• Title/Summary/Keyword: nasal obstruction

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A Case of Cerebrospinal Fluid Leakage Repair with Forearm Free Flap after Craniofacial Resection of Sinonasal Undifferentiated Carcinoma (비부비동 미분화암의 두개안면절제술 후 전완부자유피판을 이용한 뇌 척수액 유출 폐쇄 시행 1례)

  • Song, Kee Jae;Cho, Jin Mo;Jung, Woon-Yong;Kim, Hoon;Hong, Hyun Jun
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.91-94
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    • 2016
  • A 37 year-old male presented with sudden right proptosis and bilateral nasal obstruction. A huge tumor was noted in bilateral nasal cavities, ethmoid sinuses and central frontal sinus on magnetic resonance imaging. Right posterior frontal sinus wall and bilateral medial orbital wall was destructed by the tumor. Complete resection of the tumor was performed via minimal invasive craniofacial resection. Histopaghologic examination revealed sinonasal undifferentiated carcinoma (SNUC). Cerebrospinal fluid leakage was developed after 2 days of the surgery. On the 5th day, anterior skull base was reconstructed with forearm free flap (FFF). The patient got 6000cGy of radiotherapy and survived in 27 months of follow up.

Unilateral Maxillary Sinus Lesion : A Retrospective Study of 318 Cases with Surgical Treatment (수술로써 치료한 일측성 상악동 병변 318예의 후향적 연구)

  • Lee, Ho Byoung;Lee, Sang Hoon;Moon, Ji Seung;Park, Geun Hyung;Koo, Soo Kweon
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.204-211
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    • 2018
  • Background and Objectives : Unilateral maxillary sinus lesions are relatively common but may occur in variety of causes. Therefore, accurate diagnosis and appropriate treatment are needed. The aim of this study is to review patients with unilateral maxillary sinus lesion who underwent surgical treatment and to analyze causes and characteristics of unilateral maxillary sinus lesions with literature review. Materials and Methods : A retrospective chart analysis was completed on 318 patients with unilateral maxillary sinus lesions who underwent surgical treatment from January, 2008 through May, 2018. Clinical history and data such as age, sex, symptoms of initial, radiologic and dental finding, operation type were collected from medical record. Results : Patients mean age was 50.7 years with slight male gender dominance. Most common type was sinusitis (42.7%), followed by odontogenic sinusitis (22.3%) and fungal ball (19.5%). In particular, the most common cause of odontogenic sinusitis was post dental surgery such as implant. Middle meatal antrostomy (90.9%) was accounted for a great part of surgery underwent to patients. Patients complained of post nasal discharge (62.9%), nasal obstruction (40.9%) and odor smell(35.2%) most commonly. Periapical lucency (35.8%) was the most common in CT finding followed by implant perforation (17.3%) and oroantral fistula (12.3%) in odontogenic sinusitis. Conclusions : Unilateral maxillary sinus lesions are relatively common, but they are increasing recently with dental procedures such as implant surgery, and serious adverse effects due to malignant tumors or improper treatment may occur, so accurate diagnosis and treatment are needed.

Surgical Treatment for a Huge Maxillary Ameloblastoma via Le Fort I Osteotomy: A Case Report

  • Jung, Sang-pil;Jee, Yu-jin;Lee, Deok won;Kim, Hyung Kyung;Kang, Miju;Kim, Se-won;Yang, Sunin;Ryu, Dong-mok
    • Journal of Korean Dental Science
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    • v.11 no.2
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    • pp.86-91
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    • 2018
  • Ameloblastomaa are odontogenic benign tumors with epithelial origin, which are characterized by slow, aggressive, and invasive growth. Most ameloblastomas occur in the mandible, and their prevalence in the maxilla is low. A 27-year-old male visited our clinic with a chief complaint of the left side nasal airway obstruction. Three-dimensional computed tomography showed left maxillary sinus filled with a mass. Except for the perforated maxillary left edentulous area, no invaded or destructed bone was noted. The tumor was excised via Le Fort I osteotomy. The main mass was then sent for biopsy and it revealed acanthomatous ameloblastoma. The lesion in the left maxillary sinus reached the ethmoidal sinus through the nasal cavity but did not invade the orbit and skull base. The tumor was accessed through a Le Fort I downfracture in consideration of the growth pattern and range of invasion. The operation site healed without aesthetic appearances and functional impairments. However, further long-term clinical observation is necessary in the future for the recurrence of ameloblastoma. Conservative surgical treatment could be the first choice considering fast recovery after surgery and the patient's life quality.

