Effects and Related Factors of Endotracheal Intubation on Voice Change Following General Anesthesia / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Reliable studies about the impact of short-term intubation, particularly as part of general anesthesia, are scarce. That scarcity led to the following research objectives. First of all, we tried to find out how often and why voice change last more than 72 hours after intubation conducted for general anesthesia. SUBJECTS AND METHOD: The study enrolled 80 patients who were due to undergo general anesthesia at the Seoul Paik Hospital from Aug. 2009 to May 2010. The patients were examined through stroboscopic examination and voice analysis before surgery. Three days after the surgery, the same tests were performed again to single out patients whose results were abnormal; thus a proportion could be calculated. The other objective was to determine the factors involved with voice change. This was done according to the Mallampati classification, using the images from laryngoscopy and compiling records of cuff pressure, cuff volume, tube size, duration of intubations, and the number of intubation trials. RESULTS: 7.5% of the patients suffered from voice change longer than 3 days. Three factors, namely, cuff pressure, duration of anesthesia and patient age demonstrated statistically significant relationships among them. CONCLUSION: The results indicate that there is a need for patients scheduled to face general anesthesia to receive sufficient explanation about the possible postoperative voice change that could last longer than 3 days. Furthermore, surgeons and anesthesiologists need to cooperate closely by taking the patient age, duration of anesthesia and cuff pressure into account in order to limit postoperative voice change to the minimum extent.

Two Cases of Acute Palatine Tonsillitis and Adenoiditis Caused by the Phylloporia Ribis Intoxication / 대한이비인후과학회지

It is said, arguably, that a Phylloporia ribis is effective on epilepsy and a range of malignancies. That's why the Korean traditional or alternative medicine sector often takes advantage of that. Nevertheless, to the best of authors' knowledge, there's no report about toxicities. Recently, the researchers encountered two patients, a 52-year-old female and her 28-year-old son, who boiled a Phylloporia ribis and drank its extract seven days before the visit. Both started to experience sore throat 6 days later, accompanied by chills. The complete blood cell tests revealed that they were suffering from acute tonsillitis, with leukopenia and thrombocytopenia.

Comparative Values of External Nose Measurement with Photograph According to Sex and Age in Korean Adults

BACKGROUND AND OBJECTIVES: Rhinoplasty has been frequently performed for correction of injured nose or cosmetic reasons. Korean standard values are insufficient, and most reference values are based on Caucasian ones. We measured Korean values of external nose with photographs according to sex and age. MATERIALS AND METHODS: Three hundred forty seven subjects without past history of operation or trauma were included in this study. With scaled instrument for head fixation, frontal and profile views were taken. On frontal view, physiognomic face height and nasal width were measured. On profile view, midface height, nasal height, alar height, glabellar depth, nasion depth, nasal dorsum depth, nasal tip depth, nasal depth, nasofrontal angle and nasolabial angle were measured. And location of nasion and shape of nasal dorsum were also classified. RESULT: Physiognomic face height decreased with age in both men and women groups. Nasofrontal angle increased with age in men. Nasion was located between upper end of upper eyelid and lateral canthus in most cases. On classifying the shape of nasal dorsum, straight type was the most in both men and women groups. CONCLUSION: We could know average measurements of external nose and differences of those according to sex and age in Korean adults. And it is thought that these data will be useful to facial plastic surgery including rhinoplasty.

