• Title/Summary/Keyword: Nasal Obstruction

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Organized Hematoma in the Maxillary Sinus (상악동에 발생한 organized hematoma)

  • Kim, Jae-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.5
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    • pp.473-477
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    • 2010
  • Organized hematoma of the maxillary sinus is a rare, nonneoplastic benign lesion with locally destructive behavior that may mimic a malignancy. Clinically, symptoms do not usually occur while the lesion remains localized to the maxillary sinus. Because there is gradual enlargement of the lesion causing erosion and displacement of the adjacent bony structures, symptoms such as epistaxis, cheek swelling, nasal obstruc-tion, headache, and exophthalmos become manifest. Radiologically, unilateral cases are much more fre-quent than bilateral, and Waters' view shows complete opacity of the expanded maxillary sinus and some masses. CT scan shows a large heterogeneous enhancing mass causing considerable expansion of the max-illary sinus with bony erosion. On MR imaging, the mass usually has a variable signal intensity on T1- and T2- weighted images, ranging from low to high. After contrast administration, discrete areas of enhance-ment are present within the mass. Although the disease is essentially benign and nonneoplastic, differen-tial diagnosis from neoplastic disease including malignancy both clinically and radiologically has been always problematic. Accurate preoperative diagnosis of organized hematoma of the maxillary sinus is important to avoid unnecessary extensive surgery, because this condition is curative with a simple, conservative surgical approach and rarely recur. Organized hematoma of the maxillary sinus should be included in the differential diagnosis when patients have recurrent epistaxis, slow-growing mass of the cheek, nasal obstruction, and expansile mass in the maxillary sinus. A 33-year-old man was referred to the department of oral and maxillofacial surgery with a three-month history of slowly growing painful swelling of the left cheek. The mass of the maxillary sinus was resected by a Caldwell-Luc approach. Histopahtoly showed only a fibous encapsulated organized hematoma. To our knowledge, organized hematoma of the maxillary sinus has not been previously described in the Korean literature of the oral and maxillofacial surgery. We report a case of organized hematoma of the maxillary sinus presenting with an enlarging maxillary sinus mass.

Image-guided navigation surgery for bilateral choanal atresia with a Tessier number 3 facial cleft in an adult

  • Sung, Ji Yoon;Cho, Kyu-Sup;Bae, Yong Chan;Bae, Seong Hwan
    • Archives of Craniofacial Surgery
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    • v.21 no.1
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    • pp.64-68
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    • 2020
  • The coexistence of craniofacial cleft and bilateral choanal atresia has only been reported in three cases in the literature, and only one of those cases involved a Tessier number 3 facial cleft. It is also rare for bilateral choanal atresia to be found in adulthood, with 10 previous cases reported in the literature. This report presents the case of a 19-year-old woman with a Tessier number 3 facial cleft who was diagnosed with bilateral choanal atresia in adulthood. At first, the diagnosis of bilateral choanal atresia was missed and septoplasty was performed. After septoplasty, the patient's symptoms did not improve, and an endoscopic examination revealed previously unnoticed bilateral choanal atresia. Computed tomography showed left membranous atresia and right bony atresia. The patient underwent an operation for opening and widening of the left choana with an image-guided navigation system (IGNS), which enabled accurate localization of the lesion while ensuring patient safety. Postoperatively, the patient became able to engage in nasal breathing and reported that it was easier for her to breathe, and there were no signs of restenosis at a 26-month follow-up. The patient was successfully treated with an IGNS.

Clinical Study in 17cases of patients for sinusitis(treated with aroma-therapy) (향기요법(香氣療法)을 병행(幷行)한 소아비연(小兒鼻淵) 환자(患者) 17예(例)에 대한 임상적(臨床的) 연구(硏究))

  • Han Jae-Kyung;Kim Yun-Hee;Kim Yeon-Jin
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.2
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    • pp.105-120
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    • 2000
  • Clinical studies were done treated with aroma-therapy in 17cases of patients for suffering sinusitis, who were treated at Dept. of Pediatrics in the Hospital of Daejon from March 2000 to November 2000. The results were as follows. 1. In distribution of sex & age, 70.6% was men and 29.4% women. 47.1% was between 5 and 7 years old, 35.3% within 5 years old. 2. In distribution of the period of the clinical history, 35.3% was over 6 momths, 29.4% of them between 6 and 12 months. 3. In the living environment the apartment was 58.5% and the residental zone is 29.4%. 4. The incurrence of season is winter, 47.0% next is change of season, 29.4%. 5. At night the symptom is the most common, 52.9%. In the morning is the next, 35.3%. 6. In the past history. tinnitus was the best at 38.4%. The otitis media. atopic dermatitis, convulsion disease is next at 15.4%. 7. In the family history. the allergic rhinitis or sinusitis is the most rich at 38.4% and tinnitus is next at 23.0%. 8. In distribution of the chief complain companied with sinusitis, 23.3% was nasal obstruction, each 18.4% of them nasal discharge, cough. 9. In distribution of the duration of therapy, 29.4% was over 6 months, 23.5% between 5-6 months. In distribution of the therapeutic method, 47.1% was treated with western and oriental medicine and 42.1% only oriental medical care. 10. In distribution of the period of improvement of symptom(by X-ray reading), 35.2% was between 2-3 momths, 29.4% between 1-2 months. 11. In emotional change, after aroma-therapy, 82.4% of them felt good. 12. After treatment, 70.6% was excellent, 17.6% was good.

