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ABSTRACT: To evaluate baseline disease burden and surgical outcomes between middle turbinate resection and preservation groups consisting of patients diagnosed with chronic rhinosinusitis accompanying nasal polyposis (NP).
Prospective, nonrandomized study.
The preoperative disease burden (extent of NP, Lund-Mackay scores, and subjective symptom scores) was evaluated using nasal endoscopy, computed tomography, and questionnaires. Objective and subjective surgical outcomes were assessed 12 months postoperatively based on endoscopic findings, the Sino-Nasal Outcome Test 20 (SNOT-20), and a visual analogue scale (VAS).
The extent of NP, Lund-Mackay scores, and VAS scores for the two main symptoms were significantly greater in the resection group than in the preservation group. The preservation group had better objective outcomes. Preoperative SNOT-20 and VAS scores were improved significantly at 12 months postoperatively in both groups, and the improvement did not differ significantly between the groups.
The middle turbinate resection group had greater baseline disease burden (severe polyposis, more extensive disease, and poorer symptom scores) than the preservation group. This may be the reason for the poorer objective surgical outcome in the resection group despite more radical surgery. However, the subjective outcomes were successful regardless of the middle turbinate resection or preservation.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 08/2012; 41(4):259-64. · 0.71 Impact Factor
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ABSTRACT: As the molecular biology of vestibular schwannoma (VS) is better understood, new means of targeting the pathways involved for intervention in schwannoma cells are being developed. Honokiol, a bioactive constituent of Magnolia officinalis, has attracted attention due to its diverse biological effects. This study was conducted to determine the inhibitory effect of honokiol on schwannoma cell proliferation.
HEI 193 cells were used to investigate the growth-inhibitory effects of honokiol. Cell proliferation was assessed by MTT assays. Apoptosis was measured by flow cytometry analysis and immunofluorescence staining including Hoechst 33342 and TUNEL. Western blot analysis was used to assess the potential inhibition of extracellular signal-regulated kinase (ERK) and AKT signaling by honokiol.
Honokiol exhibited significant antiproliferative activity in a dose-dependent manner on HEI 193 cells. Significant apoptosis was detected on schwannoma cells with 7 mg/mL(IC50) honokiol. Western blot analysis showed significant inhibition of ERK phosphorylation.
Honokiol, a low molecular weight natural product, inhibits cell proliferation and promotes apoptosis in schwannoma cells by targeting the ERK pathway. Our data suggest that honokiol can be evaluated as a chemotherapeutic agent for VS.
The Laryngoscope 11/2011; 122(1):162-6. · 1.75 Impact Factor
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ABSTRACT: Minithyrotomy is a novel approach that provides direct access to the lamina propria and vocalis muscle without requiring incision of the vocal fold mucosa. The aim of this study was to demonstrate the efficacy of minithyrotomy vocal fold augmentation in a rabbit model by comparing the vocal fold total square amount and the density of scars between the cordotomy with minithyrotomy group and a cordotomy without minithyrotomy group.
Animal study.
Twenty adult laboratory-conditioned female rabbits were used for this study. Minithyrotomy vocal fold augmentation was performed using a single fat block implant 3 months after cordotomy. To compare total square amount and density of vocal folds between the minithyrotomy and cordotomy group, hematoxylin and eosin, Masson's trichrome, and alcian blue staining was used.
Histological examinations showed that minithyrotomy vocal fold augmentation postoperatively restored vocal fold bulkiness and maintained volume for up to 6 months, compared with the cordotomy group (P<0.05). In light of the surgical manipulation, the procedure also did not aggravate scarring of the cordectomized vocal fold.
Minithyrotomy vocal fold augmentation using an autologous fat block may soon be feasible in humans undergoing rehabilitation for postcordotomy dysphonia without causing additional damage to the vocal folds.
Journal of voice: official journal of the Voice Foundation 08/2011; 26(4):521-5. · 0.95 Impact Factor
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Tae-Hoon Kim,
Ji-Yeon Lee,
Jong-Sook Park,
Sung-Woo Park,
An-Soo Jang, Jae-Yong Lee,
Jang-Yul Byun,
Soo-Taek Uh,
Eun-Suk Koh,
Il Yup Chung,
Choon-Sik Park
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ABSTRACT: Aspirin-exacerbated respiratory disease (AERD) refers to the development of bronchoconstriction in asthmatics following the ingestion of aspirin. Although alterations in eicosanoid metabolites play a role in AERD, other immune or inflammatory mechanisms may be involved. We aimed to identify proteins that were differentially expressed in nasal polyps between patients with AERD and aspirin-tolerant asthma (ATA).
