비인두강내 식물성 괴사조직 1예

진호경,노양섭,홍상덕 대한이비인후과학회 부산,울산,경남 지부회 2019 임상이비인후과 Vol.30 No.1

Nasopharyngeal foreign bodies are rare and usually asymptomatic. Although there have been some reports about nasopharyngeal foreign body with sponges, inset or metallic bolt, there was no nasopharyngeal vegetable foreign body. We report a case of 56 year-old female patient with unusual nasopharyngeal foreign body (vegetable) presenting with postnasal drip. The foreign body was detected at right rosenmuller fossa in sinonasal computed tomography. After foreign body was removed by endoscopic endonasal approach, her postnasal drip was gone. In our knowledge, this is the first report about nasaopharyngeal foreign body with vegetable tissue.

일측성 성대마비 환자에서 내전형 갑상성형술, 피열연골 내전술, 피열연골내전술과 성대주입술 병행치료의 음성 결과 비교

진호경,원성준,최나연,손영익,Jin, Hokyung,Won, Seong Jun,Choi, Nayeon,Son, Young-Ik 대한후두음성언어의학회 2017 대한후두음성언어의학회지 Vol.28 No.2

Background and Objectives : In unilateral vocal fold paralysis (VFP), medialization thyroplasty (MT), arytenoid adduction (AA) and injection layrngoplasty (IL) are the most common procedures to correct phonatory problems. There is no consensus that which procedure is superior to the other for correcting the glottal insufficiency. The purpose of this study was to compare the phonatory parameters between MT, AA and AA with IL (AA+IL) in patients with unilateral VFP. Materials and Methods : This retrospective study enrolled patients from 2005 to 2016. Total 72 patients (49 male, 23 female, mean age 54.5 years) were classified into three groups ; MT (n=28), AA (n=12), and AA+IL (n=32). GRBAS scales, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), and voice handicap index (VHI)-10 and VHI-30 were preoperatively and postoperatively collected and compared between the three groups. Results : Age, gender and cause of VFP were not significantly different between the three groups. In MT and AA groups, MPT, VHI, G (overall grade) and B (breathiness) were significantly improved. In AA+IL group, jitter, shimmer, NHR, MPT, VHI, G and B were significantly improved. In analysis of differences (pre-postoperative values), ${\Delta}$ jitter (p<0.001), ${\Delta}$ shimmer (p=0.031), and ${\Delta}$ NHR (p=0.002) were significantly different and AA+IL group showed the greatest improvement. Conclusion : Analysis of voice parameters showed that all the three procedures for patients with unilateral VFP are effective in the improvement of voice ; especially in MPT, VHI-10, G and B scales. Compared to the others, AA+IL provided the better acoustic values including jitter, shimmer and NHR.

Early Injection Laryngoplasty With a Long-Lasting Material in Patients With Potentially Recoverable Unilateral Vocal Fold Paralysis

최나연,진호경,김학정,손영익 대한이비인후과학회 2019 Clinical and Experimental Otorhinolaryngology Vol.12 No.4

Objectives. Injection laryngoplasty (IL) is one of the major options for treatment of unilateral vocal fold paralysis (UVFP). Early IL in patients with abrupt-onset UVFP can reduce hoarseness and aspiration-related discomfort and complications. Temporary or short-lasting materials are recommended for the early IL since permanent or long-lasting materials may negatively affect the voice quality when vocal fold motion is spontaneously recovered. Methods. Patients who received IL with a long-lasting material (ArteSense) within 1 month following development of postoperative UVFP were enrolled for this study. They were categorized into a spontaneously recovered group (n=30) and unrecovered group (n=276) from UVFP. The subjective and objective voice parameters were collected before and 6 months after IL. Patients’ demographics and collected voice parameters were compared between the two groups. Results. Age and sex distributions were not different between the two groups. Aspiration symptom, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), overall grade (G) and breathiness (B) of GRBAS (grade of dysphonia, roughness, breathiness, asthenia, strain) scale score, and voice handicap index (VHI) were significantly improved after IL in both groups. The amounts of improvement in MPT, jitter, shimmer, NHR and VHI were significantly greater in the recovered group. There was no IL-related complication including granuloma formation, hypersensitivity to injection material, or worsening of hoarseness. Conclusion. Early IL with a long-lasting material can be safely performed to improve voice quality and to reduce aspiration episode for the patients with postoperative UVFP, regardless of recovery from the paralysis. The amounts of improvement in the subjective and objective voice parameters were significantly greater in patients who showed spontaneous recovery from UVFP when compared with those in patients who did not.

