• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.11 no.1
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• pp.269-283
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• 1998

Paranasal sinusitis, especially chronic is one of the most common diseases in the field of otolaryngology. It is similar to Bee Yeun(鼻淵) in oriental medicine. Most cases of sinusitis are due to anatomical abnormalities within ostiomeatal unit or disturbed mucocilliary flow. The ostiomeatal unit is the first place of contact with bacteria and allergens during aspiration, and it can be obstructed easily by minute mucosal swelling due to anatomical narrowness. Therefore the treatment of paranasal sinusitis is not easy and often leads to recurrences in spite of long term treatment or surgical therapy. We studied 83 patients who had visited our hospital with complaints of nasal symptoms; they had been diagnosed as having paranasal sinusitis through an endoscopy or CT scan in another hospital and were diagnosed as the paranasal sinusitis through a PNS series. The results were as follows: 1. Age and sex distribution: The most common occurence was found between 6-10 and 1-5 years old. The Males Were 52($62.7\%$) and Females were 31($37.3\%$). 2. By residence 58 cases lived in apts: 25 lived in houses. 3. The longest duration of disease varied from a lower of 13 to a higher of 36 months in 22 cases and from 7 to 12 months in 21 cases. 4. The most common complication & past history with otolaryngologic or allergic disease were adenoid or tonsil hypertrophy & tonsillectomy and adenoidectomy (21 cases). In decreasing order the others were atopic dematitis, otitis media with effusion and allergic rhinitis. 5. Distribution of paranasal sinus disease was most common in both maxillary sinuses in 52 cases. 12 cases showed a normal PNS X-ray series but these had been diagnosed as paranasal sinusitis with an endoscopy or CT scan in another hospital. 6. Common sinusitis - related symptoms were from highest incidence to lowest nasal obstruction, postnasal drip rhinorrhea, frontal headache, cough with sputum. 7. The most administered of prescription was Gamibangpoongtongsungsan and Sunbangpaedoksan extract. 8. In 26 cases the subjects showed significant improvement symptoms in PNS X-ray series : In 21 case showed partial improvement symptoms.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.231-233
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• 2001

Atrophic rhinitis is characterized by mucosal atrophy, bony absorption, persistent fetid odor and resistance to medical and surgical treatment. Stellate ganglion block (SGB) can be used as a therapeutic modality by improving the regional blood flow through sympathetic blockade. We present a case of a 57 year-old male patient who had been treated unsuccessully for atrophic rhinitis for several years by surgical and conservative measures. The patient presented at our pain clinic with shoulder pain and received stellate ganglion block once or twice a week. He received more than 75 SGBs in addition to the routine conservative treatment for atrophic rhinitis. As the number of blocks performed increased, the patient demonstrated subjective symptom relief. We measured regional mucosal blood flow using a laser doppler flowmeter after the 28th, 63rd and 75th blocks. Nasal mucosal blood flow was improved by 4.9%, 28.8% and 36.3% respectively. We also were able to observe the recovery of mucosal atrophy to an almost normal level by nasal endoscopy. The patient is currently free of symptoms and is being followed up on an outpatient bases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.1
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• pp.13-20
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• 2022

The lifetime incidence of epistaxis in dental and maxillofacial practice has been reported to be as high as 60% and can be caused by dental implant placement, Le Fort I osteotomy, intranasal supernumerary tooth, odontogenic tumors, blood disorders and maxillofacial trauma. Most epistaxis cases are minor and easily managed with direct compression on the nares for 10 minutes. For more significant or recurrent epistaxis, other techniques might include electrocautery, anterior or posterior nasal packing, or Foley catheter balloon. For patients with refractory epistaxis, cauterization of the sphenopalatine artery under endonasal endoscopy or embolization of the internal maxillary artery should be performed. Epistaxis control is required in patients diagnosed with inherited or acquired bleeding disorders or with drug-induced coagulopathies during dental procedures. In these cases, hemostatic system adjustment and hemostasis achieved by local and adjunctive methods are required. Dentists and maxillofacial surgeons must be aware that the nasal cavity is a potential source of perioperative hemorrhage. Depending on the invasiveness of the dental intervention, preoperative involvement of the hematologist and cardiologist is usually necessary to reverse anticoagulation or to cease anticoagulant therapy.

