BACKGROUND AND OBJECTIVES: The sense of smell is indispensable for men to appreciate food flavors and avoid potential dangers, such as spoiled foods, smoke, and gases. Despite these important roles, there have been only a few studies investigating the cause and nature of olfactory disorders. In this study, we investigated clinical aspects of olfactory disorders. MATERIALS AND METHODS: The demographic, medical, and chemosensory data of 497 patients who visited clinics complaining of smell loss were retrospectively analyzed with medical charts and a questionnaire. The statistical analyses were performed using ANOVA and chi-square test to compare several variables of data. RESULTS: Nasal and paranasal sinus disease, upper respiratory tract infection, idiopathic, and head trauma were the major causes of smell loss. The onset of smell loss, the distribution of gender and age, the incidence and severity of olfactory loss with gustatory dysfunction differed among causal groups. The association of olfactory score with allergies in nasal diseases was not noted in this study. In addition, the presence of intranasal polyp affected the severity of olfactory dysfunction, but we could not see this effect in patients who had the history of sinonasal surgery. CONCLUSION: We recommend that physicians have to consider many clinical aspects including the cause and nature of olfactory loss to treat patients with chemosensory dysfunction effectively.
Craniocerebral Trauma ; Gases ; Humans ; Hypersensitivity ; Incidence ; Male ; Nose Diseases ; Olfaction Disorders ; Paranasal Sinus Diseases ; Polyps ; Surveys and Questionnaires ; Respiratory Tract Infections ; Retrospective Studies ; Smell ; Smoke

BACKGROUND AND OBJECTIVES: Reliable prosthetic or tissue graft of trachea for reconstruction of large, circumferential tracheal defect has not yet been developed. The major limitations in this area have been anastomotic dehiscence and stenosis, which are attributed to poor epithelialization and vascularization of prosthetic grafts. MATERIALS AND METHOD: We developed a new tracheal prosthesis which has a viable lined mucosa and is well-vascularized. The prosthesis consists of Prolene mesh reinforced with polypropylene rings, and is coated with gelatin. We lined the luminal surface of the prosthesis with transplanted autogenous oral mucosa and wrapped the prosthesis with greater omentum. Animal experiments were performed using 8 adult Mongrel dogs. RESULTS: The transplanted mucosa and the greater omentum that was wrapped were tightly adhered to the prosthesis to make a single unit within two weeks. The mucosa survived well, having been vascularized by new vessels from the greater omentum, and showed normal histology. CONCLUSION: We concluded that this highly biocompatible tracheal prosthesis could be very useful for stage4 reconstruction of tracheal defects.
Adult ; Animal Experimentation ; Animals ; Constriction, Pathologic ; Dogs ; Gelatin ; Humans ; Mouth Mucosa ; Mucous Membrane ; Omentum ; Phenobarbital ; Polypropylenes ; Prostheses and Implants* ; Trachea ; Transplants

BACKGROUND AND OBJECTIVES: Many clinical and experimental methods have been developed to evaluate human olfactory function, but there is not a standard test which can be used clinically in Korea. CC-SIT (Cross-Cultural Smell Identification Test) is a smell identification test that consists of 12 items well known in most non-English-speaking cultures. So, authors evaluated the usefulness of CC-SIT in assessing olfactory function in Korea. MATERIALS AND METHODS: One hundred ninety patients who visited clinics complaining of smell loss were categorized to 3 groups (mild hyposmia, moderate hyposmia, severe hyposmia) by questionnaire and 41 healthy subjects were chosen for the normal control group. CC-SIT and a smell threshold test was performed to both patients and controls. The statistical analysis was performed using ANOVA and the Pearson correlation method. RESULTS: There were significant differences in the CC-SIT scores among 3 groups and the severity of hyposmia was correlated with the CC-SIT score. Also, the CC-SIT scores were correlated significantly with the smell threshold. In addition, the difference of familiarity among 12 items was observed. CONCLUSION: CC-SIT is a convenient, practical smell function test which can tell olfactory tunction loss and can he used clinically in Korea.
Humans ; Korea* ; Olfaction Disorders ; Surveys and Questionnaires ; Recognition (Psychology) ; Smell*

