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Background: Endoscopic sinus surgery (ESS) is the mainstay treatment for refractory chronic rhinosinusitis (CRS). Since various factors may contribute to the surgical outcome, it is challenging for physicians to predict surgical outcomes. The aim of study was to analyze the prognostic factors of postoperative outcomes and to establish the prediction model with the risk factors that impact the postoperative outcomes., Methods: Medical records of CRS patients who underwent ESS at 9 institutions in 2005, 2010, and 2016 were retrospectively reviewed. We classified the patients into 2 groups based on postoperative objective endoscopic outcomes. Demographics, nose-specific symptoms, olfactory function, eosinophil counts in blood (EoB) and nasal tissue (EoT), and Lund-Mackay CT score (LMS) were collected. Univariate and multivariate analyses were performed and established a prediction equation for postoperative endoscopic objective outcomes., Results: In total (n = 1,249), 27.0% were not satisfied under postoperative endoscopic examination. Of 10 variables, LMS (> 5), sinus dominancy (maxillary sinus and ethmoid sinus), EoB (> 210), and EoT (> 100) were statistically significant in univariate analysis ( P < 0.05, all). In multivariate analysis, EoT (> 100) and LMS (> 5) were significantly associated with poor postoperative outcome. Furthermore, 5 significant variables were employed to establish the risk model of postoperative outcomes and P (the value of prediction probability) = 1 / (1 + exp [-0.392 + 1.088 × EoT (> 100) + 0.123 × mean LMS (> 5) - 0.366 × sinus dominancy (maxillary) + 0.064 × sinus dominancy (similar) + 0.200 × EoB (4%) + 0.344 × EoB (> 210)] was developed., Conclusion: Tissue eosinophil count and radiographic severity predispose to a poorer outcome of ESS and the risk model established may be helpful to predict postoperative outcomes of ESS., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2021 The Korean Academy of Medical Sciences.)

Purpose: Fungus ball (FB) is the most common type of fungal rhinosinusitis and the prevalence of FB has increased over the past 10 years. The aim of this study was to compare the clinical characteristics of Korean adult patients with FB and chronic rhinosinusitis (CRS) without FB., Methods: We retrospectively analyzed data on 1362 patients (147 FB and 1215 CRS) who underwent endoscopic sinus surgery at nine Korean medical centers in 2005, 2010, and 2016. We evaluated the prevalence of FB and compared the clinical characteristics of FB and CRS. Medical records, computed tomography (CT) findings, atopic status, concomitant diseases, tissue, and blood eosinophil count were assessed., Results: The prevalence of FB was significantly higher in 2016 (15.9%) than in the other years (7.8% in 2005 and 7.5% in 2010). The FB patients were more likely to be female, older, have unilateral disease and less likely to have allergy compared to the CRS patients. The most common main complaint related to CRS and FB was nasal obstruction. CT determined that unilateral disease and maxillary sinus dominancy were common in patients with FB. The incidence of concomitant diseases was much higher in FB, with lower tissue and blood eosinophilia., Conclusion: FB is commonly encountered in older women with the increased prevalence. FB had a different clinical presentation, radiological findings, and prognosis than CRS. Further studies are needed to understand the pathophysiologic mechanisms underlying the development of FB.

The purpose of this study was to survey concentrations of bisphenols in canned foods using liquid chromatography-tandem mass spectrometry, to estimate the dietary exposure to bisphenols, and to assess the related risk for the Korean population from the intake of canned foods. The linearity of bisphenols in the range of 2.5 to 725 μg/L was satisfactory with correlation coefficients ( r 2 ) of 0.999. The limit of detection was 0.14 to 5.85 μg/L, and the limit of quantitation was 0.44 to 17.73 μg/L. Sample recoveries were 70.56 to 113.6%, with relative standard deviations below 10% for spiking levels of 50 and 250 μg/kg (15 and 75 μg/kg for BPS). The bisphenol concentrations in 104 canned foods ranged from undetectable to 1,525 μg/kg. The estimated mean daily intake of bisphenols was 0.54 to 78.69 ng/kg of body weight per day, and the 95th percentile daily intake was 1.92 to 134 ng/kg of body weight per day. Therefore, the intake of bisphenols from canned foods for the population in Korea is unlikely to cause human health problems. The analytical methods used are suitable for regular monitoring and assessment of human exposure to bisphenols from foods.

Conclusion: Reconstruction of a large anterior skull base defect (SBD) with the nasoseptal flap (SF) is feasible in Asians. We consider the width of the SF to be the determining factor. Increasing flap width by incorporating the mucoperiosteum of the nasal floor can compensate for the relatively small septum in Asians., Objectives: To assess the feasibility of the SF for reconstruction of large anterior SBD in Koreans, and attempt to provide tips for improving its design., Methods: Radioanatomic measurements and intraoperative findings were analyzed. Specific skull base landmarks were measured to estimate the anticipated SBD and actual SBD. The length and width of the potential SF dimension was also measured and compared with the defect size to assess its feasibility., Results: The lengths of the actual SBDs were longer than those of anticipated SBDs in all patients, while the width of actual SBDs showed less discrepancy. Length and anterior width of the potential SF exceeded the needed SF dimensions in two patients, while the posterior width of potential SF fell short of the needed dimension. In both patients, the length of harvested SF was long enough to repair the entire length of SBD, while shortage of SF width was encountered in one patient.