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Purpose@#To describe a case of ocular sarcoidosis manifesting as an atypical subretinal mass.Case summary: A 59-year-old woman reported reduced visual acuity in her left eye lasting for 1 month. Her best corrected visual acuity in the left eye had diminished to 0.3. A fundus examination revealed a whitish elevated lesion, approximately one disc diameter in size, in the perimacular area of the left eye. Optical coherence tomography identified a hyporeflective oval-shaped mass in the choriocapillaris region accompanied by subretinal fluid. Initial assessment suggested choroidal osteoma with choroidal neovascularization. Consequently, the patient underwent two intravitreal bevacizumab injections, which did not lead to improvement. To rule out systemic diseases, including syphilis, tuberculosis, and sarcoidosis, further radiologic and laboratory tests were conducted. A chest computed tomography highlighted mediastinal lymph node enlargement and pervasive nodules in both lung parenchymata, and serum angiotensin-converting enzyme levels were elevated to 77 U/L. Based on these findings, a diagnosis of sarcoidosis was confirmed, and the patient commenced treatment with oral prednisolone. Eight weeks after treatment, the subretinal lesion and fluid had resolved, and the best corrected visual acuity in the patient’s left eye had improved to 0.9. @*Conclusions@#Ocular sarcoidosis can manifest as a subretinal mass. This presentation should be differentiated from other subretinal lesions.
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Background@#Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO. @*Methods@#We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan–Meier (KM) method. @*Results@#Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010–1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312–7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004). @*Conclusion@#Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.
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Purpose@#To analyze the short-term efficacy and safety of omidenepag isopropyl 0.002% (w/v) in patients with primary open-angle glaucoma and ocular hypertension. @*Methods@#Data on 36 patients with primary open-angle glaucoma and ocular hypertension treated with omidenepag isopropyl 0.002% (w/v) from January 2021 to May 2022 were retrospectively analyzed. We investigated whether the drug lowered the intraocular pressure (IOP) at 1 and 3 months compared to baseline. Possible side effects were sought at each visit. @*Results@#The mean patient age was 59.2 years at the time of treatment. Of the 36 patients, 33 had primary open-angle glaucoma and 3 had ocular hypertension. The baseline IOP was 15.9 ± 3.6 mmHg, which significantly decreased to 13.7 ± 2.8 and 13.4 ± 2.9 mmHg at 1 and 3 months, respectively, following instillation of omidenepag isopropyl 0.002% (w/v) (both p < 0.01). Twelve patients (29.2%) experienced side effects including hyperemia, ocular pain, and itching but only two (5.5%) stopped using the medication. @*Conclusions@#In the short-term, ominedepag isopropyl 0.002% (w/v) is effective and safe in patients with primary open-angle glaucoma and ocular hypertension.
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Purpose@#We report a case of bilateral septic cavernous thrombosis caused by a dental infection.Case summary: A 58-year-old male was transferred to our hospital because of left-sided proptosis and eyelid swelling. The patient had fever and left temporal headache, which did not respond to oral and intravenous antibiotics. After experiencing a tooth injury while chewing hard food 3 months ago, the patient developed toothache and swelling around the tooth for which he did not take any treatment. The patient had left eyelid edema, ptosis, chemosis, and conjunctival congestion. The left eye movements were limited in all directions. Brain magnetic resonance imaging showed dilatation and thrombosis of the left superior ophthalmic vein and thrombosis of bilateral cavernous sinuses. The patient was treated with systemic antibiotics and anticoagulants. The blood culture showed growth of Parvimonas micra and Dialister Pneumosintes, which are common causes of dental infection. @*Conclusions@#Septic thrombosis of the cavernous sinus and superior ophthalmic vein thrombophlebitis can occur due to the spread of dental infection. Prompt diagnosis and treatment are important for rapid resolution of symptoms and good prognosis.