A Case Report of Atopic Dermatitis with Otitis Media with Effusion and Chronic Rhinitis (삼출성 중이염과 만성 비염을 동반한 아토피 피부염 1례)

  • Lee, Ju-Hyun;Jo, Eun-Heui;Hong, Ji-Eun;Park, Ji-Won;Park, Min-Cheol
    • The Journal of Korean Medicine
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    • v.42 no.1
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    • pp.110-118
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    • 2021
  • Objectives: This study aims to report a case of atopic dermatitis with otitis media with effusion and chronic rhinitis improved by oral administration of Galgeungabanha-tang. Methods: The patient of this case had symptoms such as erythema, abrasions, scales, and itching. She also complained of rhinorrhea, nasal obstruction, cough, sputum, and ear fullness. Considering the fact that she was sensitive to heat, but did not sweat well, and respiratory symptoms often occurred, Galgeungabanha-tang was prescribed. Results: After medication, the symptoms of atopic dermatitis significantly improved from 10 to 2 point. The subjective symptoms of chronic rhinitis and otitis media with effusion also improved considerably. In addition, nasal swelling and purulent exudate almost disappeared. The tympanic membrane, which was swollen due to amber exudate, also changed to a normal gray-white color. Conclusions: Atopic dermatitis accompanied by chronic rhinitis and otitis media was improved after 45 days of medication.

A Case Report of Suspected Allergic Rhinitis in a Patient with LBP Hospitalized at a Korean Medicine Hospital and Treated with Korean Medicine (한방병원에 입원한 요통을 동반한 알레르기 비염 의증 환자에 대한 한방치료 1례)

  • Kim, Sang-yoon;Park, Jin-hun;Kim, So-won;Wang, Yen-min;Baek, Gil-geun;Yun, Sang-hun;Lee, Hyung-chul;Kang, Man-ho;Park, Sung-hwan
    • The Journal of Internal Korean Medicine
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    • v.43 no.5
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    • pp.901-908
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    • 2022
  • Objective: The purpose of this study is to report the efficacy of using Korean medical treatment for suspected allergic rhinitis. Methods: We used Korean medical treatments (herbal medicines and acupuncture) to treat a hospitalized patient with suspected allergic rhinitis. To evaluate the treatment, we used Total Nasal Symptom Scores to measure sneezing, rhinorrhea, itching, and obstruction. The degree of rhinitis was also evaluated using the Visual Analogue Scale, and the patient's generic health status was measured using the European Quality of Life 5 Dimensions Scale. Results: Visual Analogue Scale and European Quality of Life 5 Dimensions Scale scores improved after treatment. The change in Total Nasal Symptom Scores showed that the patient's suspected allergic rhinitis symptoms were relieved. Conclusions: The results of this study suggest that Korean medicine therapies may be effective for treating suspected allergic rhinitis.

A Statistical Analysis of the General Anesthesia for Dental Treatment to Children with Developmental Disability (장애 환자의 소아치과 치료 시 전신마취에 대한 통계적 고찰)

  • Choi, Young-Kyoo;Lee, Sung-Min;Kim, Dong-Ok
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.2 s.3
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    • pp.101-106
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    • 2002
  • Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.

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2 Cases of Bilateral Choanal Atresia (후비공 폐쇄 2례)

  • 심강석;이석용;문태용;윤강묵
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.18.3-19
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    • 1983
  • Choanal atresia, described first by Johann Roedere (1755) is an obstruction between the nasal cavity and nasopharyngeal vault, and the diagnosis and treatment were developed because of severity of the disease. Embryologically, incomplete development of olfactory pit, or failure of nasobuccal membrane to rupture, or persistent remaining of buccopharyngeal membrane, etc, all forms the congenital choanal atresia. And the acquired type was the result from syphilis or diphtheria with a resultant stenosing cicatrix and after the inexpert surgery and the trauma. Multiple abnormalities may be present particularly affecting the head, the heart and the alimentary system in the congenital type. The operative technique employed would depend upon the type of obstruction(whether membranous or bony), the age of the patient, and the presence or absence of any associated pathologic condition. Since Emmert (1853) first tried blind puncture of the atretic plate with the trocar, other surgical techniques have been introduced over the years for the correction of choanal atresia, which were the transnasal, transpalatal, transantral and the transseptal approach. Among them, transpalatal approach was proved to be a popular technique, that it provides a direct route, thus permitting an exact reconstruction and low restenosis rate. Recently, we have experienced two cases of choanal atresia and treated successfully with transpalatal approach, so authors report these cases with a review of the literature.

