Single-Center 10-Year Experience in Treating Patients With Vascular Tinnitus: Diagnostic Approaches and Treatment Outcomes

배성천,김동기,여상원,박소영,박시내 대한이비인후과학회 2015 Clinical and Experimental Otorhinolaryngology Vol.8 No.1

Objectives. Vascular tinnitus is the most common form of pulsatile tinnitus, particularly when the tinnitus corresponds with the pulse of patients. In this study, we reviewed the 10-year clinical data on vascular tinnitus of our tinnitus clinic to investigate the frequency of the underlying etiologies, to introduce a diagnostic protocol, and to evaluate the treatment outcomes. Methods. We retrospectively collected the data of 57 patients who were diagnosed as vascular tinnitus between April 2001 and December 2011. Careful history taking, otoscopy, thorough physical examinations, audiometry, laboratory tests, as well as radiologic examinations were performed according to our diagnostic protocol to find the origin of pulsatile tinnitus. Treatment options were individualized based on the specific etiology, and the outcomes were assessed using patient’s subjective reports at the follow-up interviews. Results. High jugular bulb was the most common cause (47.4%) of vascular tinnitus, and venous hum was the next (17.5%). Dural arteriovenous fistula, intracranial aneurysm, atherosclerotic carotid artery disease, and hypertension were less common causes. Vascular tinnitus was alleviated in most patients after the appropriate treatment: surgical intervention, tinnitus retraining therapy, reassurance, and medications. Conclusion. Vascular tinnitus can be successfully diagnosed by the regular use of the suggested protocol. Many patients with vascular tinnitus have treatable underlying etiologies. Treatment of those etiologies or at least counseling about the tinnitus itself can benefit the patients with troublesome vascular tinnitus.

선택적 갑상피열분지 및 측윤상피열분지의 절단과 경신경고리 신경재지배 방법을 이용한 연축성발성장애의 수술적 치료 1례

박영학,배성천,이석은,조승호,Park, Young-Hak,Bae, Seong-Cheon,Lee, Seok-Eun,Cho, Seune-Ho 대한후두음성언어의학회 2006 대한후두음성언어의학회지 Vol.17 No.2

Spasmodic dysphonia is a voice disorder characterized by involuntary voice breaks during speech. Adductor spasmodic dysphonia is most common and characterized by strained and strangled voice breaks. The current standard of treatment of therapy for adductor spasmodic dysphonia is chemodenervation of thyroarytenoid muscle with botulinum toxin(Botox). However, Botox is a temporary treatment with each injection lasting approximately 3 months on average and require repeated injections. In this study, we report our experience with surgical treatment for adductor spasmodic dysphonia. In this procedure, the thyroarytenoid branch and lateral cricoarytenoid branch of recurrent laryngeal nerve is selectively denervated unilaterally, and its distal nerve stump of thyroarytenoid branch is reinnervated with branch of the usa cervicalis nerve. And lateral cricoarytenoid muscle partial myotomy was done unilaterally. After 6 months of treatment, voice fluency had improved and no period of breathiness or dysphagia was noted.

Small-Group Counseling in a Modified Tinnitus Retraining Therapy for Chronic Tinnitus

박시내,배성천,김동기,박용수,여상원,박소영 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.4

Objectives. The authors have treated chronic tinnitus patients using a combination of a simplified tinnitus retraining therapy (TRT) and medications, which we called modified TRT. In this clinical setting, we have attempted small-group counseling to find a time-effective equivalent of individual counseling. The aim of the present study was to evaluate the effectiveness of small-group counseling by comparing the treatment outcomes between individual and small-group counseling. Methods. The patients who had distressing chronic tinnitus with normal hearing or mild hearing loss were included. The subjects were placed into the small-group (group 1:4) or the individual (group 1:1) counseling group, and underwent a modified TRT composed of a single session of directive counseling and ambient sound stimulation. In addition, alprazolam (0.25 mg) and ginkgo biloba extract (80 mg) were administered orally to the subjects for 3 months. The 3- and 6- month outcomes were assessed using the follow-up rates and tinnitus severity scores: awareness, tinnitus handicap inventory (THI), loudness, annoyance, and effect on life. The treatment responses were classified as improvement,no changes, and worsening. Results. Of the total 149 patients (77 in group 1:1; 72 in group 1:4), 104 patients completed the protocol at 3 months, and 55 patients at 6 months. The follow-up rates were similar in both groups. Over the period of 6 months, all scores declined significantly except the loudness score at 3 months in both groups. Treatment responses showed no between-group differences. The success rate based on THI was 70% in group 1:1, and 64% in group 1:4 at 6 months. Conclusion. The small-group counseling of our modified TRT was comparable to the individual counseling for tinnitus relief. We suggest that this protocol can be implemented effectively in any crowded otolaryngology clinics.

