Showing papers in "Korean Journal of Otorhinolaryngology-head and Neck Surgery in 2007"

The Clinical Significance of Atypia in Thyroid Fine-Needle Aspiration

Abstract: Fine-needle aspiration cytology (FNAC) of thyroid nodules has become the primary diagnostic tool in the evaluation of thyroid nodules. However, the diagnostic utility of thyroid cytology may be limited by the presence of atypical cytologic patterns. In patients with atypical cytology in FNAC, treatment concept is not established. The purpose of this study is to correlate subcategories of atypical cytology of thyroid gland with final histologic diagnoses, and to help develop a treatment plan for thyroid nodules. We retrospectively reviewed 133 specimens of patients with atypical cytology of thyroid nodule according to preoperative FNAC. The atypical cytologic patterns were classified and divided into three groups: follicular neoplasm with nuclear atypia (FNA), nodular hyperplasia with nuclear atypia (NHA), possible papillary carcinoma (PP). Then we investigated the malignancy rates of each group. Among the 133 specimens with atypical cytology, 43 cases (32.3%) were proved to be malignant. Of the 97 cases in the FNA group, 29.9% were malignant. In the NHA and PP groups, 23.1 and 47.8% were malignant, respectively. However, there was no statistical significance in the incidence of malignancy among the three groups. There was also no statistical difference among all groups, with regard to lymph node metastasis and recurrence. In conclusion, if aspirates manifest atypical cytologic pattern, surgery should be considered, especially if the results are categorized as PP. Intraoperative frozen section should be confirmed and the extent of resection should be determined by final pathology.

Reflux Symptom Index(RSI) and Reflux Finding Score(RFS) of Persons Taking Health Checkup and Their Relationship with Gastrofiberscopic Findings

Abstract: Background and Objectives:Few studies were performed regarding laryngopharyngeal reflux symptoms and reflux findings in persons taking health checkup. The purpose of this study was to evaluate laryngopharyngeal reflux symptom index (RSI) and reflux finding score (RFS) at a healthcare center and their relationship with gastrofiberscopic findings. Subjects and Method:This study included 157 persons taking healthcare program which contained laryngoscopic examination between February 2006 and June 2006. The data of each patients were collected by questionnaire, fill-up sheets of laryngoscopic findings and a retrospective review of medical record. Results:The male to female ratio was about 4:1. The mean age was 47 years. The mean values of RSI and RFS were 2.95 and 3.85. Seven (4.5%) persons had RSI more than 13, and 31 (19.7%) persons had RFS more than 7. On gastrofiberscopy, 23 (14.6%) persons had reflux esophagitis, and their RSI were significantly higher than those who did not have reflux esophagitis, and had frequent gastroesophageal reflux symptoms. In persons with abnormal RSI or RFS, only 29% had reflux esophagitis on gastrofiberscopy. Age was inversely related with RSI and smoking was positively related with RFS. Conclusion:We suggest that if a person was found to have abnormally elevated RSI or RFS, a diagnostic evaluation for LPR should be considered irrespective of the presence of reflux esophagitis on gastrofiberscopy. In a person with reflux esophagitis on gastrofiberscopy, he or she showed high RSI without any significant differences in RFS:this may have been because the RSI questionnaire included the gastroesophageal reflux symptom item. (Korean J Otolaryngol 2007;50:431-7)

A Case of Schwannoma of the Nasal Cavity Mimicking Olfactory Neuroblastoma

Abstract: Schwannoma is a benign, slowly growing nerve sheath tumor which can arise from any peripheral nerve containing schwann cells. The olfactory and optic nerves, the extentions of the central nerve system, are encased by glial cells and they lack of schwann cells. They do not give rise to schwannomas in the head and neck area. Therefore, it is generally known that schwannomas seldom occur in the nasal cavity occupied by the olfactory nerve. We have experienced a tumor that developed in the upper nasal cavity including the olfactory cleft and ethmoid sinus. Based on the location of tumor development, we initially diagnosed it as an olfactory neuroblastoma, and its biopsy results reported the tumor to be a schwannoma in the nasal cavity. The tumor was completely removed through craniofacial resection. We herein report a case of an olfactory schwannoma with a brief review of the literature in order to alert other clinicians to this rare tumor to expedite appropriate management. (Korean J Otolaryngol 2007;50:548-51)

