlikely to have HHT. Epistaxis was the most common clinical presentation (38/42, 90%), followed by visceral AVMs (24/42, 57%) and telangiectasia (21/42, 50%). Five patients (12%) did not have a family history of HHT clinical symptoms. Conclusion . Only approximately half of patients with ACVRL1 or ENG genetic variants could be clinically diagnosed as having definite HHT, suggesting that genetic screening is important to confirm the diagnosis.

BACKGROUND AND OBJECTIVES: Several questionnaires had been developed to assess the handicap due to dizziness. The questionnaires for adults were used and these had been translated into Korean with validity and reliability. However, there is no Korean translation of dizziness inquiry form owing to the little concern of the pediatric dizziness. The objective of this study was to determine the reliability and validity of a Korean Dizziness Handicap Index for Patient Caregivers (KDHI-PC), and revealed the factor analysis of this index. SUBJECTS AND METHOD: We sampled the 24 pediatric patients who had dizziness-related symptoms and visited the hospitals. The patients completed a questionnaire (DHI-PC) that had been translated and reverse translated into Korean. The results of this investigation were analyzed using exploratory factor analysis, Cronbach's α coefficient and internal consistency reliability. RESULTS: By exploratory factor analysis, KDHI-PC was divided into two scales. This questionnaire showed a good internal consistency (Cronbach's α=0.945). All items had good item-total correlations. CONCLUSION: The KDHI-PC is a reliable tool for evaluating the dizziness of pediatric patients.
Adult ; Caregivers ; Child ; Dizziness ; Humans ; Methods ; Reproducibility of Results ; Weights and Measures

BACKGROUND AND OBJECTIVES: Several questionnaires had been developed to assess the handicap due to dizziness. The questionnaires for adults were used and these had been translated into Korean with validity and reliability. However, there is no Korean translation of dizziness inquiry form owing to the little concern of the pediatric dizziness. The objective of this study was to determine the reliability and validity of a Korean Dizziness Handicap Index for Patient Caregivers (KDHI-PC), and revealed the factor analysis of this index.SUBJECTS AND METHOD: We sampled the 24 pediatric patients who had dizziness-related symptoms and visited the hospitals. The patients completed a questionnaire (DHI-PC) that had been translated and reverse translated into Korean. The results of this investigation were analyzed using exploratory factor analysis, Cronbach's α coefficient and internal consistency reliability. RESULTS: By exploratory factor analysis, KDHI-PC was divided into two scales. This questionnaire showed a good internal consistency (Cronbach's α=0.945). All items had good item-total correlations. CONCLUSION The KDHI-PC is a reliable tool for evaluating the dizziness of pediatric patients.

BACKGROUND AND OBJECTIVES: Olfactory dysfunction is a common sensory disorder, but there are currently no standard diagnostics or therapeutic methods. We analyzed the effects of systemic steroid therapy in patients with olfactory dysfunction. MATERIALS AND METHOD: We analyzed patients who visited our ENT department with olfactory dysfunction for 3 years. We reviewed their charts and classified the patients according to age, sex, etiology of olfactory dysfunction, degrees of olfactory dysfunction and the effect of systemic steroid therapy. RESULTS: The mean age was 44.3 years old and there were 50 males and 55 females; 55 patients had inflammatory disease and 50 patients had non-inflammatory disease. The distribution of degrees of olfactory disorder according to cause was not significantly different (p=0.120). In 105 patients, 20% experienced improvements after systemic steroid therapy, and the response of systemic steroid therapy was better among patients with inflammatory causes. In cases of inflammatory disease, there was a larger amount of severe hyposmia patients, and their response to systemic steroid therapy was significant (p=0.015). Patients with mild and moderate hyposmia were more responsive to systemic steroid therapy than patients with severe hyposmia (p=0.382). CONCLUSION: In cases of hyposmia due to inflammatory disease, systemic steroid therapy with proper operative management may increase therapeutic effects.
Female ; Humans ; Male ; Methods ; Sensation Disorders ; Therapeutic Uses

