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ABSTRACT: The keystone area has critical importance in maintaining the stability of the nasal dorsum. However, overlap patterns between structural components in the keystone area have rarely been studied, especially in the noses of Koreans.
Dissections were performed on 18 cadaveric noses. The length and width of the structural components in the keystone area were measured. The shape of the caudal margin of the nasal bone and the overlap patterns between the upper lateral cartilage and the nasal bone were classified.
THE SHAPE OF THE CAUDAL MARGIN OF THE NASAL BONE WERE CLASSIFIED AS FOLLOWS: type A, curvilinear margin; type B, paramedian retractions or "M" shape; type C, elongated midline; and type D, retracted midline. The overlap area between the upper lateral cartilage and the nasal bone was classified as follows: type Ao, crescent shape; type Bo, short midline extension; and type Co, long midline extension. The cephalocaudal length of the overlap area between the upper lateral cartilage and the nasal bone was 4-10 mm (mean, 7 mm) in the midline, and 0-7 mm (mean, 3.1 mm) in the paramedian area. The overlap width of the upper lateral cartilage with the nasal bone was 8-14 mm (mean, 9.7 mm).
The overlap pattern of the structural components in the keystone area is variable. Therefore, a thorough understanding and a cautious evaluation of the relationships of these components before and during surgery is important in performing safe and effective nasal procedures.
Clinical and Experimental Otorhinolaryngology 10/2008; 1(3):158-60. · 0.92 Impact Factor
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ABSTRACT: This study was designed to evaluate the normal development of the nasal septum in Koreans using sagittal MRI for the valuable clinical information on septal procedures.
Two hundred eighty patients who had their whole nasal septum visualized in the midline sagittal view were selected among the 3,904 patients with brain MRI from January, 2004 to December, 2006 at Dankook University Hospital. The patients who had a history of nasal septal surgery or nasal trauma were excluded. Following parameters are calculated and analyzed: lengths of bony and cartilage dorsum and septal cartilage-nasal bone overlap, total septal area, septal cartilage area and, the proportion of the cartilage area to septal area and the maximal harvestable cartilage for grafting were calculated using the PAC program.
All the parameters were increased until adolescence. Thereafter, bony dorsal length, cartilage dorsal length, total dorsal length, total septal area and maximal harvestable cartilage for grafting have not changed significantly with age, while SC-NB overlap length, septal cartilage area, and proportion of the cartilage area to the total septal area were significantly decreased with age. The SC-NB overlap length was positively correlated with the septal cartilage area and the proportion of the cartilage area to the total septal area.
The small septal cartilage area and its proportion to the total septal area were significantly correlated with a short overlap length of the septal cartilage under the nasal bone. Septal procedures should be carefully performed in the elderly due to the risk of incurring saddle nose.
Clinical and Experimental Otorhinolaryngology 04/2008; 1(1):29-34. · 0.92 Impact Factor
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PhD In-Sang Kim MD,
PhD Chae-Seo Rhee MD,
PhD Jun Ho Lee MD,
Jeong-Hwa Heo BSc,
Jerry Park BSc,
PhD Chul Hee Lee MD, In‐Sang Kim,
Chae‐Seo Rhee,
Jun Ho Lee,
Jeong‐Hwa Heo,
Jerry Park,
Chul Hee Lee
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ABSTRACT: Objectives: We aimed to identify the functional abnormality of sinusitis-affected mucosa by observing the responsiveness of the mucosa to purinergic stimulation after the onset of sinusitis and during the recovery period. We also aimed to identify possible beneficial effects of purinergic agonists on sinusitis.Methods: A rabbit sinusitis model was developed by blocking maxillary ostia. Sinus mucosae were harvested immediately and 1 and 4 weeks after reopening the ostia. We measured chloride secretion and ciliary beat frequencies responding to purinergic stimulation.Results: The increases of ciliary beat frequency by adenosine triphosphate (100 μmol/L) were 3.2% ± 8.5%, 7.9% ± 2.3%, and 12.2% ± 1.9% immediately after establishment of sinusitis and 1 week and 4 weeks after reopening of ostia, respectively. Chloride secretion stimulated by adenosine triphosphate also showed gradual increase during the recovery period. Grossly, the mucosae appeared to have normalized in 80% (4 of 5) after 4 weeks; however, functional and microscopic improvements were still incomplete.Conclusions: Mucosal functions, assessed by increase of ciliary activity and ion secretion by purinergic stimulation, and microscopic findings showed gradual but incomplete recovery after 4 weeks of recovery, in contrast to the gross normalization. Purinergic agonists may have beneficial effects on sinusitis by stimulating decreased ciliary motility and chloride secretion in sinusitis.
