Background and Objectives: The prelacrimal window approach (PLWA) is useful for treating anterior maxillary sinus lesions. A previous study reported that the feasibility of PLWA in Chinese patients was 93.0%, which is higher than that in the European population (68.5%). This study aimed to compare the ease of PLWA between a patient group and healthy controls and to analyze the results for Koreans compared to those of previous studies. Differences between the patient and control groups and the distribution of types in the Korean population were evaluated.Methods: We analyzed 89 paranasal computed tomography (CT) scans from 51 controls and 38 patients (178 sides). We measured the distance distribution between the anterior wall of the maxillary sinus and the anterior wall of the lacrimal duct (D1) and its thickness (T). We compared the values in the control and patient groups.Results: D1 and D2 were similar between the patient and control groups (p=0.395, p=0.344), though T was greater in the patient group (p<0.001). In the patient group, sinus with inverted papilloma (IP) and normal sinus were not significantly different for any of these measures. The D1 distribution in Koreans did not differ significantly from that of Chinese but did differ from that of Europeans.Conclusion: The ease of PLWA was 92.2% in Koreans, which is more similar to that of Chinese (93.0%) than to that of Europeans (68.5%). D1 and D2 of the patient group did not differ from those of the control group, but T was greater in the patient group. In the patient group, D1 and D2 were not significantly different between sinus with IP and normal sinus. The frequency of type 2+3 in patients was similar to that of the control group.
Herpes zoster oticus (HZO) is characterized by otalgia and erythematous vesicles in the auricle or external auditory canal. Ramsay Hunt syndrome (RHS) can be diagnosed when facial nerve palsy is accompanied by these symptoms of HZO, and in this case, audio-vestibular symptoms such as hearing loss or dizziness often develop. Recently, 3D-fluid-attenuated inversion recovery sequence (3D-FLAIR) magnetic resonance imaging (MRI) has been introduced in order to evaluate the inner ear structure pathology. The purpose of this study was to investigate the audio-vestibular characteristics in correlation with temporal bone MRI findings in HZO patients. From September 2018 to June 2022, 18 patients with HZO participated in the study. Thirteen patients (77%) showed high-signal intensity in the inner ear structures in 4 h post-contrast 3D-FLAIR images. In a bithermal caloric test, the lateral semicircular canal showed high signal intensity in 4 h post-contrast 3D-FLAIR images in 75% of patients with abnormal canal paresis. While the cochlea showed high signal intensity in 4 h post-contrast 3D-FLAIR images in 75% of patients with hearing loss, the vestibulo-cochlear nerve showed enhancement in post-contrast T1-weighted images in only 33% of patients with hearing loss. The present study demonstrates that audio-vestibular deficits are well-correlated with increased signal intensity of the inner ear endorgans in 4 h post contrast 3D-FLAIR MRI.
Background and Objectives The number of otolaryngologists in Korea has increased rapidly in recent years. However, as the population is expected to decrease gradually, it is necessary to study the appropriate number of otolaryngologists. Subjects and Method We counted the number of otolaryngologists certified annually and the number of currently active otolaryngologists, and estimated the retirement time from this data. In addition, the statistics from the National Statistical Office were used to survey the total population and the youth population under the age of 14 up to 2060. Finally, changes in the number of active otolaryngologists and the population per otolaryngologist were predicted by 2060. Results The total number of otolaryngologists certified by 2020 was 4699, and the number of active otolaryngologists in 2019 was 3950. The average duration of retirement is about 36.5 years, and it is expected to be 40 years soon. Currently, 77.4% of otolaryngologists are practitioners, and 51.3% are working in Seoul and Gyeonggi-do. In 2009, the number of people per otolaryngologist was about 17000, whereas in 2019 it was sharply reduced to about 13000. If 120 otolaryngologists are produced each year, it decreases to about 10000 by 2060. However, if the number of new otolaryngologists is reduced to 100 per year, it can be maintained at around 12000 in 2060. In any case, however, the number of patients under 14 years of age cannot be prevented from falling sharply. Conclusion It is necessary to adjust the number of otolaryngologists to account for population decline.
In terms of diagnosis, a painless isolated mass lesion around the mastoid area is rarely encountered in general practice. In the present study, we report two cases of painless benign mastoid tumors located in the postauricular region. The first patient visited our department with a painless progressing mass lesion behind the right ear, which was later revealed as an intramuscular lipoma in the mastoid origin site of the sternocleidomastoid muscle. The second patient similarly presented to our department with a chief complaint of a painless, palpable mass in the mastoid region. Biopsy results confirmed the diagnosis of an osteoma. In both cases, the tumor was surgically removed by a postauricular approach. Although osteoma and lipoma are benign tumors rarely involved in the mastoid area, presenting without symptoms, it is recommended of complete excision, especially in cases with symptoms or cosmetic deformity.
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