Endoscopic Guided Power-Assisted Adenoidectomy Using Proper Combination of Endoscope and Microdebrider ; 6 Years of Surgical Experience / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Because of its advantage over the conventional method, power-assisted adenoidectomy has become an increasingly popular procedure in adenoidectomy. The purpose of this paper is to find the best combination of endoscope and microdebrider to achieve the most successful outcome in patients with various configuration of adenoid vegetation. SUBJECTS AND METHOD: One hundred ninety-one patients who underwent adenoidectomy in the department of Otolaryngology at Inje University Seoul Paik Hospital from January 2000 to February 2006 were reviewed by charts and recorded video tapes for the techniques that we applied to these patients. RESULTS: Four different combinations can be created from two different angles of endoscope and microdebrider ; transnasal 0degrees endoscopic guided transnasal adenoidectomy using straight microdebrider (TNTN), transnasal 0degrees endoscopic guided transoral adenoidectomy using curved microdebrider (TNTO), transoral 70degrees endoscopic guided transnasal adenoidectomy using straight microdebrider (TOTN) and transoral 70degrees endoscopic guided transoral adenoidectomy using curved microdebrider (TOTO). TOTO was the most frequent combination for simple adenoid vegetation. However, it is not suitable for removal of adenoid located high in the pharyngeal roof. In this case, we added TNTO to TOTO. The least frequent combined technique was TNTN, which has inherent limitation to use in small sized nares and younger age. In this situation, TOTN is a better alternative to use. CONCLUSION: From six years of experience, we confirmed that endoscopic guided powerassisted adenoidectomy should be performed with proper combination of endoscope and microdebrider based on the location and configuration of adenoid vegetation. The most ideal combination we consistently applied for removal of adenoid is as follows ; first, TNTO, secondly, TOTO. Lastly, TOTN could be useful in selected cases.

Analysis of Electrophysiological Change in the Rat LC Nucleus after Salicylic Acid Treatment / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The precise mechanism of salicylic acid induced tinnitus has not been clearly identified as yet in spite of wide range of studies undertaken. We looked for the electrophysiologic evidence that salicylic acid has effect on the Locus Coeruleus (LC) neurons in vitro. MATERIALS AND METHOD: In LC, we measured the neuronal firing rate and cell membrane property according to the concentration of salicylic acid with extracellular single unit recording and whole cell current clamp recording. RESULTS: The basal firing activity was increased in 15 of the 20 LC nuclei, which were treated with 0.3 mM salicylic acid. Both 1mM and 2 mM salicylic acid increased the basal firing rate of all except for one LC neuron (n=20). These neurons also showed recovery after washing. However, 5 mM salicylic acid induced cell death after the bursting response in all of the LC neurons (n=10)(Fig. 2). There were no specific changes in the whole cell current-clamp recording of the LC neurons during the period of drug treatment (Fig. 3). CONCLUSION: The dose dependent response pattern observed in the extracellular single unit recording and the fact that there were no specific changes in the whole-cell current-clamp recording following the salicylic acid treatment suggest that the salicylic acid induced intracellular change in the LC neuron is caused not by the direct ligand-receptor reaction but by the indirect 2nd messenger system.

Verruca Vulgaris of the Larynx: A Case Report / 대한이비인후과학회지

Verruca vulgaris is commonly seen on skin, but extremely rare in other areas, especially in larynx, where it could be not uncommonly misdiagnosed as verrucous carcinoma. In the recent studies, we noted that verruca vulgaris of the larynx is related to human papilloma virus type 6, 11, which is different from human papilloma virus type 2, 4, which is found on skin. Verruca vulgaris of the larynx occurs in old age with the average of 56 years, and it looks white in color on laryngoscopic examination, which is limited to the true vocal cords. It recurs infrequently. Pathologically, it is heavily keratinized and it contains prominent keratohyaline granules and exhibits koilocytosis. We experienced a case of verruca vulgaris of the larynx in a patient with hoarseness lasted for 3 months. So we report this case with a review of literature.