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Background and Objectives@#There have been several studies on the factors affecting posttonsillectomy bleeding; however, investigations on the relationship between postoperative bleeding and diet are insufficient. Different countries have different types of food, and while there have been studies on the effects of diet in other countries, no such studies have been reported in Korea. Therefore, we aimed to investigate the relationship between Korean diet and postoperative bleeding after tonsillectomy.Subjects and Method To compare the postoperative bleeding outcomes, patients who underwent tonsillectomy by a single surgeon between January 2017 and 2020 were divided into those who had a diet restriction after surgery and those who had a free diet. Postoperative bleeding outcomes were divided according to the degree of intervention for hemostasis and compared. @*Results@#The study included 115 and 124 patients in the diet-restricted group and free-diet group, respectively. There were no statistical differences between the two groups in terms of gender, age, presence of snoring and frequent tonsillitis, and surgical method. Bleeding occurred in four patients in the diet-restricted group and three patients in the free-diet group. There was no statistical difference between the two groups in the frequency and severity of postoperative bleeding. @*Conclusion@#Since dietary restriction after tonsillectomy was not helpful to prevent postoperative bleeding, a free and sufficient diet after surgery may prove to be better.
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Background and Objectives@#Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, and some patients require mechanical ventilation and tracheostomy. Owing to the risks of aerosol spreading to health care workers, the protocols and guidelines related to the novel timing and technique for tracheostomy are rapidly changing. We investigated the characteristics of tracheostomy with patients with COVID-19 over a year.Subjects and Method We measured the mean time from intubation to the tracheostomy, survival rate, the incidence of infection to medical staff, and operation time, complications for tracheostomy, and the time of decannulation. All patients underwent a novel percutaneous tracheostomy without bronchoscope (hybrid modified percutaneous dilatational tracheostomy, hybrid MPDT) in the negative pressure intensive care unit. @*Results@#Of the 448 patients with COVID-19 patients, 34 required invasive mechanical ventilation at a tertiary hospital from February 2020 to April 2021. Of those, 15 patients underwent tracheostomy. Of the tracheostomy patients, survival rate was 93.33%. The mean time from intubation to the tracheostomy was 18.27±14.74 days (range, 8-36 days). The incidence of infection to medical staff was zero percent whereas racheostomy-related bleeding was the most common complication (2 patients). Operation time for hybrid MPDT was 5.45±1.12 min. @*Conclusion@#The optimal timing of tracheostomy procedure for COVID-19 patients is still unknown, but it is believed that the treatment of COVID-19 can be achieved better if the hybrid MPDT is used at the right time.
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Background@#The quick sequential organ failure assessment (qSOFA) score is suggested to use for screening patients with a high risk of clinical deterioration in the general wards, which could simply be regarded as a general early warning score. However, comparison of unselected admissions to highlight the benefits of introducing qSOFA in hospitals already using Modified Early Warning Score (MEWS) remains unclear. We sought to compare qSOFA with MEWS for predicting clinical deterioration in general ward patients regardless of suspected infection. @*Methods@#The predictive performance of qSOFA and MEWS for in-hospital cardiac arrest (IHCA) or unexpected intensive care unit (ICU) transfer was compared with the areas under the receiver operating characteristic curve (AUC) analysis using the databases of vital signs collected from consecutive hospitalized adult patients over 12 months in five participating hospitals in Korea. @*Results@#Of 173,057 hospitalized patients included for analysis, 668 (0.39%) experienced the composite outcome. The discrimination for the composite outcome for MEWS (AUC, 0.777;95% confidence interval [CI], 0.770–0.781) was higher than that for qSOFA (AUC, 0.684;95% CI, 0.676–0.686; P < 0.001). In addition, MEWS was better for prediction of IHCA (AUC, 0.792; 95% CI, 0.781–0.795 vs. AUC, 0.640; 95% CI, 0.625–0.645; P < 0.001) and unexpected ICU transfer (AUC, 0.767; 95% CI, 0.760–0.773 vs. AUC, 0.716; 95% CI, 0.707–0.718; P < 0.001) than qSOFA. Using the MEWS at a cutoff of ≥ 5 would correctly reclassify 3.7% of patients from qSOFA score ≥ 2. Most patients met MEWS ≥ 5 criteria 13 hours before the composite outcome compared with 11 hours for qSOFA score ≥ 2. @*Conclusion@#MEWS is more accurate that qSOFA score for predicting IHCA or unexpected ICU transfer in patients outside the ICU. Our study suggests that qSOFA should not replace MEWS for identifying patients in the general wards at risk of poor outcome.
