Journal of Rhinology最新文献

Nasal type natural killer/T-cell lymphoma (NNKTL) is a rare and aggressive subtype of non-Hodgkin lymphoma originating from a natural killer cell or γδ T cell infected by the Epstein-Barr virus. It usually invades the aerodigestive tract and can rapidly destroy the paranasal sinus, hard palate, and central nervous system. NNKTL is often mistaken for benign conditions such as chronic hypertrophic rhinosinusitis or mucosal inflammatory change, as endoscopic findings of NNKTL presenting nasal mucosal hypertrophy are similar to endoscopic findings for these abovementioned benign conditions. Here, the authors report the diagnosis and examination of NNKTL in a 58-year-old male patient who visited our clinic for nasal cavity discomfort after he underwent a dacryocystorhinostomy to treat dacryocystitis.

Background and objectives: This study introduced and evaluated the efficacy of an ultrasonic bony aspirator (UBA) in revision endoscopic sinus surgery and compared the outcomes to those of the traditional cold instrument approach.

Methods: This retrospective study enrolled 57 patients who underwent revision endoscopic sinus surgery between June 2010 and December 2017, 17 patients with a UBA approach and 40 patients with traditional instruments.

Results: Median Lund-Kennedy scores showed a statistically significant difference between the two groups at 3 months (p=0.004). Synechiae occurred in 17.6% and 35% of cases in the UBA and traditional groups, respectively. The mean operative time was significantly shorter in the traditional group (p=0.001).

Conclusion: The use of a UBA in revision endoscopic sinus surgery was safe and effective.

This paper summarizes a recent meta-analysis of various topics in obstructive sleep apnea (OSA). In addition to cardiovascular disease and neurocognitive dysfunction, a wide variety of diseases have been associated with OSA, and associations with cancer have also been reported. Although continuous positive airway pressure is a very effective treatment, the results have shown that it does not reduce the incidence of various complications. It has been reported that uvulopalatopharyngoplasty was effective, and robotic surgery for the tongue root and hypoglossal nerve stimulation were also effective. The effectiveness of various medications to reduce daytime sleepiness has also been demonstrated. Although exercise lowered the apnea-hypopnea index, it was not related to changes in body composition, and it was also reported that exercise combined with weight control were effective. Additionally, interesting and clinically meaningful meta-analysis results were summarized and presented.

Nasopharyngeal tuberculosis can arise from both a primary infection and a secondary spread via the lymphatic or hematogenous system from a primary pulmonary lesion. Primary nasopharyngeal tuberculosis is rare and difficult to detect earlier because of the nonspecific presentations of the disease. As upper airway tuberculosis can be contagious, early initial diagnosis and suspicion of the physicians are needed in clinical practice. Recently, we successfully diagnosed and treated the disease by antitubercular medications of two cases of primary nasopharyngeal tuberculosis. Herein, we report our experience with a literature review.

Olfactory disorders one of the most frequent distinctive symptoms of COVID-19 infection. COVID-19-induced olfactory disorder can be classified as post-infectious olfactory dysfunction (PIOD). The effect of drugs on olfactory disorder following upper respiratory infection, including PIOD, has not been clearly established, which adds to the difficulty with treating the disorder. However, the effect of olfactory training on PIOD has been confirmed by numerous studies. As such, olfactory training is gaining attention, and has taken on greater importance, as the sole treatment for COVID-19-induced olfactory disorder in this pandemic age. This review describes the effect of olfactory training for COVID-19-induced olfactory disorder by analyzing the relevant literature.

Background and objectives: Little is known about studies evaluating positive airway pressure (PAP) compliance after re-prescription. Therefore, the aim of this study was to investigate PAP compliance after re-prescription in obstructive sleep apnea (OSA) patients who failed initial PAP therapy.

Methods: We retrospectively reviewed OSA patients who had received a re-prescription for PAP from March 2020 to June 2021. We compared the compliance rate between initial prescription and re-prescription for PAP and investigated the reasons for PAP failure after the first prescription.

Results: A total of 10 consecutive OSA patients (mean age=45.6±13.7 years and male:female=8:2) who received a re-prescription for PAP were included. Of them, 8 patients (80%) met the compliance criteria (i.e., Korean National Health Insurance criteria) for PAP after re-prescription. The compliance rate increased from 36.3±18.2% (initial prescription) to 61.3±28.8% (re-prescription); this was not of statistical significance (p=0.074). PAP/mask-related discomfort was the most common reason for PAP failure, followed by nasal obstruction, unintentional mask removal, and pressure-related discomfort.

