No abstract

No abstract

ObjectivesOtitis media (OM) has a high prevalence worldwide and the treatment is crucial because hearing loss in children can lead to growth disorders such as language development disorders. The aim of this study is to analyse the changes in bacterial strains and the trends of antibiotic susceptibility in otitis media with effusion (OME), chronic otitis media (COM) and cholesteatomatous otitis media (Chole OM).DesignThis retrospective study involved 2926 patients diagnosed with OME, COM, or Chole OM between January 2000 and December 2020. The clinical data were collected and analysed through chart review from May 2021 to July 2021.SettingTwo tertiary medical centres.ParticipantsThe 2926 OM patients.Main Outcomes and MeasuresAn otorrhea sample was collected on the first day of their hospital visit. Middle ear fluid samples for bacterial culture and antibiotics susceptibility test were collected from patients during middle ear surgery, including ventilation tube insertion. In each type of OM, the distribution of bacterial strains in the 2000s and the 2010s was compared. In addition, changes in the detection rate of methicillin‐resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PA) and trends in their antibiotic susceptibility over the last 10 years were analysed.ResultsThe most frequently detected bacterial strains in OME, COM and Chole OM over the study period were coagulase‐negative Staphylococcus (CNS) (29.6%), MRSA (24.1%), and PA (20.1%). Compared to the 2000s, the proportion of non‐typable Haemophilus influenzae in OME and MRSA in COM increased in the 2010s (27.4%–31.6% and 1.5%–29.5%, respectively). In total three types of OM, although there was no significant trend of change in detection rates of MRSA, PA, and multidrug resistant‐P. aeruginosa (MDR‐PA) during the last 10 years, resistance to the Quinolone class of MRSA and PA tended to increase (P < .05).ConclusionsThe composition of bacterial strains in each types of OM has changed over the past 20 years. Additionally, the antibiotic resistance of MRSA and PA has increased in the last decade. Therefore, when using empirical antibiotics in necessary situations, it is necessary to change to an appropriate antibiotic through a bacterial culture test and antimicrobial susceptibility test.

Malignant lymphoma is a malignant tumor that occurs in the lymphocytes but can also occur anywhere in the body. On the other hand, malignant lymphomas originating from the nasopharyngeal space are very rare. We experienced a case of 84-year-old female patient with a huge nasopharyngeal mass, who had no complaints other than right nasal congestion, intermittent rhinorrhea, and sneezing. A physical examination revealed a large, polypoid, transparent mass at her right nasal cavity. Nasal polyp was suspected and endoscopic sinus surgery was performed. On histological examination, she was diagnosed with diffuse large B cell lymphoma, with CD20, BCL-2, and BCL-6 positive. Low dose maintenance chemotherapy was carried out in consideration of the patient’s age. A complete remission is expected based on the imaging tests following chemotherapy. We report a huge malignant lymphoma that occurred in an elderly patient’s nasopharyngeal space and successful low dose chemotherapy with a review of literature.

Background and ObjectivesThe aims of this study were to clarify the impact of adenoidal extension toward the choana on the quality of life and to find differences in radiographic parameters between patients needing additional excision with a 90-degree tip and those who only require a 40-degree debrider tip. Subjects and Method Patients who underwent adenoidectomy with both 40-degree and 90-degree debrider tips were defined as the difficult-to-treat (DTT) group. Patients who underwent adenoidectomy using only a 40-degree debrider tip were defined as the control group. We measured the antroadenoidal distance, the adenoidal nasopharyngeal ratio (ANR), the length from the adenoid to hard palate, and reviewed the Korean Obstructive Sleep Apnea-18 (KOSA-18) scale scores. Results There was no difference in the quality of life due to OSA between the DTT and control groups, pre-and post-operatively. Correlation analysis between the antroadenoidal distance and the pre-operative KOSA-18 scale scores revealed a negative correlation. The antroadenoidal distance was shorter in the DTT group; however, a cut-off value could not be obtained. The ANR was a statistically discriminatory, but not effective, factor. Conclusion There was no difference in the KOSA-18 scale scores between the groups with the adenoidal extension toward the choana and the control. The ANR should be considered in the pre-operative radiographic evaluation but is not a diagnostic parameter for choanal extension. Further studies to find additional parameters are necessary.