비회귀성 후두 신경; 수술 전 경부 CT를 통한 신경 손상의 예방

김진성,소상수,최동일,양윤수,홍기환,Kim, Jin-Sung,So, Sang-Soo,Choi, Dong-Il,Yang, Yun-Su,Hong, Ki-Hwan 대한후두음성언어의학회 2007 대한후두음성언어의학회지 Vol.18 No.1

Background and Objectives: The nonrecurrent laryngeal nerve(NRLN) is exceedingly rare nerve anomaly that is associated with developmentally aberrant subclavian artery. The presence of NRLN is associated with an increased risk of vocal cord palsy in thyroid surgery. The purpose of this study is to investigate its prevalence, associated vascular anomaly and necessity of recognizing its possibility for prevention of intraoperative nerve damage. Materials and Methods: Between January 2004 and December 2006, 583 thyroidectomy were performed at our hospital. Of these cases, 529 cases(90.7%) were checked preoperative neck CT. Results: Patients with preopreative neck CT, 6 cases show the retroesophageal abberant right subclavian artery that arising directly form the aortic arch. 5 cases of these 6 cases(5/6, 83.3%) and of 583 patients(5/583, 0.8%) performed thyroid surgery were identified NRLN per-operatively. All of them are identified on the right side. There were 4 women and 1 man. In all cases, there were no clinical symptoms. I case was performed only left hemithyroidectomy, so we cannot identified NRLN. No vocal cord palsy was observed. Conclusion: It is possible to predict NRLN from preoperative neck CT. When NRLN is suspected, careful, complete dissection of the nerve is always advocated. These process can reduce the operative morbidity.

세침흡인검사에서 불확정으로 진단된 갑상선결절에서의 암발생률

최동일,양윤수,소상수,이은정,홍기환 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.11

Background and Objectives:The optimal management of cytologically indeterminate thyroid nodules is controversial given thevariable malignancy rates reported in this patient population. We examined the prevalence of malignancy within cytologically indeterminateatypical and follicular thyroid lesions in an attempt to predict malignancy based on cytologic features. Subjects andMethod:Cytopathologic reports obtained after fine-needle aspiration biopsy (FNAB) examination of indeterminate follicularthyroid lesions were studied over a 2-year period. The prevalence of malignancy on final pathology was determined in 2 indeterminatecytopathologic categories. Results:A total of 138 records were available (122 women, 16 men). The mean patient age was45.5±13.5 years. All patients underwent surgery and had histopathologic diagnosis. The prevalence of malignancy in atypicaland follicular thyroid lesions were 77.7% (42 of 54) and 17.8% (15 of 84), respectively. Conclusion:The high prevalence ofmalignancy within indeterminate atypical and follicular thyroid lesions may necessitate thyroidectomy for patients with indeterminateatypical and follicular lesions on the FNAB examination. (Korean J Otolaryngol 2006;49:1096-100)

갑상선 전절제술 후 1시간에 측정한 혈청 부갑상선호르몬의 유용성

양윤수,이은정,소상수,최동일,공일승,홍기환 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.11

Background and Objectives:Hypocalcemia is the most frequent complication following total thyroidectomy. This prospective study examines the predictive value of parathyroid hormone (PTH) levels measured 1 hour after surgery. Materials and Method:Twenty-four patients underwent total or near-total thyroidectomy for benign or malignant thyroid tumor in one year. Serum calcium and PTH levels were measured preoperatively and at 1 hour after surgery. Results:Al patients were clasified into three groups acording to hypocalcemic symptoms and postoperative serum calcium levels. A total of 6 (25% ) patients were found with hypocalcemia, as demonstrated by clinical and laboratory findings. PTH levels at 1 hour were below normal level (100% ) for 6 of the 6 symptomatic hypocalcemia patients, 5 (45% ) of the 11 biochemical hypocalcemia patients, and in 1 (14% ) of 7 normocalcemic patients (p= 0.002). The sensitivity and specificity of postoperative 1 hour PTH asesment to predict symp-tomatic hypocalcemia were 100% and 66%. The positive and negative predictive rate of postoperative 1 hour PTH assesment to predict symptomatic hypocalcemia were 50% and 10%. Conclusion:of transient hypocalcemia after bilateral thyroid surgery. Low PTH level at 1 hour after surgery is therefore a feasible predictor of postoperative symptomatic hypocalcemia and permanent hypoparathyroidism. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 :1012-6)

편도적출술이 구강 및 비강 음향스팩트럼에 미치는 영향

최동일,공일승,이은정,소상수,양윤수,홍기환,Choi, Dong-Il,Kong, Il-Seung,Lee, Eun-Jung,So, Sang-Soo,Yang, Yoon-Soo,Hong, Ki-Hwan 대한후두음성언어의학회 2007 대한후두음성언어의학회지 Vol.18 No.1

Background and Objectives: It has been suggested that tonsillectomy possibly causes changes of voice because the morphology of the vocal tract is altered. This may cause serious problems for professional voice users. Materials and Method: Subjects were 26 patients. The oral and nasal sound spectrum of oral vowel /a/, /e/ and /i/ were measured before and after tonsillectomy. The formant frequencies and intensities for oral and nasal spectra were compared. The nasality and fundamental frequencies for oral vowel were measured. Results: The first formant frequencies for oral spectra of all vowels were not changed after surgery, but the second formant frequencies were increased significantly after surgery in the vowel /e/ and /i/. The first and second formant intensities for oral spectra were increased significantly after surgery in the all vowels. The first and second formant frequencies for nasal spectra of all vowels were not changed after surgery, but their intensities for nasal spectra were increased after surgery. The nasalities for oral vowel were not changed after surgery. Conclusion : Tonsillectomy appeared to change the spectral features of oral and nasal components of oral vowel, especially spectral intensities.

