수술 중 초음파로 국소화하여 적출한 상부식도 괄약근 매몰 가시

임길채,조승연,부선진,김흥업 대한상부위장관ㆍ헬리코박터학회 2019 Korean Journal of Helicobacter Upper Gastrointesti Vol.19 No.2

The prevalence of people presenting with fish bone foreign body (FFB) is high in Asian countries, including Korea, and coastal areas around the world. Pointed linear-shaped FFBs are common in the oral cavity and upper esophageal sphincter, whereas large flat bones are more common FFBs in the esophagus. If the FFB is not found on endoscopy, residual foreign body sensation or embedded FFB is possible. In such cases, CT is helpful. However, in the case of totally embedded FFB, not only preoperative diagnosis but also localization during operation or surgery is important. If these are not performed, the initial incision site or operation method would be difficult to determine. For this purpose, no standard guideline has been established yet. We report a case of upper esophageal sphincter-embedded FFB diagnosed using CT rather than endoscopy. The bone was successfully localized using conventional ultrasonography during the operation and then removed surgically.

환기관 삽입 후 재발하는 점액성 이루로 발견한 호산구성 중이염 3예

임길채,현창림,최승효 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.7

We studied three patients in whom otorrhea occurred without bacterial infection following ventilation tube (VT) insertion. These patients took oral steroids since the conventional therapy was not effective; however, the oral steroids produced temporal effect since sticky otorrhea occurred when the oral steroids were stopped. We collected ear discharge from each patient and consulted the pathologist about histopathologic findings of it. We identified the predominant eosinophilic infiltration at specimen. We tried to relate this type of otitis media with eosinophilic otitis media (EOM) and treated the patients with intratympanic steroid injection.

안면부의 다발성 손상 환자에서 시행된 악하 기관삽관술 2예

임길채 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.5

Submental endotracheal intubation is a method introduced by Hernandez Altemir in 1986 for maintaining the airway. In the treatment of multiple facial fractures, the appropriate airway maintenance is a challenge for both anesthesiologists and surgeons. Oral endotracheal intubation precludes achieving adequate access to the fracture and maxillomandibular fixation for proper occlusion. Nasotracheal intubation is contraindicated in cases accompanying fractures of skull base or nasal bones. Tracheostomy is the standard method for airway management in these traumas. It does not interfere with surgical access and occlusion, and can be used for prolonging ventilation treatment. However, it has a significant risk of iatrogenic complications. On the other hand, submental endotracheal intubation is an alternative method of airway maintenance in facial traumas. It does not compromise the surgical fields but enables maxillomandibular fixation and can avoid complications of tracheostomy. In this case report, we present our experience of submental endotracheal intubation in two cases with multiple facial traumas.

삼출성 중이염으로 환기관삽입술을 받은 소아에서 중이삼출액 내의 면역세포 유형과 환기관 이루 발생의 관계

임길채,현창림,김동영,최승효,송찬일 대한이비인후과학회 2018 대한이비인후과학회지 두경부외과학 Vol.61 No.3

Background and Objectives Tympanostomy tube insertion is one of the most commonsurgical procedures in children. Despite aseptic procedures with prophylactic antibiotic treatment,postoperative otorrhea may be encountered in some patients. The purpose of this study isto identify the relation between the types of immune cells in otitis media with effusion (OME)and tympanostomy tube otorrhea (TTO) in children. Subjects and Method Fifty-six patients underwent tympanostomy tube insertion withOME were analyzed retrospectively. Fluid from OME was harvested by suction via syringe connectorafter myringotomy. Light microscopic examination of middle ear effusion was performedby a pathologist after hematoxylin and eosin staining. We analyzed the relation between the typesof immune cells from middle ear effusion and TTO. Results Of 56 children, 36 were male and 22 were female. The mean age for tympanostomytube insertion was 3.56 (±2.63) years, with the average follow-up period of 12.56 (±9.96)months. Neutrophils were detected in 19, eosinophils in 14, lymphocytes in 22, mast cells in 2,plasma cells in 7, and histiocytes in 9. TTO occurred in 15 patients. In patients with early TTO,eosinophils were detected more frequently than in patients without TTO (p=0.006). Plasmacells were detected more frequently in patient with late TTO than without TTO (p=0.011). Conclusion According to the analysis of different types of immune cells, eosinophils in themiddle ear effusion related with the occurrence of TTO.

