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Human papillomavirus (HPV)–related multiphenotypic sinonasal carcinoma (HMSC) is a recently described neoplasm entity that presents only in the sinonasal tract. Histologically, it displays features of both a surface-derived carcinoma and a salivary gland carcinoma, and is associated with high-risk HPV, specifically HPV type 33. Whereas majority of the cases display high-grade histologic features, HMSC paradoxically behaves in a relatively indolent fashion. It is important and meaningful to distinguish HMSC from other histopathologic mimickers as the clinical features and management are distinctive. A 64-year-old woman presented having intermittent left-side epistaxis and progressive nasal obstruction. A well-defined, solitary, friable mass with an irregular surface that easily bled upon contact was found in the posterior part of the left nasal cavity. Endoscopic excision of the tumor which was originated from left nasal septum was done and the tumor was confirmed as HMSC. After surgery, definitive radiotherapy was performed in 28 fractions. HMSC is a histopathological type that has been rarely reported so that we report this case with literature review.

Background and Objectives Several studies have assessed the impact of laryngopharyngeal reflux disease (LPRD) on the health-related quality of life (HR-QoL), showing significant impairment of HR-QoL. This study aims to assess the impact of proton pump inhibitor (PPI) treatment of LPRDs to enhance HR-QoL.Subjects and Method We prospectively collected data from LPRD patients from April 2017 to July 2019. Patients who have reflux symptom index (RSI) of ≥13 or reflux finding score (RFS) of ≥7 were enrolled in this study. We assessed HR-QoL using a questionnaire with EORTC QLQ-H&N35, -C30 on the first visit. Patients were treated with PPI (Ilaprazole 20 mg/day) on their visits at 4, 8, and 12 weeks. RSI and RFS were measured at each visit and HR-QoL was reevaluated on the last visit.Results Ninety-five patients completed the 3-months follow-up and were enrolled in this study. Female : male ratio was 71:24 and the mean age was 57.0±11.9 (27-80). The initial RSI and RFS were 16.3±8.8 and 12.6±2.9, respectively, but were changed to 11.1±9.7 and 9.7±2.6 (p

Chronic rhinosinusitis with nasal polyps (CRSwNP) in asthmatic patients has a high recurrence rate even after surgery. For this reason, oral steroids are frequently used, but their long-term use may cause side effects. The purpose of this study is to investigate the long-term effects of budesonide nasal irrigation (BNI) in CRSwNP and asthma. An analysis of 33 patients with CRSwNP and well-controlled asthma, who performed BNI for more than 12 months, was performed. We compared oral steroid and antibiotic dosages as well as nasal endoscopy scores before, and every six months after, BNI. The six-month dosages of oral steroids and antibiotics prescribed were significantly decreased at all time points after BNI compared to before BNI. When the dosages were compared at the time point immediately preceding six months, oral steroid intake decreased significantly until 12 months, and antibiotic intake decreased until 6 months. Furthermore, the endoscopic score decreased significantly until 12 months. The nasal symptom questionnaire score also significantly improved after BNI. Therefore, BNI is considered an effective treatment method that can improve subjective symptoms and objective intranasal findings while reducing oral steroid and antibiotic doses after long-term use in patients with CRSwNP accompanied by asthma.

Summary Objectives Maximal extrathyroidal extension (ETE) is known to be an important prognostic factor in papillary thyroid carcinoma (PTC). However, the significance of minimal ETE is controversial. The aim of this study was to investigate the clinicopathologic characteristics and prognostic significance of minimal vs maximal ETE in PTC. Materials and methods A group of 967 patients who underwent thyroidectomy for PTC in a tertiary hospital between January 2000 and December 2011 were studied retrospectively. Patients were classified into three groups: absence of ETE, and minimal and maximal ETE. The minimal ETE group was further categorized into two subgroups according to invasion of strap muscles or no invasion (STI+ and STI−). Results Gender did not differ between the three groups of patients. The mean age of the patients with maximal ETE was significantly higher than in those belonging to the other groups. Tumor size, bilaterality, lymph node metastasis and stage increased significantly according to the degree of ETE. Recurrence and survival rates did not differ between the absence and minimal ETE groups, or between the STI− and STI+ subgroups of minimal ETE. However, the maximal ETE group had significantly higher recurrence and lower survival rates than the other groups (P Conclusion Maximal ETE is a significant factor for poor prognosis. However, minimal ETE is not associated with increased recurrence or decreased survival in patients with PTC.