BACKGROUND AND OBJECTIVES: The clinical reports for the treatment of vocal fold scar and sulcus vocalis are limited, also there is no best one for the treatment of them. This study is to evaluate the effect of Injection laryngoplasty (IL) for the treatment of vocal fold scar and sulcus vocalis. MATERIALS AND METHODS: from January 2013 to May 2015, the Nineteen patients who were diagnosed as vocal fold scar, sulcus and atrophy, and underwent IL, were engaged in this study. Clinical information and voice parameters were analyzed by retrospective chart review. Pre and post voice parameters were compared. RESULTS: Subgroups of diagnosis were classified into sulcus vocalis for 12 patients, vocal fold scar for 5, and atrophy for 2. IL was performed under local anesthesia through cricothyroid membrane except one patient. Atesense®, Radiessess®, and Rofilan® were used as injected materials in 9, 9, and 1 patients respectively. Maximal phonation time (p=0.0124), dynamic range (p=0.0028), pitch range (p=0.0141), voice handicap index (p=0.028), glottal closure (p=0.0229), and mucosal wave (p=0.0132) had significant improvement for post-IL voice assessment than Pre-IL. While GRBAS, Mean flow rate, Jitter, Shimmer, Harmony to Noise ratio didn't have improvement. CONCLUSION: IL is a feasible option for the treatment of glottis incompetence with normally mobile vocal folds such as sulcus vocalis and vocal fold scar.
Anesthesia, Local ; Atrophy ; Cicatrix* ; Diagnosis ; Glottis ; Humans ; Laryngoplasty* ; Membranes ; Noise ; Phonation ; Retrospective Studies ; Vocal Cords* ; Voice

Precise fixation of fracture fragments is important for the successful management of facial bone fractures. However, the conventional metal plates and screws used in such procedures are sometimes difficult to place when the facial bone fracture occurs in a narrow area or has significant comminution. We report herein our experience with 6 patients with facial fractures, which were difficult to fix using titanium plates and screws. All injuries were satisfactorily repaired using octyl-2-cyanoacrylate (OCA). In addition, there were no significant complications related to OCA during the follow-up period.
Facial Bones ; Follow-Up Studies ; Fracture Fixation ; Fractures, Bone ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Ophthalmoplegia ; Titanium

BACKGROUND AND OBJECTIVES: Low concentration hypochlorous acid is known for being an endogenous anti-bacterial and anti-viral agent. Saline irrigation has been used as an adjunctive treatment for patients with chronic sinusitis. In this study, we tried to compare the effectiveness of hypochlorous acid and saline nasal irrigation to patients with intractable sinusitis after surgery. SUBJECTS AND METHOD: A total of 35 patients who had a frequent relapse of chronic sinusitis or had persisting symptoms post-surgically were recruited. The experimental group was given hypochlorous acid and saline nasal irrigation, while the control group was given saline nasal irrigation for eight weeks. The curative effects were assessed on the basis of the symptom score, nasal endoscopic score, bacterial culture, and inflammatory cytokines on the first day, fourth week, and eighth week after treatment. RESULTS: A total of 26 participants were assessed. The study finally consisted of 15 patients in experimental group and 11 in the control group. The symptom scores in the experimental group were substantially lower before, and after four and eight weeks of treatment. However, there was no specific difference in symptom score improvement between the two groups. The endoscopic score improved in experimental group (p<0.01). Similar tendencies were shown in the bacterial culture test of both groups. In the experimental group, the values of TNF-alpha, IL-8, and IL-1beta decreased in the fourth week, whereas they increased in the eighth week. CONCLUSION: Hypochlorous acid nasal irrigation may be to used as an alternative adjunctive treatment in addition to saline irrigation.
Cytokines ; Humans ; Hypochlorous Acid ; Interleukin-8 ; Nasal Cavity ; Nasal Lavage ; Recurrence ; Sinusitis ; Tumor Necrosis Factor-alpha

OBJECTIVE: This article describes use of the osteoplastic technique in the treatment of maxillary benign tumors. This procedure yielded favorable outcomes in situations where the tumor was difficult to remove using the standard endoscopic approach. METHODS: This study included six sinuses of six patients with maxillary sinus benign tumors (five inverted papillomas and one hemangioma). The tumors were located in the anterior wall of the maxillary sinus and were difficult to remove by the endoscopic approach. The traditional gingivobuccal incision was performed to expose the anterior maxillary sinus wall. A rectangular bone flap was designed on the anterior maxillary wall and a bony window was made using a reciprocating saw. After eradicating all lesions, the bone flap was repositioned to its original site and fixed with a miniplate. Postoperative paranasal sinus computed tomography was performed after 12 and 24 months. RESULTS: All bone flaps healed without any complications. Patients had succes-sful postoperative outcomes without any complications. In one inverted papilloma case, the lesion recurred and was removed easily with the same procedure. CONCLUSION: The osteoplastic technique is a simple and useful method to eradicate benign lesions in the maxillary sinus due to its good access to the maxillary sinus antrum, optical surgical view, and minimal complications.
Humans ; Maxillary Sinus ; Papilloma, Inverted