In Vitro Allergen Challenge Upregulates the Expression of Local Vascular Endothelial Adhesion Molecules in the Nasal Mucosa of Allergic Rhinitics

이봉재,김재호,이인철 대한비과학회 1995 Journal of rhinology Vol.2 No.2

Background : The increases of inflammatory cells in the nasal lavages and the mucosal tissues hours after antigen challenge in the allergic rhinitics propose the possibility of the corresponding increase of vascular endothelial adhesion molecules. The purpose the this study is to investigate the effect of allergen challenge on the expression of adhesion molecules and their temporal pattern of expression in the nasal mucosa of allergic rhinitis. Materials and Methods : The inferior turbinate mucosae were taken from 6 patients with perennial allergic rhinitis and cultured in the RPMI 1640 media with relevant antigen(D.farinae) for 0, 1, 2, 4, 6, 12, 24, and 48 hours. The proportion (%) of mucosal vessels expressing endothelial adhesion molecules such as ICAM-1, E-seletin, and VCAM-1 was obtained from the specimens immunostained with ABC-AP method. Results : The expression of E-selectin, with minimal at baseline, was significantly upregulated 1hour after culture with antigen, reached peak at 4 hour (38.3%), and then returned to baseline at 24 hour. The baseline expression of ICAM-1 was most prominent (48%). The incubation of allergic mucosa with antigen increased the ICAM-1 expression slowly until reaching to the peak level (77%) at 12 hour , and the level was maintained as long as 48 hours. Unlike E-selectin or VCAM-1, ICAM-1 was also expressed on the epithelial cells, especially in the basal cell layer. Conclusion : The expression of E-selectin showed a characterisctic of rapid induction and decline in the allergic nasal mucsoa. The prominent expression of ICAM-1 on the epithelial cells as well as on the vascular endothelial cells suggests the active role of ICAM-1 in the extravasation of inflammatory cells and also in the transepithelial migration into the nasal secretion.

하비갑개 골-골막-점막 복합이식을 이용한뇌척수액 유출 복원술

백광하,김지형,문영민,김창훈,윤주헌,조형주 대한비과학회 2018 Journal of rhinology Vol.25 No.2

Background and Objectives: Endoscopic repair of cerebrospinal fluid (CSF) leak can avoid morbidity of open approachesand has shown a favorable success rate. Free mucosal graft is a good method, and multi-layered repair is more favorable. Theinferior turbinate has been commonly utilized for the free mucosal graft, but we newly designed it as a bone-periosteal-mucosalcomposite graft for multilayered reconstruction. Subjects and Method: Four subjects with a skull base defect were treated with this method. The inferior turbinate was partiallyresected including the conchal bone and was trimmed according to defect size. Both bony parts and periosteum were preservedon the basolateral side of the mucosa as a composite graft. The graft was applied to the defect site using an overlay technique. Results: All cases were successfully repaired without any complications. Three of them had a defect size greater than 10-12mm, and the graft stably repaired the CSF leakage. Conclusion: Endoscopic repair of CSF leakage using inferior turbinate composite graft is a simple and easy method andwould be favorable for defect sizes greater than 10 mm.

A Case of Nasal Swell Body (Septal Turbinate) Combined with Pneumatization of Perpendicular Plate of the Ethmoid Bone

구수권,정성훈,문지승,손현이 대한비과학회 2016 Journal of rhinology Vol.23 No.1

The “nasal swell body” (NSB) or septal turbinate is a distinct structure of the anterior nasal septum that is observed on endoscopic and radiographic examination. It is primarily a glandular rather than a venous formation that is comprised of septal cartilage, bone, and thick mucosal lining. It is commonly found in patients with symptoms of chronic sinusitis and allergic rhinitis, and is linked to septal deviation. Space occupying lesions of the septum such as tumors, mucoceles, and pneumatization of the septum can lead to anatomical and functional disorders such as nasal obstruction and sinusitis, while more serious clinical conditions can develop when these lesions are combined with the NSB. Recently, there has been emphasis on the functional aspects of the NSB. It is especially being emphasized for clinicians to pay attention to the NSB and its connection with the stuffy nose. We report an interesting case of the NSB combined with pneumatization of the perpendicular plate of the ethmoid bone causing severe nasal obstruction and repetitive sinusitis along with a literature review.