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Speech Outcome after Closure of Oronasal Fistula Following Cleft Palate Repair: A report of a case (구개봉합술 후 발생한 구비강누공의 폐쇄 후 말소리 결과 : 증례보고)

  • Seo, Min-Gyo;Kim, Da-Wa;Kim, Eun-Ju;Yoon, Bo-Keun;Kim, Seong-Il;Leem, Dae-Ho;Ko, Seung-O;Moon, Seung-Young;Kim, Hyun-Ki;Shin, Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.1
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    • pp.1-6
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    • 2009
  • Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter, had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in $mm^2$. Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.

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Clinical Study on 340 Cases of Allergic rhinitis (荊芥連翹湯加味가 알레르기性 鼻炎에 미치는 效能에 대한 臨床報告)

  • Song, Young-Lim;Kim, Hee-Tack;Roh, Sek-Sun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.8 no.1
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    • pp.163-176
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    • 1995
  • The cilinical study was done in 340 patients with allergic rhinitis who had been dosed with HYUNG GAE YUN GYO TANG GAMI. The results were summarized as follows 1. Distridution by Sex and Age $64\%\;of\;them\;were\;man,\;and\;36\%$ of them were women(It was common to men than to women) Of those who were attacted(very diverse), $25.0\%$ of them were between 10 and 19 years of age(most frequent), $23.8\%$ were between 30 and 39, $18.2\%$ between 20 and 29, $14.1\%$ between birth and 9, $12.6\%$ between 40 and 49, and $6.2\%$ of them were 50 years and over. 2. Duration $47.6\%$ of them suffered from this disease for 1 to 5 years, $13.8\%$ for 10 years or longer, $24.1\%$ for both 5 to 10 years and $7.4\%$ for 6 months to 1 years, and $6.5\%$ shorter than 6 months. 3. Symptom that appeared to them were nasal obstruction($91.5\%$,top), sneezing($90\%$), rhinorrhagir($77.4\%$), headache ($30.9\%$), itch($26.8\%$), nasal discharge through gullet($15.3\%$), and pharyngitis($15.3\%$). 4. Other diseases that occured with it were sinusitis(most often), Atopic keratoconjunctivitis, allergic dermatitis, asthma, otitis media, tonsillitis, hepertropic rhinitis, nasal polyp, and atropic rhinitis(most unusual). 5. Time and Improvement After 6 months 2 cases($20\%$) were improved excellently, 3 cases($30\%$) considerablely, after 6 months to 1 year 5 case($38.5\%$) considerably, after 1 year to 5 year 10 cases($13\%$) excellently, 20 cases ($26\%$) considerably, after 5 year to 10 years 4 cases($8.7\%$) excellently, 13 cases($28.3\%$) considerable, and after 10 years 2 cases($10\%$) improved excellently, 2 cases($10\%$) considerab. 6. Dosage and Improvemont With 10 papers 6 cases($7.8\%$) were improved excellently, 22 cases($27.8\%$) considerably, with 20 papers 4 cases($10.3\%$) were improved excellently, 6 cases($15.4\%$) considerably, with 30 papers 3 cases($15.8\%$) excellently, 2 ($10.5\%$) considerably, with 40 papers 3 cases($23.1\%$) excellently, 5($38.5\%$) considerably, with 50 papers 1 cases($10\%$) excellently, 4($40\%$) considerably, with 60and 70 papers one cases($33.3\%,\;100\%$) for each was improved considerable, with 80 papers 1 cases($100\%$) excellently, and 90 papers 2 cases($66.6\%$) considerable. 7. Improvement with additional outward application With external application 8 cases($16.6\%$) were improved excellently, 9 cases($18.7\%$) considerably without external application 10 cases($8.4\%$) were improved excellently, 34 cases($28.8\%$) considerably. 8. General Improvement 18 cases($10.8\%$) were improved excellently, 43 cases($25.9\%$) improved considerably, and 40 cases($24.0\%$) improved quite a little.thus has improvement shown in 60.8 per cent of case, and proved its efficacy.

