Objective: To investigate postoperative course of eosinophilic chronic rhinosinusitis (ECRS).
Methods: Adult fourteen patients with ECRS, who underwent initial endoscopic sinus surgery (ESS) between 2008 and 2011 and were followed-up for 12 months or more, were retrospectively analyzed. There were 8 men and 6 women with median age of 54 years (23-74). Median value of following-up period was 12 months (12-26) after ESS. The ECRS was diagnosed when nasal congestion and olfactory disorder, bilateral CRS with nasal polyps (CRSwNPs), eosinophila, and ethmoid sinus dominant opacification were completely fulfilled. Both pre- and postoperative sinonasal computed tomography (CT) findings of each sinus and olfaction cleft (OC) were scored. The CT score is the total score expressed as a percentage of the possible maximum score (24 points). Olfaction was evaluated using self-administered odor questionnaire (SAOQ), visual analog scale (VAS), and T&T olfactometer.
Results: Anterior ethmoid sinus with polypous mucosa was observed as the most severe inflammatory sinus before, during, and after ESS. Mean CT score significantly improved from 71% to 44% (p=0.0026, n=14) after ESS. On average, all olfaction tests, SAOQ (p=0.0400), VAS (p=0.0159), and T&T recognition threshold (p=0.0077), significantly improved. Improvement rate was 50% (7/14 patients). CT scores in the improvement group of olfaction were significantly better than those in the no-changed group.
Conclusion: A half of patients with ECRS showed benefit in postoperative course more than 12 months. This study demonstrated that the better olfactory results tended to show the better CT findings after ESS.

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Relapsing polychondritis (RP) is a very rare disease characterized by repeated inflammation of cartilage tissue and of tissue containing many mucopolysaccharides such as external ears, nose, eyes, joints, trachea, cochlea and vestibule. It is sometimes difficult to diagnose this disease because initial symptoms are not always sufficient to meet the diagnostic criteria. We experienced a case of a thirteen-year-old boy that was difficult to both diagnosis and treatment. His first symptoms were left acute sensory neural hearing loss and vertigo, and after treatment sleep apnea and hoarseness (subglottic stenosis) appeared. It took several months to diagnose the RP because there were scarce symptoms. It was also difficult to control the inflammation with only steroids and immunosuppressive agents and a biological agent was required.

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