OBJECTIVES: Recurrent mucosal disease and anatomic obstruction are commonly cited causes of failed endoscopic sinus surgery (ESS). Hyaluronic acid (HA) has been reported to reduce scarring and to promote wound healing in sinonasal surgery. HyFence is HA stabilized by 1, 4-butandiol diglycidyl ether, which makes it less-water-soluble and highly viscoelastic. The purpose of this study is to examine the anti-adhesion effect of HyFence after ESS compared to that of HA-CMC (Guardix-Sol). METHODS: Seventy-four patients with chronic rhinosinusitis who underwent ESS were included in the study. After the ESS procedure, Merocel was placed in the ethmoidectomized areas of the both sides. Five milliliters of Guardix-Sol was then applied to the Merocel of one side and HyFence LV was applied to the other side. The effect of the agents was evaluated at one, two, and four weeks after surgery by endoscopic examination. The severity of adhesion, edema, infection and complications were evaluated. RESULTS: There was no significant difference in the incidence of postoperative adhesion between the HyFence group and the Guardix-Sol group (P>0.05). Mean postoperative grades of edema and infection showed no significant difference between groups (P>0.05). There was no significant postoperative complications associated with either anti-adhesion agent (P>0.05). CONCLUSION: HyFence has equivalent anti-adhesion effect compared to Guardix-Sol following ESS.
Cicatrix ; Edema ; Ether ; Humans ; Hyaluronic Acid ; Incidence ; Postoperative Complications ; Wound Healing

STUDY DESIGN: Retrospective study. OBJECTIVES: We reported the therapeutic usefulness of a selective nerve root block (SNRB) for patients with a single level spinal stenosis. SUMMARY OF LITERATURE REVIEW: Selective nerve root block for the radiculopathy due to lumbar disc herniation, spinal stenosis, and spondylolisthesis have been reported frequently. MATERIALS AND METHODS: We retrospectively examined 44 patients with single-level spinal stenosis, for whom surgical treatment was considered due to the failure of other conservative treatments from January 2005 to January 2010. All 44 patients were admitted for surgical decompression. Selective nerve root block was done just before a final decision of surgical procedure; patients with his or her 50% or more pain reduction could avoid surgery. RESULTS: In fourty-four cases, twenty-seven pateints underwent a surgical operation. Seventeen patients avoided surgical procedures by successful SNRB. As a result of a 3 year follow-up, the VAS score was significantly and continuously low on the operation group (p=0.02~0.03). K-ODI and Roland-Morris Disability scores were low in both groups until 1 year after the operation and SNRB procedure (p=0.026~0.042, p=0.03), but there was no statistically significant difference beteween the two groups after 2 years upon follow-up (p=0.072~0.14, p=0.06). Generally, the operation group had good results until 1 year after operation and had better tendency for improvement. The data displayed a high probability of surgical treatment among the patients with foraminal stenosis (p=0.039) highlight - this sentence says there is no difference after 1 year and there is still no difference after 2 years. If this is true, the sentence needs to be rewritten so that it says both times show no difference. If there is a difference between 1 year and 2 year then the sentence needs to be rewritten to make this more clear. The next sentence seems to say they are different. CONCLUSIONS: Selective nerve root block avoided the surgical intervention in 39% of the patients with the spinal stenosis refractory to the conservative treatment. Thus it is one of options for the refractory spinal stenosis.
Appointments and Schedules* ; Constriction, Pathologic ; Decompression, Surgical ; Follow-Up Studies ; Humans ; Radiculopathy ; Retrospective Studies ; Spinal Stenosis* ; Spondylolisthesis