Sentinel Lymph Node Biopsy Versus Elective Neck Dissection: Long-Term Oncologic Outcomes in Clinically Node-Negative Tongue Cancer

박우리,진호경,허유진,정한신,손영익,정만기,백정환 대한이비인후과학회 2022 Clinical and Experimental Otorhinolaryngology Vol.15 No.1

Objectives. The aim of this study was to compare the long-term oncologic outcomes of sentinel lymph node biopsy (SLNB) versus elective neck dissection (END) in clinically node-negative (cN0) tongue cancer. Methods. This was a retrospective cohort study of patients with cN0 tongue cancer from a single institution, including 91 patients in the SLNB group and 120 patients in the END group. Results. The overall recurrence rate showed no significant difference between the two groups. The regional control rate was also comparable between the two groups (P=0.490). The 5-year recurrence-free survival (RFS) was slightly better in the SLNB group than in the END group (P=0.427). The 5-year overall survival (OS) rate was 89.9% in the SLNB group versus 91.9% in the END group (P=0.737). In a propensity-matched subgroup analysis, the type of neck management did not affect RFS or OS. Conclusion. SLNB showed non-inferior oncologic outcomes compared to END in patients with cN0 tongue squamous cell carcinoma.

의학과 4학년 선택실습으로서의 해부학

공태환(Tae-Hwan Kong),김상훈(Sang-Hun Kim),손용훈(Yong-Hun Son),정기상(Ki-Sang Chung),진호경(Ho-Kyung Jin),장혜원(Hye Won Jang),오창석(Chang-Seok Oh) 대한체질인류학회 2016 해부·생물인류학 (Anat Biol Anthropol) Vol.29 No.1

의학과 4학년 5명이 선택실습 (Elective course)으로 해부학을 선택했다. 1개월간 시신 1구를 해부했으며, Digital Report를 조사했다. 학생들의 연구주제는 갑상샘의 모양 및 잘록의 위치, 왼, 오른심장동맥의 분지, 콩팥혈관과 요관의 위치관계 및 콩팥깔때기 모양, 정중신경의 원엎침근 통과유형, 손등에서 손가락폄근의 양상 등이었다. 한편, 이자 부분절제술을 받은 시신에 남아 있는 이자꼬리부분과 간에서 조직을 절취하여, H&E 염색 후 광학현미경으로 관찰했다. 실습 마지막 단계에서, 해부 및 Digital Report 조사, 광학현미경 관찰 소견을 토대로 소논문을 작성하였다. 교수의 관점에서 볼 때, 의학과 4학년의 해부학실습은 1학년의 실습과는 큰 차이가 있었고, 교육적으로 많은 긍정적인 효과가 있었다. Five medical students in the fourth-year took anatomy as their elective courses for 1 month. They dissected one cadaver, and investigated Digital Report, under the course subjects as follows; (1) the shape of thyroid gland and the location of its isthmus, (2) the branches of left and right coronary arteries, (3) the number of blood vessels and bronchi on the hilum of lung, (4) topographical relationship of the renal vessels and ureter, and the shape of the renal pelvis, (5) the location and attachment of the appendix, (6) the penetration of median nerve through the pronator teres, (7) the sensory nerves and the extensor tendons on the dorsum of hand, (8) the branches of deep femoral artery. The pancreatic and live samples were processed and stained with H&E, for LM observation, since the individual had suffered from pancreatic cancer and got a Pylorus preserving pancreatico-duodenectomy (PPPD). At the last step of the elective course, students wrote small articles following the conventional method for writing manuscript. From the viewpoint of professor, the anatomy course for the fourth-year students were definitely different from that for first-year students, and had many positive effects in terms of anatomy education.