이비인후과 영역에서 줄기세포의 적용

황봉운,이윤세,이병주 대한이비인후과학회 부산,울산,경남 지부회 2012 임상이비인후과 Vol.23 No.1

자가 분열능력, 분화능력,면역조절 기능 때문에 줄기세포는 임상의 다양한 분야에서 장기 및 기관의 손상에 대한 기능회복을 목표로 활발한 연구가 진행되고 있다. 최근 이비인후과 질환과 관련해서도 줄기세포에 대한 많은 연구가 이루어지며 다양한 성과들과 함께 일부에서는 임상 적용을 위한 단계에 도달하였다. 향후 기존의 치료법에 더하여 줄기세포를 이용한 치료가 환자들의 삶의 질을 향상시킬 수 있으리라 기대된다. 하지만 임상에 적용하기 위해서는 아직 넘어야 할 문제들이 남아있다. 줄기세포 이식에 있어 낮은 생착율의 문제, 생착한 곳에서 원하는 세포로의 분화문제, 그리고 인접 세포들과의 상호작용, 면역학적 거부반응 등은 앞으로 연구를 통해 해결해 나가야 할 점이다. 또한 치료에 따른 기능적, 해부학적 치료 결과를 객관적으로 판단할 수 있는 방법의 개발과 임상적으로 줄기세포를 사용하는데 따른 제도적 장치를 마련하는 것도 해결해야 할 숙제이다.

술후성 협부 낭종에 대한 임상적 분석 : 10년의 경험

이재훈 대한이비인후과학회 부산,울산,경남 지부회 2012 임상이비인후과 Vol.23 No.1

The aim of this study was to evaluate the clinical analysis of postoperative cheek cyst for past 10 years and causes of revision surgery. Subjects and Methods:The study design was a retrospective clinical series. We reviewed the medical records of 45 cases (43 patients : both cases in two patients) with postoperative cheek cyst who were diagnosed and treated from 1999 to 2009. Results:The patients underwent middle and/or inferior meatal antrostomy with or without Caldwell-Luc operation. All patients were followed at least for more than 24 months after surgery, and revision surgeries were noted in 9 cases (20%). Of the 9 cases in revision surgery, the obstruction of inferior meatal antrostomy site in 7 cases and remained cyst from multiple septated cysts in 2 cases were showed. Conclusion:In order to avoid of revision surgery for postoperative cheek cysts, we should carefully review of paranasal computed tomography scan findings such as bulging state of the cyst into the inferior meatus and presence multiple septated cysts. 본 연구를 통해 술후성 협부 낭종에 대한 재수술의 분석을 통해 두가지 사항에 대해 생각할 수 있었다. 첫째, 다발성 낭종에 대한 가능성을 염두하고 세심하게 부비동 단층촬영영상에 대한 관심을 가져야 할 것으로 생각된다. 둘째, 술후성 협부 낭종의 하비도내에서 돌출형태를 확인한후 하비도내로 충분히 돌출된 낭종은 하비도 접근으로 해결이 되면 수술 후 배액공의 유지가 잘 될 가능성이 많으나 낭종이 돌출되지 않은 경우 시간이 지남에 따라 배액공의 폐쇄될 가능성을 염두 해야 할 것으로 생각된다. 만약 하비도 배액공의 폐쇄 가능성이 많은 경우 본 연구에서처럼 T자 형태의 튜브를 위치시킴으로써 폐쇄의 가능성을 줄일 수 있을 것으로 생각된다.