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Background@#A rapid response system (RRS) contributes to the safety of hospitalized patients. Clinical deterioration may occur in the general ward (GW) or in non-GW locations such as radiology or dialysis units. However, there are few studies regarding RRS activation in non-GW locations. This study aimed to compare the clinical characteristics and outcomes of patients with RRS activation in non-GW locations and in the GW. @*Methods@#From January 2016 to December 2017, all patients requiring RRS activation in nine South Korean hospitals were retrospectively enrolled and classified according to RRS activation location: GW vs non-GW RRS activations. @*Results@#In total, 12,793 patients were enrolled; 222 (1.7%) were non-GW RRS activations.There were more instances of shock (11.6% vs. 18.5%) and cardiac arrest (2.7% vs. 22.5%) in non-GW RRS activation patients. These patients also had a lower oxygen saturation (92.6% ± 8.6% vs. 88.7% ± 14.3%, P < 0.001) and a higher National Early Warning Score 2 (7.5 ± 3.4 vs. 8.9 ± 3.8,P < 0.001) than GW RRS activation patients. Although non-GW RRS activation patients received more intubation (odds ratio [OR], 3.135; P < 0.001), advanced cardiovascular life support (OR, 3.912; P < 0.001), and intensive care unit transfer (OR, 2.502;P < 0.001), their hospital mortality (hazard ratio, 0.630; P = 0.013) was lower than GW RRS activation patients upon multivariate analysis. @*Conclusion@#Considering that there were more critically ill but recoverable cases in non-GW locations, active RRS involvement should be required in such locations.
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Objectives@#. Crosshatching incision has been considered a useful method for correcting cartilaginous septal deviation. The aim of this study was to determine the utility and limitations of this approach. @*Methods@#. This retrospective case-control study included 353 patients who underwent septoplasty performed by a senior surgeon between January 2004 and December 2010. Patients were classified into two groups according to whether crosshatching incision was performed (n=151) during septoplasty or not (n=202). All other techniques performed during septoplasty were identical. The parameters of surgical success (improvement of nasal obstruction, correction of deviation, and acoustic rhinometry results) and adverse effects were compared between the groups. @*Results@#. There were no significant differences in the parameters of surgical success between the groups (improvement of nasal obstruction, P=0.333; correction of deviation, P=0.608; acoustic rhinometry results, P=0.322 for the difference in the minimal cross-sectional area; P=0.919 for difference in volume). Relative to patients who did not undergo the cross-hatching incision, patients with whom the technique was performed showed a significantly higher incidence of saddle nose (0/202 vs. 4/151 cases, P=0.033) and overcorrection (0/202 vs. 5/151 cases, P=0.014). @*Conclusion@#. Crosshatching incision during septoplasty did not produce better surgical outcomes; however, it caused adverse effects such as saddle nose and overcorrection. Therefore, the use of crosshatching incision should be re-evaluated.
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Malignant tumors rarely occur in the paranasal sinuses. Paranasal tumors, when they occur, exhibit atypical symptoms, such as nasal obstruction, rhinorrhea, facial pain, and nasal bleeding. Because of nonspecific symptoms commonly observed in the sinusitis and their infrequent occurrence, malignant tumors of the paranasal sinuses are generally diagnosed late. If there is bone destruction or invasion of the surrounding tissues in the imaging studies, malignant tumors could be suspected; however, without such findings, it is difficult to predict the existence of cancer. It is more difficult to suspect malignant tumors when they coexist with sinus diseases. In addition, since the concomitant presence of fungal balls and cancer is extremely rare, it is difficult to suspect the presence of cancer when treating fungal balls. We report a case of a fungal ball accompanied by squamous cell carcinoma without any sign of malignancy, such as bone destruction, which has not been reported in the English literature to date.
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Angiomyolipoma is a benign tumor that is composed of adipose tissue, blood vessels and smooth muscle. The kidney is the most common site for this tumor. Although extrarenal angiomyolipoma is rarely found in areas other than the kidney, it has been observed in other organs such as liver, heart, mediastinum, spermatic cord, vaginal wall, oral cavity, and so on. Angiomyolipoma in the nasal cavity especially, has been very rarely reported in literature. Furthermore, nasal angiomyolipoma is mostly found in middle aged or old men. In this case, angiomyolipoma was found in a 29-year-old male patient who was the youngest of the reported cases. He complained of nasal obstruction and physical examination revealed a 1.5 cm sized mass in the left posterior part of the nasal septum. The mass was composed of an intimate mixture of mature fat, smooth muscle cells, and thick walled varying sized blood vessels histopathologically coinciding with angiomyolipoma. It was removed via endoscopic surgery without complications.