저음역 돌발성 난청 환자에서 고실 내 덱사메타존 주입술 및 경구 스테로이드 병합 요법의 효과와 경구 스테로이드 복용량 조절을 위한 예비연구

임길채,최승효 대한이비인후과학회 부산,울산,경남 지부회 2012 임상이비인후과 Vol.23 No.2

Prevalence of low tone sudden sensorineural hearing loss (LSSNHL) has increased. However there was no definite treatment regimen of LSSLHL. The objective of this study is to analyze results of oral steroid therapy and intratympanic steroid injection (ITSI) as first line therapy for LSSLHL. Addtionally, we compared side effects as treatment modality. Materials and Methods:We studied retrospectively 43 patients with LSSLHL at Jeju National University Hospital from March 2010 to July 2011. Under approval of patients we classified patients into 3 groups as treatment types. Patients to be treated with only ITSI were classified as group I (n=11), patients to be treated with ITSI and high dose oral methylprednisolone (1 mg/kg/day) were classified as group II (n=9) and patients to be treated with ITSI and half dose oral methylprednisolone (0.5 mg/kg/day) were classified as group III (n=23). Patients got 3 times of ITSI for a week. Before injection we warm-ed up dexamethasone (5 mg/mL) ample and we injected at posterosuperior portion of tympanic membrane. We carried out a pure tone audiometry (PTA) on the 1st day of their visit to hospital and before injection. We compared change of bone conduction threshold at 250, 500 and 1,000 Hz between 3 groups. Results:The hearing threshold of patients improved regardless of groups since the treatment. And there was no clinically significant differences in the outcome between groups. Conclusions:We could use ITSI as therapy in LSSLHL. If we used oral steroids for treatment of LSSLHL, we could consider reduction dosage of them.

Use of Acellular Allogenic Dermal Matrix in Soft Palate Reconstruction after Excision the Pleomorphic Adenoma

이재성,임길채,김정홍,강재경,신명수,윤병민,Lee, Jae Seong,Lim, Gil Chae,Kim, Jeong Hong,Kang, Jae Kyoung,Shin, Myoung Soo,Yun, Byung-Min The Korean Society for Head and Neck Oncology 2019 대한두경부 종양학회지 Vol.35 No.1

Recent studies have reported on the reconstruction of oral mucosal defects using acellular dermal matrix (ADM). This case report describes the reconstruction of a soft-palate mucosal defect using ADM. A 43-year-old man developed a $2.5cm{\times}3cm$ soft-palate mucosal defect after the removal of a lump on the soft palate andreconstructed the defect using ADM without further complications. Reconstruction of the soft palate with ADM could be more convenient than traditional methods including primary closure, skin graft, and local or free flap without complications.

혈액 투석 중 양측 돌발성 난청이 순차적으로 발생한 만성신부전 환자 1예

김세형,임길채,최승효 대한이비인후과학회 부산,울산,경남 지부회 2012 임상이비인후과 Vol.23 No.1

Hemodialysis (HD) is a valid treatment modality in patients with chronic renal failure (CRF). Both CRF and HD have been noted as a possible cause of tinnitus, vertigo and sensorineural hearing loss (SNHL). There have been many efforts to elucidate the etiologic factors of hearing impairment in patients with CRF who underwent HD. But, it is difficult to explain association between them. Especially, sudden SNHL (SSNHL) in patients with CRF who underwent HD is highly unusual. We report, with a review of literatures bilateral SSNHL associated with CRF and HD as its treatment. At first, patient developed profound SSNHL in right side with benign paroxysmal positional vertigo (BPPV) after HD for 18 months. In spite of the treatment with systemic steroid and intratympanic dexamethasone injection (ITDI) hearing result was poor. And then SSNHL occurred in left side after 6 months. Hearing result was poor.

