A Case of An Inverted Papilloma Originating From a Lacrimal Sac / 대한이비인후과학회지

Inverted papillomas are benign but invasive tumors with malignant potential characterized by a high recurrence rate. Although most cases arise from the nasal wall and paranasal sinuses, inverted papillomas originating from the nasolacrimal system have been rarely reported. We describe a rare case of an inverted papilloma in the left nasal cavity, which originated from the lacrimal sac in a 40-year-old female who had a medical history of endoscopic dacryocystorhinostomy at the department of ophthalmology. At first, it was believed to be an inverted papilloma simply occurring in the nasal cavity, but after several recurrences, it was found to originate from the lacrimal sac. All intranasal lesions and the involved lacrimal sac were removed through cooperative surgery between department of otolaryngology and ophthalmology. This case illustrates the importance of including nasolacrimal system in differentiating the origin of inverted papilloma.

Application of Three Dimensional-Printed Polycaprolactone Nasal Mesh With the Figure of 8 Anchoring Suture Technique for Correction of Caudal Septal Subluxation / 대한이비인후과학회지

Background and Objectives@#We evaluated the symptom improvement, surgical outcomes and post-operative complications of the figure of 8 anchoring suture technique using polycaprolactone (PCL) nasal mesh for the treatment of caudal septal subluxation.Subjects and Method We conducted a retrospective study of patients who underwent between March 2020 and March 2021 endonasal septoplasty using the figure of 8 anchoring suture technique and a PCL nasal mesh as a protective supporting graft. Fourteen patients were divided into two groups, the allergic and non-allergic rhinitis group. Symptom improvements were assessed using the Nasal Obstruction Symptoms Evaluation (NOSE) scores and visual analog scale (VAS) scores for epistaxis and headache. Post-operative patient-reported subjective changes in nasal obstruction were also recorded. All evaluations were conducted one to four months post-operatively. @*Results@#Post-operative endoscopic examination revealed that all patients had their septum straightened. The mean post-operative NOSE scores in overall and each item were significantly lower than the mean NOSE scores in the pre-operative period (p<0.05). The mean post-operative NOSE scores for patients both with and without allergic rhinitis were also significantly decreased compared to those in the pre-operative period (p<0.05). A decrease in VAS scores was significant (p=0.008) for headache but not for epistaxis (p=0.141). All patients reported improvement of subjective nasal obstruction post-operatively. @*Conclusion@#The use of figure of 8 anchoring suture technique with a PCL nasal mesh as a protective and supportive graft was proven to be a successful method for correcting caudal septal subluxation.

Tumor Necrosis Factor-Alpha and Interleukin-4 Levels in Patients With Idiopathic Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

Background and Objectives@#The pathogenesis of idiopathic sudden sensorineural hearing loss (ISSNHL), an otologic emergency disease, remains unclear. Several studies have attempted to illustrate the association between cytokines and ISSNHL. The purpose of this study was to evaluate the prognostic significance of various cytokines in patients with ISSNHL. Subjects and Method In this case-control study, a total of 55 patients with ISSNHL underwent treatment with oral prednisolone for 2 weeks. Serum cytokine levels, including interleukins (ILs) (IL-1a, IL-1b, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12), and tumor necrosis factors (TNF-α and TNF-β), were measured using human cytokine panels at first visit. Patient characteristics such as age, gender, the status of hypertension, diabetes mellitus, vertigo, time from onset to visit, and initial hearing levels were also evaluated. @*Results@#Serum levels of cytokines were correlated with the prognosis of ISSNHL patients. IL-4 ≥0.225 (pg/mL) and TNF-α ≥5.155 (pg/mL) were significantly associated with poor therapeutic outcomes (OR=44.317, p=0.015 and OR=269.465, p=0.006, respectively). In addition, age and initial hearing levels were also significant prognostic factors. @*Conclusion@#Patients’ age, initial hearing levels, and serum levels of IL-4 and TNF-α prior to treatment are associated with hearing recovery and can be used as prognostic factors for patients with ISSNHL.

Current Update of Local Allergic Rhinitis / 대한이비인후과학회지

Local allergic rhinitis (LAR) is a localized nasal allergic response in the absence of systemic atopy. The symptoms, duration, severity, and comorbidities of LAR are similar to those of allergic rhinitis. Although pathophysiology of LAR is not fully understood, in some patients specific IgE can be demonstrated in the nasal secretions. The diagnosis currently relies on the positive results of nasal provocation test. Nasal provocation test has shown high sensitivity and specificity with safety, and is considered as the gold standard. LAR patients benefit from the same therapeutic strategies as allergic rhinitis patients, including the avoidance of allergen exposure and the pharmacotherapy. Effectiveness and safety of allergen immunotherapy open a window of treatment opportunity in LAR. This review provides a current update on LAR.