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A Clinical Study of Hypersensitive rhinitis including Allergic rhinitis (알레르기성 비염을 포함하는 과민성 비염 환자에 관한 임상적 연구)

  • Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.2
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    • pp.169-182
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    • 2002
  • Background: Allergic rhinitis(AR) is a heterogeneous disorder that despite its high prevalence is often undiagnosed. It is characterized by one or more symptoms including sneezing, itching, nasal congestion, and rhinorrhea. And it is frequently accompanied by symptoms involving the eyes, ears, and throat, including postnasal drainage. There are many different causes of rhinitis in children and adults. Approximately 50$\%$ of all cases of rhinitis are caused by allergy. In the case of rhinitis caused by allergens, symptoms arise as a result of inflammation induced by a gamma globulin E-mediated immune response to specific allergens such as pollens, molds, animal dander, and dust mites. The immune response involves the release of inflammatory mediators and the activation and recruitment of cells to the nasal mucosa. AR is similar to 鼻?, hypersensitive rhinitis in Oriental Medicine. I think hypersensitive rhinitis is including of AR, vasomotor rhinitis and non-allergic rhinitis related with eosinophil increased and so on. Purpose: To perform a clinical analysis of hypersensitive rhinitis including allergic rhinitis and estimate the efficacy of Oriental Medical treatment. Objective: We studied 96 patients who had visited our hospital with complaints of nasal symptoms from March 2000 to February 2002; they had the signs more than 2 - nasal obstruction, watery discharge, sneezing and eye or nasal itching. Parameters Observed & Methods: We treated them with acupuncture & herb-medication. Sometime they used aroma oil or external medicine. 1) the distribution of sex & age groups 2) the clinical type based on duration & the severity of symptom 3) the breakdown of complication & pasl history of Otolaryngologic or allergic disease 4) the clinical assessment and classification of rhinitis(sneezers and runners & blockers) 5) the associated symptoms and signs 6) the classification of Byeonjeung 7) the classification of prescriptions and 8) the efficacy of treatment. Result: 1. In the clinical type of based on duration, the intermittent type was 42.7$\%$ and the persistent was 57.3$\%$. 2. We observed the severity of symptoms based on the quality of life. The mild type was 24.0$\%$ and the moderate-severe was 76.0$\%$. 3. In the clinical assessment and classification of rhinitis, the sneezers and runners type was 69.8$\%$ and the blockers was 30.2$\%$. 4. The most common family history with otolaryngologic or allergic disease were allergic rhinitis(17.7$\%$), urticaria, paranasal sinusitis and T.B.(3.1$\%$). 5. The most common past history with otolaryngologic or allergic disease were paranasal sinusitis(14.6$\%$), atopic dermatitis and asthma(8.3$\%$). It was 31.3$\%$ they had a family history and 44.8$\%$, past history. 6. The most common complication was paranasal sinusitis(15.6$\%$). In decreasing order the others were otitis media with effusion(9.4$\%$), GERD and headache(6.3$\%$), asthma, bronchitis, nasal bleeding and allergic dermatitis(5.2$\%$). 7. Classification through Byeonjeung : ⅰ) 39 cases(34.9$\%$) were classified as showing Deficiency syndrome. The insuffficiency of Qi was 17.7$\%$, deficiency of Kidney-Yang, 12.5$\%$ and Lung-Cold, 10.4$\%$. ⅱ) 57 cases(59.4$\%$) were classified as showing Excess syndrome. The Fever of YangMing-meridian was 35.4$\%$, Lung-Fever, 24.0$\%$. 8. The efficacy of treatments showed: an improvement in 22cases(22.9$\%$); an improvement partly in 24 cases(25.0$\%$); no real improvement or changes in 16 cases(16.7$\%$); and couldn't check the results 18cases(18.6$\%$). Conclusion: We suggest that this study could be utilized as a standard of clinical Oriental Medical treatment when we treat hypersensitive rhinitis including allergic rhinitis.

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