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Background and Objectives Fungal biofilm is commonly found in non-invasive fungal rhinosinusitis. Previous endodontic maxillary teeth treatments have increased fungus ball development in the maxillary sinus. We sought to evaluate the effects of zinc oxide (ZnO), the main component of endodontic sealers, on developing the Aspergillus fumigatus biofilms on primary human nasal epithelial cells.Subjects and Method Primary human nasal epithelial cells were cultured with A. fumigatus spores with (1 and 3 µg/mL) or without ZnO for 72 h. Interleukin (IL)-6, IL-8, and transforming growth factor (TGF)-β1 levels in cultural supernatant were determined by enzyme linked immunosorbent assay. ZnO’s effects on the formation of A. fumigatus biofilm were determined using crystal violet, safranin, concanavalin A staining, and confocal scanning laser microscopy.Results IL-6, IL-8, and TGF-β1 protein levels in primary human nasal epithelial cells increased significantly by A. fumigatus exposure. During coculturing with ZnO and A. fumigatus, biofilm dry weight, crystal violet, safranin, and concanavalin A staining intensity increased with time. On the other hand, ZnO did not enhance A. fumigatus biofilm formation.Conclusion A. fumigatus biofilm formation increased in the presence of primary human nasal epithelial cells. However, in vitro study, ZnO alone did not influence or aggravate biofilm formation in sinonasal mucosa.

Transoral thyroidectomy using the vestibular approach has achieved excellent cosmetic outcomes without leaving any visible scars. However, concerns have been raised on how to prevent complications, such as skin perforation and anterior jugular vein injury, especially in the learning period. This is because working space is generally created via blind and blunt dissection using a blunt dilator through small vestibular incisions unfamiliar to beginners. Herein, we explain an intraoperative real-time ultrasound technique employed in transoral thyroidectomy to safely elevate a skin flap while avoiding any damage to the flap and anterior jugular vein in the learning period.

Background and Objectives Several studies have shown that three single nucleotide polymorphisms (SNPs) in the TAS2R38 gene demonstrate a strong association with the ability to sense the bitter taste of phenylthiocarbamide (PTC) in. We have previously reported about TAS2R38 genotypes in normal volunteers. The aim of this study was to investigate the role TAS2R38 gene plays in taste disorder by examining SNPs in the TAS2R38 gene in taste disorder patients.Subjects and Method Ninety-four patients with taste dysfunction from multiple etiologies were enrolled. The genotypes were defined by identifying SNPs on the TAS2R38 gene. The proportion of different TAS2R38 genotypes in the group was compared with that in the normal volunteers of our previous study. The whole mouth taste threshold tests were performed and the thresholds were compared among the three different genotypic groups.Results The proportion of each diplotype in taste disorder patients were as follows: PAV/ PAV 36.2% (34/94), PAV/AVI 34.0% (32/94), and AVI/AVI 29.8% (28/94). The proportion of AVI/AVI type was higher in the group than in the normal volunteers (p=0.031). The detection and recognition thresholds of all four basic tastes were increased in the order of PAV/PAV, PAV/AVI, and AVI/AVI genotypes.Conclusion The proportion of AVI/AVI homozygous was significantly higher in taste disorder patients than in the normal volunteers. Our findings suggest that the genotypes of TAS2R38 may represent one of the risk factors responsible for the development of taste disorders.

Background and Objectives Olfactory and gustatory dysfunctions have been known as characteristic symptoms of coronavirus disease 2019 (COVID-19). However, the study of the clinical features of olfactory and gustatory dysfunctions in COVID-19 is still insufficient.Subjects and Method Mild COVID-19 patients who complained of olfactory or gustatory dysfunctions in the telephone monitoring from March 8 to April 8, 2020 were included in this study. Patient information was collected using a Google questionnaire. COVID-19 symptoms, severity and improvement of olfactory and gustatory dysfunctions of patients were investigated.Results A total of 228 patients participated in this study. The number of male and female were 76 and 152, and the average age was 32.1±11.5 years. There were 210 patients (92.1%) of olfactory dysfunction, 179 patients (78.5%) of gustatory dysfunction, and 165 patients (71.4%) who complained of both symptoms. The 18.4% of patients complained only olfactory or gustatory dysfunction without other symptoms of COVID-19, and 51.1% of patients presented olfactory and gustatory dysfunctions as the first symptoms. Most of the patients (95.6%) improved olfactory and gustatory dysfunctions within several months, but only 79.8% of patients were normalized.Conclusion Since olfactory and gustatory dysfunctions are the first symptoms in the numerous COVID-19 patients, and continued research on these patients play an important role in the screening and prevention of COVID-19. Long-term observation and further studies of treatment are needed for 20.2% of patients who have not fully recovered.