BACKGROUND AND OBJECTIVES: It is known that patients with malignant tumor often have depressed antitumor immunity. Much information has been generated about a biologically-based therapy, which can induce or activate antitumor cytotoxic T lymphocytes (CTL) capable of recognizing the antigens associated with the major histocompatibility complex molecules (MHC). Optimal induction of CTL seems to require contact with antigenic peptides presented by antigen presenting cell (APC). Dendritic cells (DC) are currently considered to be the most effective and professional APC. MATERIALS AND METHODS: With an injection of SCC cells (1x105) to the back of C3H mouse, a consistent and immunocompetent experimental animal tumor model was achieved. DCs were successfully cultured from the bone marrow of C3H mouse, and phenotypically they expressed high levels of co-stimulatory molecules and abundant MHC. Cultured DCs were intraperitoneally injected into the tumor-established mouse. RESULTS: In the treated group, tumor sizes were smaller, infiltration to the adjacent structures were limited. T cells extracted from the spleen of the treated group showed better proliferative and cytolytic activity toward tumor cells. The results of this study suggest that DCs have an effect to suppress the growth of tumors and to induce higher T cell reactivity toward tumor cells. CONCLUSION: These results may help in proceeding further immunologic approaches to reduce the morbidity and mortality in patients with the head and neck SCC.
Animals ; Bone Marrow* ; Carcinoma, Squamous Cell* ; Dendritic Cells* ; Head ; Humans ; Immunotherapy, Adoptive* ; Major Histocompatibility Complex ; Mice ; Mice, Inbred C3H ; Mortality ; Neck ; Peptides ; Spleen ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic

In the treatment of chronic maxillary sinusitis, endoscopic sinus surgery, unlike the more radical Caldwell-Luc (C-L) operation, enables the preservation of mucosa. However, although a middle meatal antrostomy is superior in function and patency to an inferior meatal antrostomy, at times it is very difficult to remove diseased mucosa located at the antero-inferior or antero-medial side of the maxillary sinus : to prevent recurrence, the C-L procedure is often chosen. In an effort to decrease the failure rate of endoscopic maxillary sinus surgery, we applied the microdebrider technique, a new approach of puncture and shaving. To evaluate the effectiveness of the microdebrider technique, we retrospectively reviewed the medical records of 33 patients (43 sinuses) who have been treated by this method. We analyzed the clinical courses of these patients during recovery and evaluated endoscopic findings made during follow-up examinations. Nasal symptoms were alleviated in every case except for two. Three cases required revision ESS or a C-L procedure at the puncture and shaving site. The maxillary sinuses of most patients (80%) were normalized, but five sinuses demonstrated polypoid or thickened mucosa. The ostiums of 36 maxillary sinuses remained patent but nine sinuses became stenotic. Complications, which included facial pain and facial paresthesia, were rare and disappeared shortly. We consider this new technique to be an effective method of eradicating maxillary sinus disease that is not otherwise accessible through the MMA window.
Facial Pain ; Follow-Up Studies ; Humans ; Maxillary Sinus* ; Maxillary Sinusitis ; Medical Records ; Mucous Membrane ; Paresthesia ; Punctures ; Recurrence ; Retrospective Studies

BACKGROUND AND OBJECTIVES: With the advent of free flap reconstruction techniques, several free flaps were used for a variety of head and neck defects. The objective of this study was to review our experience during 3-year period in performing 40 microvascular free flaps for head and neck defects. Materials and Method: A review of 40 microvascular free flaps performed in 38 patients between April 1995 through August 1998 was undertaken. Patient's age, sex, stage of disease, types of free flaps, short-term postoperative outcome including the flap success rate, postoperative complications, effect of preoperative irradiation on the development of the wound complications such as fistula were evaluated. RESULTS: 36 (90%) of 40 free flaps were successful with 4 failures resulting from 3 venous thromboses and 1 infection. Emergent reexploration was done in 2 patients, none of whom were successfully salvaged. The postoperative surgical complications including donor site complications and medical complications were seen in 17 flaps (47%) and in 8 flaps (22%), with multiple complications seen in several patients. The preoperative radiotherapy did not affect the incidence of the postoperative surgical complications (p=0.273). CONCLUSION: In review of our experience, we believe that free flap reconstruction in head and neck regions has become a useful procedure with acceptable outcome and complication rates and has surpassed conventional techniques cosmetically and functionally.
Fistula ; Free Tissue Flaps* ; Head* ; Humans ; Incidence ; Neck* ; Postoperative Complications ; Radiotherapy ; Tissue Donors ; Venous Thrombosis ; Wounds and Injuries

