Sam Hyun Kwon

Increased expression of IL-4, IL-5, IFN-gamma, IL-6, IL-8, and TGF-beta mRNAs in maxillary mucosa of patients with chronic sinusitis.

This study aimed to investigate expression of various cytokine mRNAs, including IL-6, IL-8, TGF-β, IL-4, IL-5, and IFN-γ in maxillary sinus mucosa of patients with chronic sinusitis. Maxillary sinus mucosae of six patients with chronic sinusitis and turbinate mucosae of six healthy subjects were obtained. We performed RT-PCR and Southern blot to examine gene expression of the cytokines IL-6, IL-8, TGF-β, IL-4, IL-5, and IFN-γ in maxillary sinus mucosa and compared the results with cytokine gene expressions in normal turbinate mucosa. IL-6, IL-8, TGF-β, IL-4, IL-5, and IFN-γ mRNAs were expressed more frequently in maxillary sinus mucosa from patients with chronic sinusitis than in normal turbinate mucosa. All the maxillary sinus mucosa specimens revealed relatively higher mean density ratio for each cytokine investigated than did normal turbinate mucosa. IL-6, IL-8, TGF-β, IL-4, IL-5, and IFN-γ mRNAs were expressed simultaneously in maxillary sinus mucosa of chronic sinusitis. These cytokines may be responsible for recruitment of inflammatory cells and for mucosal thickening in chronic sinusitis, and thus chronicity of the disease.

The Assessment of Nasality with a Nasometer and Sound Spectrography in Patients with Nasal Polyposis

With the development of computerized acoustic analysis systems, an objective measure of nasal speech has become readily available by means of a simple, noninvasive technique. In this study, we assessed the nasality in patients with multiple nasal polyposis before and after endoscopic sinus surgery. With the nasometer, we measured nasalance, which reflects the ratio of acoustic energy output of nasal sounds from the nasal and oral cavities, and the slope score of the nasogram curve. The nasalance scores of nasal sentences and the slope scores of the nasogram curves for all nasal consonants were significantly lower in patients with nasal polyposis than in healthy subjects. After surgery, however, the nasalance and slope scores increased significantly to the normal range. On the sound spectrographic analysis, the frequencies of the first nasal formant decreased slightly and the sound intensity increased slightly for all nasal consonants after surgery. However, no significant change was noticed in the frequencies of the second nasal formant. In conclusion, nasometric and sound spectrographic analyses are considered to be useful tools for objectively assessing the extent of nasality in patients with nasal airway obstruction.

The effect of acupuncture on postoperative nausea and vomiting after pediatric tonsillectomy: A meta‐analysis and systematic review

Tonsillectomy is one of the most frequently performed pediatric surgical procedures worldwide. The complications of this procedure include postoperative nausea and vomiting (PONV) and pain; therefore, both the treatment and prevention of PONV are important. Classical antiemetics include drug therapies such as ondansetron, which are undesirable because they often carry a high cost and several side effects. Therefore, in this study we aimed to evaluate the antiemetic effect of acupuncture after pediatric tonsillectomy.

The increasing incidence of paranasal sinus fungus ball: A retrospective cohort study in two hundred forty-five patients for fifteen years.

• There is converging evidence in that the suppression of neural hyperactivity by lateral inhibition using tailormade notch filtering is a promising approach to support tinnitus treatments. • We evaluated a new notched environmental sound technology for the first time as hearing aid-supported tinnitus treatment in 20 tinnitus patients. • This technology employs a notch filter which abruptly filters out environmental sounds in behind-the-ear hearing aids at the tinnitus frequency. • We evaluated this new approach using a double-blind pre-/post-therapy evaluation in 20 tinnitus patients (10 controls, 10 patients with notched environmental sound) using a widely accepted psychometric instrument and objective electroencephalographic means. • The subjective and objective results show that tailormade notch filtering in hearing aids might support tinnitus treatments.

Treatment outcomes of sinonasal malignant melanoma: a Korean multicenter study.

The aim of this work was to evaluate factors that influence local recurrence and survival after surgical resection of sinonasal malignant melanoma, using a large population‐based multicenter study in Korea.

Is nonabsorbable nasal packing after septoplasty essential? A meta‐analysis

Septoplasty is one of the most frequently performed rhinologic surgeries. Complications include nasal bleeding, pain, headache, septal hematoma, synechia, infection, residual septal deviation, and septal perforation. In this study, we aimed to compare complication rates among patients according to packing method.

The increasing incidence of paranasal organizing hematoma: a 20-year experience of 23 cases at a single center.

