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혈관내 스텐트를 이용하여 경정맥구 게실에 의한 박동성 이명을 치료한 증례보고
노현영(Hyunyoung Noh),김영학(Younghac Kim),김건하(Keon-Ha Kim),조영상(Young Sang Cho) 대한두개저학회 2023 대한두개저학회지 Vol.18 No.1
Pulsatile tinnitus is a rare otologic symptom that presents a diagnostic and management dilemma for experienced otolaryngologists. Treatment options range from conservative management to surgery, but patients may not be able to tolerate symptoms with the former and the latter procedure may be associated with significant morbidity We describe the case of using a stent-assisted coil approach to treating a patient with jugular bulb diverticulum (JBD) and severe pulsatile tinnitus. We describe a 41-year-old woman who presented with disabling pulsatile tinnitus due to right JBD. Both surgical or endovascular approaches were possible, but we decided to treat the diverticulum with coil emboli-zation and stenting of the jugular bulb. Following the procedure, tinnitus presence and severity were self-reported or assessed using the tinnitus handicap inventory (THI) and tinnitus magnitude index (TMI). The total score of both THI and TMI improved in 6 months after surgery, and there was no complication. Therefore, we report this experience, which was resolved through successful endovas-cular coiling and stent procedure for severe pulsatile tinnitus with no complication.
증례 : 혈액종양 ; 방사선치료 후 비출혈로 나타난 추체내경동맥의 가성동맥류 1예
이수진 ( Su Jin Lee ),안희경 ( Hee Kyung Ahn ),김수아 ( Su A Kim ),김건하 ( Keon Ha Kim ),안용찬 ( Young Chan Ahn ),박근칠 ( Keun Chil Park ),안명주 ( Myung Ju Ahn ) 대한내과학회 2010 대한내과학회지 Vol.78 No.2
비인두암으로 동시 항암방사선치료를 받았던 환자가 2개월 전부터 청력저하와 두통을 호소하였고, 비출혈이 있어 응급실에 내원하였다. CT상 좌측 경동맥의 가성동맥류가 의심되어 혈관조영술을 시행하였고, 이로써 가성동맥류를 확진하였다. 이후 코일을 이용하여 좌측 경동맥 폐색술을 시행하였고, 이후 환자의 증상은 호전되었다. 방사선치료를 받은 비인두암 환자에서 내경동맥 가성동맥류의 발생은 그 빈도가 매우 적으며, 현재까지 한국에서 보고된 바 없기에 문헌고찰과 함께 Rupture of an internal carotid artery pseudoaneurysm is a rare but lethal complication in patients with nasopharyngeal cancer. Here, we report a case of severe nasal bleeding from a left petrous internal carotid artery aneurysm after chemoradiotherapy in a
경동맥 내막절제술 후 조기 합병증(<30일) 발생에 대한 고찰 및 술 후 뇌경색 발생 위험인자 분석
이경복(Kyung-Bok Lee),이광호(Kwang-Ho Lee),정진상(Chin-Sang Chung),김경문(Gyeong-Moon Kim),변홍식(Hong-Sik Byun),전평(Pyoung Jeon),김건하(Keon-Ha Kim),김동익(Dong-Ik Kim),김영욱(Young-Wook Kim) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.3
Purpose: We aimed to evaluate the early (<30 days) results and to analyze risk factors for the development of stroke and new brain infarction (NBI) after carotid endarterectomy (CEA). Methods: From September 2003 to August 2008, 233 CEAs were performed on 222 patients with critical internal carotid artery (ICA) stenosis in a single center. Patient characteristics, history of neurological symptoms, procedural details, and postoperative complications were examined based on the medical records. The incidence and risk factors for early postoperative stroke were evaluated. After excluding CEAs without performing diffusion-weighted brain MRI, 128 CEAs were investigated for frequency and the risk factors of NBI were analyzed. Chi-square test, Fisher’s exact test, Student T-test, and logistic regression model were used for statistical analysis. Results: Of a total of 233 CEAs, any and ipsilateral stroke rates were 1.3% and 0.4%, respectively. There was no early postoperative mortality. Early postoperative complications included 4.3% in transient cranial nerve injury, 1.7% in myocardial infarction, and 3.4% in hematoma. In univariate analysis, the significant risk factor for stroke was plaque ulceration (P=0.04). The frequency of NBI and ipsilateral NBI were 8.4% and 3.1%, respectively. The ulceration on ipsilateral ICA revealed statistically significant risk factors for the development of NBI (RR, 5.29; 95% CI, 1.024∼27.325; P=0.04). Conclusion: Our study showed a lower incidence of stroke and NBI after carotid endarterectomy and that it is safe procedure for the treatment of patients with severe (>70%) carotid stenosis. We also found that plaque with ulceration was a significant risk factor for the development of postoperative NBI.