코내시경 수술로 치료한 외상후 지연성 기뇌 1예

이학천,박일호,최창재,이흥만 대한비과학회 2010 Journal of rhinology Vol.17 No.1

Pneumocephalus is the presence of intracranial air, the most common cause of which is head trauma that allows contact between the intracranial cavity and the atmosphere. Pneumocephalus, commonly associated with increased intracranial pressure,causes rapid neurologic deterioration requiring emergent intervention. Recently, endoscopic sinus surgery techniques have been used in the diagnosis and repair of cerebrospinal fluid leaks. We present a case in which endoscopic techniques were used to treat pneumocephalus that occurred three years after head trauma. The procedure for and advantages of the endoscopic endonasal approach over the external approach are presented in this paper.

안와 침범을 동반한 전두동 B세포 림프종 1예

최창재,이학천,박일호,이흥만 대한이비인후과학회 부산,울산,경남 지부회 2010 임상이비인후과 Vol.21 No.1

Sino-nasal B cell lymphoma is an uncommon malignancy which is difficult to diagnose. A 66-year-old male presented with left orbital pain and swelling which were unresponsive to 2 weeks of antibiotic treatment. Nasal endoscopy revealed no specific finding in both nasal cavities. CT scans of paranasal sinuses demonstrated whole soft tissue density with bony erosion in the left frontal and ethmoid sinus. Lamina papyracea and orbital content were displaced laterally by the frontal sinus mass. MRI showed no direct invasion to the anterior cranial fossa or the orbit. Biopsy of the frontal sinus mass was confirmed as a diffused large B-cell lymphoma. The patient was successfully treated with chemotherapy.

Endoscopic Endonasal Treatment of a Pott’s Puffy Tumor

정진호,이학천,박일호,이흥만 대한이비인후과학회 2012 Clinical and Experimental Otorhinolaryngology Vol.5 No.2

Pott’s puffy tumor is an infrequent entity characterized by a subperiosteal abscess associated with frontal bone osteomyelitis. It has become rare due to the development of antibiotics and is usually seen as a complication of frontal sinusitis. Although Pott’s puffy tumor is more commonly described in children, it should also be included in the differential diagnosis of swelling on the forehead in adults. Once the diagnosis is suspected, appropriate imaging should be performed to evaluate the possible complications. The treatment of Pott’s puffy tumor combines medical and surgical approaches in order to prevent further complications. The goal of surgery is to drain the sinus and to excise the infected bone if necessary. The endoscopic endonasal approach is a safe and effective alternative to the external approach. This report describes the case of a 25-year-old man with Pott’s puffy tumor resulting from frontal sinusitis Pott’s puffy tumor is an infrequent entity characterized by a subperiosteal abscess associated with frontal bone osteomyelitis. It has become rare due to the development of antibiotics and is usually seen as a complication of frontal sinusitis. Although Pott’s puffy tumor is more commonly described in children, it should also be included in the differential diagnosis of swelling on the forehead in adults. Once the diagnosis is suspected, appropriate imaging should be performed to evaluate the possible complications. The treatment of Pott’s puffy tumor combines medical and surgical approaches in order to prevent further complications. The goal of surgery is to drain the sinus and to excise the infected bone if necessary. The endoscopic endonasal approach is a safe and effective alternative to the external approach. This report describes the case of a 25-year-old man with Pott’s puffy tumor resulting from frontal sinusitis

비전정에 발생한 피지선 과형성 1예

신영기,이학천,이흥만 대한비과학회 2009 Journal of rhinology Vol.16 No.2

Sebaceous hyperplasia is a cutaneous lesion consisting of soft, yellow, papular lesions usually occurring on the face of elderly patients. The occurrence of the lesion on the nasal vestibule is exceptionally rare. Except for cosmesis, the condition has no clinical significance. However, the lesion is sometimes confused with early basal cell carcinomas. It should be considered as a differential diagnosis in the neoplasm of the nasal vestibule. Biopsy may be necessary if there is any concern about a malignancy. Treatment options include electrodesiccation, laser therapy, and topical bichloracetic acid. In this study, we report a case of sebaceous hyperplasia of the nasal vestibule with an unusual presentation. Sebaceous hyperplasia is a cutaneous lesion consisting of soft, yellow, papular lesions usually occurring on the face of elderly patients. The occurrence of the lesion on the nasal vestibule is exceptionally rare. Except for cosmesis, the condition has no clinical significance. However, the lesion is sometimes confused with early basal cell carcinomas. It should be considered as a differential diagnosis in the neoplasm of the nasal vestibule. Biopsy may be necessary if there is any concern about a malignancy. Treatment options include electrodesiccation, laser therapy, and topical bichloracetic acid. In this study, we report a case of sebaceous hyperplasia of the nasal vestibule with an unusual presentation.