Two Cases of Postoperative Cheek Cyst with Exophthalmos / 대한이비인후과학회지

Postoperative cheek cysts develop as a delayed complication of Caldwell-Luc operation, usually 10 to 20 years following the surgery. The general clinical presentations are swelling of the cheek, accompanied by dull maxillary facial pain and numbness. Enlarged postoperative cheek cysts infrequently protrude into the orbit and elevate the eyeball, causing double vision. Recently, we experienced two cases of exophthalmos caused by the protrusion of a postoperative cheek cyst into the orbit. One patient, a 39-year-old man, underwent Caldwell-Luc operation 21 years ago, and the other patient, a 53-year-old man, 36 years ago. We were able to secure an accurate measurement of the defective orbital floor using the preoperative 3-dimensional reconstruction CT scan. The postoperative cheek cyst was completely removed using the endonasal and transantral endoscopic approach, and the widely defective orbital floor was reconstructed with Medpor(R).

Tinnitus

Tinnitus is a perception of sound without external stimuli. The increase of noise from industrialization, complex psychological state, increase of old age people, and excessive medication make tinnitus a more common disease than ever before. However, the knowledge regarding diagnosis and treatment of tinnitus is still limited. Tinnitus can be categorized into paraauditory tinnitus and sensory neural tinnitus. Paraauditory tinnitus may occur from the sound generated by the vessel near the ear such as an arteriovenous fistula, abnormal vessel, a tumor around vessel, palatal myoclonus, and patent E tube. Sensory neural tinnitus can arise from senile hearing loss, noise-induced hearing loss, sudden deafness, sensorineural hearing loss associated with chronic otitis media, excessive medication, and so on. But there are many cases in which the specific cause cannot be defined. Diagnosis needs thorough history taking, physical examination, and radiologic and audiologic examination. Treatments for the paraauditory tinnitus are vessel ligation or coil embolization of arteriovenous fistula and removal of the causative factors. Although there are many treatment modalities for managing sensory neural tinnitus, a standardized treatment modality has not been established. Sensory neural tinnitus can be managed with tinnitus retraing therapy and electrical stimulation therapy. Although tinnitus is essentially not a life-treatening disease, advancing quality of life and the increasing number of patients with tinnitus mandate health-care providers to be more concerned with the disease tinnitus.

A case of huge cholesterol granuloma in fibrous dysplasia of temporal bone / 대한이비인후과학회지

No abstract available.

Pure tone and speech audiometry before and after surgery of chronic otitis media / 대한이비인후과학회지

No abstract available.

Cytokine mRNA Expression of Otitis Media with Effusion in Children / 대한이비인후과학회지

Otitis media with effusion(OME) is the most common cause of acquired hearing loss in children. Some children suffer from a chronic form of this disease known as chronic otitis media with effusion(COME), which is manifested by the retention of fluid and inflammatory products in the middle ear cleft and by the eustachian tube dysfunction. The etiology and pathogenesis of COME, however, have not been fully elucidated. Middle ear effusion(MEE) is a complex mixture of transudate, secretory products from glands of middle ear mucosa and products from inflammatory cells and infecting organisms. Recently, there has been a great interest in the pathogenetic roles of cytokines, a group of low molecular weight glycoproteins produced by macrophages, lymphocytes and other cells. Activities of cytokines include fever production, activation of osteoclasts, fibroblasts, phagocytes and cytotoxic cells, regulation of antibody formation and inhibition of growth of cartilage, bone and endothelial cells. In this study, we have utilized the reverse transcription polymerase chain reaction(RT-PCR) technique to determine accurately the existence of mRNAs for five cytokines in MEEs collected from 22 children with COME. Messenger RNAs for TNF-alpha, IL-1beta, IL-2 and IL-8 were detected in 68%, 86%, 59% and 95% of specimens, respectively, Interleukin-4 mRNA was absent in all the specimens. The persistent production of cytokines by the inflammatory cells in MEE of COME due to sustained presence of antigens or most-recent antigenic stimuli may play the central role in prolonged OME and responsible for the mucosal damage, bone erosion, fibrosis and resulting hearing loss seen in some cases of COME.

A clinical study on the labyrinthine fistula / 대한이비인후과학회지

No abstract available.

