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Background and Objectives Squamous cell carcinoma associated with inverted papilloma (IP+SCC) is different histologically and biologically from sinonasal de novo squamous cell carcinoma (dnSCC). However, few studies have compared the characteristics of patients, behaviors of tumor, and treatment outcome of two different forms of SCC.Subjects and Method We retrospectively reviewed the medical records of 30 patients with IP+SCC and 39 patients with dnSCC who had been treated at Chungnam National University Hospital from 1989 to 2018. Demographics, clinicopathological characteristics, treatment modalities and outcome were analyzed.Results The mean age, sex ratio, and the proportion of smokers were similar in both groups. On the other hand, the presenting symptoms of each group were somewhat different: nasal symptoms were more frequent in the IP+SCC group, whereas facial symptoms were more frequent in the dnSCC group. Patients with dnSCC showed significantly more advanced T stage, poorer differentiation of cancer cells, and more bone destruction. The upfront method of treatment was surgery in both groups, whereas radiotherapy and chemotherapy were more frequently used as an adjuvant or main treatment in the dnSCC group. Patients with IP+SCC demonstrated better 5-year overall survival and disease-free survival than the dnSCC group. In both groups, patients with the lower T stage had better outcome than those with the higher T stage. The presence of nodal or distant metastasis was an independent, poor prognostic factor for survival regardless of the type of tumor.Conclusion Although sinonasal IP+SCC and dnSCC are often considered similar diseases, our findings suggest that IP+SCC may represent a less aggressive form of malignancy than dnSCC.

Background and Objectives A recent study revealed that calcitonin gene-related protein (CGRP) plays an important role in inflammatory airway diseases. However, the influence of CGRP on chronic rhinosinusitis (CRS) has not been studied. This study investigated the expression, activity, and potential pathogenic role of CGRP in patients with CRS with nasal polyposis (CRSwNP).Subjects and Method Patients with CRSwNP and control subjects were enrolled. The CRSwNP group was divided according to the presence of eosinophilic polyps and non-eosinophilic polyps. Nasal polyps (NPs) and uncinate tissues (UTs) from patients with CRSwNP and UTs from control subjects were obtained to investigate the expression of α-/β-CGRP and chromogranin A. In addition, the expression patterns of cytokines following exposure to exogenous CGRP were analyzed in dispersed nasal polyp cells (DNPCs) from patients with eosinophilic or non-eosinophilic CRSwNP. The effects of CGRP on lipopolysaccharide (LPS)-induced nuclear factor-kappa light chain enhancer of activated B cells (NF-κB) signaling change were evaluated in THP-1 cells.Results The expression of α-/β-CGRP and number of CGRP-producing cells were significantly higher in NPs from patients with CRSwNP than in UTs from controls. Exogenous CGRP decreased the expression of inflammatory cytokines and increased that of the anti-inflammatory cytokines in DNPCs from patients with eosinophilic nasal polyps (EPs) and also increased the expression of tissue remodeling-related and anti-inflammatory cytokines in DNPCs from patients with non-eosinophilic nasal polyps (N-EPs). CGRP inhibited the nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor (IκB) phosphorylation and NF-κB translocation in LPS-stimulated M1 macrophages.Conclusion CGRP expression in NPs may play a significant role in nasal polypogenesis through inflammatory modulation, and it could be a future target to modulate certain aspects of CRSwNP.

The Korean Society of Otorhinolaryngology-Head and Neck Surgery and Korean Rhinologic Society appointed a guideline development group (GDG) to establish a clinical practice guideline, and the GDG developed a guideline for nasal irrigation for adult patients with chronic rhinosinusitis (CRS). The guideline focuses on knowledge gaps, practice variations, and clinical concerns associated with nasal irrigation. Nasal irrigation has been recommended as the first-line treatment for CRS in various guidelines, and its clinical effectiveness has been demonstrated through a number of studies with robust evidence. However, no guidelines have presented a consistent nasal irrigation method. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a predefined search strategy. When insufficient evidence was found, the GDG sought expert opinions and attempted to fill the evidence gap. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. The committee developed 11 evidence-based recommendations. This guideline focuses on the evidence-based quality improvement opportunities deemed the most important by the GDG. Moreover, the guideline addresses whether nasal lavage helps treat CRS, what type of rinsing solution should be used, and the effectiveness of using additional medications to increase the therapeutic effect.

Background and Objectives Polylactic-co-glycolic acid (PLGA) plate has been recognized for its biocompatibility and biomechanical properties and used widely in various clinical fields. The aim of this study was to evaluate the usefulness and reliability of PLGA plate as a graft material in septorhinoplasty.Subjects and Method Medical records were retrospectively analyzed for patients who underwent septorhinoplasty including extracorporeal septoplasty from January 2017 to June 2020. We evaluated demographics, diagnosis, operation techniques, and complications of PLGA plate as a graft material used in these patients.Results A total of 33 patients were enrolled in this study. Twenty-eight were male and 5 were female. The median age was 32 years old. The follow-up period after surgery was 6-32 months, and the mean follow-up period was 18.03 months. The PLGA plate was used in unilateral spreader graft (n=17), bilateral spreader graft (n=10), batten graft (n=3), strengthening of septal extension graft (n=2) and columellar strut graft (n=3), and fixing L-strut during extracorporeal septoplasty (n=12). During the follow-up period, no patient experienced extrusion or exposure of the grafts. Mild complications, such as redness of the columella skin, granulation in the marginal incision site, and pain on the nasal dorsum were observed in three patients; these complications were temporary and patients improved with conservative treatments.Conclusion The PLGA plate may be a useful graft material in correcting deviated nose especially when the harvested septal cartilage is insufficient and if used carefully in limited locations such as L-strut and columella.