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Inhibitory Effect of Hyeonggaeyeongyo-tang Water Extract on production of Nitric Oxide, IL-6 and Expression of iNOS, COX-2 in LPS - Activated Raw 264.7 Cells (형개영교탕(荊芥蓮翹湯)이 lipopolysaccharide로 유도된 nitric oxide의 생성 및 iNOS와 COX-2의 발현, cytokine에 미치는 영향)

  • Kim, Min-Ji;Lee, Jong-Rok;Kim, Sang-Chan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.2
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    • pp.491-497
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    • 2007
  • Hyeonggaeyeongyo-tang (HYT; Jingjielianqiao-tang), is known to be effective in lowering wind-heat blended as a pathogen of kidney. HYT has been traditionally used for the treatment of a syndrome in kidney meridian, due to invasion of pathogenic wind and heat. Nowadays, this prescription is used to treat diseases marked by excessive wind and heat in the kidney meridian, such as acute otitis media, empyema, hypertrophic rhinitis, nasal bleeding, nasal obstruction, acne and tonsillitis. The present study was conducted to evaluate the effect of HYT on the regulatory mechanism of cytokines and nitric oxide (NO) for the immunological activities in Raw 264.7 cells. After the treatment of HYT water extract, cell viability was measured by MTT assay, NO production was monitored by measuring the nitrite content in culture medium. Cyclooxygenase-2 (COX-2_ and inducible nitric oxide synthase (iNOS) were determined by immunoblot analysis, and levels of cytokine were analyzed by sandwich immunoassays. The production of No was significantly inhibited by pre-treatment (1h) with HYT(0.1-0.3 mg/ml) on LPS-activated Raw264.7 cells. The expression of iNOS and COX-2 protein were up-regulated by LPS, but the increased levels of iNOS and COX-2 were inhibited by pre-treatment of HYT (0.3-1.0 mg/ml), respectively. And the level of interleukin-6 (IL-6), cytokine released from macrophage, was reduced by HYT pre-treatment (0.3-1.0 mg/ml). Thus, the present data suggest that HYT may play an important role in adjunctive therapy in Gram-negative bacterial infections.

A Case of Early Diagnosed Hunter Syndrome Detected by Large Head on Routine Examination (큰 두위를 주소로 내원하여 헌터 증후군으로 일찍 진단된 증례 1례)

  • Lee, Seung Ho;Park, Woo Sung;Lee, Young Seok;Yu, Jeesuk
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.2
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    • pp.156-162
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    • 2014
  • A 25-month-old boy was referred to the hospital due to large head detected on routine physical examination. At visit, dysmorphic facial appearances, including broad nose, prominent forehead, and coarse face, were noted. Nasal obstruction with nasal voice, prominent adenoids, and bilateral middle ear effusions were detected. His abdomen was distended, and liver and spleen were palpated about 3 finger and 2 finger breadths, respectively. He was operated for bilateral inguinal hernias. The motion of both elbow joints was mildly limited on supination and pronation. Urinary level of glycosaminoglycan was elevated and the enzyme activity of iduronate sulfatase in leukocytes was decreased. The mutational analysis of the gene iduronate 2-sulfatase (IDS) revealed c.263G>A (p.Arg88His) mutation. His developmental scale showed delayed development and there was cardiac valvular involvement (tricuspid regurgitation and mitral valve prolapse). After the diagnosis of Hunter syndrome, enzyme replacement therapy started on a weekly basis without progression of any clinical features. Here we report a case of early diagnosed Hunter syndrome detected by large head on routine examination. Thus, it is important to associate Hunter syndrome in the patient with large head especially, if there is the history of bilateral inguinal hernia and prominent adenoids to increase the possibility of early diagnosis and treatment.