PURPOSE: The purpose of this study is to evaluate the usefulness of locally harvested bone in anterior cervical interbody fusion. MATERIALS AND METHODS: A retrospective review was conducted, including 31 patients who underwent anterior cervical interbody fusion using a polyetheretherketone (PEEK) cage and anterior plate fixation. We randomly divided the patients into two groups, local bone group and iliac bone group. In 15 patients of the local bone group, the cage was filled with locally harvested bone, and in another 16 patients of the iliac bone group, the cage was filled with autogenous iliac bone. RESULTS: Improvements in mean visual analogue scale (VAS) scores, from 5.8 and 7.7 to 1.6 and 2.3 for neck pain and arm pain, respectively, were observed in cases using locally harvested bone, while the improvements were from 5.7 and 7.2 to 1.4 and 2.2, respectively, in those using autogenous iliac bone grafts. However, no significant differences in mean VAS and neck disability index were observed between the two groups at the last follow up (p>0.05). Radiologic union was achieved at 14.0+/-2.50 weeks in the local bone group, and at 12.62+/-1.58 weeks in the iliac bone group. However, no significant difference was observed between the two groups (p=0.076). CONCLUSION: Utilization of locally harvested bone for packing in a PEEK cage for anterior cervical interbody fusion is considered a useful method because it gives satisfactory clinical results for retention of bone union and lordosis angles.
Animals ; Arm ; Follow-Up Studies ; Humans ; Lordosis ; Neck ; Neck Pain ; Retrospective Studies ; Transplants

Tonsillectomy, with or without adenoidectomy, remains the most frequently performed surgical procedure by otolaryngologists. Postoperative hemorrhage, which is classified as primary (<24 h) or secondary (>24 h) hemorrhage, is recognized as a rare but potentially life-threatening complication. Although most oral bleedings occuring after tonsillectomy are considered as post-tonsillectomy hemorrhages, there could also be other origins such as gastrointestinal hemorrhage. We recently experienced a case of gastrointestinal hemorrhage that was misdiagnosed as secondary post-tonsillectomy hemorrhage. We report this case with a review of the literature.
Adenoidectomy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Postoperative Hemorrhage ; Stomach Ulcer ; Tonsillectomy

Spontaneous tonsillar hemorrhage (STH) is an extremely rare event. Usually, the causes of STH are ascribed to vessel wall erosion secondary to bacterial or viral infection of tonsils. Other causes include vascular or tumorous lesions around tonsil, coagulation disorders and idiopathic one. On one hand, the total number of reported STH has slightly increased because STH is defined as all forms of "bleeding tonsils", including even minor bleeding. On the other hand, the portion of the total STH that is life-threatening has become relatively few. Management of STH involves the use of antibiotics, and early tonsillectomy is recommended. We have experienced a case of a 29 year-old female with tonsillar hemorrhage in the absence of any identifiable cause. We report the case with a review of the related literatures.
Anti-Bacterial Agents ; Female ; Glycosaminoglycans ; Hand ; Hemorrhage ; Humans ; Palatine Tonsil ; Tonsillectomy

Fibrous dysplasia is a benign fibro-osseous lesion originally described by Lichtenstein in 1938. Currently, three general subtypes of disease are recognized: monostotic, polyostotic, and McCune-Albright syndrome. Fibrous dysplasia is not rare, with the incidence report being about 5% to 7%. Common sites of fibrous dysplasia are the skeletal system including long bones, ribs, craniofacial bones, and the pelvis. However, fibrous dysplasia is rare in the nasal cavity, especially involving the turbinate. In the review of literature over the past 50 years, we were able to discover only 4 cases in which the fibrous dysplasia involved inferior turbinate, with all of them being the polyostotic form found around the sinuses. There were only 4 cases in which monostotic fibrous dysplasia involved the middle turbinate, but none the inferior turbinate. We present this case, with a review of the relevant literature, as the first report on monostotic fibrous dysplasia of the inferior turbinate.
Fibrous Dysplasia, Monostotic ; Fibrous Dysplasia, Polyostotic ; Incidence ; Nasal Cavity ; Pelvis ; Ribs ; Turbinates