The Laryngoscope 08/2007; 117(9):1677 - 1682. · 1.75 Impact Factor
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ABSTRACT: We have developed a simple, reliable method for the simultaneous determination of the ciliary wave disorder (CWD) and ciliary beat frequency (CBF) of actively beating cilia.
The CBF and the directions of beating cilia are two important components of mucociliary transport. Although lots of studies have been performed on the measurement of the CBF, there have been few studies on the direction of cilia, with the exception of those using electron microscopy (EM). EM takes too long to determine the directions of cilia, and it cannot determine the direction of actively beating cilia. The aim of this study was to develop an image analysis (IA) system to conveniently determine the wave directions of multiple actively beating cilia as well as the CBF.
Sphenoid sinus mucosae obtained from 10 patients undergoing pituitary tumor removal via a trans-septal trans-sphenoidal approach were divided into two 4 x 4 mm2-sized pieces. One piece was studied using IA, the other with EM. Using IA, ciliary wave directions were determined from 5 20 x 20 microm2 regions of interest and the mean of 5 consecutive values was regarded as the CWD of each sample. The CBF was also measured. CWD was also measured using EM.
The average number of cilia analyzed by EM was 102.50 (range 48-136). The mean CWDs determined using IA and EM were 28.25+/-4.84 degrees and 23.59+/-8.16 degrees, respectively. There was a significant correlation between the CWDs determined using these two methods (Spearman's correlation coefficient =0.648; p =0.043). The mean CBF of sphenoid mucosa was 10.50+/-2.20 Hz.
Acta Oto-Laryngologica 06/2005; 125(5):571-6. · 1.08 Impact Factor
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ABSTRACT: Although there have been many therapeutic options for allergic disease, the true allergen desensitization remains a challenging goal. The classic immunotherapy has a limited efficacy, is inconvenient, and has a risk of anaphylaxis. Recent reports revealed that immunostimulatory DNA sequences (ISS-oligdeoxynucleotide [ODN], CpG motif) act as a strong Th1 response-inducing adjuvants and that DNA-based vaccination might be an effective therapeutic option. In this study, we investigate whether ISS-ODN/Dermatophagoides farinae (Der f) conjugate has antiallergic effects in the allergic rhinitis mouse model, sensitive to house-dust mites. Der f is the most common allergen-inducing allergic rhinitis in Korea.
C57BL/6 mice were sensitized with crude extract of Der f. After injection of ISS-ODN or ISS-ODN/Der f conjugate, several parameters of allergic response were evaluated.
Scratching and sneezing symptoms and eosinophilic infiltration into nasal mucosa were suppressed by injection with ISS-ODN only and ISS-ODN/Der f conjugate. Interleukin-5 level was decreased and interferon gamma level was increased in nasal lavage fluid by injection of ISS-ODN/Der f conjugate. Der f-specific immunoglobulin E was decreased by injection of ISS-ODN or Der f /ISS-ODN conjugate; however, these were not statistically significant. Transforming growth factor beta1 secreted by cultured splenocyte was increased significantly in ISS-ODN/Der f conjugate group.
These results suggest ISS-ODN/Der f conjugate induces an antiallergic effect and induces an increase in transforming growth factor beta1 level in the allergic rhinitis model using Der f allergen. Allergic response developed by Der f allergen could be more effectively reduced by injection with ISS-ODN/Der f conjugate than by injection with ISS-ODN only.
American Journal of Rhinology 20(2):212-8. · 1.36 Impact Factor