• Imaging Science in Dentistry
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• v.50 no.4
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• pp.299-307
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• 2020

Purpose: The diagnosis of chronic rhinosinusitis requires a comprehensive knowledge of the signs and symptoms of the disease and an accurate radiographic assessment. Computed tomography (CT) is the superior imaging modality for diagnosis of chronic rhinosinusitis. However, considering the lower dose and higher resolution of cone-beam computed tomography (CBCT) compared to CT, this study aimed to assess the agreement between the findings of CBCT and functional endoscopic sinus surgery (FESS). Materials and Methods: This descriptive prospective study evaluated 49 patients with treatment-resistant chronic rhinosinusitis who were candidates for FESS. Preoperative CBCT scans were obtained before patients underwent FESS. The agreement between the CBCT findings and those of FESS was determined using the kappa correlation coefficient. The frequency of anatomical variations of the paranasal sinuses was also evaluated on CBCT scans. Results: Significant agreement existed between pathological findings on CBCT scans and those of FESS, such that the kappa correlation coefficient was 1 for mucosal thickening, 0.644 for nasal deviation, 0.750 for concha bullosa, 0.918 for nasal polyp, 0.935 for ostiomeatal complex (OMC) obstruction, and 0.552 for infundibulum thickening. Furthermore, 95.9% of patients had 1 or more and 79.6% had 2 or more anatomical variations, of which nasal deviation was the most common (67.3%). Conclusion: Considering the significant agreement between the findings of CBCT and FESS for the detection of pathological changes in the paranasal sinuses, CBCT can be used prior to FESS to detect chronic rhinosinusitis and to assess anatomical variations of the OMC.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.162-165
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• 1999

Background and Objectives: Multiple primary tumors of the upper aerodigestive tract are not unusual. We examined head and neck cancer patients to discover the presence of second primary cancer in their upper gastrointestinal tract, using esophagogastroscopy. Materials and Methods: Endoscopic examination of the upper gastrointestinal tract was performed on 51 patients whose head and neck cancers were treated at department of therapeutic radiology from August 1996 to April 1999. Two of all patients had been studied by barium swallowing study. In 51 patients, twenty-four had a primary tumor in the larynx, 8 in the oropharynx, 6 in the nasopharynx, 6 in the oral cavity, 6 in the hypopharynx, and 1 in the nasal cavity. Endoscopically pathologic lesions were biopsied. In control group, endoscopy was performed on 1097 patients who didn't complain any symptoms. Results: Endoscopy showed early malignant lesions in 4 cases(7.7%). Histology of esophageal cancers showed squamous cell carcinoma. Malignant lesions of stomach in 2 cases were histologically identified as adenocarcinoma. Two esophageal cancers occurred in patients whose primary lesions had oropharynx and hypopharynx. Two cases of gastric cancer were also accompanied by oropharynx and hypopharynx. The incidence of second primary cancer was 2 in oropharynx and 2 in hypopharynx. In all cases, second primary cancers were found simultaneously. In control group, 9(0.8%) of 1097 patients were confirmed as early esophageal and gastric cancers. Conclusion: The majority of esophageal and gastric cancer detected by endoscopy were early stage in both head and neck cancer and control group. The incidence of esophageal and gastric cancer of head and neck cancer patients was 10 times as high as that of control group. Although followup period was short, all second primary cancers were detected simultaneously. We would recommend that endoscopic evaluation be included in the workup and followup of all patients with newly diagnosed head and neck cancer.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.2
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• pp.155-159
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• 2020

Chronic maxillary atelectasis (CMA) is a progressive alteration in the volume of the maxillary sinuses that may result in facial asymmetry. CMA in asymptomatic patients is known as silent sinus syndrome (SSS) and is a rare entity, especially in pediatric patients. This study reports a case of SSS in a pediatric patient who received an early diagnosis through cone-beam computed tomography (CBCT). An asymptomatic 12-year-old female patient in orthodontic treatment presented with opacification of the left maxillary sinus on a panoramic radiograph. Clinically, the patient had discrete hypoglobus and enophthalmos. CBCT and nasal video-endoscopy revealed ostiomeatal obstruction with bone deformity, leading to diagnosis of SSS. Endonasal endoscopic maxillary sinusotomy was performed. Two years later, the patient remained asymptomatic, and a second CBCT exam confirmed a stable condition. This case highlights the role of optimal radiographic interpretation for early diagnosis of maxillofacial alterations in pediatric patients.