역설적 성대운동을 보이는 3명의 환자에 대한 임상분석

최선명,임길채,한광우,남순열 대한기관식도과학회 2003 大韓氣管食道科學會誌 Vol.9 No.1

Background and Objectives : Paradoxical vocal cord movement is a series of paroxysmal adduction of the anterior two-thirds of the vocal cords during respiration or during phonation. The choking, stridor, and wheezing in this condition occur primarily on inhalation, rather than on exhalation. The two pathognomonic diagnostic criterias that need to be assessed during an acute presentation are laryngoscopy with direct visualization of paradoxical adduction of the vocal cords and pulmonary function testing. Materials and Methods : A retrospective review of 3 patients who were referred to otolaryngologist from pulmonology department, and were confirmed by typical laryngoscopic findings with paradoxical adduction of the vocal cords was conducted. Results The patients were misdiagnosed as exercised-induced asthma, and unresponsive to corticosteroid and bronchodilators. Improvement was achieved only by diagnosis with paradoxial vocal cord movement. Biofeed back therapy, voice therapy, treatment for reflux laryngitis improved symptoms. Conclusion The etiology of paradoxical vocal cord movement is unknown. It may be functional or emotional. The functional factors that were proposed are neurologic deficit and gastroesophageal reflux. Management methods of this condition consist of psychological counselling, voice therapy, and antireflux medication.

비강내 반전성 유두종과 동반된 치아 임플란트 합병증 1예

김세형,임길채,김정홍 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.6

Unexpected displacement of a dental implant into the maxillary sinus is an unusual but potential complication in dental procedure. A dental implant that migrates into the maxillary sinus often develops paranasal sinusitis and cause diverse peri-implant soft tissue complications. A 59-year-old man complaining of nasal obstruction for several months presented with a huge polypoid mass in the nasal cavity. He had undergone a dental implant procedure in the maxilla at a dental clinic seven years ago. The implant fixture was found displaced to the maxillary sinus. The migrated fixture and nasal mass were removed by endonasal endoscopic surgery and mini Caldwell-Luc operation. The pathology was diagnosed as an inverted papilloma. To our knowledge, this is the first case reported in the literature regarding a dental implant complication that developed independently of sinonasal inverted papilloma.

Carcinoma Ex Pleomorphic Adenoma(CXPA)의 임상적 예후 인자

이윤세,현상민,임길채,최승호,김상윤,남순열 대한이비인후과학회 부산,울산,경남 지부회 2009 임상이비인후과 Vol.20 No.1

Carcinoma ex plemorphic adenoma (CXPA) originated from the salivary glands is rare but aggressive. It is known to be a high-grade carcinoma, frequently showing poor prognosis due to disease- related death and metastasis. Materials and Methods:We reviewed medical charts of patients who were diagnosed to have CXPA and received treatment from January, 1990 to July, 2008 at Asan medical center. Results: Thirty one patients (male:female=20:11) underwent surgery and/or adjuvant radiation therapy. The parotid gland was the most common site (74%). The tumors in the parotid were resected in the method of simple excision (4%), superficial parotidectomy (26%) or total parotidectomy with or without neck dissection (70%). Five year overall survival rate was 84.07%. According to site or treatment method in parotid gland originated tumor, there was no significant difference in survival rate and local control rate. Postoperative pathologic status of margin was the only factor influencing prognosis (p=0.04). Conclusion:Proper excision is a mainstay in the treatment of CXPA and preoperative evaluation of tumor extent is important. (J Clinical Otolaryngol 2009; 20:49-54)