Received June 15, 2015 Revised July 10, 2015 Accepted July 20, 2015 Address for correspondence Mi Kyung Ye, MD, PhD Department of OtorhinolaryngologyHead and Neck Surgery, College of Medicine, Catholic University of Daegu, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea Tel +82-53-650-4525 Fax +82-53-650-4533 E-mail miky@cu.ac.kr Background and ObjectivesZZSalt-taste threshold can influence salt appetite, and is thought to be another marker of sodium intake. Many studies have found an association between sodium intake and blood pressure. The aim of this study was to compare the salt-taste threshold and salt intake between hypertensive and normotensive groups. Subjects and MethodZZOne hundred twenty volunteers (51 men and 69 women) who did not take antihypertensive medications were evaluated. First, a questionnaire, which included questions regarding demographic information and preference of salty taste, was conducted, and 24-hour ambulatory blood pressure was checked. Then salt taste threshold was measured by assessing the ability of the subjects to discern the taste of salt in graded solutions of saline. Lastly, 24-hour urinary sodium was measured in a 24-hour urine collection. ResultsZZThe salt taste threshold and taste preference for salt were slightly higher in hypertensive group. There was slightly higher salt intake measured as 24-hour urinary sodium in the hypertensive group, compared with the normotensive group. However, there were no significant differences in salt taste threshold, preference of salty taste, and salt intake between the normotensive and the hypertensive groups. ConclusionZZThe threshold of salt taste was not related to sodium intake and hypertension status. These results suggest that the development of hypertension depends on the complex interaction of factors such as genes and environmental factors rather than sensory factors like taste threshold and taste preference. Korean J Otorhinolaryngol-Head Neck Surg 2015;58(10):687-93

Received April 3, 2015 Revised June 26, 2015 Accepted June 27, 2015 Address for correspondence Seung-Heon Shin, MD Department of Otorhinolaryngology, School of Medicine, Catholic University of Daegu, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea Tel +82-53-650-4530 Fax +82-53-650-4533 E-mail hsseung@cu.ac.kr *Seung-Gul Kang and Jae-Jin Ko contributed equally to this work. Background and ObjectivesZZObstructive sleep apnea (OSA) is a common yet an under-diagnosed sleep related breathing disorder associated with many adverse health outcomes. OSA is commonly associated with cardiovascular disorders that include coronary artery disease, heart failure, hypertension, cardiac arrhythmias and stroke. The aim of this study was to investigate the physical characteristics of OSA patients as a screening test for sleep apnea associated cardiovascular disease. Subjects and MethodZZOne hundred twenty-six adult OSA patients were enrolled in this study. All subjects underwent an overnight polysomnography (PSG) and were determined body mass index (BMI), neck circumstance, waist circumstance, tonsil size, etc. Cardiovascular events, such as hypertension, cardiovascular accident, myocardial infarction, and angina were analyzed. The correlation and multiple regression analysis were conducted to find influential and predictive factors of cardiovascular complications of OSA. ResultsZZPSG findings, apnea-hypopnea index (AHI), minimal oxygen saturation, and oxygen desaturation index were associated with BMI, neck circumstance, and waist circumstance. Tonsil size was also associated with AHI and oxygen desaturation index. However, PSG results were not associated with cardiovascular accidents of OSA patients. Hypertension was associated with tonsil size, angina was associated with Mallampati score and cardiovascular accident was associated with tonsil size. ConclusionZZAlthough we cannot find the statistical relation between PSG results and cardiovascular disease, tonsil size and Mallampati score influenced the risk of cardiovascular accident. Korean J Otorhinolaryngol-Head Neck Surg 2015;58(11):759-63