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It is well known that the presence of arachnoid cysts (ACs) in young patients is a risk factor for developing a chronic subdural hematoma (CSDH) after a minor head injury. Although there have been controversies with the treatment, most authors recommend only draining the CSDH if the AC is asymptomatic. This judgement is based on the facts that this surgical approach has shown good clinical outcomes, and the AC usually remains unchanged after the surgery. Our case demonstrates that the AC of a young patient who developed a CSDH after a minor head injury completely disappeared after a burr hole drainage of the CSDH. Although the chances of an AC disappearing are low, this case shows that an AC might disappear after only draining a CSDH when a rupture of the AC membrane is identified. In such cases, we recommend first draining only the CSDH for the treatment of AC-associated CSDHs.
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Humanos , Quistes Aracnoideos , Aracnoides , Traumatismos Craneocerebrales , Drenaje , Hematoma Subdural Crónico , Membranas , Factores de Riesgo , RoturaRESUMEN
OBJECTIVE: Selecting an appropriate guiding catheter to provide both sufficient supportability for working devices and sufficient distal navigability is essential for ensuring the success of a procedure. This study aimed to evaluate the advantages and disadvantages of using the ENVOY 6F distal access (DA) guiding catheter in coil embolization of anterior circulation cerebral aneurysms.METHODS: We included 98 patients (72 [73.5%] women, median age: 63 [range: 25–84] years) who underwent endovascular coiling with the ENVOY 6F DA guiding catheter from May to November 2016. We analyzed data on patient demographics and the number of co-axial techniques to position the guiding catheter, initial and final location of the catheter, and complications related to the catheter.RESULTS: The co-axial technique was used to position the ENVOY 6F DA guiding catheter in the internal carotid artery (ICA) in 20 cases (20.41%). The initial position of the ENVOY 6F DA guiding catheter involved the cervical ICA (79.6%), horizontal petrous ICA (17.3%), and vertical petrous ICA (3.1%). Final control angiograms after endovascular coiling showed proximal change in the final, compared to the initial, position of the ENVOY 6F DA guiding catheter in 25 cases (25.51%). Procedure-related complications were observed in nine patients (9.18%), involving vasospasm in all cases; however, there was no symptomatic case.CONCLUSION: The ENVOY 6F DA guiding catheter had relatively sufficient distal navigability without symptomatic procedural complications. However, the change in the catheter position after endovascular coiling denoted insufficient supportability.
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Femenino , Humanos , Aneurisma , Arterias Carótidas , Arteria Carótida Interna , Cateterismo , Catéteres , Circulación Cerebrovascular , Demografía , Embolización Terapéutica , Aneurisma IntracranealRESUMEN
BACKGROUND: The lack of medical personnel has led to the employment of hospitalists in Korean hospitals to provide high-quality medical care. However, whether hospitalists' care can improve patients' outcomes remains unclear. We aimed to analyze the outcome in patients cared for by hospitalists. METHODS: A retrospective review was conducted in 1,015 patients diagnosed with pneumonia or urinary tract infection from March 2017 to July 2018. After excluding 306 patients, 709 in the general ward who were admitted via the emergency department were enrolled, including 169 and 540 who were cared for by hospitalists (HGs) and non-hospitalists (NHGs), respectively. We compared the length of hospital stay (LOS), in-hospital mortality, readmission rate, comorbidity, and disease severity between the two groups. Comorbidities were analyzed using Charlson comorbidity index (CCI). RESULTS: HG LOS (median, interquartile range [IQR], 8 [5–12] days) was lower than NHG LOS (median [IQR], 10 [7–15] days), (P < 0.001). Of the 30 (4.2%) patients who died during their hospital stay, a lower percentage of HG patients (2.4%) than that of NHG patients (4.8%) died, but the difference between the two groups was not significant (P = 0.170). In a subgroup analysis, HG LOS was shorter than NHG LOS (median [IQR], 8 [5–12] vs. 10 [7–16] days, respectively, P < 0.001) with CCI of ≥ 5 points. CONCLUSION: Hospitalist care can improve the LOS of patients, especially those with multiple comorbidities. Further studies are warranted to evaluate the impact of hospitalist care in Korea.