Oculoauriculovertebral spectrum (OAVS) is a disease which has wide range of phenotypic expression from hemifacial microsomia. Hemifacial microsomia denotes unilateral microtia, mandibular hypoplasia to Goldenhar syndrome, which consists of epibulbar dermoids and vertebral anomalies in addition. Various auricular, external ear and middle ear deformities are combined in this disease spectrum. We experienced a case which was characterized as OAVS. The patient complained about congenital hearing loss and showed unilateral conductive hearing loss. Microtia type I with mild stenosis of ear canal, hemifacial microsomia and abnormality of cervical vertebrae were found. Exploration revealed middle ear anomalies with ossicular deformity and aberrant facial nerve. To correct the conductive hearing loss, oval window fenestration was performed with KTP laser and piston wire prosthesis was inserted. Hearing was improved successfully after the surgery. It should be stressed that hearing should be carefully assessed in the patients with OAVS, regardless of the type of clinical findings. The correction of anomalies of the middle ear would be one of the important points for otolaryngologists in treatment of OAVS.
Cervical Vertebrae ; Congenital Abnormalities* ; Constriction, Pathologic ; Dermoid Cyst ; Ear Canal ; Ear, External ; Ear, Middle ; Facial Nerve ; Female ; Goldenhar Syndrome* ; Hearing ; Hearing Loss ; Hearing Loss, Conductive ; Humans ; Lasers, Solid-State ; Prostheses and Implants

BACKGROUND AND OBJECTIVES: When the impairment of nasal airway patency in patients with chronic sinusitis such as mucosal edema or nasal polyps is resolved after functional endoscopic sinus surgery (FESS), it is expected that patients no longer complain of hyponasal voice. However, patients who have undergone FESS sometimes complain of more hyponasal voice, or thick voice. The purpose of this study was to examine the effect of FESS on voice in terms of nasality. MATERIALS AND METHODS: Thirty-three patients who underwent FESS and thirty normal adults who had no sinus or nasal pathology were selected for this study. We performed nasalance test for patients group before and 3 months after the operation and for the control group without any medication. RESULTS: Patients' preoperative mean nasalance were not low compared with that of control group in all sentences. It was different from perceptual hyponasality they had complained. Postoperative mean nasalance in patients showed statistically significant increase. Higher change ratio of nasalance was noted in Mamma passage than the other passages. CONCLUSION: There was significant increase in nasalance scores after FESS. Thus, we must consider the possibility of voice changes postoperatively in professional voice users.
Adult ; Edema ; Humans ; Nasal Polyps ; Pathology ; Sinusitis ; Voice

PURPOSE: Structural alterations of p53 and overexpression of the p53 protein are the most common genetic abnormalities in various kinds of human cancers. In this study, we examined the mutational status and the frequency of p53 mutations in head and neck squamous cell carcimona (HNSCC) cell lines. MATERIALS AND METHODS: 7 human head and neck squamous cell carcinoma cell lines were included in this analysis. Using polymerase chain reaction(PCR), single strand confonmation polymorphism(SSCP) and PCR-DNA sequencing analysis, we tested the mutational status of 7 cell lines. Exon 4~9 of the p53 gene was amplified for the direct DNA sequencing analysis. RESULTS: Our results showed 100% nuclear p53 immunostaining and 3 electrophoretic abnomalities by PCR-SSCP in three cancer cell lines and mutations of the p53 gene including 2 base substitutions and 1 base deletion were detected in 3 cancer cell lines using PCR directed DNA sequencing analysis. CONCLUSION: 7 HNSCC cell lines examined in this study provide excellent systems for study of gene therapy using p53 gene.
Carcinoma, Squamous Cell* ; Cell Line* ; Exons ; Genes, p53 ; Genetic Therapy ; Head* ; Humans ; Neck* ; Polymerase Chain Reaction ; Sequence Analysis, DNA

Many techniques have been employed for the treatment of dysthyroid optic neuropathy. With the development of intranasal endoscopic skills, endoscopic orbital decompression is now performed as one of surgical treatments of the disease. Orbital decompression was performed by endoscopic approach on 3 orbits in 2 patients. Proptosis was reduced 3 mm each in 2 orbits of a patient by Hertel measurement and visual acuity was improved in both patients. The endonasal endoscopic approach provided visual improvement without the morbidity of the traditional Walsh-Ogura method.
Decompression* ; Exophthalmos ; Humans ; Optic Nerve Diseases* ; Orbit* ; Visual Acuity