The presence of N-nitrosodimethylamine (NDMA) in drinking water supplies has raised concern over its removal by common drinking water treatment processes. However, only limited studies have been examined to evaluate the potential removal of NDMA by numerous water treatment technologies within a realistic range (i.e., sub μg/L) of NDMA levels in natural water due to analytical availability. In this study, a simple detection method based on scintillation spectroscopy has been used to quantify the concentration of 14C-labeled NDMA at various ratios of sample to scintillation liquid. Without sample pretreatment, the method detection limits are 0.91, 0.98, 1.23, and 1.45 ng/L of NDMA at scintillation intensity ratios of 10:10, 5:15, 15:5, and 2.5:17.5 (sample: scintillation liquid), respectively. The scintillation intensity in all cases is linear (R2>0.99) and is in the range of 0 to 100 ng/L of NDMA. In addition, because scintillation intensity is independent of solution pH, conductivity, and background electrolyte ion types, a separate calibration curve is unnecessary for NDMA samples at different solution conditions. Bench-scale experiments were performed to simulate individual treatment processes, which include coagulation and adsorption by powdered activated carbon (PAC), as used in a drinking water treatment plant, and biosorption, a technique used in biological treatment of waste water. The results show that coagulation and biosorption may not be appropriate mechanisms to remove NDMA (i.e., hydrophilic based on its low octanol-water partitioning coefficient, Log Kow=0.57). However, relatively high removal of NDMA (approximately 50%) was obtained by PAC at high PAC dosages and longer contact times.

분리종이란 조직학적으로 정상인 조직이 본래의 위치가 아 닌 다른 곳에서 존재하는 것으로 정의하며, 비정상조직과 정 상조직이 혼합되어 있는 하마종과는 구분된다. 중이 내에서는 침샘 분리종, 교세포 분리종이 발생할 수 있으며, 이 중 중이 침샘 분리종은 정상적인 침샘이 중이공간에 존재하는 것을 의 미한다. 이러한 분리종은 병리학적으로만 진단이 가능하다. 중이 내 침샘 분리종은 매우 드문 질환으로 1961년 Taylor 와 Martin이 처음 보고한 이후 세계적으로 30여 예만이 보 고되고 있다. 일반적으로 전도성 난청을 동반한 중이강내 종물로 관찰되며, 선천성 진주종, 고실 사구종, 안면신경 신 경수초종 등 다른 중이 종물들과 감별되어야 한다. 하지만 중이 침샘 분리종에 대한 술전 진단 방법, 영상의학적 소견 에 대해서는 알려진 바가 없다. 저자들은 이내시경 소견과 자기공명영상 검사 결과상 고실 사구종으로 의심되었던 중이 침샘 분리종 1예를 이내접근법 으로 성공적으로 제거하였기에 문헌고찰과 함께 보고하는 바이다.

Received September 25, 2014 Revised December 1, 2014 Accepted December 16, 2014 Address for correspondence Kyung Tae, MD Department of OtorhinolaryngologyHead and Neck Surgery, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 133-817, Korea Tel +82-2-2290-8585 Fax +82-2-2293-3335 E-mail kytae@hanyang.ac.kr Background and ObjectivesZZModified Blair incision (MBI) and Modified facelift incision (MFI) are mainly used for paroidectomy. MBI can provide a wide surgical view for parotidectomy. MFI was designed for better cosmesis by hiding the incision behind the auricle and hair line. This study was performed to evaluate surgical outcomes, functional and cosmetic results after parotidectomy using MBI and MFI. Subjects and MethodZZWe retrospectively reviewed medical records of 120 patients who underwent parotidectomy from September 2005 to April 2012. Tumor characteristics, operative outcome, and cosmetic outcome according to incision method were investigated. Cosmetic satisfaction was assessed using a questionnaire 12-18 months after surgery. ResultsZZTumor characteristics such as size, location and pathologic features did not differ between the two groups. The extent of parotidectomy, operation time, amout of drainage, and complications were also not different between the two groups. Cosmetic satisfaction was significantly supeior in the MFI group than that of the MBI group. ConclusionZZMFI is superior to MBI for parotidectomy for having similar surgical outcome but better esthetical success compared to MBI. Korean J Otorhinolaryngol-Head Neck Surg 2015;58(5):337-40