Two-dimensional electrophoresis was adopted for differential display proteomics. Proteins were identified by liquid chromatography-tandem mass spectrometry (LC-MS). Western blotting and immunohistochemical staining were performed to compare the amount of fatty acid-binding protein 1 (FABP1) in the nasal polyps of patients with AERD and ATA. Fifteen proteins were significantly up- (seven spots) or down-regulated in the nasal polyps of patients with AERD (n = 5) compared to those with ATA (n = 8). LC-MS revealed an increase in seven proteins expression and a decrease in eight proteins expression in patients with AERD compared to those with ATA (P = 0.003-0.045). FABP1-expression based on immunoblotting and immunohistochemical analysis was significantly higher in the nasal polyps of patients with AERD compared to that in patients with ATA. FABP1 was observed in epithelial, eosinophils, macrophages, and the smooth-muscle cells of blood vessels in the polyps.
Our results indicate that alterations in 15 proteins, including FABP1, may be related to the development of AERD.
PLoS ONE 01/2011; 6(8):e22711. · 4.09 Impact Factor
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Otolaryngology Head and Neck Surgery 11/2010; 143(5):704-5. · 1.72 Impact Factor
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Otolaryngology Head and Neck Surgery 10/2010; 143(4):601-2. · 1.72 Impact Factor
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Otolaryngology Head and Neck Surgery 08/2010; 143(2):309-10. · 1.72 Impact Factor
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Otolaryngology Head and Neck Surgery 10/2009; 141(4):535-6. · 1.72 Impact Factor
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ABSTRACT: Surgical excision via a sublabial approach is considered the standard treatment for nasolabial cysts. Although transnasal marsupialization has been proposed as an alternative method, no prospective study has compared the effectiveness of these techniques. We thus compared the surgical procedure, operating time, postoperative pain, complications, and recurrence rate between the two surgical methods.
Twenty patients diagnosed with nasolabial cysts were allocated randomly into two groups according to the surgical technique. In the sublabial approach group, the cysts were excised completely using a sublabial approach, while in the transnasal marsupialization group, the cysts were marsupialized transnasally under the guidance of nasal endoscopes. The pure operating time was measured and postoperative pain was evaluated using a visual analog scale. Complications after the procedure were assessed and recurrence was determined according to the clinical symptoms and postoperative radiologic findings.
The transnasal marsupialization group had significantly shorter operating times, less postoperative pain, lower complication rates, and shorter duration of side effects than the sublabial approach group. No recurrence occurred in either group after a 1-yr follow-up period.
Although both methods are effective for treating nasolabial cysts, the transnasal marsupialization of nasolabial cysts has many benefits over the conventional sublabial approach. Therefore, we propose that transnasal marsupialization be the treatment of choice for nasolabial cysts.
Clinical and Experimental Otorhinolaryngology 07/2009; 2(2):85-9. · 0.92 Impact Factor
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ABSTRACT: To construct a partial two-dimensional electrophoresis (2-DE) reference map of the proteins that compose normal human nasal mucosa.
Normal inferior turbinate mucosa samples were subjected to 2-DE, the protein spots were visualized by silver staining, and 78 spots were selected for analysis by mass spectrometry and bioinformatics. Reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemical techniques were performed for validation and localization analysis.
Among the identified proteins, the largest functional groups included proteins associated with the human immune response and enzymes, particularly those of protein metabolism. Proteins participating in the cell cycle, cell division, calcium metabolism, and ion transport were also detected. The mRNA transcripts for 10 selected proteins were amplified by RT-PCR. Immunohistochemistry revealed that secretagogin was localized in the submucosal gland and calsenilin was localized in the epithelium and submucosal gland.
This database will serve as the basis for further comparative proteomic studies of nasal mucosal disorders.
Clinical biochemistry 02/2009; 42(7-8):692-700. · 2.02 Impact Factor
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ABSTRACT: Craniopharyngiomas that originate in the nasopharynx and sphenoid bone (known as infrasellar craniopharyngiomas) are rare and comprise only 5% of all craniopharyngiomas. The involvement of the maxillary sinus has been reported only twice. We present a very rare case that involved the maxillary sinus.