Received March 24, 2014 Revised June 30, 2014 Accepted July 10, 2014 Address for correspondence Mi Kyung Ye, MD Department of OtorhinolaryngologyHead and Neck Surgery, College of Medicine, Catholic University of Daegu, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 705-718, Korea Tel +82-53-650-4525 Fax +82-53-650-4533 E-mail miky@cu.ac.kr Background and ObjectivesZZThe aim of the study was to compare the gustatory function between age-matched men and women in Korean subjects. Subjects and MethodZZHealthy non-smoking volunteers without smell and taste disorders were investigated. Thirty-nine men and women of the same age group were evaluated for gustatory function. Whole mouth taste test was performed with successive solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride. The electrical taste thresholds were measured using an electrogustometer for four different sites in the oral cavity, i.e., both sides of anterior and posterior tongue. ResultsZZFemale subjects had lower mean values of detection and recognition thresholds for all of the four tastes than male subjects, although these results did not reach statistical significance except for the detection threshold for salt and the recognition threshold for quinine. In electrogustometry, thresholds in the posterior tongue of glossopharyngeal nerve area were significantly higher for men than women. ConclusionZZMen had higher taste threshold than women of the same age category. For additional information on the effects of gender and aging on taste thresholds, further studies including a large number of well-controlled subjects are essential. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(10):692-7

Received December 13, 2013 Revised May 12, 2014 Accepted June 9, 2014 Address for correspondence Seung-Heon Shin, MD Department of OtolaryngologyHead and Neck Surgery, School of Medicine, Catholic University of Daegu, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 705-718, Korea Tel +82-53-650-4530 Fax +82-53-650-4533 E-mail hsseung@cu.ac.kr Background and ObjectivesZZGlucocorticoids are a potent anti-inflammatory agent. The authors conducted this study to investigate the effect of Omnaris on suppression of inflammation induction and mucin gene expression in nasal polyp epithelial cells. Subjects and MethodZZPrimary nasal polyp epithelial cells were stimulated by 5 ug/mL of streptococcal enterotoxin B (SEB) and lipopolysaccharide (LPS). To determine the effects of Omnaris, cells were pretreated with 200, 100, 10, 1 ng/mL of Omnaris. The anti-inflammatory effect of epithelial cells were confirmed by measuring interleukin (IL)-6, IL-8, and granulocyte-macrophage colony stimulating factor (GM-CSF), and mucin gene expressions were determined by real time PCR for MUC4, MUC5AC, MUC5B, MUC8. ResultsZZSEB and LPS enhanced the production of IL-6, IL-8, and GM-CSF from nasal polyp epithelial cells. The increased cytokine levels were significantly suppressed by Omnaris at 100 and 10 ng/mL. The expressions of MUC4, MUC5AC, MUC5B, MUC8 mRNA, and MUC4 mRNA were increased by SEB and LPS, respectively. The increased expression of these mucin genes were significantly suppressed by 100, 10, and 1 ng/mL of Omnaris. ConclusionZZOmnaris significantly suppressed the production of chemical mediators and mucin gene expression, which indicated that Omnaris is effective in improving and treating inflammatory diseases in the nasal cavity. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(9):603-9

Background and ObjectivesZZThe sense of taste is one of the most important human senses and plays a critical role in an individual’s food preferences and the nutritional status. Proper gustatory function in older people is important for quality of life and enjoyment of food. The objectives of this study was to investigate the effect of aging on taste thresholds in Korean subjects. Subjects and MethodZZOne hundred sixty normal volunteers without smell and taste disorders were investigated. Each subject was given a questionnaire for age, sex, status of smoking and medication. Then, a whole mouth taste test was performed with successive solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride. ResultsZZOlder subjects (over 50 years) showed worse taste sensitivity compared with younger subjects (age 20-29 years). The detection thresholds of all four basic tastes and the recognition threshold of salty taste of elderly participants were significantly higher than those of young par ticipants. ConclusionZZGustatory sensitivity was found to decrease with age. Especially, older subjects appeared to have a reduced perception of salt, which can alter eating habits, such as intake of more salty foods. Our data can provide preliminary normative values for future investigation of chemosensation in the Korean population. � Korean J Otorhinolaryngol-Head Neck Surg 2013;56:286-90 Key WordsZZAging ㆍTaste ㆍTaste threshold .

비부비동염은 비폐색, 점액성 비루, 두통, 후각장애 등의 증 상을 동반하는 비부비동 점막의 염증성 질환이다. 급성비부 비동염의 경우 바이러스와 세균 감염이 주된 병인으로 알려져 있지만 만성비부비동염의 경우 그 원인과 병태생리에 대한 다 양한 주장과 가설이 제시되고 있다. 만성비부비동염의 분류 또한 증상의 정도, 동반질환의 종류, 약물 혹은 수술적 치료 방법 등에 따라 다양하게 나누어지고 있다. 일반적으로 비용 의 동반유무와 조직내 호산구 증가유무에 따른 분류는 치료 방법의 선택과 예후 판단에 도움이 된다. 조직과 혈중 호산구 증가는 비부비동염의 정도가 심한 경우가 많았으며, 호산구 가 증가한 환자의 20%에서 알레르기가 동반된다는 사실이 Newman 등에 의해 처음 보고되었다. 조직내 호산구의 증 가는 알레르기성 진균성 비부비동염, 기관지 천식이 동반되는 경우, 반복적인 비부비동염의 감염이 있는 경우와 수술 후 비 용의 재발 및 재수술이 필요한 경우에 많았다. 본 론