Respiratory Epithelial Adenomatoid Hamartoma Originating from Nasal Septum

박일호,이학천,이흥만 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.1

Respiratory epithelial adenomatoid hamartoma (REAH) is a rare benign lesion in nasal cavity. We report two cases of REAH of the nasal cavity arising from nasal septum. The etiology of REAH is unknown although inflammation may induce gland proliferation observed in hamartomas. One of our cases was associated with nasal polyposis. REAH is a self-limiting disease, so it is important to differentiate REAH from other pathologic process, including inverted papilloma and low-grade adenocarcinoma. The treatment of choice is complete excision through a conservative approach.

정상 청력으로 진단이 지연된 하전정신경초종 1예

최창재,전형진,이학천,채성원 대한평형의학회 2008 Research in Vestibular Science Vol.7 No.2

Vestibular schwannoma is a benign tumor arising from the Schwann cells in the vestibular nerve. It causes unilateral hearing loss, tinnitus, vertigo and unsteadiness. The most common symptom is reduced hearing on the affected side. In most cases patients present complaining of hearing impairment or vertigo from which the otologist can get a clue to diagnose vestibular schwannoma. We experienced an unusual case of 45-year-old woman presented with recurrent mild dizziness without any hearing loss so the patient initially diagnosed with recurrent vestibulopathy. However, subsequent neurotologic evaluation and posterior fossa MRI scanning confirmed diagnosis of huge vestibular schwannoma originated from inferior vestibular nerve. Vestibular schwannoma is a benign tumor arising from the Schwann cells in the vestibular nerve. It causes unilateral hearing loss, tinnitus, vertigo and unsteadiness. The most common symptom is reduced hearing on the affected side. In most cases patients present complaining of hearing impairment or vertigo from which the otologist can get a clue to diagnose vestibular schwannoma. We experienced an unusual case of 45-year-old woman presented with recurrent mild dizziness without any hearing loss so the patient initially diagnosed with recurrent vestibulopathy. However, subsequent neurotologic evaluation and posterior fossa MRI scanning confirmed diagnosis of huge vestibular schwannoma originated from inferior vestibular nerve.

자궁경부 및 질에 발생한 악성 흑색종의 1 예

김영태,김재욱,이학천 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.6

자궁경부 및 질흑색종은 매우 드문 악성 부인과종양의 하나로서 치료법에 대한 의견이 다양하게 제시되고 있으며, 예후는 매우 불량한 것으로 알려져 있다. 연세대학교 의과대학 산부인과학교실에서 자궁경부 및 질에 발생한 악성 흑색종의 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Malignant melanoma of the female genital tract comprises 3% of all melanomas afflicting females. The majority of these genital tract lesions arise in the vulva and very seldom in the ovary, uterus, and uterine cervix. The history, mode of presentation, and treatment of this neoplasm has been discussed. The tumor seems to arise from melanocytes that are usually present in the cervix and vagina. Vaginal bleeding was the most common complaint. Histochemical (Fontana-Masson silver stain) and immunohistochemical (Vimentin, S-100 protein, HMB-45 antibody), procedures confirm the initial diagnosis. Although there has been no consensus as to comprehensive treatment, radical abdominal hysterectomy with bilateral salpingo-oophorectomy is generally advocated. Although malignant melanoma is usually classified as a radioresistant tumor, reports show that local excision combined with high-dose irradiation is effective in treating primary disease. Also, radiation can be used as adjuvant or palliative treatment but its efficacy has not been well established. Systemic chemotherapy would be the theoretical best therapy. Unfortunately, effective chemotherapy with tolerable side effects is not presently available. Prognosis for this entity is poor. This article reports one new case and reviews the literature of primary malignant cervical and vaginal melanoma.

