Journal of Rhinology最新文献

Various invasive fungal infections can occur in immunocompromised hosts, and an acute invasive fungal infection (AIFI) can be fatal. Because of its high mortality rate, AIFI must be quickly diagnosed and treated, such as anti-fungal agents or surgical debridement. In an immunocompromised host, nasal herpes simplex infection, usually caused by herpes simplex virus (HSV) type-1, can have various clinical manifestations, some of which can mimic AIFI. However, the management of acute viral infection differs significantly from invasive fungal infections of the nose. A fast and accurate differential diagnosis is mandatory because a delay in the disease-specific treatment of acute invasive infections can lead to mortality. This report describes two immunocompromised patients with mucosal and skin lesions around the nose. We provide clinical clues when mucosal lesions of the nasal cavity and skin lesions around the nose develop in immunocompromised hosts.

Primary sinusoidal non-Hodgkin's lymphoma (NHL) is a very rare disease. The main symptoms of sinusoidal NHL are rhinorrhea, nasal obstruction, and post-nasal drip. Symptoms such as eye protrusion, diplopia, trismus, and periorbital pain can also occur. Epiphora is a very rare symptom of sinusoidal NHL, which can lead to a misdiagnosis of dacryocystitis or dacryostenosis. The authors report the case of a 46-year-old female patient who visited hospital for symptoms of epiphora, which did not improve even after 3 months of eye treatment, leading to a final diagnosis of maxillary NHL.

Rhino-orbito-cerebral mucormycosis (ROCM) is an invasive fungal infection that usually occurs in immunocompromised patients. It is aggressive and has a high risk of mortality. With unclear guidelines, ROCM is treated in various ways. We present a patient who underwent kidney transplant and who treated for ROCM without major complications.

Background and objectives: Microvascular remodeling and angiogenesis are elements of tissue remodeling characteristic of chronic inflammatory diseases, including nasal polyps (NPs). Angiogenesis reflects the balance between the actions of pro- and anti-angiogenic factors. Many pro-angiogenic factors are known, including vascular endothelial growth factor (VEGF). A number of anti-angiogenic factors (e.g., angiostatin and endostatin) also has been identified. Our objective was to assess the roles of VEGF, angiostatin, and endostatin in NP development.

Methods: The expression levels of VEGF, angiostatin, and endostatin were measured in NPs harvested during endoscopic endonasal surgery and compared with those in inferior turbinate mucosa (control) samples acquired from patients with hypertrophic rhinitis without allergy. Western blotting and immunohistochemical staining were used to analyze all samples.

Results: The levels of VEGF and angiostatin were significantly higher in the NP subjects than in the controls. Neither the VEGF/angiostatin ratio nor the endostatin level differed significantly between the two groups. However, the VEGF/endostatin ratio was significantly higher in the NP than in the control group. Both the NP and control tissues were diffusely immunoreactive for VEGF, angiostatin, and endostatin.

Conclusion: NP-associated hypoxia can elevate angiostatin level; moreover, an imbalance in the VEGF/endostatin ratio can contribute to NP formation.

Endoscopic skull-base surgery (ESBS) is a rapidly growing surgical area that involves collaboration of otolaryngology-head and neck surgeons and neurosurgeons. Various tumor pathologies and extents have been successfully treated with ESBS, and diverse reconstruction methods have been adopted since its introduction. The optimal reconstructive strategy should be based on heterogeneous surgical situations and tumor extent. Nevertheless, there are few current guidelines for selecting reconstructive methods. Therefore, we review diverse options for endoscopic skull-base reconstruction.