British Journal of Oral and Maxillofacial Surgery 12/2008; 47(5):422-4. · 1.95 Impact Factor
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ABSTRACT: Objectives/Hypothesis: To determine the optimal frequency of postoperative care after endoscopic sinus surgery, we evaluated the relationship between the frequency of postoperative debridement and patient discomfort, healing period, surgical outcomes, and compliance.Study Design: A prospective randomized study.Methods: Patients diagnosed with chronic rhinosinusitis with or without nasal polyposis were randomly allocated to three groups (N = 10 each group), according to the frequency of office visits for postoperative debridement during a 4-week postoperative period. Group 1 underwent debridement twice a week, group 2 once a week, and group 3 once every 2 weeks. Four weeks after the procedure, the patients in each group were asked about discomfort between visits for postoperative debridement, including nasal obstruction, nasal discharge, foul odor, postnasal drip, and headache. Responses were scored using the visual analogue scale (VAS). Six months after surgery, the healing period was evaluated and both subjective and objective surgical outcomes were assessed using the Sinonasal Outcome test 20 and endoscopic findings. Patient compliance to postoperative debridement was also evaluated using the VAS. We compared the statistical significance of these parameters among the three groups.Results: In groups 1, 2, and 3, nasal polyposis was present in eight, eight, and six patients, respectively, and five, one, and four patients had unilateral sinusitis. The VAS scores for four of the five main symptoms regarding patient discomfort differed significantly among thegroups; group 3 reported the worst scores. However, healing periods, Sinonasal Outcome test-20 scores, and objective endoscopic findings did not show statistical differences among the groups. Patient compliance to the frequency of postoperative debridement differed significantly among the groups. Patients in group 1 reported the greatest disturbance in academic and socioeconomic activities, whereas the patients in groups 2 and 3 demonstrated similar scores.Conclusions: One-week intervals seem to be the optimal frequency for postoperative debridement during the healing period after endoscopic sinus surgery. However, patient individualization should be taken into account depending on the extent of surgery and healing progress.
The Laryngoscope 09/2008; 118(10):1868 - 1872. · 1.75 Impact Factor
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ABSTRACT: To compare the efficacy and safety of BiClamp forceps tonsillectomy (BT) with standard electrocautery tonsillectomy (ET) in terms of postoperative pain and complication rates.
Prospective randomized study.
The following variables were examined: postoperative complications, intraoperative blood loss, operating time, postoperative pain and diet scores using visual analog scales, and time until return to normal activity.
The mean operating time and the grade of intraoperative blood loss were significantly lower in the BT group than in the ET group for both pediatric and adult patients. For adult patients, the overall complication rates were significantly lower in the BT group. In addition, a significant early decrease in the pain score and significant improvement in dietary intake until postoperative day 14 were observed in the BT group for both pediatric and adult patients.
The use of BiClamp forceps in tonsillectomy reduces the intraoperative blood loss and postoperative pain score, and facilitates an early return to normal diet and activity.
Otolaryngology Head and Neck Surgery 08/2008; 139(2):228-34. · 1.72 Impact Factor
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Jae Yong Lee
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ABSTRACT: This study observed a much higher percentage of unilateral sinus pathology than reported in the literature. Comprehensive evaluations of patient age, presenting symptoms, nasoendoscopy examination, and computed tomography (CT) findings help in the diagnosis of unilateral sinus disease. Nevertheless, histological confirmation remains obligatory for diagnosis.
To evaluate the clinical features, diagnosis, pathology, and CT findings in patients who had undergone sinus surgery for unilateral sinus diseases.
Among 524 patients who had undergone sinus surgery, patients with unilateral sinus opacification on the preoperative CT scans were selected. Data were collected from the medical records and CT findings were evaluated.
Unilateral sinus opacification was identified in 121 (23.1%) patients. Male gender was predominant and the greatest number of patients had chronic rhinosinusitis. The mean age was oldest for fungus ball and youngest for antrochoanal polyp. Purulent discharge and foul odor were the common presenting symptoms under inflammatory conditions, while frequent epistaxis and cheek swelling were the main symptoms in neoplastic diseases. Calcifications were observed only in patients with fungus ball, while bony destruction was detected in both benign and malignant tumors. Punch biopsy performed in the office offered accurate histopathologic diagnosis in 94.3% of the patients.