Intramuscular Hemangioma of the Sternocleidomastoid Muscle: An Unusual Neck Mass / 대한이비인후과학회지

Hemangiomas are the most common benign tumors in infancy, occurring most often on cutaneous and mucosal surfaces. Although less than 1% of hemangiomas occur in skeletal muscle, 15% of intramuscular hemangiomas arise in the head and neck musculature. Less than 10 cases of the sternocleidomastoid muscle have been reported in the English literatures. The masseter muscle is most commonly involved in the head and neck. Clinically, these tumors are present as distinct, localized, rubbery swelling. Neck computed tomography scan with enhancement may suggest a vascular mass within the muscle while angiography may detect feeding arteries in large intramuscular hemangiomas. The treatment of the hemangiomas is based on location, accessibility, depth of invasion, age, and cosmetic considerations. The optimal treatment is complete wide resection including the cuff of surrounding muscle. We report a case of hemangioma that occurred in the sternocleidomastoid muscle along with a with literature review.

Intramuscular Hemangioma of the Sternocleidomastoid Muscle: An Unusual Neck Mass / 대한이비인후과학회지

Hemangiomas are the most common benign tumors in infancy, occurring most often on cutaneous and mucosal surfaces. Although less than 1% of hemangiomas occur in skeletal muscle, 15% of intramuscular hemangiomas arise in the head and neck musculature. Less than 10 cases of the sternocleidomastoid muscle have been reported in the English literatures. The masseter muscle is most commonly involved in the head and neck. Clinically, these tumors are present as distinct, localized, rubbery swelling. Neck computed tomography scan with enhancement may suggest a vascular mass within the muscle while angiography may detect feeding arteries in large intramuscular hemangiomas. The treatment of the hemangiomas is based on location, accessibility, depth of invasion, age, and cosmetic considerations. The optimal treatment is complete wide resection including the cuff of surrounding muscle. We report a case of hemangioma that occurred in the sternocleidomastoid muscle along with a with literature review.

Clinical Characteristics of Benign Oral Cavity Tumors: A Single-Institution Retrospective Study of 257 Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The study aimed to analyze the histopathologic types and clinical characteristics of benign oral cavity tumors and to identify their possible etiologic factors. SUBJECTS AND METHOD: This was a 10-year retrospective analysis of histologically diagnosed benign tumors in the oral cavity. Data was compiled for each case, documenting information about gender, age, habits (smoking and alcohol), characteristics of the lesion (site, size, color, surface and consistency), comorbidities and denture. RESULTS: Of 257 pathologically confirmed cases of excisional biopsies, the most prevalent were in the order of mucocele (47.08%), fibroma (14.79%), and hemangioma (9.34%). Labium (50.19%) and oral tongue (22.18%) were among the most frequently affected sites. In this study, there was a significant female predominance in fibroma and granuloma. On comparing the mean age of the patients for the different types of tumors, we found that mucocele had the lowest age and that there is a similar mean age among the tumors. The vast majority (99.2%) was represented by non-ulcerated masses and only 2 (0.8%) were ulcerative masses. With respect to habits, we found no significance between comorbidities and denture. CONCLUSION: Based on this study, we can state that while mucocele is the most frequent benign tumor of the oral cavity, labium is the most frequently affected site. The mean age of the patients is lowest for mucocele, and there is a high prevalence of fibroma and granuloma occurring among females. However, with respect to habits, we found no significance between comorbidities and denture.

A Case of a Primary Branchiogenic Carcinoma with a Synchronous Tonsil Squamous Cell Carcinoma / 대한이비인후과학회지

Branchiogenic carcinoma (BC), which is defined as squamous cell carcinoma arising from a branchial cyst, was first described by Volkmann in 1882. This rare disease is regarded as hypothetical, and remains a controversial disease entity. Among the diagnostic criteria of BC, the key point is the histologic demonstration of a cancer developing from the wall of an epithelial-lined cyst in the lateral site of the neck. In previous literature, many authors argued that this malignancy is actually cystic metastasis from oropharyngeal squamous cell carcinoma. We report a case of a 49-year-old female who was diagnosed as a primary BC patient with a synchronous tonsillar squamous cell carcinoma. Although this case did not meet the traditional diagnostic criteria because of existing tonsil cancer, we could diagnose these diseases as primary malignancies, since the transition zone was clearly seen, and there was no lymph node component in the histopathologic examination.

Transcriptome analysis and promoter sequence studies on early adipogenesis in 3T3-L1 cells

To identify regulatory molecules which play key roles in the development of obesity, we investigated the transcriptional profiles in 3T3-L1 cells at early stage of differentiation and analyzed the promoter sequences of differentially regulated genes. One hundred and sixty-one (161) genes were found to have significant changes in expression at the 2nd day following treatment with differentiation cocktail. Among them, 86 transcripts were up-regulated and 75 transcripts were down-regulated. The 161 transcripts were classified into 10 categories according to their functional roles; cytoskeleton, cell adhesion, immune, defense response, metabolism, protein modification, protein metabolism, regulation of transcription, signal transduction and transporter. To identify transcription factors likely involved in regulating these differentially expressed genes, we analyzed the promoter sequences of up- or -down regulated genes for the presence of transcription factor binding sites (TFBSs). Based on coincidence of regulatory sites, we have identified candidate transcription factors (TFs), which include those previously known to be involved in adipogenesis (CREB, OCT-1 and c-Myc). Among them, c-Myc was also identified by our microarray data. Our approach to take advantage of the resource of the human genome sequences and the results from our microarray experiments should be validated by further studies of promoter occupancy and TF perturbation.