이비인후과 질환 별 일상적 스트레스 비교

정대한,서미경,강호민,이준석,박문서,여승근 대한이비인후과학회 부산,울산,경남 지부회 2011 임상이비인후과 Vol.22 No.1

Background and Objectives:Stress is defined as excited state resulted from interaction of body and mind. It is subjective notion in that the amount of stress can be different in each person from same event. Nevertheless, there have been many studies to find objective measure to assess stress and many questionnaires have been developed. In our study, we tried to measure the amount of stress of representative diseases of Otorhinolaryngology and head and neck surgery using ‘Daily Hassless Scale’, one of well known stress questionnaire. Materials and Methods:276 people including 36 people of normal control, 20 patients of chronic sinusitis, 20 of laryngopharyngeal reflux, 20 of obstructive sleep apnea, 19 of nasal septal deviation, 20 of facial palsy, 20 of vocal nodule, 21 of allergic rhinitis, 20 of hearing disturbance, 20 of dizziness, 21 of tinnitus, 23 of chronic otitis media and 16 of preauricular fistula were enrolled to our study. They were made to fill up the questionnaire form when they visited our clinic. The questionnaire is composed of 36 questions and each is 4 point scale. We statistically compared total stress score and health related score. Results:Laryngopharyngeal reflux and allergic rhinitis patients group showed significantly higher stress score than control group (p=0.003). Laryngopharyngeal reflux, facial palsy, vocal nodule, allergic rhinitis patients group showed significantly higher score than control group in sum of four health related questions (p=0.000). Conclusion : Laryngopharyngeal reflux, facial palsy, vocal nodule, allergic rhinitis patients group were suffered from higher stress than other otolaryngology disesases and these shoud be considered during managing patients.

다발성 뇌신경 침범 후 지연성 안면신경 마비를 동반한 Ramsay Hunt 증후군 1예

김영중,김영준,정성훈,박병건 대한이비인후과학회 부산,울산,경남 지부회 2015 임상이비인후과 Vol.26 No.1

Ramsay Hunt syndrome is a disease in which reactivation of latent varicella zoster virus infection occurs in the geniculate ganglion, causing otalgia, auricular vesicles and peripheral facial paralysis. Rarely also other cranial nerves can be affected and the variability in the timing or presence of neurological complications in varicella zoster virus reactivation has been known clinically. We report the case of a 71-year-old female who was diagnosed with Ramsay Hunt syndrome complicated with cranial nerve VIII, IX, X and delayed onset facial palsy with a review of literature.

성인에서 발생한 양측성 상악동 후비공 비용 1예

조준만,정규환,백무진,김용완 대한이비인후과학회 부산,울산,경남 지부회 2012 임상이비인후과 Vol.23 No.2

Antrochoanal polyp (ACP) is a rare, benign solitary mass from inflamed, edematous maxillary sinus mucosa. It may cross its ostium and reaches into the choana causing unilateral nasal obstruction and mouth breathing. It represent four to six per cent of all nasal polyps. Although it is usually unilateral, extremely rare cases it could be bilateral. In this paper, we report a case of bilateral ACPs in an adult and discuss the clinical presentation, endoscopic and radiologic evaluation, pathogenesis and surgical treatment.

소아의 만성비부비동염에 동반되는 비용의 임상양상 및 조직학적 특성 : 성인과의 비교연구

홍성룡,정한진,신재민,안용휘,한두희,원태빈,김동영,이재서,민양기 대한이비인후과학회 부산,울산,경남 지부회 2011 임상이비인후과 Vol.22 No.2

Background and Objectives:Nasal polyps (NPs) in children often make the treatment of chronic rhinosinusitis (CRS) difficult. However, there have been few studies focused on pediatric NPs. The authors attempted to investigate the clinical and pathological features of NP in pediatric CRS by comparing them with those in adult CRS and to determine risk factors for their recurrence. Materials and Methods:This study included a total of 286 adults and 56 children who were diagnosed with CRS with bilateral NPs and were treated at Seoul National University Hospital between 2005 and 2008. Their demographic data and information about comorbidities (allergic rhinitis and asthma), preoperative serum total IgE levels, peripheral blood eosinophil counts and the recurrence of NPs were collected by a retrospective chart review. In addition, the polyp tissues were harvested and stained with hematoxylin-eosin for counting the total number of inflammatory cells, including eosinophils. Results:The prevalence of allergic rhinitis was higher in the pediatric group than in the adult group (46.4% versus 30.8%). However, total IgE levels and the proportion of eosinophilic polyps were lower in the pediatric group than in the adult group (99.2 versus 246.9 kU/L and 16.7% versus 30.1%, respectively). In the pediatric group, patients with asthma, peripheral blood eosinophilia or eosinophilic NPs were at higher risk of NP recurrence. Conclusions:The clinical and pathological characteristics of pediatric patients with NPs were different from those of adult patients. Pediatric patients with asthma, peripheral blood eosinophilia or eosinophilic NPs should be aggressively managed to decrease the recurrence of NPs.