Relationships of Tinnitus to Frequency and Hearing Loss in Elderly Patients

Abstract: Background and Objectives：Tinnitus in elderly patients has been well noticed by many physicians, and it was especially related to age induced hearing loss. Moreover, there were many hypothesis and suggestions in mechanisms and characteristics in senile tinnitus but there have been little studies examining the features of tinnitus in elderly patients. So we tried to reveal features of tinnitus in elderly patients. Subjects and Method：We examined the tinnitus of 75 different ears of patients who aged over 60 years old. Also, features of tinnitus were analyzed in aspect of sound and Hz. Additionally, we analyzed hearing levels, tinnitus levels of those patients and questionnaires for tinnitus. Results：Most patients complained of ringing sound. 57 (76.0%) ears indicated high pitched ringing sound, and 16 (21.3%) ears had low pitched beating sound. The number of patients who had hearing disturbance and tinnitus was 60 (96.8%). But in the case of hearing loss, the number of ears with more than 30 dB was 35 (58.3%). Other 25 (41.7%) patients also had hearing disturbance but didn’t complain of significant hearing disturbance. Conclusion：A large number of elderly patients complained of tinnitus in nearly high pitched ringing sound and hearing disturbance. These findings can be helpful in the treatment of tinnitus when considering medications and hearing aids in aged persons. (Korean J Otorhinolaryngol-Head Neck Surg 2007;50:869-75)

Correlation Analysis between Self-reported Measures in Patients with OSA

Abstract: Background and Objectives:Our study evaluated the necessity of measuring the quality of life (QOL) with physiologic para- meters by assessing inter-relationship between self reported measures, which are known as a tool for evaluation of generic and disease specific QOL. Subjects and Method:From Oct. 2004 to Apr. 2006, polysomnograpy (PSG) results of 127 patients were retrospectively reviewed. QOL was assessed using the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36), Self-reported measures including Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Stanford Sleepiness Scale (SSS), Insomnia Severity Index (ISI), and Beck Depression Inventory (K-BDI). The association between each domain on the SF-36 and self-reported measures were examined by Spearman correlation measures. Results:ESS, SSS, PSQI and ISI cor- related well with SF-36, except for ESS, which didn't with Physical Functioning of SF-36. PSG indexes of patients with OSAS did not show correlation with self-reported measures. Conclusion:All self reported measures including generic and disease speci- fic QOL have their own significance in reflecting psychosomatic status in patients with OSAS. Self-reported measures could be more informative in the reflecting severity and pre/post treatment results in the aspect of psychosomatic effects in OSAS patients. (Korean J Otorhinolaryngol-Head Neck Surg 2007;50:888-95)

A Case of Pulsatile Tinnitus with High Jugular Bulb Treated by Ligation of Internal Jugular Vein

Abstract: Objective tinnitus due to high jugular bulb is a rare presenting symptom. Annoying pulsatile tinnitus caused by high jugular bulb which may cause sleep disturbance or hearing impairment can be treated by surgical therapy of ligation of internal jugular vein. We present a case of pulsatile tinnitus with high jugular bulb which has been treated by surgical therapy. Otologic examination demonstrated bluish mass in hypotympanic portion behind intact tympanic membrane and temporal bone CT showed the high jugular bulb. Audiological characteristics and the nature of tinnitus was also described. After the angiographic examination, the site for venous ligation was confirmed by compression of internal jugular vein with the probe of doppler sonogram. The patient’s pulsatile tinnitus has completely disappeared two weeks after surgery. (Korean J Otorhinolaryngol-Head Neck Surg 2007;

A Case of Superior Semicircular Canal Dehiscence Syndrome

Abstract: Superior semicircular canal dehiscence (SSCD) syndrome and otosclerosis have overlapping clinical manifestations that can be difficult to distinguish. Audiovestibular symptoms are caused by noise or straining in SSCD, which is associated with the presence of an air-bone gap that overlaps with the characteristic of otosclerosis. We recently examined a 51-year-old woman presenting with unilateral pulsatile tinnitus and ipsilateral hearing loss in the left ear. Computerized tomography, audiometry and vestibular function test confirmed the diagnosis of ipsilat eral SSCD syndrome with coexisting ipsilateral otosclerosis. The patient underwent surgical repair of dehiscence by middle fossa approach and stapes surgery for otosclerosis sequentially. She has not had pulsatile tinnitus postoperatively, and hearing improved with the closure of airbone gap at most frequencies. In conclusion, when SSCD syndrome and otosclerosis coexist and patient has representative symptoms of both ear pathologies, a sequential surgery can be an effective treatment option. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(1):68-72 Key WordsZZOtosclerosis ㆍSemicircular canal ㆍ Superior semicircular canal dehiscence syndrome.