BACKGROUND AND OBJECTIVES Sinonasal organized hematoma is a rare, benign disease that can be locally aggressive and may be mistaken for malignancy. Because of its rarity, the clinical characteristics are not well known. The aim of this study is to investigate the distinguishing features of organized hematoma with an emphasis on incidence change. MATERIALS AND METHODS In this retrospective study, we reviewed the records of 23 patients with organized hematoma confirmed histopathologically among 5,378 patients who underwent endoscopic sinus surgery performed by a single surgeon from January 1995 to December 2014 at a tertiary care center. Clinical symptoms, endoscopic photography, computed tomography, and operative findings were reviewed. We also reviewed the relevant literature. Age, sex, site, origin subsite and histopathology were investigated. A statistical review was performed using R 3.1.2 to examine incidence change. RESULTS The most common complaint was frequent epistaxis and nasal obstruction (52.1%). Of the 23 patients, eight were women and 15 were men with an age range of 18 to 75 years. (mean 38.9 years). Nine of these hematomas occurred on the right side and 14 on the left side. The predominant occurrence site was the antrum (65%), followed by the septum (17.3%), inferior turbinate (8%), and ethmoid sinus (8%). The incidence steadily increased over 20 years. CONCLUSION Investigation of the clinical characteristics and incidence change of organized hematoma can provide useful information. Through analysis of the 23 cases in our study, the age distribution was found to be bimodal and the incidence of organizing hematoma was observed to steadily increase. Clinicians should be aware of these characteristics to avoid misdiagnoses of malignant tumors.

Recurrence of sinonasal inverted papilloma following surgical approach: A meta-analysis.

Inverted papilloma (IP) is a rare benign tumor, which is found in the sinonasal area. It is characterized by recurrence, local destruction, and malignant change. Of these, recurrence is a challenging problem to many otolaryngologists. In this study, we evaluated recurrence based on the type of surgical approach using a meta‐analysis.

Can Intracapsular Tonsillectomy Be an Alternative to Classical Tonsillectomy? A Meta-analysis

Objective Tonsillectomy is the most common operation performed in the otolaryngologic fields. Efforts have been made to reduce postoperative complications, and one of these is intracapsular tonsillectomy and adenoidectomy (ICTA), which leaves the tonsillar tissue with tonsillar capsule. This study aimed to evaluate intracapsular tonsillectomy compared with classical extracapsular tonsillectomy in terms of efficacy of the technique for managing obstructive sleep apnea (OSA) and reducing postoperative complications. Data Sources We performed a literature search using PubMed, EMBASE, and the Cochrane Library through December 2016. Review Methods Summarized risk ratio (RR), risk differences (RDs), and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were estimated by summarizing the risk estimates of each study using random-effects models that considered both within- and between-study variations. Results Our search included 15 randomized controlled studies. The RRs for postoperative bleeding and residual tonsils were, respectively, 0.44 (P = .01) and 6.02 (P = .0002). There were significant differences in postoperative pain (P = .0022), need for analgesics (P < .0001), days to normal diet (P = .006), and days to normal activity (P < .00001) between intracapsular tonsillectomy and extracapsular tonsillectomy. Conclusions Intracapsular tonsillectomy can effectively reduce postoperative pain and bleeding, which shortens the time required to return to normal life. There was no difference between microdebrider and coblator in intracapsular tonsillectomy regarding postoperative pain and bleeding. It can increase the risk of remnant tonsils; however, it does not increase the risk of recurrent infection.

Atypical Kawasaki disease presenting as a retropharyngeal abscess

Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology, also called an acute febrile mucocutaneous lymph node syndrome, which is first identified by Dr. Tomisaku Kawasaki in 1967. This disease is characterized by fever, erythematous rash, cervical lymphadenitis, strawberry tongue, nonpurulent conjunctivitis and desquamation of hands and feet. Of these symptoms, the most infrequent symptom is cervical lymphadenitis (50%--75%) while the others occur in 90% of the cases. Cervical lymphadenitis as initial presenting symptom occurs in only 12% of the times and may be misdiagnosed as other disease entity. KD involves all blood vessels, especially medium sized vessels like the coronary artery. In this regard, KD may cause severe complications with delayed treatment. Image of retropharyngeal low-density area, in addition to retropharyngeal abscess and edema is usually associated to a fatal condition if not appropriately treated. Otolaryngologists are familiar with this disease and may treat it withA doença de Kawasaki (DK) é uma vasculite sistêmica aguda de etiologia desconhecida, também denominada síndrome do linfonodo subcutâneo, originalmente identificada pelo dr. Tomisaku Kawasaki, em 1967. Essa doença é representada por febre, erupção eritematosa, linfadenite cervical, língua em morango, conjuntivite não purulenta e descamação das mãos e pés. Desses sinais e sintomas, o menos frequente é a linfadenite cervical (50-75%), sendo que os outros ocorrem em 90% dos casos.1 Como manifestação inicial, a linfadenite cervical ocorre em apenas 12%,2 podendo ser equivocadamente diagnosticada como outra entidade nosológica. DK envolve todos os vasos sanguíneos, especialmente os de calibre médio, como a artéria coronária. Nesse tocante, DK pode causar graves complicações, se houver atraso no tratamento. Imagens com áreas de baixa densidade retrofaríngea, associadas a abscesso retrofaríngeo e edema, podem significar uma condição fatal se não for apropriadamente tratada. Os otorrinolaringologistas estão familiarizados com a doença e podem tratar esse abscesso por meio de cirurgia, objetivando a drenagem e, com isso, prevenindo o bloqueio das vias aéreas. DK acompanhada por abscesso retrofaríngeo é doença muito rara e pode se constituir em desafio para muitos otorrinolaringologistas. Tivemos a oportunidade de examinar uma menina com 9 anos que se apresentou como tendo um abscesso retrofaríngeo, o que resultou em atraso no diagnóstico.