만성 비부비동염 환자의 비음도 분석

박성제,박지수,XU JUN,강영애,김용민,나기상 대한비과학회 2016 Journal of rhinology Vol.23 No.1

Background and Objectives: This study was designed to compare the nasalance between chronic rhinosinusitis (CRS) patients and normal controls and to determine the correlation of nasalance with nasal volume, nasal resistance, CT score, and polyp score in CRS patients. Materials and Methods: This study enrolled 150 CRS patients and 154 normal adults. All subjects underwent acoustic rhinometry and rhinomanometry. Nasalance scores were measured with the nasometer. All CRS patients were graded according to the Lund-Mackay CT staging system and the degree of nasal polyp. Results: Nasal volume was decreased and nasal resistance was increased in CRS patients compared with normal controls. However, the nasalance scores for oro-nasal and nasal passages were significantly higher in CRS patients compared with normal controls. In CRS patients, the nasalance score for the nasal passage showed positive correlation with nasal volume and negative correlation with nasal resistance and Lund-Mackay CT score. However, no significant correlation was found between nasalance score and endoscopic polyp score. Conclusion: Contrary to expectations, nasalance was increased in CRS patients despite decreased nasal volume and increased nasal resistance. Thus, nasal resonance likely depends on a multitude of factors other than changes in the sinonasal cavity.

Prevention of Septal Perforation Using a Combination of Crushed Cartilage and Thin Silastic Sheet During Septoplasty

Young Gun Kim,김상준,배우용 대한비과학회 2021 Journal of rhinology Vol.28 No.3

Background and Objectives: The aim of the present study was to investigate the effects of a combination of crushed cartilage and thin silastic sheet for patients with a risk of septal perforation during septoplasty. Materials and Methods: A total of 195 people who underwent septoplasty surgery at Dong-A University Hospital from January 2019 to December 2020 were enrolled retrospectively. Among 195 people, our surgical method was provided for those with damage to both septal mucosa. The cartilage was collected, crushed with the cartilage crusher, and inserted between perforated mucosa. After the cartilage insertion, a 0.254-mm-thin silastic sheet was designed to cover both sides of the perforated septal mucosa. Next, a penetrating suture was placed. After thin silastic was applied on both mucosa, a 1-mm-thick silastic sheet was inserted on both sides of the nasal cavity and penetrating sutures were placed on the anterior and inferior septum. The operation concluded after packing both sides of the nasal cavity using non-absorbable packing material. The packing was removed on the second day after the operation, and the nasal cavity condition was checked every week. Thick silastic sheets were removed 5 days after surgery, and thin silastic sheets were maintained until both septal mucosa healed. Results: Of nine total cases, only one 78-year-old male experienced septal perforation at the cartilage portion two months after surgery. In this case, no other action was taken to cover the perforation site because he reported no symptoms or discomfort during the 9 months after surgery. In the other eight cases, both septal mucosa healed completely, and there were no complications. Conclusion: This method with crushed cartilage and silastic sheets to fill the defect after septal surgery is thought to help prevent postoperative perforation at no additional cost, and further research is needed. Background and Objectives: The aim of the present study was to investigate the effects of a combination of crushed cartilage and thin silastic sheet for patients with a risk of septal perforation during septoplasty.Materials and Methods: A total of 195 people who underwent septoplasty surgery at Dong-A University Hospital from January 2019 to December 2020 were enrolled retrospectively. Among 195 people, our surgical method was provided for those with damage to both septal mucosa. The cartilage was collected, crushed with the cartilage crusher, and inserted between perforated mucosa. After the cartilage insertion, a 0.254-mm-thin silastic sheet was designed to cover both sides of the perforated septal mucosa. Next, a penetrating suture was placed. After thin silastic was applied on both mucosa, a 1-mm-thick silastic sheet was inserted on both sides of the nasal cavity and penetrating sutures were placed on the anterior and inferior septum. The operation concluded after packing both sides of the nasal cavity using non-absorbable packing material. The packing was removed on the second day after the operation, and the nasal cavity condition was checked every week. Thick silastic sheets were removed 5 days after surgery, and thin silastic sheets were maintained until both septal mucosa healed.Results: Of nine total cases, only one 78-year-old male experienced septal perforation at the cartilage portion two months after surgery. In this case, no other action was taken to cover the perforation site because he reported no symptoms or discomfort during the 9 months after surgery. In the other eight cases, both septal mucosa healed completely, and there were no complications.Conclusion: This method with crushed cartilage and silastic sheets to fill the defect after septal surgery is thought to help prevent postoperative perforation at no additional cost, and further research is needed.

