• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.21 no.3
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• pp.140-149
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• 2008

Objective : This study was performed to find out the difference of symptoms between rhinitis and sinusitis in young patients who were diagnosed by PNS plain radiograph( PNS series), Methods: We did statistical analysis about 147 new outpatients under 12 year-old who had visited the department of ophthalmology, otolaryngology, dermatology in Kyung Hee Oriental Medicine Center from March 2, 2006 to February 29, 2008. All of the patients were diagnosed by PNS series and we divided the patients with two groups; rhinitis group and sinusitis group. We checked the OPD records and explore the distribution on sex, experience of past western therapy, age and duration. Then we divided symptoms into nine; 'nasal obstruction', 'purulent rhinorrhea', 'cough & sneezing', 'watery rhinorrhea', postnasal drip', 'sputum', 'head problem', 'snoring & throat discomfort' and 'epistaxis'. We also divided age into 2 groups: $0\sim7$ years old and $8{\sim}12$ years old. We carried out chi-square test as a statistical method. Results : The results were as follows. 1. Sinusitis group were 102(69.5%); 62 have only sinusitis. 40 have both sinusitis and adenoidal hypertrophy. Rhinitis group were 45(30.5%); 13 have adenoidal hypertrophy and 32 were negative. 2. Male were 98(sinusitis 65, rhinitis 33), female were 49(sinusitis 37, rhinitis 12). 3. Patients who had experienced past western therapy were 120(sinusitis 81, rhinitis 39), no experienced patients were 27(sinusitis 21, rhinitis 6). 4. Distribution on age of sinusitis was 1(1 yr), 2(2 yrs), 3(3 yrs), 15(4 yrs), 15(5 yrs), 23(6 yrs), 13(7 yrs), 12(8 yrs), 8(9 yrs), 5(10 yrs), 1(11 yrs), 4(12 yrs). Distribution on age of rhinitis was 1(1 yr), 0(2 yrs), 1(3 yrs), 1(4 yrs), 9(5 yrs), 5(6 yrs), 3(7 yrs), 5(8 yrs), 1(9 yrs), 8(10 yrs), 6(11 yrs), 5(12 yrs), 5. Duration of sinusitis was 20(<2 months), 6($2{\sim}3$ months), 11($3\sim6$ months), 34($6\sim12$ months), 31(>12 months) and of Rhinitis was 11(<2 months), 0($2\sim3$ months), 5($3\sim6$ months), 18($6\sim12$ months), 11(>12 months) 6. Distribution on symptoms, sinusitis patients were 86(nasal obstruction), 52(purulent rhinorrhea), 46(cough & sneezing), 38(watery rhinorrhea), 41(postnasal drip), 23(sputum), 18(head problem), 15(snoring & throat discomfort), 6(epistaxis). The each symptom and sinusitis have no relation by chi-square test. 7. The number of patients who were 0 $\sim$ 7 years old was 92: sinusitis 72(49%), non-sinusitis 20(13.6%). The number of patients who were 8 $\sim$ 12 years old was 58: sinusitis 30(20.4%), non-sinusitis 25(l7%). By chi-square test(confidence level 95%), sinusitis and age under 7 have a significant relation(p=0.003). Conclusions : There is no relation between rhinologic symptoms and sinusitis. Patients under 7 years old with rhinologic symptoms tend to have sinusitis.

• Journal of Rhinology
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• v.25 no.2
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• pp.108-113
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• 2018

Cholesterol granuloma is a disease in which cholesterol crystals act as a foreign substance in the surrounding tissues and cause granulomatous reaction and fibrosis within the chamber. It is found in various locations of the body, but the most common location is the temporal bone associated with middle ear disease. Because the disease is associated with breathing disturbance, it may also occur in the paranasal sinus. However, it has been rarely reported since its first report by Graham and Michaels in 1978. Recently, we experienced a case of cholesterol granuloma of the right maxillary sinus of a 63-year-old female patient without any nasal symptoms. We successfully managed this case with Caldwell-Luc operation. Also, we summarized the cases of cholesterol granuloma of the sinonasal region reported in Korea.

• Journal of Rhinology
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• v.25 no.2
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• pp.114-117
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• 2018

Postoperative maxillary cyst (POMC) is relatively common complication among patients who underwent Caldwell-Luc surgery. Patients with POMC usually have no symptoms, although cyst extension can result in bone destruction or cystic infection with pain. The trigeminal nerve consists of the ophthalmic nerve, maxillary nerve, and mandibular nerve. Among these branches, the maxillary nerve runs to the lateral and frontal sides of the maxillary sinus wall. POMC can rarely lead to trigeminal neuropathy caused by cyst enlargement that compresses some branches of the trigeminal nerve. Recently, we experienced a case with trigeminal neuralgia due to POMC. The patient was successfully treated with inferior meatal antrostomy. We report this rare case with a literature review.