Experience of BAHA(Bone Anchored Hearing Aid) Surgery

Abstract: For auditory rehabilitation in patients with hearing loss, air conduction hearing aids are primarily considered. However, when applying to patients with congenital atresia or chronic ear infection, limitations are expected and conventional bone conduction hearing aids may be used in these cases. Nevertheless, since bone conduction hearing aids also were found to have a number of drawbacks such as poor sound quality, high battery consumption, poor aesthetics, and headache by the pressure from the device against the skull, the bone anchored hearing aid (BAHA) has been introduced as an effective means to overcome such limitations. Whereas traditional bone conductors are transcutaneous and they works by exerting pressure against the skull, BAHA works percutaneously. Three cases of BAHA insertion surgery are presented along with the indications and surgical methods of BAHA surgery. (Korean J Otolaryngol 2007;50:369-72)

Case Report：Parotid Sialolithiasis

Abstract: Salivary duct lithiasis is a condition characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions or sialoliths resulting in salivary ectasia and even provoking the subsequent dilation of the salivary gland. It most commonly involves submandibular gland (80 to 90%) and less frequently parotid (10 to 20%). The authors report 2 cases of parotid sialolithiasis. The first case involved a 46-year-old male patient complaining of the left parotid area pain and swelling, and presenting with a salivary calculus in the left parotid duct. When the patient was diagnosed, he refused surgical removal. The second case involved a 41-year-old male patient complaining of the right parotid area pain and swelling, and presenting with a salivary calculus in the right parotid duct. The sialolith was surgically removed under general anesthesia. In this paper, we also reviewed a series of concepts related to the etiology, diagnosis and treatment of sialolithiasis. (Korean J Otorhinolaryngol-Head Neck Surg 2007;50:829-32)

A Case of Maxillary Venous Hemangioma with Invasion to Hard Palate and Nasal Cavity

Abstract: Hemangiomas are common benign soft tissue tumors in the head and neck, but they occur infrequently in the sinonasal cavity. Capillary, cavernous, mixed, and venous types of hemangiomas have been described. Venous hemangiomas are less commonly seen and are composed of thickened blood vessels that can still be recognized as veins. Chief symptoms are recurrent epistaxis and nasal obstruction; if the tumor becomes large, it may cause adjacent bony erosion. Preoperative diagnosis of maxillary sinus hemangioma is important since these lesions can frequently cause a large amount of hemorrhage during surgery. We report a case of a 80-year-old woman with a huge tumor in the maxillary sinus and oral cavity that was histopathologically diagnosed as venous hemangioma. (Korean J Otorhinolaryngol-Head Neck Surg 2007;50:954-7)

A Case of Ethmoidal Sarcoidosis

Abstract: Sarcoidosis is a multisystemic, chronic granulomatous disease of unknown etiology. Most commonly, it involves the lung parenchyme and hilar lymph nodes. Head and neck involvement is found in 9% of the patients, with sinonasal involvement demonstrated only in 1% of these patients. Diagnosis is usually performed according to the clinical, laboratory, radiographic and histological features and by excluding other granulomatous diseases. Of these features, the histologic finding is a major diagnostic tool. In sinonasal sarcoidosis, the most common symptoms are nasal obstruction and crusting, and the most consistent finding was an edematous, friable, erythematous and hypertrophied mucosa. The clinical course is variable and there is no consensus about the treatment options. But, the systemic corticosteroid is the mainstay of treatment. We report a case of ethmoidal sarcoidosis which was successfully managed by endoscopic sinus surgery along with systemic corticosteroid. To our knowledge, this is the first report of sinonasal sarcoidosis in Korea. (Korean J Otorhinolaryngol-Head Neck Surg 2007;50:716-8)

A Case of Subepidermal Calcified Nodule in Auricle

Abstract: Subepidermal calcified nodule, also called as cutaneous calculi, is a rare form of calcinosis cutis, which is not associated with biochemical abnormalities, or other dermatologic disorder or systemic illness. It occurs on the face and ear of children, and is asymptomatic. It usually presents as a solitary verrucous nodule and histologically shows as basophilic granules and masses in the dermis. We experienced one case of subepidermal calcified nodule in a 9-year-old boy with auricular mass. He did not have any other dermatologic disorder or systemic illnesses. Physical examination showed a 1.5×3 cm sized, non-tender, hard, fixed mass on left helix. It was surgically excised. It was finally reported as calcinosis cutis. We report it with a review of the current literature. (Korean J Otorhinolaryngol-Head Neck Surg 2007;50:947-9)