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Humanos , Comorbilidad , Servicio de Urgencia en Hospital , Empleo , Mortalidad Hospitalaria , Médicos Hospitalarios , Corea (Geográfico) , Tiempo de Internación , Habitaciones de Pacientes , Neumonía , Estudios Retrospectivos , Infecciones UrinariasRESUMEN
PURPOSE: We compared the oncologic outcomes of breast-conserving surgery plus radiation therapy (BCS+RT) and modified radical mastectomy (MRM) under anthracycline plus taxane-based (AT) regimens and investigated the role of adjuvant radiation therapy (RT) in patients with pathologic N1 (pN1) breast cancer treated by mastectomy. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 2,011 patients with pN1 breast cancer who underwent BCS+RT or MRM alone at 12 institutions between January 2006 and December 2010. Two-to-one propensity score matching was performed for balances in variables between the groups. RESULTS: The median follow-up duration for the total cohort was 69 months (range, 1 to 114 months). After propensity score matching, 1,074 patients (676 in the BCS+RT group and 398 in the MRM-alone group) were analyzed finally. The overall survival, disease-free survival, locoregional failure-free survival, and regional failure-free survival (RFFS) curves of the BCS+RT group vs. MRM-alone group were not significantly different. The subgroup analysis revealed that in the group with both lymphovascular invasion (LVI) and histologic grade (HG) III, the BCS+RT showed significantly superior RFFS (p=0.008). Lymphedema (p=0.007) and radiation pneumonitis (p=0.031) occurred more frequently in the BCS+RT group than in the MRM-alone group, significantly. CONCLUSION: There are no differences in oncologic outcomes between BCS+RT and MRM-alone groups under the AT chemotherapy regimens for pN1 breast cancer. However, BCS+RT group showed superior RFFS to MRM-alone group in the patients with LVI and HG III. Adjuvant RT might be considerable for pN1 breast cancer patients with LVI and HG III.
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Humanos , Antraciclinas , Neoplasias de la Mama , Mama , Estudios de Cohortes , Supervivencia sin Enfermedad , Quimioterapia , Estudios de Seguimiento , Linfedema , Mastectomía , Mastectomía Radical Modificada , Mastectomía Segmentaria , Registros Médicos , Puntaje de Propensión , Neumonitis por Radiación , Estudios RetrospectivosRESUMEN
OBJECTIVES: There is a great deal of interest in the possibility that environmental factors may influence the risk of developing allergic rhinitis (AR) in early life. We investigated the simultaneous effects of mode of delivery and duration of breastfeeding on the development of AR in children. METHODS: Data from 1,374 children participating in the Allergic Rhinitis Cohort Study for kids (ARCO-kids study) was analyzed. All subjects were divided into AR or non-allergic rhinitis (NAR) groups. Data on environmental factors, mode of delivery and duration of breastfeeding were collected using a questionnaire. RESULTS: Compared with short-term breastfeeding (<6 months), long-term breastfeeding (≥12 months) was significantly associated with a lower prevalence of AR (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.34 to 0.88). Children in the AR group also had a higher cesarean delivery rate than those in the NAR group (39.1% vs. 32.8%, P=0.05). Regarding the combined effects of mode of delivery and duration of breastfeeding, long-term breastfeeding with a vaginal delivery strongly suppressed the development of AR, compared to short-term breastfeeding with a cesarean delivery (aOR, 0.47; 95% CI, 0.30 to 0.73). CONCLUSION: Long-term breastfeeding (≥12 months) and a vaginal delivery are associated with a lower risk of developing childhood AR.
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Niño , Femenino , Humanos , Embarazo , Lactancia Materna , Cesárea , Estudios de Cohortes , Parto Obstétrico , Oportunidad Relativa , Prevalencia , Rinitis , Rinitis AlérgicaRESUMEN
BACKGROUND: Since the first report of a rapidly resolved subdural hemorrhage (SDH) in 1986, few additional case reports have been presented in the literature. CASE REPORT: An 82-year-old female patient presented with a SDH over the left convexity. The SDH was removed via catheter drainage through a burr hole trephination. Post-operative computed tomography (CT) following 300 mL drainage from the chronic SDH demonstrated a newly developed SDH along the right convexity. A follow-up CT performed 2 hours later revealed an unexpected significant resolution of the acute SDH. CONCLUSION: The spontaneous resolution of acute SDH is believed to result from redistribution by washout of the hematoma by cerebrospinal fluid dilution. However, its exact pathophysiology is not well understood. When surgical evacuation is considered in acute SDH, conservative management should also be considered because spontaneous resolution of hemorrhage remains a possibility.