• Journal of Rhinology
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• v.25 no.2
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• pp.103-107
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• 2018

Pregnancy rhinitis is a relatively common condition. It is characterized by the presence of nasal symptoms, especially nasal congestion, not present prior to pregnancy, but typically present during the last 6 or more weeks of pregnancy, without other signs of respiratory tract infection or any known allergic causes, and disappearing completely within 2 weeks after delivery. Nasal saline irrigation, intranasal steroid spray, and oral antihistamines are usually recommended as the first line of treatment for rhinitis. However, most pregnant women refuse medical treatment for pregnancy rhinitis because of the fear of teratogenicity. Severe pregnancy rhinitis increases the risk of snoring, which has been suggested as having adverse effects on the fetus. In cases where the patients are unable to control their symptoms, pregnancy rhinitis can negatively affect the quality of life (QOL) as well as the pregnancy outcome. Therefore, special caution is required for determining the appropriate diagnosis and treatment modalities for pregnancy rhinitis. Here, we report for the first time, the successful treatment of pregnancy rhinitis that was unresponsive to conservative management and medical therapy by using microdebrider-assisted inferior turbinoplasty at the final stages of pregnancy, along with a review of the relevant literature.

• Journal of Rhinology
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• v.25 no.2
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• pp.86-90
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• 2018

Background and Objectives: Although polyvinyl acetate ($Merocel^{(R)}$) has been widely used as a packing material after septoplasty, removable nasal packing can increase patient discomfort, local pain, and pressure. Furthermore, the removal of nasal packing has been described as the most uncomfortable and distressing feature associated with septoplasty. The purpose of this study was to investigate the efficacy of polyvinyl acetate with carboxymethyl cellulose sheet ($Rhinocel^{(R)}$) nasal packing on patient subjective symptoms, degree of bleeding, hemostasis, and wound healing following septoplasty. Subjects and Method: Forty patients with nasal septum deviation requiring septoplasty were included. Following surgery, one nasal cavity was packed with $Rhinocel^{(R)}$ and the other one with $Merocel^{(R)}$. Patient subjective symptoms while the packing was in situ, hemostatic properties, pain on removal, degree of bleeding on removal, duration of hemostasis after removal, postoperative wound healing, and the cost of the pack were evaluated. Results: Although the two types of packing materials were equally effective in controlling postoperative bleeding after septoplasty, $Rhinocel^{(R)}$ was significantly more comfortable while in situ and less painful on removal than $Merocel^{(R)}$, which was associated with significantly more bleeding on removal and so more time was needed to control hemorrhage. There was no significant difference in postoperative wound healing or pack cost. Conclusion: The use of $Rhinocel^{(R)}$ after septoplasty has less discomfort, greater patient satisfaction, and less bleeding on removal with no adverse reactions compared to $Merocel^{(R)}$ packing. Therefore, $Rhinocel^{(R)}$ may be a useful packing material after septoplasty.

• Journal of Rhinology
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• v.25 no.2
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• pp.69-74
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• 2018

Background and Objectives: Sleep disturbances and excessive daytime sleepiness (EDS) are the major symptoms of obstructive sleep apnea (OSA). This study aimed to investigate clinical implications of insomnia and EDS in patients with OSA using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Materials and Method: We evaluated 131 subjects with suspected OSA who were undergoing polysomnography (PSG) and performing the PSQI and ESS surveys. OSA was diagnosed when the apnea-hypopnea index was five or more. EDS was defined when ESS score was 11 points or higher. Detailed history and questionnaire were used to categorize insomnia. We compared clinical variables and PSG results in subgroups with or without insomnia and EDS. Results: There were no significant differences of PSQI and ESS score between controls and OSA. OSA with insomnia had significantly increased total score (p<0.001) and decreased total sleep time (p=0.001) and sleep efficiency (p=0.001) on the PSQI compared to those without insomnia. OSA with EDS showed significantly increased PSQI score (p=0.022) and decreased total sleep time (p=0.018) on PSG compared to those without EDS. Neither PSQI nor ESS score had a correlation with respiratory variables such as AHI and oxygen saturation. Total sleep time had a significant effect on both insomnia and EDS in patients with OSA. Conclusion: Decreased total sleep time had important effects on subjective symptoms of OSA and comorbid insomnia. Therefore, restoration of decreased sleep time is important in the management of OSA.