Carotid Arterial Calcium Scoring Using Upper Airway Computed Tomography in Patients with Obstructive Sleep Apnea: Efficacy as a Clinical Predictor of Cerebrocardiovascular Disease

OBJECTIVE: To evaluate the value of airway computed tomography (CT) in patients with obstructive sleep apnea (OSA) as a predictor of cerebrocardiovascular disease (CCVD) clinically, by quantitatively analyzing carotid arterial calcification (CarAC). MATERIALS AND METHODS: This study included 287 patients aged 40–80 years, who had undergone both polysomnography (PSG) and airway CT between March 2011 and October 2015. The carotid arterial calcium score (CarACS) was quantified using the modified Agatston method on each upper airway CT. The OSA severity was categorized as normal, mild, moderate, and severe using the PSG results. Clinical characteristics, comorbid diseases, and lipid profiles of all patients were analyzed, and the prevalence of CCVDs was investigated during the follow up period (52.2 ± 16.0 months). RESULTS: CCVD occurred in 27 patients (9.3%) at the end of follow-up, and the CCVD-present groups showed a significantly older mean age (57.5 years vs. 54.2 years), higher prevalence of hypertension (59% vs. 34%) and CarAC (51.9% vs. 20.8%), whereas sex, other comorbid diseases, and severity of OSA were not significantly different from the CCVD-absent group. A univariate analysis showed that age, hypertension, incidence of CarAC, and CarACS were risk factors for the occurrence of CCVD events. In a multivariate analysis, the incidence of CarAC was the only independent risk factor for CCVD. CONCLUSION: CarAC is an independent risk factor for CCVD, whereas the severity of OSA is not a contributory risk factor in patients with OSA. Therefore, additional analysis of CarACS based on airway CT scans may be useful for predicting CCVD.

A Case of Adenosquamous Carcinoma Arising from the Base of Tongue / 대한이비인후과학회지

Adenosquamous carcinoma (ASC) of the head and neck is a rare malignancy. This entity was first described in 1968 by Gerughty, et al. Nowadays, ASC is defined in the World Health Organization classification of tumors of the upper respiratory tract and ear as a malignant tumor with histological features of both adenocarcinoma and squamous cell carcinoma. We report a case of adenosquamous carcinoma arising from the base of tongue salvaged by transoral robotic surgery with review of literature.

Atypical Angiofibroma Originating from the Inferior Turbinate / 대한이비인후과학회지

Angiofibromas arise from soft tissue, but occur rarely in the nasal cavity. Of these, only six cases have risen from inferior turbinate. Six such cases have been reported previously in English literature and only 1 case in Korea. We present an atypical case of an angiofibroma arising from the inferior turbinate in a 57-year-old woman. The mass was removed with endoscopic approach without massive bleeding.