상악동 후비공 비용의 변형물인 혈관종성 비용 1예

박찬순,노혜일,배성천,박용진 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.4

Angiomatous nasal polyps are a rarely reported subtype of inflammatory sinonasal polyps that are characterized by extensive vascular proliferation and ectasia. The blood vessels present in these sinonasal polyps may be subjected to compromise at certain areas within the nasal cavity, leading to venous stasis, thrombosis and infarction. Recently, we experienced a case of angiomatous nasal polyp that caused significant diagnostic difficulty at the time of her presentation in a 12-year-old girl. Although entirely benign, angiomatous nasal polyps may simulate neoplastic process, thus awareness of their existence is of considerable importance. Especially, differential diagnosis between angiomatous polyp and angiofibroma is important for evaluation and treatment. In the present paper, the clinical, radiological and pathological features of angiomatous nasal polyps is also discussed. (Korean J Otolaryngol 2006;49:443-6)

유리피판을 이용한 기능적 상악 재건술

주영훈,선동일,배성천,박영학,조승호,김민식 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.9

외이도에 발생한 연골성 분리종 1예

박정미,김효민,배성천,박시내 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.3

Cartilaginous choristoma of bony external auditory canal is very rare. Appearing as a horny sha-ped hard mass, cartilaginous choristoma can be found in the medial portion of anterior wall of external auditory canal. Histologically, it consists of adult-type hyaline cartilage without neoplastic features. If cartilaginous choristoma shows growing tendency or ear symptoms, surgical excision would be the treatment of choice. Here, we report a case of cartilaginous choristoma that occurred in the external auditory canal in an 8-year-old boy.

비중격과 경사대에서 발생한 비내 다형성 선종 1예

박용진,박찬순,정지한,배성천 대한비과학회 2006 Journal of rhinology Vol.13 No.1

Pleomorphic adenomas arise most commonly in the major salivary glands. It has rarely been described arising in the nasal cavity. A 65-year-old woman presented with a 9-month-history of left sided nasal obstruction. Endoscopic examination and computed tomographic scan revealed a lobulated tumor mass arising from the left bony nasal septum and clivus. It was removed endoscopically with endonasal approach. Histologic examination showed a lobular and duct-like structures consisting of a loose myxoid stoma consistent with characteristics of a pleomorphic adenoma. There was positive immunohistochemical expression of cytokeratin and S-100 protein which confirmed earlier histopathological diagnosis. We report a very rare case of pleomorphic adenoma originating from the nasal septum and clivus with a review of literature.

기니아 피그 고막에서 성체신경줄기세포의 분리 배양

박경호,박시내,김부영,배성천,김준규,성용해,이창훈,배민영,이병훈,장기홍,백지혜,여상원 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.1

Tympanic membrane perforation is an important clinical problem found in various populations of the world. In large number of cases, acute traumatic perforations heal spontaneously, and in the healing process, stem cells appear to play an important role. However, no studies have been reported regarding somatic stem cells in the tympanic membrane. Herein, we tried to show that guinea pig’s tympanic membrane contains cells that display the characteristic features of stem cells. Materials and Method:The tympanic membrane was obtained from the guinea pig. The cells were cultured in a medium with epidermal growth factor (EGF) and fibroblast growth factor (FGF). Proliferating cells were checked with stem cell markers, bromodeoxyuridine (BrdU) and nestin. Differentiated cells from stem cells are checked with βIII tubulin and S-100. Results:We observed that some of the cultured cells from the tympanic membrane were stained with both stem cell markers, BrdU and nestin. And we observed that these cells differentiated into neuron and gilal cells, which expressed βIII tubulin and S-100, respectively. Conclusion: These results suggest that the tympanic membrane of guinea pigs may have neural stem cells. Further study is needed for finding the origin of stem cells. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:28-32)

국내 전정기능검사실의 운영 현황

김태수,김미주,김병건,김현아,배대웅,배미란,배성천,이익성,전은주 대한평형의학회 2018 Research in Vestibular Science Vol.17 No.4

Objectives: This study was conducted to assess the current management status of the vestibular function test laboratories in Korea. Methods: Questionnaire about the management status of the vestibular function test laboratories was sent by email to the entire members of the Korean Balance Society. The contents of questionnaire included situation of employees who perform the tests, the types of vestibular function tests and equipment, frequency of the test and types of dizziness related questionnaires. Results: Forty-nine hospitals and clinics responded. All the 49 respondents answered that they have videonystagmography. Spontaneous nystagmus analysis by videonystagmogrphy was the most frequently tests for patients with dizziness. Questionnaires for dizziness were used by 27 respondents (55.1%) for initial evaluation of the dizziness patients. The Korean version of dizziness handicap inventory was the most frequently used dizziness related questionnaire.Conclusions: We analyzed the current management status of vestibular function test laboratories to comprehend the present condition of the vestibular function test. We think that these results will help to provide a standard for laboratory operations and prepare for the education, focusing on high-demand tests.