급성 음향 외상의 예후 인자

이재근,윤용주,김진성,소상수,권삼현 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.5

Background and Objectives:The prognosis and prognostic factors for acute acoustic trauma are difficult to predict. The aimof this study was to assess the prognostic factors of acute acoustic trauma. Subjects and Method:The cases selected for thisreport are 27 patients with acute acoustic trauma and 139 patients with sudden deafness are selected for control group. Thefollowing factors were examined for prognostic factors : age, vestibular symptom, degree of initial hearing loss, number of daysbefore the start of treatment. Results:Most strongly related factor for prognosis is number of days before the start of treatment,but other factors are not significant relation for prognosis. The overall hearing recovery rate of acute acoustic trauma was 29.6%and that of sudden deafness is 56.1%. Conclusion:Early treatment of acute acoustic trauma increases hearing recovery rate,and acute acoustic trauma has worse prognosis than sudden deafness. (Korean J Otolaryngol 2006;49:494-8)

후두질환에 따른 자음의 음성발현시간의 특성

홍기환,이화욱,김진성,이은정,소상수,최동일,양윤수,Hong, Ki-Hwan,Lee, Hwa-Uk,Kim, Jin-Sung,Lee, Eun-Jung,So, Sang-Soo,Choi, Dong-Il,Ynng, Yoon-Soo 대한후두음성언어의학회 2006 대한후두음성언어의학회지 Vol.17 No.2

Background and Objectives : Voice onset time(VOT) is defined as the time interval from oral release of a stop consonant to the onset of glottal pulsing in the following vowel. VOT is a temporal characteristics of stop consonants that reflects the complex timing of glottal articulation relative to supraglottal articulation. Stop consonants are characterized by creation of a pressure difference across a complete occlusion in the vocal tract, followed by a sudden release 'burst' due to opening that occlusion. The objects of this study is to evaluate a usefulness of voice onset time in the assessment of voice disorderd patients. Subjects : Subjects were 20 adults with normal voice and with benign laryngeal disorders. Subjects with voice disorders represented the following vocal pathologies : vocal polyp, vocal nodule, Reinke's edema and unilateral vocal fold paralysis(UVFP). Control subjects were matched for age (21-40 yews old) and sex(male) with the voice disorders subjects and had normal vocal qualities with no history of voice disorders. Methods : Each voice-disordered and matched control subject read the test passages containing three types of Korean bilabial consonants. VOT measures were made for the initial $/p/p^h/\;and\;/p'/$. VOT was measured using acoustic waveform or wide band spectrogram. Results : For each voiceless stop consonants, there was a significant difference in VOT between the voice disordered and normal subjects. The mean VOTs of the lax stops in UVFP was significantly shorter than those of control subjects in the UVFP. The mean VOTs of the aspirated stops in the vocal polyp and nodule were longer than those of control subjects, but not significant. The mean VOTs of the glottalized in voice disordered groups were longer than those of control subjects, and significant statistically in the UVFP. Conclusions : VOT may be a clinically useful acoustic parameter in the assessment of voice disordered patients, especially in the unilateral vocal fold paralysis.

터너 증후군 환아에서 이과적, 청각학적 특징의 임상적 고찰

박희택,이종민,윤진,김문준,윤연섭,이현두,소상수,이대열,김민선,권삼현,윤용주,이은정 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.9

Background and Objectives Turner syndrome (TS) is known to be caused by a total or partial deletion of one X-chromosome. Besides short stature and failure to enter puberty due to ovarian dysgenesis, auricular malformations, middle ear diseases and hearing impairment are also other clinical features of Turner syndrome. The goal of this study is to report otologic and audiologic characteristics in a group of children with Turner syndrome and correlate with these findings to karyotype. Subjects and Method We retrospectively reviewed the outpatient charts of those who visited at our department for otologic and audiologic screening test between 2008 and 2011. All 23 TS children (46 ears) were enrolled under regular control of their pediatric endocrinologist for treatment with growth hormon and Estrogen. The mean age was 12.6 years (6-24 years). All children were evaluated by otologic history taking, otoscopy, pure tone audiometry and karyotyping. Furthermore, 16 children undertook auditory brain stem response (ABR) test and 10 children temporal bone computed tomography (CT). Results Abnormal otoscopic findings were found in 48% (22 ears), abnormal otologic history in 70% (16 children), and abnormal audiologic findings in 70% (32 ears). According to karyotyping, the total p-arm deletion group (74%) showed unfavorable audiologic results. ABR test and temporal bone CT did not show any unique findings, except five poor pneumatization of mastoid. Conclusion Hearing impairment can be present at early age in Turner syndrome. Careful follow up during childhood is necessary to detect early ear and hearing problems for active intervention. Karyotype may be used as a predictor for future hearing impairment.