메니에르병에서 고실 내 스테로이드 주입술에 대한 고찰

김지아,최성원 대한이비인후과학회 부산,울산,경남 지부회 2021 임상이비인후과 Vol.32 No.3

Meniere’s disease is one of common cause of recurrent vertigo. If the symptoms of Meniere’s disease cannot be controlled, the patients’ quality of life would be decreased and anxiety or depression could be induced. Currently, there are various treatment methods for Meniere’s disease. Intratympanic corticosteroid injection (ITSI) is one of them, but it is considered as an optional treatment, and the protocol is not standardized. Since ITSI can be easily performed in outpatient setting, we thought that it could be an alternative treatment for patients suffering from recurrent and intractable symptoms of Meniere’s disease. Therefore, it is necessary to evaluate the effectiveness of the ITSI, and to organize appropriate targets and protocols. In this study, we reviewed and compared the protocols and results of previous studies about ITSI in Meniere’s disease.

주관적 이명 환자에서 신체화 증상 동반의 평가

조창건,지준혁,이은경,김보해,송재준 대한이비인후과학회 부산,울산,경남 지부회 2013 임상이비인후과 Vol.24 No.1

Background and Objectives:The mechanism of subjective tinnitus was not identified clearly. The goal of this study is to evaluate the somatization symptoms in subjective tinnitus patients and to define the relationship be-tween tinnitus and somatization symptoms. Materials and Methods:A total of 107 patients who were diagnosed as subjective tinnitus were included. Somatization subscales from Symptoms Check List-90-Revision (SCL-90-R) were administered to patients for the evaluation of somatization symptoms. Tinnitus handicap inventory and the subjective patterns of tinnitus by visual analogue scales were also assessed. Correlation analysis between somati-zation scores, THI scores and the VAS scores were performed. Results:Among the total number of tinnitus pa-tients, there were 18 patients (16.8%) over mild somatization symptoms. Significant correlation between somati-zation scores and THI scores was observed, especially in the moderate or severe tinnitus group. The results of relationship between somatization scores and 4 items of VAS scores, loudness and effect on life of tinnitus were significantly related to the somatization scores. Conclusions:We found the positive correlation between subjec-tive tinnitus and somatization symptoms. Subjective tinnitus may be a somatization symptom and it seems neces-sary to consider somatization disorder in management of tinnitus patients.

갑상선 유두암 원주세포변형 1예

최시홍,이동후,정수진,김도훈 대한이비인후과학회 부산,울산,경남 지부회 2018 임상이비인후과 Vol.29 No.2

Columnar cell variant of papillary thyroid carcinoma (CCV-PTC) is a rare variant representing 0.15-0.2% of all PTCs. The CCV is aggressive, due to its rapid growth, high local recurrence rate, and frequent lung, brain and bone metastasis. Aggressive surgical and medical management are recommended for these neoplasias. The authors experienced a case of CCV-PTC in a 45-year-old man. We performed total thyroidectomy with neck dissection. The patient received radiation and radioactive iodine therapy. There were no recurrences or complications in the following 24 months after the operation. The patient will closely undergo continuous follow up. We present the clinical characteristics, pathology, treatment, and prognosis of the tumor with a review of the literature.

고도 및 심도 돌발성 난청에 대한 고실내 스테로이드 주입술과 경구 스테로이드 병합치료의 효과

김세형 대한이비인후과학회 부산,울산,경남 지부회 2016 임상이비인후과 Vol.27 No.1

most commonly accepted treatment. Recently, intratympanic steroid injection has been proposed as a safe and an effective in the salvage therapy. However, treatment protocol for severe to profound SSNHL has not been established. As there has been little discussion about the efficacy of combined method, this study aims to evaluate the effects of combined intratympanic and oral steroid treatment compared with oral steroid therapy alone for severe to profound SSNHL. Methods:We reviewed the medical records of patients with severe to profound SSNHL between January 2009 and February 2012, and 34 patients were categorized into the oral steroid treatment alone group (PO group). And 33 patients of combined intratympanic and oral steroid treatment group (CT group) were evaluated from March 2012 to June 2015. We compared demographics, clinical findings, audiological results, and treatment outcomes between two groups. Results:Significant difference of hearing recovery was identified between PO group and CT group. The mean PTA gain was 23.5±18.3 dB in PO group and 31.6±13.2 dB in CT group (p=0.048). When Siegel’s criteria was used, more patients showed significant hearing improvement in CT group than in PO group (p=0.0204). Conclusions:This study concluded that the combined intratympanic and oral steroid treatment might lead to favorable hearing outcomes when compared with the oral steroid treatment alone. We recommend that the combined treatment could be considered as primary management for patients with severe to profound SSNHL.