A Case of Pregnancy Induced Venous Hum Treated by Ligation of the Internal Jugular Vein / 대한이비인후과학회지

The patient with pulsatile tinnitus can bo annoying and the tinnitus can be the only clue to a potentially devastating and life-threatening disease, too. This tinnitus may originate from the arterial, arteriovenous, venous vessels and the myoclonus. Occasionally it is the cause of underlying condition in increased flow volume such as anemia, hyperthyroidism, pregnancy, medication or increased intracranial pressure. And then control of these underlying condition is important treatment in those occasions. If anyone suffered from venous pulsatile tinnitus, then simple ligation of the internal jugular vein could be the simplest treatment. Recently the authors experienced a case of 28-year-old woman with left pulsatile tinnitus originating from venous hum. The tinnitus had developed at fourth month of pregnancy and persisted after 20 months of delivery. The patient was treated by ligation of the internal jugular vein in local anesthesia. The proper ligation site was decided by angiography. She remains free of symptoms and complications 7 months after treatment.

Complement system in otitis media with effusion / 대한이비인후과학회지

No abstract available.

A Case of the Middle Ear Adenoma / 대한이비인후과학회지

The middle ear adenoma is a rare neoplasm originating from the lining epithelium of the middle ear mucosa. The first report of a middle ear glandular tumor was published in 1898 by Treitel and since then over 100 cases have been reported. At least 14 different descriptions have been given to these lesions, reflecting the controversies relating to their presumed histogenesis and differentiation. The middle ear adenoma has been often classified into mixed and papillary type by cellular morphology, growing pattern, prognosis, and clinical manifestations. The most common initial symptom was decreased hearing, followed by ear-fullness, otalgia, headache, and otorrhea. Radiologically, the most common finding is a soft tissue mass in the middle ear. In this study, we present a case of the middle ear adenoma of the patient complaining hearing difficulty and otorrhea, which was diagnosed by histopathologic finding, and then discuss the current approach to this tumor with a review of literature.

The Efficacy of Palatine Tonsillectomy Under Local Anesthesia: Comparative Analysis with Tonsillectomy Under General Anesthesia / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tonsillectomy is one of the most common surgical procedures in otolaryngologic field and it can be carried out under general anesthesia or local anesthesia. The author compared tonsillectomy under local anesthesia to general anesthesia with respect to operation, anesthesia and recovery time as well as satisfaction of the patients. SUBJECTS AND METHOD: Fifty patients who underwent tonsillectomy were divided into a local anesthesia group (25 patients) and a general anesthesia group (25 patients). Parameters such as time spent for anesthesia, operation, recovery time, episodes of cautery, initiation of normal daily life including normal diet, pain, and complication were compared between the two groups. Paired student t-tests were used for statistical analysis. RESULTS: Among other parameters, local tonsillectomy was superior in terms of saving time during anesthesia, operation, recovery as well as hospital course compared to tonsillectomy under general anesthesia. However, ease on the initiation of normal daily life including normal diet, pain, and complication did not differ between the two groups. CONCLUSION: The author feels that local tonsillectomy should be advocated not only for time saving during operation, anesthesia and recovery but also for the satisfaction or compliance of the patients. In these respects, it is suggested that more active training should be provided to surgeons during their residency on tonsillectomy under local anesthesia.

Differentiation characteristics of cholesteatoma epithelium determined by expression of transglutaminase isoenzymes

Transglutaminase (TGase) isoenzymes are involved in the process of the differentiation and cornification of keratinocytes in the epidermis. This study investigates the presence and localization of three TGase isoenzymes to elucidate the nature and differentiation status of the squamous epithelium in human aural cholesteatoma. Twenty cholesteatoma specimens were used. The presence and localization of three TGase isoenzymes were studied by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. mRNA expression of three TGase isoenzymes were detected in the tested cholesteatomas with variable levels. The immunohistochemical staining patterns of three TGase isoenzymes showed variations within specimens, relating to keratinizing activity. TGase K is the most abundant among three isoenzymes. Keratinizing epithelium of cholesteatoma have similar expression profiles of TGase isoenzymes with those of epidermis of the skin. Other areas, particularly those showing non-keratinizing epithelium, showed weak immunostaining of TGase E and C, suggesting its different maturation status from keratinizing epithelium. The results of this study indicate that epithelium of cholesteatoma undergoes same direction of maturation and differentiation characteristics as the epidermis of skin, evidenced by similar expressions of TGases both in mRNA level and immunohistochemistry.

