Comparison of Sodium Thiosulfate Solution and a Mixture of Diflucortone Valerate and Isoconazole Nitrate for Pityriasis Versicolor / 대한피부과학회지

Background@#Skin diseases associated with Malassezia species include malassezia folliculitis, pityriasis versicolor, and seborrheic dermatitis. Although several treatment options are available for the treatment of pityriasis versicolor, there is a lack of research data on sulfur preparation, which is a time-honored therapeutic agent; furthermore, data comparing topical antifungal agent and sulfur preparation is not available. @*Objective@#The purpose of this study was to compare the efficacy and usefulness of a mixture of diflucortone valerate 1 mg/g and isoconazole nitrate 10 mg/g ointment (Travocort) and sodium thiosulfate solution 25% for pityriasis versicolor. @*Methods@#A retrospective review was performed with 185 patients diagnosed with pityriasis versicolor who presented to the Department of Dermatology, Daegu Catholic University Medical Center between August 2002 and December 2021. @*Results@#Of the 185 patients, 82 used Travocort while 103 used sodium thiosulfate solution. The average duration of the treatment was 19.3 days for Travocort and 28.8 days for sodium thiosulfate solution (p=0.001). The success rate of the treatment after 2 weeks was 65.8% for Travocort and 56.3% for sodium thiosulfate solution. Side effects occurred in 12.1% and 4.8% of the patients in the Travocort and sodium thiosulfate solution group, respectively. @*Conclusion@#Travocort had a faster healing rate than sodium thiosulfate solution. However, topical antifungal agents can cause side effects like localized cutaneous reaction. Furthermore, the glucocorticoid portion in combination therapy may induce various side effects with long-term use. Therefore, considering the side effects of Travocort, sodium thiosulfate solution can be used as a safe alternative when long-term treatment is required.

Corrective Septorhinoplasty in Acute Nasal Bone Fractures

OBJECTIVES: Closed reduction is generally recommended for acute nasal bone fractures, and rhinoplasty is considered in cases with an unsatisfactory outcome. However, concomitant rhinoplasty with fracture reduction might achieve better surgical outcomes. This study investigated the surgical techniques and outcomes in patients who underwent rhinoplasty and fracture reduction concomitantly, during the acute stage of nasal bone fracture. METHODS: Forty-five patients who underwent concomitant rhinoplasty and fracture reduction were enrolled. Nasal bone fractures were classified into three major types (type I, simple fracture; type II, fracture line that mimics nasal osteotomy; and type III, comminuted fracture) based on computed tomography images and preoperative facial images. Two independent otolaryngology-head and neck surgeons evaluated the surgical outcomes and telephone based survey were made to evaluate patients satisfaction. RESULTS: Among 45 patients, there were 39 males and 6 females. Type I was the commonest type of fracture with 18 patients (40%), while the most frequently used surgical technique for corrective surgery was dorsal augmentation with 44 patients (97.8%). The mean visual analogue scale satisfaction score of the surgeons and patients were 7.62 and 8, respectively, with no significant differences between fracture types. CONCLUSION: Concomitant rhinoplasty with fracture reduction can be performed for acute nasal bone fracture patients, and it might lead to better aesthetic outcomes.

A Case of Adenosquamous Carcinoma Ex Pleomorphic Adenoma of Submandibular Gland / 대한이비인후과학회지

We experienced a case of carcinoma ex pleomorphic adenoma arising in the submandibular gland of a 47-year-old male patient. The patient underwent submandibular gland ressection and supraomohyoid neck dissection. Histologic examination revealed that the malignant component of carcinoma ex pleomorphic adenoma was adenosquamous carcinoma. The patient refused postoperative radiation therapy and tumor recurred at the neck and lung about 18 month later. Modified radical neck dissection was carried out, and additional postoperative radiotherapy and palliative chemotherapy were initiated. To the best of our knowledge, this is the first case of carcinoma ex pleomorphic adenoma, of which the malignant component is adenosquamous carcinoma in the submandibular gland. Therefore the authors report this rare case with a literature review.

Clinical Characteristics of Bilateral Chronic Otitis Media / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to determine the prevalence of bilateral chronic otitis media (BCOM) and the ratio of unilateral or bilateral cholesteatoma in BCOM. Pre- and post-operative hearing were analyzed to see if bilateral balanced hearing were achieved. SUBJECTS AND METHOD: A retrospective review was done with a computerized otologic database to identify all patients who underwent surgical treatments for COM between 1998 and 2011, and has a follow up duration for at least 6 months. Comparative analysis between pre- and post-operation hearing was measured by pure tone audiometry and achievement of bilateral balanced hearing was analyzed with 'The Belfast rule of thumb'. RESULTS: Two hundred and eighty-one (14.5%) of 1938 patients suffered from BCOM, and of these, 73 (25.9%) of the patients with BCOM had cholesteatomas in one (12.4%) or both ears (13.5%). When a patient with BCOM is found with cholesteatoma in one ear, the odds of there being cholesteatoma in the other ear was 52.1%. According to 'The Belfast rule of thumb', it is considered difficult to achieve successful bilateral hearing gains sufficient for the patients to perceive subjective hearing improvements in BCOM. CONCLUSION: Approximately 15% of the COM patients were found with the disease in both ears, and the odds of a patient with BCOM having cholesteatoma in one ear also having cholesteatoma in the other ear was 53.4%. It was difficult to achieve subjective, successful and balanced bilateral hearing gain with three-dimensional hearing improvements.

Two Cases of Epiphora Following Le Fort I Osteotomy / 대한이비인후과학회지

The lacrimal drainage system begins at the puncta and empties through the valve of Hasner into the inferior meatus. The varieties of the anatomic location, size and morphology of this valve can predispose susceptible individuals to an increased incidence of iatrogenic injury during nasal surgical procedures, thus necessitating a comprehensive understanding of the system. We report two cases of epiphora following two-jaw surgeries for cosmetic purposes. Nasolacrimal duct obstructions were diagnosed, and the symptoms were improved with dacryocystorhinostomies.

Clinical Characteristics of Labyrinthine Concussion

BACKGROUND AND OBJECTIVES: Inner ear symptoms like hearing loss, dizziness or tinnitus are often developed after head trauma, even in cases without inner ear destruction. This is also known as labyrinthine concussion. The purpose of this study is to determine the clinical manifestations, characteristics of audiometry and prognostic factors of these patients. MATERIALS AND METHODS: We reviewed the medical records of the 40 patients that had been diagnosed as labyrinthine concussion from 1996 to 2007. We studied the hearing levels in each frequency and classified them according to type and degree of hearing loss. Rates of hearing improvement were evaluated according to age, sex, hearing loss type, degree and presence of dizziness or tinnitus. To find out any correlation between hearing improvement and these factors, we used chi2 test or Fisher's exact test. RESULTS: Bilateral hearing loss was observed in 22 patients, and unilateral hearing loss in 18 patients. There were 4 (6.5%) ascending, 34 (54.8%) descending, 24 (38.7%) flat type hearing loss, which indicated hearing loss was greater in high frequencies than low frequencies. Among 62 affected ears, 20 (32.3%) gained improvement, and it was achieved mainly in low frequencies. There were only 2 ears with dizziness in 20 improved ears and among 20 dizziness accompanied ears, also only 2 ears were improved. CONCLUSIONS: High frequencies are more vulnerable to trauma than low frequencies. The hearing gain is obtained mainly in low frequencies, and association with dizziness serves poor prognosis.