Radiologic laryngeal parameters in acute supraglottitis in Korean adults.

Soft-tissue lateral neck radiography is important for diagnosing acute supraglottitis. This study aimed to determine the objective criteria for a diagnosis of acute supraglottitis from soft-tissue lateral neck radiographs in Korean adults. The parameters in 30 adult patients with acute supraglottitis were compared with those of age- and sex-matched normal 30 Korean adults. The mean of epiglottis width (EW) and aryepiglottic fold width (AEW) in the control group were 4.37 +/- 0.93 mm, 2.45 +/- 0.71 mm, respectively and in the patient group they were 15.87 +/- 3.60 mm, 6.4 +/- 2.55 mm, respectively. The sensitivity and specificity of an EW greater than 7 mm were 100%, and 100% respectively. The sensitivity and specificity of an AEW greater than 4.5 mm were 83%, and 100% respectively.

Endonasal endoscopic reduction of blowout fractures of the medial orbital wall.

PURPOSE: This article describes the endonasal endoscopic reduction (EER) of blowout fractures (BOFs) of the medial orbital walls and reports the clinical results. PATIENTS AND METHODS: Sixteen patients who underwent EER for a BOF of the medial orbital wall were analyzed. The surgical indications for treatment were diplopia, limitation of eye movements, and significant enophthalmos. They were followed-up for at least 3 months after the surgery. Surgical techniques, surgical results, and postoperative complications were reviewed. RESULTS: There were no significant intraoperative or postoperative complications. Fourteen patients showed complete resolution of symptoms after the surgery. One patient, who had persistent diplopia and remaining enophthalmos, underwent medial wall reconstruction with a Medpor surgical implant (Porex Surgical Inc, College Park, GA) by a transorbital approach. Another patient, who had residual enophthalmos, had correction of enophthalmos after insertion of a Medpor implant. Both patients are now symptom-free. CONCLUSION: The results indicate that EER is a safe and effective technique for the treatment of BOFs of the medial orbital wall.

Relationship between the extent of fracture and the degree of enophthalmos in isolated blowout fractures of the medial orbital wall.

PURPOSE: This study investigated the relationship between the extent of fracture and enophthalmos in blowout fractures of the medial orbital wall. PATIENTS AND METHODS: Nine patients with isolated blowout fractures of the medial orbital wall, confirmed by computed tomography scans, were evaluated. The area of fracture and the volume of herniated orbital tissue were determined from computed tomography scans using simple linear measurements. Each of the calculated values for area and volume were compared with the degree of enophthalmos to determine whether there was any significant relationship between them. RESULTS: Enophthalmos increased proportionally as the area of fracture or the volume of herniated orbital tissue increased (P < .05). The area of fracture and the volume of herniated orbital tissue associated with 2 mm of enophthalmos were 1.9 cm2 and 0.9 mL, respectively, as calculated from the regression curve. CONCLUSION: Enophthalmos of 2 mm or more, which is a frequent indication for surgery, can be expected when the area of fracture is 1.9 cm2 or more, or the volume of herniated orbital tissue is 0.9 mL or more.

Cytochrome P-450 inhibition blocks bone resorption in vitro and in vivo.

Although the cyclooxygenase and lipoxygenase pathways of arachidonic acid metabolism have been shown to lead to osteoclastic resorption, the cytochrome P450 pathway has not been implicated. We investigated the effects of the cytochrome P450 pathway in IL-1beta-induced calcium release from cultured mouse calvaria in vitro in the presence of clotrimazole, a cytochrome P450 inhibitor, or L-N(G)-arginine methyl ester, a nitric oxide synthase inhibitor. Clotrimazole inhibited calcium release in a dose-dependent manner; however, L-N(G)-arginine methyl ester did not inhibit resorption. These results suggest that cytochrome P450 may be another possible mediator of IL-1beta-induced bone resorption in vitro. In the in vivo portion of the study, clotrimazole was administered in the gerbil model of adaptive bone modeling. Clotrimazole inhibited osteoclast surface; however, it did not reduce the osteoclast number, mean erosion surface per osteoclast, mineralization surface, or mineral-apposition rate. These results suggest that clotrimazole may inhibit the activation of osteoclasts and that cytochrome P450-dependent enzymes may be related to osteoclast activation in vivo.

A case of spontaneous cervical and mediastinal emphysema.

Subcutaneous cervical and mediastinal emphysema usually can occurs as a result of surgery or trauma. Spontaneous cervical subcutaneous emphysema and pneumomediastinum, occurring in the absence of previous disorders or provocating factors, is very rare. The following case report of spontaneous cervical and mediastinal emphysema is assumed to be the first of its kind in Korea. The patient has been followed up for three years without recurrence or sequelae.

A traumatic pseudoaneurysm of the superficial temporal artery.

Pseudoaneurysm arising from the superficial temporal artery (STA) is very rare and is most commonly caused by blunt trauma. Most pseudoaneurysms of the STA usually present as a painless pulsating mass, with concomitant symptoms according to location, and their size may rapidly increase. The treatment of choice is ligation and resection. We present a case of pseudoaneurysm arising from STA after a penetrating injury caused by broken glass. We describe the history, findings of physical examination, Doppler sonography, angiography, histopathology, and the outcome of treatment. We also include a brief review of this condition.

Dacryocystitis associated with nasolacrimal duct cyst.

An infant presented with persistent epiphora after successful probing of the lacrimal system. Examination of the nose showed a cystic structure occluding lower portion of the lacrimal drainage system. In cases of recurrent obstruction, nasal examination and endoscopic marsupialization may help guide the clinician towards the most appropriate treatment.

Histopathologic changes in the olfactory epithelium in mice after exposure to sulfur dioxide.

To investigate the effects of sulfur dioxide (SO2) on olfactory epithelium, an experiment was performed with 56 mice from the same colony. Experimental animals were divided into three groups consisting of a 30-min exposure group (group 1), a 60-min exposure group (group 2), and a 120-min exposure group (group 3). The olfactory mucosa in these mice were studied by light microscopy immediately, and after 24 h, 48 h, or 72 h exposure to 20 ppm of SO2. Edema, loss of cilia, epithelial thinning, and epithelial desquamation in the olfactory epithelium were observed in groups 2 and 3. The basal lamina and the connective tissue were well preserved throughout the entire mucosa. Injuries to olfactory epithelium became severer with exposure time. These changes were further pronounced 24 h after exposure. Regenerated epithelia were not observed in any group. Scanning electron microscopic findings were consistent with light microscopic findings. Olfactory epithelial surface were consistent with light microscopic findings. Olfactory epithelial surface was sloughed off and revealed, underlining intact basal lamina. The results of this study suggest that early lesions of olfactory epithelium after exposure to SO2 may be primarily degenerative.