A Case of Posterior Ischemic Optic Neuropathy after Endoscopic Sinus Surgery / 대한이비인후과학회지

Recently, endoscopic sinus surgery (ESS) has been acknowledged as a standard surgical procedure for the treatment of chronic rhinosinusitis. Orbital complications of varying degrees that may occur during ESS have been widely reported. Blindness, one of the major complications that can occur during or immediately after ESS, is mainly attributed to orbital hematoma or direct injury to the optic nerve. In contrast to such direct mechanical trauma caused during ESS, we report a case of acute loss of vision that followed ESS without a definite cause. A postulated mechanism for idiopathic optic neuropathy is that it is ischema resulted from vasospasm in the branches of ophthalmic artery due to topical use of vasoconstrictive agents. Otorhinolaryngologists should be aware that this condition may occur following an uncomplicated ESS procedure. When loss of sight is diagnosed postoperatively, patients should be given prompt ophthalmological consultation and possible causes should be considered.

Recent Trends of Laryngopharyngeal Reflux Disease / 대한이비인후과학회지

Laryngopharyngeal reflux disease (LPRD) refers to the retrograde flow of gastric content to the laryngopharynx, where it comes in contact with tissues of the upper aerodigestive tract. In Korea, up to 1 out of every 5 patients who visit otorhinolaryngology clinic is supposed to have LPRD with symptoms and physical findings. In the absence of definite diagnostic criteria, LPRD is suspected when the history and laryngoscopy findings are suggestive of the diagnosis. A diagnosis of LPRD is usually based on response of symptoms to empirical treatment. Most patients with LPRD are treated with proton pump inhibitor with education of life style modification, but there is still little or no solid evidence on the treatment as well as the diagnosis. Failure to respond to a usual treatment suggests the need for confirmatory studies and consideration of alternative diagnoses. LPRD appears to be a common but controversial disorder, with conflicting data on pathophysiology, diagnosis, and treatment. Whereas trends are observed and many clinical practices are accepted widely on the basis of experience, we need definitive, prospective, evidence-based studies. In this article, we will review current concept of diagnosis and treatment of LPRD.

3 Cases of Acute Retropharyngeal Calcific Tendinitis Misconceived as Acute Retropharyngeal Abscess / 대한이비인후과학회지

Acute retropharyngeal calcific tendinitis or calcific tendinitis of the longus is an under-recognized clinical syndrome first described by Hartley in 1964. This syndrome is caused by calcium hydroxylapatate deposition in the longus colli muscle and tendon. Patients typically present with acute neck pain, neck spasm, a restrained range of motion, odynophagia, dysphagia and sore throat. Clinically, it can be misconceived as acute retropharyngeal abscess because of its rather non-specific presentation and rare occurrence. Diagnosis of retropharyngeal calcific tendinitis can be made radiographically with plain radiograph and CT by detecting calcifications anterior to C1-C3 and swelling prevertebral soft tissue. Recognizing this radiologic imaging findings and features can prevent unnecessary treatment and test. We report three patients with acute prevertebral calcific tendinitis, which was misdiagnosed as acute retropharyngeal abscess.

A Case of Pleomorphic Rhabdomyosarcoma of Maxillary Sinus Accompanied with Inverted Papilloma / 대한이비인후과학회지

Rhabdomyosarcoma is an aggressive malignant tumor rarely developing in the head and neck in adults. In the sinonasal region, rhabdomyosarcoma constitutes a clinically important group because of the difficulty of surgical resection and its generally poor prognosis. Inverted papilloma is a relative rare and benign sinonasal lesionconstituting 0.5% to 4% of all nasal tumors that has a known propensity for recurrence, local aggressiveness, and association with transformation to malignancy. Squamous cell carcinoma is the major malignancy that is associated with inverted papilloma. To our knowledge, this is the first case report of pleomorphic rhabdomyosarcoma accompanied with inverted papilloma, and we represent the case with a review of the related literatures.