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Anciano de 80 o más Años , Femenino , Humanos , Catéteres , Líquido Cefalorraquídeo , Drenaje , Estudios de Seguimiento , Hematoma , Hematoma Subdural , Hematoma Subdural Crónico , Hemorragia , TrepanaciónRESUMEN
BACKGROUND AND OBJECTIVES: The effectiveness of turbinate surgery has been well demonstrated in allergic rhinitis refractory to medication. On the contrary, the efficacy of surgery in allergic rhinitis that responds to medication has not been assessed. The aim of this study was to determine the surgical outcomes in patients with allergic rhinitis responsive to medication. SUBJECTS AND METHOD: Patients with allergic rhinitis responsive to medication and those who had undergone coblation turbinate reduction were enrolled in this study. The visual analog scale was used to assess the allergic symptoms before treatment, during medication treatment as well as postoperatively at 6 and 12 months. In addition, the degree of patient satisfaction regarding the surgery was investigated postoperatively at 12 months. RESULTS: Twenty-four patients (mean age=33.6±14.9 years; men-to-women ratio=1:1) were included in this study. During the pretreatment period, all allergic symptoms significantly improved after treatment with both medication and surgery. At 6 months postoperatively, the degree of patients' allergic symptoms was lower than in those treated with medication. However, when compared at 12 months postoperatively, all the symptoms, excluding nasal obstruction, were not significantly different from those who received medication. Surveyed postoperatively at 12 months 54.2% of patients advocated for surgical treatment. CONCLUSION: Although surgery yielded better outcome than did medication during the early postoperative period, there was little difference in the outcome at 12 months postoperatively. Therefore, we need to be careful when choosing surgical intervention for patients with allergic rhinitis responsive to medication.
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Humanos , Métodos , Obstrucción Nasal , Satisfacción del Paciente , Periodo Posoperatorio , Tratamiento de Radiofrecuencia Pulsada , Rinitis Alérgica , Resultado del Tratamiento , Cornetes Nasales , Escala Visual AnalógicaRESUMEN
Solitary fibrous tumor is a rare spindle cell neoplasm of mesenchymal origin that occurs most commonly in the pleura. This tumor can be found in various extrathoracic sites that contain soft tissue. There are few reports of solitary fibrous tumors in the head & neck and only 5 cases of solitary fibrous tumors of the cheek have been reported. A 53-year-old man visited our department complaining of a firm mass in the left cheek. We suspected a schwannoma originating from the infraorbital nerve. The mass was removed via a gingivobuccal approach and was diagnosed as a solitary fibrous tumor.
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Humanos , Persona de Mediana Edad , Mejilla , Cabeza , Cuello , Neurilemoma , Pleura , Tumores Fibrosos SolitariosRESUMEN
BACKGROUND AND OBJECTIVES: Various techniques have been reported for the correction of deviated nasal septum, most of them for caudal septal cartilage. For deviated posterior septal cartilage, the typical method of the day is the resection of deviated portion. However, we developed a bone anchoring technique that conservatively corrects deviated posterior septal cartilage. The aim of the current study is to determine the efficacy of this bone anchoring technique. SUBJECTS AND METHOD: The patients who had undergone septoplasty using bone anchoring technique by a single surgeon (J.S.K) between October 2015 and June 2016 were enrolled in this study. The result of the surgery was evaluated using a visual analogue scale (VAS, ranged 0– 10) for nasal obstruction, acoustic rhinometry, and assessment of surgeon. RESULTS: A total of 44 patients were included in this study. The VAS of nasal obstruction was significantly decreased after surgery from 7.5±1.7 to 2.4±1.4. In acoustic rhinometry, minimal cross-sectional area and volume were increased after surgery from 0.35±0.18 to 0.52±1.40 cm2 and from 3.6±1.1 to 5.8±1.5 cm3, respectively. Most of the deviated septum was well corrected, and complication or recurrence did not developed. CONCLUSION: Bone anchoring technique is easy to perform. It enables the preservation of septal cartilage, which is useful in revision septoplasty or rhinoplasty. We conclude that this technique is a good method for the correction of deviated posterior septal cartilage.