PURPOSE: The purpose of this study was to correlate erectile function with polysomnographic indexes of obstructive sleep apnea(OSA) and other associated factors. MATERIALS AND METHODS: Among the 42 patients who visited our sleep clinic, we enrolled 32 patients who scored lower than 22 on the IIEF-5(International Index of Erectile Function-5). Polysomnography(PSG) was performed for OSA evaluation. Apnea-hypopnea index(AHI), AHI during REM sleep, AHI during non-REM sleep, arousal index(AI), and sleep efficacy(SE) were used as PSG indexes. Obesity was quantified by body mass index(BMI). The patients were divided into 2 groups according to AHI: group A< or =10(n=13); group B> 10(n=19). BMI and erectile function scores were compared between the 2 groups. The correlations among erectile function scores, PSG indexes, and BMI were analyzed. RESULTS: IIEF-5 score was negatively correlated with AHI(r=-0.372, p <0.05) and AI(r=-0.472, p <0.05), and there was a positive correlation with SE(r=0.372, p <0.05) of PSG. Between the 2 AIH groups, the low AHI group had a statistically higher mean erectile function score, especially in the EF domain and in the total IIEF score compared to the high AHI group. CONCLUSIONS: Indexes for penile rigidity were negatively correlated with AHI and AI. These findings suggest that AHI, AI, and SE of PSG are meaningful indexes of erectile function and support the hypothesis that hypoxia induced by sleep apnea plays a role in poor rigidity. Further studies in larger groups, including analysis of PSG indexes and erectile function changes before and after the treatment of sleep apnea, would be necessary to confirm this hypothesis.
Anoxia ; Arousal ; Erectile Dysfunction* ; Humans ; Male ; Obesity ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep, REM

The granulocytic sarcoma is a rare tumor and occurs primarily in patients with acute myelogenous leukemia (AML). The granulocytic sarcoma can arise before, concurrent with, or following acute myeloid leukemia. This tumor can be rarely represented as the initial presentation of acute myeloid leukemia without any signs or symptoms of leukemia. Granulocytic sarcoma, rarely, can also occur in unexpected regions, including the head and neck. This tumor is very often misdiagnosed as a malignant lymphoma which leads to inappropriate treatment and poor outcome. Therefore, clinical, histopathological and immumohistochemical findings should be evaluated before any diagnosis of malignant lymphoma. We report, with a brief review of literature, a case of granulocytic sarcoma presenting as a head and neck neoplasm.
Diagnosis ; Head* ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Lymphoma ; Neck* ; Sarcoma, Myeloid*

Chemical pneumonitis induced by nitric acid inhalation is a rare clinical condition. The previously reported radiologic findings of this disease include acute permeability pulmonary edema, delayed bronchiolitis obliterans, and bronchiectasis. In very few published rare radiologic reports has this disease manifested as acute alveolar injury; we report a case of acute chemical pneumonitis induced by nitric acid inhalation which at radiography manifested as bilateral perihilar consolidation and ground-glass attenuation, suggesting acute alveolar injury.
Bronchiectasis ; Bronchiolitis Obliterans ; Inhalation* ; Nitric Acid* ; Permeability ; Pneumonia* ; Pulmonary Edema ; Radiography

Cavernous transformation of the portal vein is a rare condition probably arising secondary to extrahepatic portal vein thrombosis or obstruction with recannalization and/or collateral veins formation to bypass the obstruction. It is believed that cavernous transformation of the portal vein is caused by a variety of diseases associated with periportal collateral development and hepatopedal flow. It is known that portal vein occlusion, which is the actual cause of cavernous transformation, has a wide variety of etiologies, such as congenital abnormalities, omphalitis, pancreatitis, various carcinoma, and liver cirrhosis. In most cases, the revealing symptom is upper gastrointestinal bleeding. Rarely, however, diagnosis is made from obstructive jaundice. Extensive collateral veins due to portal vein occlusion may compress and narrow the biliary tract. A 39-year-old man was admitted due to jaundice and abdominal discomfort for 1 month. He was confirmed to have obstructive jaundice due to collateral vessels of cavernous transformation of the portal vein. We report a case of obstructive jaundice caused by cavernous transformation of the portal vein.
Adult ; Biliary Tract ; Congenital Abnormalities ; Diagnosis ; Hemorrhage ; Humans ; Jaundice ; Jaundice, Obstructive* ; Liver Cirrhosis ; Pancreatitis ; Portal Vein* ; Veins ; Venous Thrombosis