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이한빈,임혜진,조민혁,양석민,박기현,박훈이,정연훈 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.3
Objectives. Mastoid obliteration is used to obliterate the mastoid cavity following a mastoidectomy or to prevent the formation of a retraction pocket. This study evaluated the effectiveness of β-tricalcium phosphate and polyphosphate (β-TPP) for mastoid obliteration in middle ear surgeries in prospective human and animal studies. Methods. Twenty patients with chronic otitis media underwent mastoid obliteration using β-TPP after a intact canal wall mastoidectomy or simple mastoidectomy. The clinical data were prospectively evaluated including: the diagnosis,temporal bone computed tomography (TBCT), otoscopic findings, pure tone audiogram, and complications. In the animal experiment, β-TPP was applied into the right bulla in five rats, and the opposite bulla was used as the control in the non-obliterated state. The skulls of five other rats were drilled out and the holes were obliterated with β-TPP. TBCT were obtained at 3, 6, and 9 months after the obliteration and histologic analysis was done at 3 and 9 months after surgery. Results. In the human study, fourteen TBCTs were obtained at 12 months after the surgery. All demonstrated no bone resorption in the obliterated mastoids. Among the 15 cases displaying retracted tympanic membranes preoperatively,11 showed no retraction, 2 showed retraction postoperatively, 1 was lost to follow-up and 1 was a case of postoperative wound infection. Among 20 cases, one case developed a postoperative infection that necessitated a second operation. Sixteen underwent ossiculoplasty; hearing improvements were obtained in 15 cases and 1 case showed decreased hearing. In the animal study, new bone formation without significant bone resorption in the radiologic and histologic findings were noted in both the skull and bulla groups. Conclusion. Although β-TPP is a foreign material having the possibility of infection, mastoid obliteration with it can be a treatment option in middle ear surgeries to prevent retraction pockets or the recurrence of diseases.
이한빈,김윤,임병수,김종욱,김진권 대한신경과학회 2014 대한신경과학회지 Vol.32 No.4
Coagulopathies are a relatively common cause of young-age stroke. We present herein a 15-year-old male who wasadmitted for acute cerebral infarction with dysarthria and weakness of the right side. He had previously been diagnosedwith autosomal dominant protein-S deficiency. His left internal carotid artery was totally occluded. Emergencymechanical thrombolysis resulted in recanalization of that occluded artery and consequent improvement in symptoms. The patient was discharged with an oral anticoagulant.