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Background and Objectives@#This study was investigated to compare the clinical outcomes and complications of powered intracapsular tonsillectomy and adenoidectomy (PITA) with those of conventional extracapsular tonsillectomy and adenoidectomy (ECTA) in treatment of pediatric obstructive sleep apnea (OSA).Subjects and Method Eighty-one children with adenotonsillar hyperplasia underwent tonsillectomy and adenoidectomy (46 PITA and 35 ECTA) from December 2016 to July 2017 for OSA. The choice of surgical procedure (PITA vs. ECTA) was determined by the number of episodes of acute tonsillitis. The quality of life measurement was performed using Korean Obstructive Sleep Apnea Survey (KOSA-18) score. Postoperative bleeding was assessed as number of revisit or readmission. Postoperative pain was evaluated by visual analog scale (VAS) at postoperative day 1, 3, and 7. @*Results@#PITA and ECTA significantly reduced KOSA-18 scores postoperatively (p＜0.01, p＜0.01, respectively) and were equally effective in pediatric OSA treatment. Postoperative bleeding was lower in the PITA group, but there was no statistical difference due to small number of cases. VAS score for postoperative pain was significantly lower in the PITA group at day 1, 3, and 7 (p=0.03, p＜0.01, and p＜0.01, respectively). @*Conclusion@#PITA is effective in pediatric OSA treatment with less morbidity, and less complications.
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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.
Assuntos
Angiografia , Artérias , Cabeça , Hemangioma , Hemangioma Capilar , Músculo Masseter , Músculo Esquelético , Músculos do Pescoço , PescoçoRESUMO
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.
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Pulsatile tinnitus coexists with patient's heartbeat and objective tinnitus is audible to other persons such as examiner. It can be disagreeable for the patient and can also be the only clue to a potentially devastating and life-threatening disease. Pulsatile tinnitus with a normal otoscopic examination often presents a diagnostic challenge, and its differential diagnosis includes a wide range of conditions. Evaluation of a patient with tinnitus requires a detailed history, a comprehensive audiological evaluation with hearing thresholds, neuro-otological physical examination with otoscopy and imaging studies. We recently experienced a case of a 28-year-old male complaining of right-sided pulsatile tinnitus. The tinnitus was objectively audible at the left side of the posterior neck. Non-contrast enhanced computed tomography of temporal bone showed a high jugular bulb on the left side. A 6-vessel angiography showed prominent left paravertebral venous plexus and prominent venous plexus around the skull base.
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OBJECTIVES: Nasal packing after endoscopic sinus surgery is frequently used to control postoperative bleeding, enhance the wound healing process, and prevent lateralization of the middle turbinate, which causes insufficient ventilation. Many biodegradable materials have been developed to reduce pain and mucosal damage during packing removal. The purpose of this study was to compare the efficacy of Guardcel (Genewel Co.) middle meatal packing with a traditional nonabsorbable middle meatal packing, Merocel (Medtronic Xomed), on wound healing and patient satisfaction. METHODS: In this prospective, single-blind, randomized controlled study, we enrolled 32 consecutive patients (64 nostrils) undergoing bilateral endoscopic sinus surgery at Korea University Guro Hospital from February 2015 to August 2015. Guardcel and Merocel were inserted postoperatively into a randomly assigned side. Objective findings about bleeding, hemostasis, adhesion, and infection were evaluated with nasal endoscopy. Patients’ symptoms including pain and nasal obstruction were evaluated with a visual analog scale. Each evaluation was done at 2–3 days, 1 week, 2 weeks, and 4 weeks after surgery. RESULTS: At 2–3 days after endoscopic sinus surgery, the Guardcel side had a significantly less hemostasis time than the Merocel side (P=0.001). During this period, the pain during packing removal was significantly lower on the Guardcel-inserted side than the Merocel-inserted side (P=0.002). At two weeks after surgery, the adhesion score on the Guardcel side was significantly lower than that of the Merocel side (P=0.011). Other parameters during the study follow-up periods were not statistically significant. There were no severe adverse reactions. CONCLUSION: Guardcel, a newly developed packing material, appeared to shorten the hemostasis time and reduce pain sensation at 2–3 days after surgery; it also prevented adhesion formation 2 weeks after surgery when compared with the control. Guardcel can be an effective and safe candidate to replace conventional packing materials after endoscopic sinus surgery.