Acta Oto-Laryngologica 07/2008; 128(6):621-6. · 1.08 Impact Factor
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ABSTRACT: To evaluate the necessity of canine fossa puncture (CFP) by comparing the symptom scores and postoperative computed tomography (CT) findings between patients with severe maxillary sinus disease who underwent CFP and those who underwent maxillary sinus clearance through a middle meatal antrostomy (MMA).
A prospective, randomized study.
Fourteen patients met the inclusion criteria for each of the CFP and MMA groups. In both groups, all diseased sinuses were addressed in the same manner using the same surgical techniques; the only difference was management of the maxillary sinus. Most of the patients completed the Sinonasal Outcome Test 20 (SNOT-20) and visual analogue scales (VAS) for the six main symptoms preoperatively and 3, 6, and 12 months postoperatively. The Lund-Mackay scores for the maxillary sinus and for all sinuses were calculated from the preoperative CT scan and another scan taken 12 months postoperatively. The mucosal thickening as a percentage of the total volume of the maxillary sinus was also evaluated on the postoperative CT scans, and complications related to both procedures were investigated.
Twenty-four patients completed the follow-up, questionnaires, and postoperative CT scans and were included in the analysis: 11 CFP patients and 13 MMA patients. All of the patients had chronic rhinosinusitis with nasal polyposis (NP). There were no significantdifferences in polyp extent or Lund-Mackay score for the maxillary sinus and for all sinuses on the pre- and postoperative CT scans between the groups. The volume of mucosal thickening also did not differ significantly between the groups on the postoperative CT scans. The SNOT-20 and VAS scores improved significantly 3, 6, and 12 months after the procedure in both groups. However, there were no significant differences between the two groups except for the VAS for postnasal drip 3 months postoperatively, which was better in the CFP group. Six of 11 patients in the CFP group experienced one or more complications after the procedure, although all of the symptoms resolved spontaneously within 3 months. In the MMA group, three patients had bleeding from the branches of the sphenopalatine artery during widening of the ostium, which was controlled intraoperatively with suction cauterization.
We could not find any benefits of the CFP procedure over the conventional MMA method in the present study. Although CFP is a useful method for removing severe mucosal disease that cannot be reached through the MMA, it does not guarantee a better subjective or objective surgical outcome in patients who have accompanying NP.
The Laryngoscope 07/2008; 118(6):1082-7. · 1.75 Impact Factor
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ABSTRACT: The primary role of the otolaryngologist in managing patients with a sinonasal malignancy is to make an early diagnosis. However, this can be difficult because of the relatively nonspecific signs and symptoms associated with the progress of the disease, especially in the pediatric population. Recently, we observed a nasal extranodal natural killer/T-cell lymphoma in a 12-year-old girl with a 6-month history of right nasal obstruction. Her symptom worsened gradually despite medical treatment at a private hospital. Endoscopic examination revealed ulcerative changes and hypertrophy of the right inferior turbinate mucosa. The histopathology and immunohistochemical staining of a punch biopsy confirmed the diagnosis. In this case, we emphasize the importance of a complete endoscopic examination of the nasal cavity in a pediatric patient with unilateral nasal symptoms and the possible necessity of referral to an otolaryngologist to prevent misdiagnosis and management of the pathology as benign.
Journal of Pediatric Hematology/Oncology 06/2008; 30(5):401-4. · 1.16 Impact Factor
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ABSTRACT: The possibility of postsurgical hypothyroidism after hemithyroidectomy is no longer a new subject. Although many previous studies have mentioned posthemithyroidectomy hypothyroidism, the incidence and contributing factors for hypothyroidism remain uncertain. We intended to evaluate the incidence and the time of development of hypothyroidism after hemithyroidectomy and to analyze the relationship of posthemithyroidectomy hypothyroidism with preoperative biochemical parameters and postoperative histopathological findings. From February 2001 through December 2004, 287 consecutive cases of hemithyroidectomized patients were retrospectively analyzed; 136 of these patients were included in this study after the exclusion criteria were applied. The relationship between posthemithyroidectomy hypothyroidism and several parameters such as sex, age, preoperative free T4, TSH, microsomal antibody (Ab), thyroglobulin antibody (Ab) levels and lymphocytic infiltration of the resected gland was statistically analyzed. Postoperative hypothyroidism developed in 58 patients (42.6%). In hypothyroid group, 11 patients (19%) showed overt hypothyroidism and 47 patients (81%) showed subclinical hypothyroidism. Preoperative TSH value was significantly higher in the hypothyroid group (2.15+/-1.30 microU/ml) compared to the euthyroid group (1.29+/-0.9 microU/ml). Positive ratio of preoperative microsomal Ab and thyroglobulin Ab were significantly higher in hypothyroid group (38.9 and 41.9%) compared to euthyroid group (3.6 and 19.3%) (P <0.05). In addition, patients with a higher grade of lymphocytic infiltration were found to have a higher probability of developing hypothyroidism. About 85% of postoperative hypothyroidism was detected between 1 and 6 months postoperatively. We might predict the possibility of developing the posthemithyroidectomy hypothyroidism especially in case of preoperatively positive microsomal antibody, thyroglobulin antibody and high-grade lymphocytic infiltration of the resected gland. In addition, our findings support the recommendation for regular serum TSH follow-up at least for 12 months after hemithyroidectomy.
Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 04/2008; 265(4):453-7. · 1.29 Impact Factor
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ABSTRACT: We describe a 60-year-old woman who developed extensive emphysema, bilateral pneumothorax, and pneumomediastinum after total thyroidectomy and central neck dissection with sacrifice of a recurrent laryngeal nerve. In this report, we discuss the possisle etiology of those rare complications.
Clinical and Experimental Otorhinolaryngology 04/2008; 1(1):49-51. · 0.92 Impact Factor
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ABSTRACT: Polyacrylamide hydrogel (PAAG, Aquamid) is widely used as permanent facial tissue filler during facial plastic surgery. In this study, we examined the long-term effects and safety aspects of PAAG as a vocal fold augmentation material for patients with permanent unilateral vocal cord paralysis.
Prospective clinical trials.
PAAG injection laryngoplasty was performed in 34 consecutive patients with permanent unilateral vocal cord paralysis. Percutaneous injection was performed under local anesthesia into the vocalis muscle using disposable 25 gauge long needles. Of the 34 patients, 16 completed acoustic, perceptual, stroboscopic, and subjective evaluations prior to the injection and at 6 and 12 months after the injection.
Acoustic and perceptual parameters (GRBAS [Overall grade of dysphonia, Roughness, Breathiness, Aesthenia, Strain], Maximal phonation time [MPT], jitter, and shimmer) were significantly improved (P < .05) after injection and remained stable over 12 months. The grades of mucosal waves and glottic closure were also significantly improved (P < .01). The voice handicap index (VHI), as well as the visual analogue scale (VAS) of hoarseness and aspiration significantly improved over 12 months. No adverse effects were observed except for a decrease in the mucosal wave of one patient, after injection into a superficial area of the vocal fold.
Based on the preliminary results of this trial, PAAG appears to be a long-lasting and safe injection material that is suitable for the treatment of glottal insufficiency caused by permanent unilateral vocal cord paralysis.
The Laryngoscope 10/2007; 117(10):1871-5. · 1.75 Impact Factor
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ABSTRACT: To investigate whether the insertion of a Silastic sheet between the middle turbinate and lateral nasal wall can prevent lateral synechia formation when an unstable, floppy middle turbinate results from endoscopic sinus surgery (ESS).
Prospective study.
University hospital.
Thirty patients who developed an unstable, floppy middle turbinate during ESS were allocated in order of occurrence as follows: group 1, 15 patients, 17 sides including 2 bilateral cases; group 2, 15 patients, 18 sides including 3 bilateral cases.
In group 1, a fan-shaped Silastic sheet was inserted between the middle turbinate and lateral nasal wall and secured to the caudal septum. In group 2, no specific procedure was performed except for meticulous postoperative care to prevent lateralization of the middle turbinate.
We observed the patients for 5 months and compared the occurrence rate of synechia formation between the 2 groups.
Synechiae developed in 1 of 17 sides (6%) in group 1 and 8 of 18 sides (44%) in group 2, for success rates of 94% and 56%, respectively. The success rates differed significantly. The middle turbinate was preserved in all patients in group 1.
The results of this study suggest that the insertion of a Silastic sheet in the middle meatus is a useful method for preventing lateral synechia formation and for preserving the middle turbinate.
Archives of Otolaryngology - Head and Neck Surgery 09/2007; 133(8):776-9. · 1.63 Impact Factor