The anterior clinoid process may be pneumatized by an extension of the sphenoid sinus air space. An anterior clinoid mucocele is a particularly rare entity, which can lead to optic complication due to its proximity to the optic nerve. Optic neuropathy is seldom recoverd if there is a delay in treatment for more than 10 days. The primary treatment for mucocele is surgical excision. We report a patient with mucocele of the anterior clinoid process that resulted in recurrent monocular visual loss. The patient underwent endoscopy-assisted transnasal marsupialization of mucocele with full recovery of visual function. � Korean J Otorhinolaryngol-Head Neck Surg 2013;56:655-8 Key WordsZZAnterior clinoid process ㆍEndoscopic sinus surgery ㆍMucocele ㆍOptic neuropathy.

Received December 12, 2011 Revised February 6, 2012 Accepted February 6, 2012 Address for correspondence Mi-Kyung Ye, MD Department of OtolaryngologyHead and Neck Surgery, College of Medicine, Catholic University of Daegu, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 705-718, Korea Tel +82-53-650-4525 Fax +82-53-650-4533 E-mail miky@cu.ac.kr * These authors contributed equally to the work. Background and ObjectivesZZThe phenylthiocarbamide (PTC) and 6-n-propylthiouracil (PROP) taste sensitivity varies among individuals. Recently, it is reported that PROP taste responsiveness is associated with carbonic anhydrase 6 (CA6) gene polymorphism. The CA6 gene, a zinc metalloprotein in human saliva, is affected in taste function and might be correlated with gustatory diversity. The aim of this study was to examine whether PTC taste sensitivity and taste disorder is associated with the CA6 gene polymorphism rs2274327 (C/T), rs2274328 (A/C), and rs2274333 (A/G). Subjects and MethodZZA total of 217 healthy normal subjects were recruited as controls, and 50 taste disorder patients were recruited as experimental group. The polymorphisms of CA6 gene were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis. All statistical analyses were calculated using the statistical package for the social science software. Haplotypes were estimated by Haploveiw and the PHASE programs. ResultsZZThe CA6 gene polymorphisms showed association with taste disorder but not with PTC sensitivity (taster/nontaster). The number of control subjects carrying AA genotype of single nucleotide polymorphism rs2274328 (A/C) in the CA6 gene was higher than the number of the subjects with taste disorder (p=0.048). However, there was no association between controls and taste disorder subjects in the haplotype analysis. ConclusionZZThese data suggest that the CA6 gene polymorphism rs2274328 could affect taste function impairment in patients with taste disorder. This observation requires a further functional study of gustin protein to clarify the association of the CA6 gene polymorphisms with the taste disorder and sensitivity. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:155-60

악성종양 치료 방법의 하나로 방사선치료가 광범위하게 이 용되고 있으나, 방사선치료는 조사 범위 내에 조직의 악성 변 화를 초래할 수 있는 위험요소를 가지고 있다. 연골육종은 연 골에서 기원하는 종양으로 주로 장골, 골반, 늑골 등에서 발생 하며, 그 중 5~10%가 두경부에서 발생한다. 방사선치료 후에 이차적으로 생긴 두경부의 연골육종은 매우 드문 질환으로 국내에서는 아직 보고된 바가 없다. 연골육종은 그 형태와 발생부위에 따라 다양한 임상양상을 보이며, 치료 방법으로는 깨끗한 절제연을 포함하는 광범위절제술이 가장 중요하다. 방 사선치료나 화학약물요법 등의 효과에 대해서는 명확하게 밝혀지지 않았지만 수술이 불가능할 경우나 완전한 수술적 절제가 어려운 경우에는 방사선치료를 시행하여야 한다. 저 자들은 비인두 악성종양으로 진단받고 약물치료와 방사선치 료를 받은 후 별다른 문제없이 지내던 환자가 방사선치료 종 료 후 9년이 지나 방사선 조사 영역으로 포함되었던 접형골 및 사대에 연골육종이 발생한 환자를 경험하여 문헌고찰과 함께 보고하는 바이다.

