부비동 내시경 수술 이후 발생한 후방 허혈성 시신경병증 1예

허세형,이선욱,이정엽,이경철 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.7

Recently, endoscopic sinus surgery (ESS) has been acknowledged as a standard surgical procedure for the treatment of chronic rhinosinusitis. Orbital complications of varying degrees that may occur during ESS have been widely reported. Blindness, one of the major complications that can occur during or immediately after ESS, is mainly attributed to orbital hematoma or direct injury to the optic nerve. In contrast to such direct mechanical trauma caused during ESS, we report a case of acute loss of vision that followed ESS without a definite cause. A postulated mechanism for idiopathic optic neuropathy is that it is ischema resulted from vasospasm in the branches of ophthalmic artery due to topical use of vasoconstrictive agents. Otorhinolaryngologists should be aware that this condition may occur following an uncomplicated ESS procedure. When loss of sight is diagnosed postoperatively, patients should be given prompt ophthalmological consultation and possible causes should be considered.

설 기저부에 발생한 염증성 가성종양 1예

이현섭,허세형,진성민,이상혁,Lee, Hyun-Sub,Huh, Se-Hyung,Jin, Sugn-Min,Lee, Sang-Hyuk 대한후두음성언어의학회 2011 대한후두음성언어의학회지 Vol.22 No.1

Inflammatory pseudotumor is characterized by the presence of a mass that may mimic malignancy and is composed of spindle cells mixed with variable amounts of extracellular collagen, lymphocytes, and plasma cells It is benign tumor commonly involves lung and orbit and rarely that occurs in the head and neck The cause and pathogenesis of inflammatory pseudotumor still remain controversial. Some bacterial infection or chronic irritation may have prompted some speculation that an initially reactive process can change into an overt neoplastic disease. It tends to affect children and young adults than old ages. We present a case of inflammatory pseudotumor involving the tongue base, in a 73-year-old patient with repeated oral bleeding that aggravated over a few days. Clinical examination showed angiomatous polyp like findings in oropharynx that easy bleeding tendency. CT images showed well defined soft tissue mass with focal enhancement. After surgery, tumor was finally diagnosed inflammatory pseudotumor by histopathologic examinations showed plasma cells and inflammatory cells in variable fibrotic tissues.

인후두 역류질환의 최근 경향

이상혁,허세형 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.8

Laryngopharyngeal reflux disease (LPRD) refers to the retrograde flow of gastric content to the laryngopharynx, where it comes in contact with tissues of the upper aerodigestive tract. In Korea, up to 1 out of every 5 patients who visit otorhinolaryngology clinic is supposed to have LPRD with symptoms and physical findings. In the absence of definite diagnostic criteria, LP-RD is suspected when the history and laryngoscopy findings are suggestive of the diagnosis. A diagnosis of LPRD is usually based on response of symptoms to empirical treatment. Most patients with LPRD are treated with proton pump inhibitor with education of life style modification, but there is still little or no solid evidence on the treatment as well as the diagnosis. Failure to respond to a usual treatment suggests the need for confirmatory studies and con-sideration of alternative diagnoses. LPRD appears to be a common but controversial disorder, with conflicting data on pathophysiology, diagnosis, and treatment. Whereas trends are observed and many clinical practices are accepted widely on the basis of experience, we need definitive, prospective, evidence-based studies. In this article, we will review current concept of diagnosis and treatment of LPRD.

급성 인두후 농양으로 오인된 급성 석회화 인두후 건염 3예

이창희,허세형,진성민,이상혁 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.6

Acute retropharyngeal calcific tendinitis or calcific tendinitis of the longus is an under-recognized clinical syndrome first described by Hartley in 1964. This syndrome is caused by calcium hydroxylapatate deposition in the longus colli muscle and tendon. Patients typically present with acute neck pain, neck spasm, a restrained range of motion, odynophagia, dysphagia and sore throat. Clinically, it can be misconceived as acute retropharyngeal abscess because of its rather non-specific presentation and rare occurrence. Diagnosis of retropharyngeal calcific tendinitis can be made radiographically with plain radiograph and CT by detecting calcifications anterior to C1-C3 and swelling prevertebral soft tissue. Recognizing this radiologic imaging findings and features can prevent unnecessary treatment and test. We report three patients with acute prevertebral calcific tendinitis, which was misdiagnosed as acute retropharyngeal abscess.