Conclusion: Even if initial PAP therapy fails, the proportion of patients who meet the compliance criteria may be improved through various forms of clinical aid and support after re-prescription of PAP.

Background and objectives: Considering the prevalence and health effects of obstructive sleep apnea (OSA), early diagnosis and proper treatment are essential. Polysomnography (PSG) has limitations in diagnosing or tracking large-scale OSA patients. Smartwatches (SWs) can be equipped with a photoplethysmograph (PPG) that can indirectly measure heart rate and blood oxygen saturation by detecting the difference of light absorption through blood. The purpose of this study is to compare oxygen saturation parameters of PPG-based SWs with those of PSG to determine the diagnostic accuracy for OSA.

Methods: After obtaining voluntary consent from patients who were scheduled to undergo PSG in a sleep clinic due to suspected OSA, they were randomly assigned to wear a Galaxy watch4 (GW) or Apple watch7 (AW) on their wrist. The agreement rates between the oxygen saturation parameters of the two SW types and PSG were evaluated. The accuracy, sensitivity, and specificity of the oxygen saturation parameters for diagnosis of OSA (apnea-hypopnea index [AHI] ≥5/h) were compared between the two types of SW.

Results: A total of 133 patients underwent PSG while wearing an SW. Including duplicates, 109 patients wearing a GW and 69 wearing an AW were included. The diagnostic accuracy of AHI ≥5/h according to oxygen saturation time measured by a GW was less than 90%, the respective sensitivity and specificity were 82.9% and 75.8%. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.807 (p<0.001). Using the lowest oxygen saturation value of GW, the sensitivity was 81.6%, the specificity was 69.7%, and the AUC of the ROC was 0.849 (p<0.001). The diagnostic accuracy of AHI ≥5/h according to the average oxygen saturation of AW, and the sensitivity and specificity were 75.6% and 70.8%, respectively. The AUC of this ROC curve was 0.757 (p<0.001). Using the lowest oxygen saturation value of AW, the sensitivity was 71.1%, the specificity was 62.5%, and the AUC of the ROC was 0.705 (p=0.005).

Conclusion: This study found that the two types of SW showed considerable accuracy in diagnosing OSA, but the accuracy decreased as the severity of OSA increased.

We present a case of localized nasal endometriosis to contribute to the literature. A primiparous, primigravida, 37-year-old female was diagnosed with nasal septal endometriosis in the presence of history of periodic epistaxis, nasal pain, and nasal fullness. After a nasal biopsy for exclusion of malignancy, a comprehensive general screening was performed on the recommendation of a gynecologist, definitive endometriosis was diagnosed, and oral treatment was initiated. Significant relief was reported in her nasal symptoms during the 1-year follow-up period. We report this case to demonstrate the importance of clinical awareness of periodic cyclic perimenstrual epistaxis, nasal lesions, and nasal pain as a cause of nasal septal endometriosis.

Actinomycosis is rarely accompanied by fungus balls. It is difficult to distinguish between actinomycosis and a fungus ball due to their similar clinical and computed tomography scan results. Thus, a meticulous histopathological examination is required for definite diagnosis. We report a case of actinomycosis accompanied by a fungus ball, found incidentally in a patient without rhinologic symptoms. The patient was successfully treated with endoscopic sinus surgery, followed by short-term antibiotic therapy. We suggest that shortterm antibiotic therapy may be more appropriate than long-term antibiotic therapy based on our case study as well as several other studies.

A paranasal sinus mucocele is an epithelial-lined, mucus-containing sac that completely fills the sinus and forms an expandable cystic structure. It most commonly affects the frontal and ethmoidal sinuses, and rarely the maxillary and sphenoid sinuses. Orbital displacement or external disfigurement resulting from the expansion of the frontal or ethmoid sinuses is common; however, facial asymmetry caused by maxillary bone remodeling is rare. We describe a case of large maxillary sinus mucocele that destroyed the maxillary sinus bony wall, resulting in notable left cheek swelling and disfigurement, and review the relevant literature.