Successful High Flow Nasal Oxygen Therapy for Excessive Dynamic Airway Collapse: A Case Report

  • Park, Jisoo;Lee, Yeon Joo;Kim, Se Joong;Park, Jong Sun;Yoon, Ho Il;Lee, Jae Ho;Lee, Choon-Taek;Cho, Young-Jae
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.455-458
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    • 2015
  • Excessive dynamic airway collapse (EDAC) is a disease entity of excessive reduction of the central airway diameter during exhalation, without cartilage collapse. An 80-year-old female presented with generalized edema and dyspnea at our hospital. The patient was in a state of acute decompensated heart failure due to pneumonia with respiratory failure. We accordingly managed the patient with renal replacement therapy, mechanical ventilation and antibiotics. Bronchoscopy confirmed the diagnosis of EDAC. We scheduled extubation after the improvement of pneumonia and heart condition. However, extubation failure occurred due to hypercapnic respiratory failure with poor expectoration. Her EDAC was improved in response to high flow nasal oxygen therapy (HFNOT). Subsequently, the patient was stabilized and transferred to the general ward. HFNOT, which generates physiologic positive end expiratory pressure (PEEP) effects, could be an alternative and effective management of EDAC. Further research and clinical trials are needed to demonstrate the therapeutic effect of HFNOT on EDAC.

A Clinical study of Paranasal Sinusitis (副鼻洞炎에 關한 臨床的 硏究)

  • Choi, In-hwa;Chae, Byung-yoon
    • 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.

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The Effects of Tongkwansan on the Changes of Total IgE and Specific IgE in Allergic Rhinitis Mouse Model (알레르기성 비염 모델에서 통관산(通關散)이 Total IgE, specific IgE 생산에 미치는 영향)

  • Lee, Seung-Joo;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.20 no.1 s.32
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    • pp.16-26
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    • 2007
  • Background &Objectives : Rhinitis is an inflammation of nasal mucosa and the major symtoms are watery rhinorrhea, sneezing, itchy nose, and nasal obstruction. Rhinitis is classified into allergic rhinitis and nonallergic rhinitis. Allergic rhinitis is an immune reaction by allergen, and vasomotor rhinitis which is nonallergic and noninfectious is hypersensitive reaction. The incidence of allergic rhinitis has increased and the rate of vasomotor rhinitis is high. However there have been no studies about vasomotor rhinitis compared with allergic rhinitis. And there have been no studies so far performed on the effect of Tongkwansan. Therefore this study is aimed to find out the effects of Tongkwansan on allergic rhinitis and vasomotor rhinitis. Materials and Methods : Fifteen BALC/c mouses were divided into three groups : normal group, control group and sample group. To induce the allergic rhinitis in control group and sample group, mouses were sensitized intrapertioneally 0.1% ovalbumin solution three times at intervals of 1 week. Then intranasal sensitization was performed by diffusing 0.1 % ovalbumin solution 3 times at intervals of 2 days. After that time, mouses in the sample group were oral administration treated by Tongkwansan for 28 days. We observed changes in the segment of IL-4, IL-5, $IFN-{\gamma}$, Total IgE, and ovalvumin specific IgE in blood. We used the statistical methods of ANOVA test(p<0.05). Results : There were no significant changes statistically in $IFN-{\gamma}$, IL-4, and IL-5 in blood(p<0.05). There were also no significant changes statistically in Total IgE, OVA-specific IgE in blood(p<0.05). Conclusion : According to above results, it is supposed that Tongkwansan has no significant effects on allergic rhinitis. But it is supposed that Tongkwansan has significant effects on vasomotor rhinitis which is nonallergic and noninfectious

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A Study on Oriental Medical Treatment Programs for Adolescents with Rhinitis in Collaboration with Community Health Center (청소년 비염 환자에 대한 보건소 연계 한방치료 효과에 관한 연구 - 피내침과 한약을 이용한 치료 효과 -)

  • Kim, Jong-Uk;Cho, Yi-Hyun;Lee, Jin-Bok;Im, Jeong-Gyun;Song, Beom-Yong;Yook, Tae-Han;An, Seung-Hun
    • Korean Journal of Acupuncture
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    • v.27 no.3
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    • pp.57-65
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    • 2010
  • Objectives : The purpose of this study is to investigate for rhinitis of middle school students and to confirm the effect of oriental medical treatments on rhinitis. We proceeded with this oriental medical treatment programs in collaboration with community health center. Methods : We have given oriental medical treatment, such as herbal medicines(pillet type Gamisinicheongpye-um and ointment) and intradermal acupuncture therapy at Hapgok (LI4), Yeonghyang (LI20), Indang, Bi-ik points, to patients for 9 weeks. Results of this treatment program were evaluated on a 4-point-scale depends on symptoms ; 'severe ()', 'moderate (++)', 'mild (+)' and 'no symptom (-)'. Results : After oriental medical treatments, rhinitis symptoms (sneezing, rhinorrhea, nasal obstruction, nasal itching and dysosmia) were improved significantly compared to before treatments (p<0.05). Conclusions : We confirmed rhinitis treated with oriental medicine should significant improvement and suggest that it is necessary to expand oriental medical treatment programs in collaboration with community health center.

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.