반전성 유두종에 병발한 상악동의 다형성 횡문근 육종 1예

이성진,권희준,허세형,이상혁 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.1

Rhabdomyosarcoma is an aggressive malignant tumor rarely developing in the head and neck in adults. In the sinonasal region, rhabdomyosarcoma constitutes a clinically important group because of the difficulty of surgical resection and its generally poor prognosis. Inverted papilloma is a relative rare and benign sinonasal lesionconstituting 0.5% to 4% of all nasal tumors that has a known propensity for recurrence, local aggressiveness, and association with transformation to malignancy. Squamous cell carcinoma is the major malignancy that is associated with inverted papilloma. To our knowledge, this is the first case report of pleomorphic rhabdomyosarcoma accompanied with inverted papilloma, and we represent the case with a review of the related literatures.

갑상선 종물 내 석회화 양상과 유두상암과의 연관성

이남훈,최현진,허세형,이창희,진성민,이상혁 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.11

Backgraound and Objectives Thyroid calcification is widely known as a highly specific sign of malignancy. However, there are few studies on the correlation between the calcification and papillary thyroid cancer (PTC). The aim of this study was to describe the features of calcification in thyroid mass, and determine the relationship between thyroid calcification and PTC. Subjects and Methods Patients (116) who underwent surgery for thyroid mass during the period of March 2006 to December 2008 were reviewed retrospectively. Each patient underwent preoperative sonography (n=96) and computed tomography (CT)(n=110) to evaluate the thyroid lesion. We subdivided the calcification according to characteristic features and compared the pathologic results. The association between the type of calcification and PTC was verified through the Chi-square test or likelihood ratio. Results Of 96 patients who underwent sonography, 41 (42.7%) had calcification, of which 23 had microcalcificaiton, 15 had focal calcification, and three had rim calcification. Of 41 calcified lesions, 34 (82.9%) were PTC. Incidence of cancer from thyroid which had no calcified lesion was 30.9%. Three (6.7%) of 45 benign lesions had microcalcification, and 20 (39.2%) of 51 were PTC. We found statistically significant correlation between the presence of calcification, especially microcalcification, on sonography and PTC. Thirty of 110 patients (27.3%) who underwent neck CT had calcification, and among them, 20 patients (66.7%) were diagnosed as PTC. There was no statistical significance in relationship between calcification on CT and malignancy. Conclusion This study suggests that microcalcification which is shown by sonography were more specific for PTC than other calcified lesions.

편도외 농양 환자의 발화시 조음 및 음성의 변화

최현진,송윤경,여장옥,허세형,진성민,Choi, Hyun-Jin,Song, Yun-Kyung,Yeo, Jang-Ok,Huh, Se-Hyung,Jin, Sung-Min 대한후두음성언어의학회 2008 대한후두음성언어의학회지 Vol.19 No.2

Background and Objectives: The voice changes can occur in peritonsillar abscess and the labeling of this changes as a "muffled voice". The aim of this study was to investigate the changes in acoustic feature of voice before and after treatment in patients with peritonsillar abscess. Materials and Method: 12 patients with peritonsillar abscess were enrolled in the study. Acoustic analysis on sustained Korean vowels /a/, /i/ and /u/ were performed before and after treatment. Results: In patients with peritonsillar abscess, the first formant frequency (F1) and second formant frequency (F2) of /a/ were decreased. There was tendency of articulation of back-low vowel /a/ as back-high vowel /u/. F1 of /i/ and /u/ were increased, while F2 were decreased. There was tendency of articulation of front-high vowel /i/ as back-low vowel /a/. The third, forth, fifth formant frequency (F3, F4, F5) of /a/, /i/ and /u/ were decreased although statistically not significant. Conclusion: The anatomical and functional changes of oropharynx by peritonsillar abscess can cause changes in resonance and speech quality. We suggest that these changes could be the cause of 'muffled voice' in patients of peritonsillar abscess.

비구개관낭종 1예

이선욱(Seon Uk Lee),허세형(Se Hyung Huh),이제연(Je Yeon Lee),이상혁(Sang Hyuk Lee) 대한두경부종양학회 2011 대한두경부 종양학회지 Vol.27 No.1

Nasopalatine duct cysts are the most common non-odontogenic developmental cyst originating in the incisive canal of maxilla and occuring in approximately 1% of the population. Clinical presentation is mostly asymptom-atic in small cysts, but sometimes shows swelling, pain and drainage when it is infected. The definite diagnosis should be based on clinical, radiological and histopathologic findings. Marsupialization of the cystic tissue can be performed, however, complete surgical excision is the the choice of treatment of nasopalatine duct cysts. We report a case of nasopalatine duct cyst occurred in the midline of hard palate treated by complete excision via transoral approach.