Background and Objectives The nucleotide-binding oligomerization domain-like receptor (NLRP) 3 is known as a member of the NLR family, and it has been confirmed that the NLRP3 inflammasome is associated with various diseases such as asthma, inflammatory bowel disease, metabolic disorders and multiple sclerosis, as well as other auto-immune and auto-inflammatory diseases. However, the role of NLRP3 in chronic rhinosinusitis with nasal polyps (CRSwNP) has not yet been explored.Subjects and Method Forty-four specimens of nasal polyps and 25 specimens of uncinate processes were collected from patients with chronic rhinosinusitis with nasal polyps, and 25 specimens of uncinate tissues were collected from patients who underwent other rhino-surgeries. The western blot assay was employed to analyze the expression of NLRP3; interleukin (IL)-1β and IL-17A were detected using immunohistochemistry and real-time polymerase chain reaction. The production of lipopolysaccharide (LPS) induced IL-1β and IL-17A with or without the NLRP3 inflammasome inhibitor (MCC950) was measured using an enzyme linked immunosorbent assay in cultured dispersed nasal polyp cells.Results NLRP3 showed a high level of expression in nasal polyps than in the control group (ppp

Objectives This study was performed to investigate the effects of aging on nasality and the influence of age-related changes in nasal cavity volume and nasal patency on nasality. Methods A total of 180 healthy Korean-speaking adult volunteers, who had no nasal or voice-related complaints, were enrolled in this study. Nasometry, acoustic rhinometry, and rhinomanometry were performed to obtain the nasalance score, nasal cavity volume, and nasal resistance, respectively. Changes in these parameters with age were analyzed. Results Nasal cavity volume increased significantly, and nasal resistance decreased significantly, with age. The nasalance scores for the nasal passage and oronasal passage decreased significantly with age, while there were no age-related changes in nasalance scores for the oral passage. Conclusion Nasalance scores for the passages containing nasal consonants decreased with age although significant increases were observed in nasal cavity volume and nasal patency with age. Therefore, the age-related decreases in nasalance scores may result from factors other than changes in the nasal cavity.

다형선종유래암종(carcinoma ex pleomorphic adenoma) 은 타액선 종양 중 드문 종양으로 기존의 양성 종물인 다형선 종에서 유래한 악성 혼합종이다. 75%는 이하선에서 발생하 며, 그 외에는 악하선 및 소타액선에서 발생한다. 진단은 조 직학적으로 기존의 다형선종에서 악성종양세포로 일부분 또 는 대부분 치환된 양상을 통해 규명할 수 있다. 다형선종유래 암종 내의 악성종양은 선암종(adenocarcinoma), 미분화암종 (undifferentiated carcinoma), 편평세포암종(squamous cell carcinoma) 등의 빈도로 나타난다. 악하선에서 발생하는 다 형선종유래암종은 국내외에서 몇 예가 보고되어 있으나, 악하 선에서 발생하는 다형선종 내의 암종이 선조직과 편평세포조 직으로 구성된 다형선종유래 선편평세포암종은 국내외에서 아직 보고된 바 없어, 저자들은 최근 악하선에서 발생한 다형 선종유래 선편평세포암종 1예를 경험하였기에 문헌고찰과 함 께 보고하는 바이다.

Chronic otitis media (COM) is the medical term for longstanding or persistent inflammation of the middle ear. This condition can cause ongoing damage to the middle ear and eardrum, resulting in a perforated eardrum that does not heal or a middle ear infection that does not improve or keeps recurring. COM often produces nonreversible pathologic lesions, including granuloma, cholesteatoma, tympanic sclerosis, and osteomyelitis, in the middle ear cavity. The prevalence of COM varies by country and province and is influenced by intrinsic factors, such as genetic factors, race and age, and environmental factors, including crowding, economic activities, social and cultural differences. Kim, et al. reported that the prevalence of COM in Korea was 2.19% and 22.8% of the COM patients had cholesteatoma. Similary, the Fifth Korean National Health and Nutrition Examination Survey reported that the prevalence of COM in Koreans over 4 years old, 19 years old, and 30 years old is 3.0%, 3.5%, and 4.2%, respectively. Surgery is often indicated to repair the tympanic membrane and remove the infected tissue and pathologic lesions from the middle ear and the mastoid bone. In cases with bilateral Clinical Characteristics of Bilateral Chronic Otitis Media