• Journal of Veterinary Clinics
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• v.27 no.2
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• pp.194-197
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• 2010

A 14-year-old gelded dressage horse weighing 500 kg was presented to the Equine Medical Center of the Seoul Racecourse of Korea Racing Authority (KRA) due to coughing and mucopurulent nasal discharge. The horse was initiated with empirical antibiotic in the first place. However, the clinical signs did not improve but were rather exacerbated even after 3 weeks of therapy. Extensive diagnostic procedures including transtracheal wash (TTW) fluid cytology were undertaken. The localized wheezes and crackles were auscultated and an increase in the amount of mucopurulent exudate in trachea was observed at endoscopy. Infiltration of neutrophils was observed in the TTW fluid cytology implying chronic obstructive pulmonary disease (COPD). Therefore, the systemic glucocorticoid therapy was to be given for 3 weeks with improved ventilation provided at the same time. The respiratory symptoms started to improve in 7 days of therapy and were fully resolved by when the therapy was terminated. The horse is clinically normal now and being monitored for development of any signs of chronic obstructive pulmonary disease.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.218-222
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• 2013

Objective : To clarify the anatomical correlations of the sphenoid sinus with surrounding structures in the normal Korean population, and to identify surgical landmarks for safe sellar floor dissection in the anterior skull base by endoscopy and microscopy. Methods : We reviewed the 196 brain magnetic resonance imaging findings showing a normal appearance, and measured the distances between anatomical landmarks. Results : The mean distances from the base of the columella to the anterior wall of the sphenoid sinus and the sellar floor were $69.71{\pm}4.25$ mm and $86.26{\pm}4.57$ mm, respectively in the over 15 age group, and showed the smallest degree of variation among the measurements. The mean angles between the floor of the nasal cavity and the straight line connecting the base of the columella and the sellar floor were $29.45{\pm}3.25^{\circ}$ and $24.75{\pm}4.00^{\circ}$ in the over 15 and under 15 age groups, respectively. The mean values of both distances and angles increased with age until 15 years after which no further increases were evident. There were no significant differences in the measurements between males and females or among subjects with different degrees of pneumatization in the over 15 age group. Conclusion : The distances from the base of the columella to the sellar floor and the anterior wall of the sphenoid sinus, which were consistent among individuals, could be used as a surgical indicator to investigate the sellar floor in endoscopic or microscopic transsphenoidal approaches.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.475-482
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• 2019

This report is a case of 76-year old male patient who had difficulty in swallowing, pronunciation and suffered regurgitation of food. The patient lacks uvula and both tonsils, had short palatoglossal arch and soft palate, as well as defective left palatopharyngeal arch. The height and width of the soft palate defect were measured by reconstructing the Computed Tomography (CT) image in three dimensions. Phonation and soft palate obstructing ability were examined by nasometry and nasal endoscopy. Evaluations on phonetics and swallowing were done and improvements were shown. The patient was satisfied with the results of treatment.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.114-122
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• 2022

Objective : Early descent of the diaphragm sellae (DS) during endoscopic endonasal transsphenoidal surgery (EETS) for pituitary macroadenoma surgery is occasionally a troublesome event by blocking the surgical field. Here we introduce an alternative technique with the new pituitary retractor and present our clinical experiences. Methods : We designed a simple and rigid pituitary retractor with the least space occupation in the nasal cavity to be compatible in EETS. The pituitary retractor was held by external holder system to support the herniated DS stably. We retrospectively reviewed a clinical 22 cases of pituitary macroadenomas underwent EETS using the pituitary retractor. Results : The pituitary retractor stably pushed up the herniated DS in all cases, and the surgeon proceeded the procedure with bimanual maneuver. The pituitary retractor was helpful to remove tumors around the medial cavernous sinus and behind the DS in 16 and seven cases, respectively. In four cases, the meticulous hemostasis was completed with the direct visualization by the DS elevation with this retractor. Gross total tumor resection was performed in 20/22 patients (91%). The impaired visual function and hypopituitarism were improved in 18/20 (90%) and 7/14 (50%) patients after surgery, respectively. There was no complication related with the pituitary retractor. Conclusion : During EETS for pituitary macroadenomas, the novel pituitary retractor reported in this study is a very useful technique when the herniated DS block the surgical field and bimanual maneuver. This pituitary retractor can help to result in the excellent surgical outcomes with minimal morbidity.