중등도-중증 폐쇄성수면무호흡증 환자의 수술결과에 관한 임상연구

이우현,오승용,오훈,박용균,민상기,신지호,김현직 대한비과학회 2017 Journal of rhinology Vol.24 No.1

Background and Objectives: Surgical treatment is considered as a secondary treatment option for obstructive sleep apnea (OSA). This study was performed to determine whether surgical treatment can be considered in patients with moderate-severe OSA as a treatment modality. Materials and Method: A total of 127 patients with moderate-severe OSA were retrospectively enrolled. The anatomic narrowing sites were mainly evaluated using cephalometry and drug induced sleep endoscopy (DISE), and then multi-level surgeries were performed. Results: Both uvula and soft palate were the most frequent narrowing sites and a total of 110 patients showed upper airway narrowing more than two anatomic structures. A total of 79 patients (62.1%) were categorized as responders and 48 patients (39.1%) were non-responders. After multi-level sleep surgeries, patients’ subjective symptoms and sleep parameters were significantly improved. However, AHI was not considerably decreased. Non-responders to sleep surgeries showed relatively higher rates of severe OSA and body mass index. Tongue base narrowing, incomplete corrections of nasal pathologies and soft palate were significant factors for lower success rates. Conclusion: We estimate that sleep surgery might be a therapeutic option for moderate to severe patients with OSA. A delicate pre-operative evaluation for upper airway narrowing is necessary to adapt sleep surgery to these patients.

술전 색전술 없이 제거한 하비갑개에서 발생한비인강외 혈관 섬유종 치험 1례

이호민,이정민,김재기,남정권 대한비과학회 2013 Journal of rhinology Vol.20 No.2

The angiofibroma is a highly vascular and histologically benign neoplasm that usually arises in the nasopharyx in adolescent male patients. It accounts for less than 0.5% of all head and neck neoplasm. Reports of primary extra-nasopharyngeal angiofibroma have appeared sporadically in the literature. The inferior turbinate is a very rare site of extra-nasopharyngeal angiofibroma, with only 5 cases reported in the medical literature. Also, the value of embolization in surgery for extra-nasopharyngeal angiofibroma is a controversial matter. We report a case of extra-nasopharyngeal angiofibroma arising from the inferior turbinate of a 37-year-old male. The tumor was completely removed through endonasal, endoscopic technique without pre-operative embolization. Histopathology confirmed it to be a case of angiofibroma. The patient is currently free of relapse 6 months after surgery. Endoscopic resection is a feasible and safe method for angiofibroma surgery. The current evidence does not support obligatory embolization in every case of endoscopic angiofibroma resection.

후비중격에서 발병한 반전성 유두종 1예

이동훈,임상철,이창준,조시영 대한비과학회 2012 Journal of rhinology Vol.19 No.1

Inverted papilloma is an uncommon benign nasal tumor which usually occurs on the lateral nasal wall. An inverted papilloma originating from the medial nasal cavity, especially the nasal septum, is considered very rare. A 47-year-old male was referred with a 1-month history of snoring. On endoscopic examination, a nasal mass was observed in the left posterior septum. The mass filled the left nasal cavity and extended choanae and nasopharynx. The histopathologic examination of the nasal mass showed inverted papilloma, which was completely removed by endoscopic surgery. Herein, the authors report a case of inverted papilloma originating from the posterior nasal septum as well as a review of literature.

알레르기 질환의 건강증진과 예방

구수권 대한비과학회 2008 Journal of rhinology Vol.15 No.2

The prevalence of allergic diseases have been increasing over the last few decades. These diseases have become a global public health problem and a burden to health care resources. Allergen exposure in the high risk group is one of the numerous factors contributing to the developing and worsening allergic diseases. Thus, prevention is a very important strategy in treating allergic diseases. This review focuses on environmental risk factors and possible preventive methods in combating allergic diseases. The prevalence of allergic diseases have been increasing over the last few decades. These diseases have become a global public health problem and a burden to health care resources. Allergen exposure in the high risk group is one of the numerous factors contributing to the developing and worsening allergic diseases. Thus, prevention is a very important strategy in treating allergic diseases. This review focuses on environmental risk factors and possible preventive methods in combating allergic diseases.

Two Cases of Angioleiomyoma in the Nasal Cavity

박일호,홍성문,신재민,이흥만 대한비과학회 2013 Journal of rhinology Vol.20 No.2

Leiomyoma is a benign tumor arising from smooth muscle cells. They are commonly found in the uterus, skin, and gastrointestinal tract. However, it is rare in the head and neck area. Especially, only 3% of leiomyomas in the head and neck area occur in the nasal cavity. Rhinologists need to know leiomyoma as a differential diagnosis of the tumors in the nasal cavity. Herein we present two cases of angioleiomyoma in the nasal cavity and review the literature.