Psychological Analysis with Symptom Check List-90-Revision in Patients with Tinnitus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Psychological distress may develop from tinnitus, or that recognition of tinnitus may even be greater during exposure to environmental stress. So, patients with tinnitus need to consider the psychologic aspect in their diagnosis and treatment. The aim of this study is to evaluate the degree and characteristics of the psychologic factors associated in patients undergoing tinnitus retraining therapy. MATERIALS AND METHOD: 119 patients with tinnitus who received the Symptom Check List-90-Revision (SCL-90-R) and a control group without tinnitus were compared first; and then 92 out of 119 patients performed the follow up study after three months of tinnitus retraining therapy. RESULTS: The results were as follows. 1. The tinnitus group scored higher than the control group in somatization, anxiety, phobic anxiety (p0.05). 3. The psychologic aspect of patients with tinnitus were related to loudness, pitch, annoyance (p<0.05). 4. The follow-up study of 3 months on patients who underwent tinnitus retraining therapy showed diminished score in all components of SCL-90-R, except phobic anxiety, and paranoid (p<0.05). CONCLUSION: This study indicated that the compliant behaviour of tinnitus is related closely with intrinsic psychodynamic mechanism.

C-fos Expression in Brain Stem of Rats after Salicylic Acid Treatment / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Subjective tinnitus, a distracting internal noise, is experienced by humans. Tinnitus is evoked by salicylic acid treatment in rats as confirmed by Jastreboff in 1994 in an animal behavior model of tinnitus with salicylic acid. The objective of this study is to evaluate c-fos expression in the brain stem of rats after salicylic acid treatment. MATERIALS AND METHOD: After salicylic acid (450 mg/kg) and saline treatment (450 mg/kg), c-fos immunohistochemical staining expression in the auditory and nonauditory brain stem nuclei were observed. RESULTS: Many immunoreactive cells were observed in the Locus Ceruleus of the salicylic acid treated animals, but not in the saline treated animals. No immunoreactive cells were found in the auditory brain stem nuclei. CONCLUSION: The Locus Ceruleus is the nucleus of the brain stem and produce norepinephrine which results in arousal of the neuronal activity for stress. These results suggest that salicylic acid may evoke tinnitus through a combined effect on the auditory and nonauditory brain nuclei. It seems possible that the interaction of these effects at particular locations of the brain causes tinnitus.

Effects of Salicylate on ABR and ECoG in Guinea Pig / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has been recognized that salicylate induces ototoxicity in animals and humans. Many studies have been done to identify the mechanisms of ototoxicity of salicylate with histopathological, biochemical and electrophysiological methods. Among these methods, the electrophysiological method is useful for clinical diagnosis and evaluation of therapeutic effect. The studies reported here were aimed at performing electrophysiological effects of salicylate by using Auditory Brainstem Response (ABR) and Electrocochleography (EcoG) through non-invasive approach. MATERIAL AND METHODS: Auditory brainstem response and electrocochleogram were observed by non-invasive approaching method after the intraperitoneal injection of 450 mg/kg of lysine salicylate on 10 ears of 5 guinea pigs. RESULTS: The threshold shifting of ABR and ECoG were less than 10 dB. The latency of ABR waves and Summating Potential were increased after salicylate was administered especially at low intensity sound stimulation. CONCLUSION: The latency of ABR wave and SP would be useful in diagnosing ototoxicity and evaluating the therapeutic effect in ototoxic patients.