Fungal rhinosinusitis was once considered a rare disorder but is now reported with increasing frequency throughout the world. This entity is now thought to comprise five subtypes. Acute invasive fungal rhinosinusitis, chronic invasive fungal rhinosinusitis, and chronic granulomatous invasive fungal rhinosinusitis make up the invasive group, whereas noninvasive fungal rhinosinusitis is composed of fungal ball and fungus related eosinophilic rhinosinusitis including allergic fungal rhinosinusitis (AFRS). These five subtypes are distinct entities with differ ent clinical, histological, and radiologic features. The diagnosis of each category is important for optimum therapy and predicting the course. However, consensus on terminology, pathogenesis, and optimal management is lacking. The distinction of granulomatous from chronic invasive type is not beyond controversy as both types have a chronic course and predominant orbital involvement. AFRS, eosinophilic fungal rhinosinusitis, and esinophilic mucin rhinosinusitis are imprecise and require better definition. The clear differentiation and definition of categories of fungal rhinosinusitis is related to the development of a management protocol of each category. Prompt diagnosis and initiation of appropriate therapy are essential to avoid a protracted or fatal outcome. Korean J Otorhinolaryngol-Head Neck Surg 2011;54:454-61

Received August 11, 2011 Revised September 29, 2011 Accepted October 11, 2011 Address for correspondence Mi Kyung Ye, MD Department of OtorhinolaryngologyHead and Neck Surgery, College of Medicine, Catholic University of Daegu, 3056-6 Daemyeong 4-dong, Nam-gu, Daegu 705-718, Korea Tel +82-53-650-4525 Fax +82-53-650-4533 E-mail miky@cu.ac.kr Background and ObjectivesZZGenetic variations of bitter taste receptors (TAS2R) have shown different responses to bitter taste compounds and the frequencies of these variations were different within and between populations. Recently, single nucleotide polymorphisms (SNPs) in the TAS2R38 and TAS2R16 genes demonstrated a significant association with smoking and alcohol consumption in several studies. The aim of this study was to determine the relationship between bitter taste gene polymorphism and cigarette smoking and alcohol intake in Korean. Subjects and MethodZZOne hundred seventy four healthy normal volunteers were asked to fill in a questionnaire regarding demographic information, smoking history, frequency of alcohol intake. Peripheral blood samples were obtained for DNA extraction and genotyping. Single nucleotide polymorphisms were identified on the TAS2R38 and TAS2R16 genes. ResultsZZHaplotype analyses of the three SNPs inside the TAS2R38 gene allowed identifying of only two haplotypes that were associated with the non-taster phenotype (AVI homozygous) and the taster phenotype (PAV homozygous and PAV/AVI heterozygous). Common SNP within TAS2R16, which results in aminoacid change in the protein (K172N), is not demonstrated in this study. Smokers and frequent drinkers were more prevalent among non-tasters than tasters in male. ConclusionZZFunctional variants in TAS2R38 correlated with cigarette smoking in the Korean male. Our findings suggest that taster status plays a role in governing the development of nicotine dependence. Korean J Otorhinolaryngol-Head Neck Surg 2011;54:847-52

Background and Objectives : Phenylthiocarbamide (PTC) and its chemically related compound, 6-n-propylthiouracil (PROP), both produce a taste that is extremely bitter to some subjects (tasters) but tasteless or only slightly bitter to others (non-tasters). Earlier studies had used PTC, but most investigators have switched to PROP because of its several advantages. Recently, three single nucleotide polymorphisms in the TAS2R38 gene were identified and several studies have demonstrated a strong association between these genes with taster status. The aim of this study was to investigate the relationship between taste thresholds of PTC and PROP and their correlation with the TAS2R38 genotype. Subjects and Method : Seventy-five healthy normal volunteers were included. Taster status was determined using successive solutions of PTC and PROP, which comprised a total of 15 grades. All participants were genotyped for polymorphism of the TAS2R38 gene that affects taste sensitivity to PTC and PROP. Results : PTC taste thresholds showed 96% correlation with the taste thresholds for PROP. Non-tasters defined by the PTC threshold test were the exactly the same with those identified as AVI (alanine, valine, isoleucine) homozygous, but taster status determined by the PROP threshold test showed 96% correlation with the genotypes. Conclusion : The PTC threshold test was more reliable for determining taste blindness than the PROP threshold test.