Gossypiboma, an infrequent surgical complication, describes a mass of cotton material inadvertently left in the body cavity after an operation. It is an extremely rare iatrogenic complication of nasal surgery, with only a few cases reported in literature to date. Here we present a case of gossypiboma in the nasal septum of a 35-year-old male patient who previously underwent septorhinoplasty fourteen years prior. He was treated by endoscopic endonasal surgery to remove the lesion. Pathologic findings showed a foreign body (gauze filament) with a giant cell reaction. This report will be helpful for treating patients with similar histories in the future.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide; a simple diagnostic test is becoming increasingly important. Polymerase chain reaction tests of nasal swab samples are expensive and time-consuming. Detailed observation of the nasal cavity is required. No nasal endoscopic study regarding patients with SARS-CoV-2 has been published. Here, we compared endoscopic images of normal subjects and patients with allergic rhinitis (AR) to images from a patient with confirmed SARS-CoV-2 infection. Nasal cavity endoscopic images (of the inferior turbinate) were compared using the hue, saturation, and luminance (HSL) color system of Matrox Design Assistant, version 5.0. The multiple allergen simultaneous test was used to distinguish normal subjects from patients with AR. HSL patterns were compared among images. We enrolled 14 normal subjects and patients with AR and 1 patient with confirmed SARS-CoV-2 infection. The inferior turbinates of normal subjects and patients with AR were smooth and uniform, while those of the patient with SARS-CoV-2 were scratched and stretched. Although additional data are needed, optical analysis of nasal endoscopy images may be useful to screen for SARS-CoV-2 infection. This imaging method is rapid, non-invasive, and inexpensive.

Background and objectives: YouTube is a widely used web site. In general, many people search for medical information on YouTube. We evaluated the septoplasty and turbinoplasty videos on YouTube from an expert's point of view.

Methods: We used "septoplasty," "turbinoplasty," and "septoplasty turbinoplasty" to search YouTube. Of the 150 videos, we eventually viewed 83. Two researchers assessed the sources, lengths, and numbers of likes, dislikes, and views. The videos were classified as "excellent," "moderate," or "poor" in terms of utility; we also evaluated the uploaded material and content.

Results: Of the 83 videos, 18 (21.7%) were excellent, 27 (32.5%) were moderate, and 38 (45.8%) were poor. We found no significant differences in length and mean likes, dislikes, and views between the groups classified as useful. Fifteen (39.5%) of 38 poor videos were by patients, and 13 (34.2%) of 38 poor videos were by physicians. When organized by content type, videos on personal experiences were significantly longer than the others. Of 20 videos on personal experiences, 15 (75%) were poor and all 5 advertisement videos (100%) were poor.

Conclusion: Information from YouTube on septoplasty and turbinoplasty is not yet adequate. However, since YouTube content cannot be controlled, it is necessary to upload objective and accurate videos for patients and experts in professional groups such as the medical society. Such videos should be promoted and used actively.

Olfaction is an important aspect of quality of life, beyond simply smelling food and recognizing danger. Recently, research has focused on its association with various diseases, such as neurodegenerative diseases or viral infections. The evaluation of olfactory function must take into consideration the cultural experience of the target group. A new Korean culturefriendly olfactory function test, the YSK olfactory function test (YOF test, Kimex Co.), uses safe odorants, such as phenyl-ethyl alcohol (PEA) (not n-butanol), for the threshold test. Furthermore, odorants in the YOF identification test reflect each of eight major chemical functional groups. The diagnostic cut-off for anosmia was a Threshold Discrimination Identification (TDI) score of ≤14.5 and that for hyposmia was 14.5

Herpes zoster ophthalmicus (HZO) occurs due to reactivation of dormant varicella zoster virus infection in the ophthalmic division of the trigeminal nerve. Hutchinson's sign, a herpetic skin lesion in the nasal tip, is a predictor of ocular complications, as the nasal tip area and ocular structure are innervated by the same nasociliary nerve. Patients who present with Hutchinson's sign should be referred to an ophthalmologist due to possibility of ocular complications. Here, we present a case of a 44-year-old man with HZO that was confused with delayed rhinoplasty complication. The patient presented with nasal tip skin lesions 17 years after undergoing augmentation rhinoplasty. A graft-related infection was suspected due to operation history and skin lesions. However, surgical exploration disclosed no infection or inflammation, and serological tests revealed positive varicella zoster virus immunoglobulin M, and immunoglobulin G, antibodies. Based on these findings, the patient was diagnosed with HZO. Further, the patient received antiviral treatment with famciclovir. The lesions gradually improved with conservative treatment and became almost unrecognizable. Therefore, HZO should be considered when there is an unexplained skin lesion at the nasal tip in patients with history of rhinoplasty.