거대 난소 낭종 1 예

김영태,김재욱,이학천,김낙근,조용선,오연수 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7

본 예는 21세 미혼 여성의 우측 난소에서 발생한 거대 난소 낭종으로서, 정맥 환류에 장애를 일으켜 복벽에 caput medusae를 형성하였다. 낭종은 조직학적으로는 장내막세포성 점액성 경계성 난소종양으로 보고되었으며, 그 무게는 62 kg에 달하였다. 저자들은 pig-tail 카테테르를 삽입하여 배액시킴으로써 반복천자에 따르는 합병증을 예방하였고, 이어서 정맥 환류의 회복으로 환자의 증상이 완화됨에 따라 우측 난소 난관 절제술을 시행하였다. 수술 후 8일째 환자는 합병증 없이 지내다 퇴원 후 2주째 추적 관찰에서 시행한 CA 125는 43.1 IU/ml, 2개월 후 시행한 CA 125 18.3 IU/ml이며, 이완된 후 위축되었던 복부 피부가 정상으로 회복되는 과정을 보면서 만족할 만한 결과를 얻었기에 문헌적 고찰과 함께 보고하는 바이다. Huge ovarian cysts (more than 12 kg) are now rarely seen because of the development in health care systems and education. We had a patient with an ovarian cyst weighing 62 kg, marked distended abdomen, forming caput medusae on abdominal wall, tachypnea, dyspnea, and edema of both legs. The decompression procedure using now is repetitive aspiration of contents of tumor, but there are risks of bleeding, infection, adhesion and seeding of tumor cells. For reducing these risks, the pig-tail catheter was used on the patient. About 44,480 ml of fluid from cyst was drained by a pig-tail catheterization before surgery that improved cardiovascular and respiratory function of the patient. We observed the increase of urine output with the recovery of venous return. Right salpingo-oophorectomy was done. Pathologic diagnosis was intestinal mucinous borderline tumor confined to the capsule of right ovary. She was discharged on postoperative day 8. We report a huge ovarian cyst, which was successfully treated, with review of the literatures.

통년성 알레르기비염 환자에서 비강내 광치료

권혁성,이상학,전형진,박일호,이학천,이흥만 대한비과학회 2009 Journal of rhinology Vol.16 No.2

Background and Objectives:Phototherapy has a profound immuno- suppressive effect and is widely used for the treatment of immune- mediated skin diseases. The purpose of this study was to investigate the effectiveness of intranasal phototherapy in treating patients with perennial allergic rhinitis. Materials and Methods:We conducted a study on 19 patients with perennial allergic rhinitis from January 2008 to July 2008. Each intranasal cavity was illuminated three times in the first week and then once a week the following five weeks. Symptom scores and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were assessed. Results:Phototherapy was well tolerated by the patients and resulted in a significant improvement of clinical symptoms for rhinorrhea, nasal obstruction, nasal itching, sneezing and total nasal score. In addition, significant improvements were achieved for itching of eyes, itching of the palate and total non-nasal symptom score except tearing and redness of eyes. After six weeks, the overall RQLQ scores significantly improved by 51% from the baseline in the treatment. Conclusion:These results suggest that phototherapy is an effective modality for treating clinical symptoms of perennial allergic rhinitis and represents an alternative treatment for perennial allergic rhinitis. Background and Objectives:Phototherapy has a profound immuno- suppressive effect and is widely used for the treatment of immune- mediated skin diseases. The purpose of this study was to investigate the effectiveness of intranasal phototherapy in treating patients with perennial allergic rhinitis. Materials and Methods:We conducted a study on 19 patients with perennial allergic rhinitis from January 2008 to July 2008. Each intranasal cavity was illuminated three times in the first week and then once a week the following five weeks. Symptom scores and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were assessed. Results:Phototherapy was well tolerated by the patients and resulted in a significant improvement of clinical symptoms for rhinorrhea, nasal obstruction, nasal itching, sneezing and total nasal score. In addition, significant improvements were achieved for itching of eyes, itching of the palate and total non-nasal symptom score except tearing and redness of eyes. After six weeks, the overall RQLQ scores significantly improved by 51% from the baseline in the treatment. Conclusion:These results suggest that phototherapy is an effective modality for treating clinical symptoms of perennial allergic rhinitis and represents an alternative treatment for perennial allergic rhinitis.

원발성 난관암

이지원,황동훈,김영태,이학천 대한산부인과학회 1996 대한산부인과학회 학술대회 Vol.78 No.-