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특발성 안면신경 마비 이후에 생긴 Oculostapedial Synkinesis 1예
강제형,홍병수,정원호,홍성화 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.8
Oculostapedial synkinesis following Bells palsy, Ramsay Hunt syndrome and traumatic facial nerve paralysis is a rarely reported phenomenon. Oculostapedial synkinesis accompanying with hemifacial spasm also has ben reported. We experienced with oculostapedial synkinesis after Bells palsy. We objectively proved this oculostapedial synkinesis with impedance aud-iometry. The patient was successfuly treated by transmeatal tenotomy of the left stapedius muscle tendon under local anes-thesia. (Korean J Otolaryngol 2002;45:817-20)
정한신,강제형,김상우,송재훈,백정환,손영익 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.5
Background and Objectives: (TCL) is not an uncommon inflammatory disorder. Yet, the management strategy of TCL is controversial and there are no clear answers for when, how and to whom surgical intervention should be applied. This study aimed to analyze the eficacy of antituberculous chemotherapy (AC) and surgical treatment to provide the guidelines of surgical intervention. Materials and Method:A retrospective chart review was carried out for 153 patients with TCL who were treated between Jan. 1998 and Jun. 2001 at Samsung Medical Center, Seoul, Korea. AC ory to the medical management. Treatment results of AC and indications of the surgical intervention were analyzed. Results:AC, as a sole treatment modality, was successful in most (83.7%) of the patients while combined surgical intervention was neded for 16.3%. Overall cure rate (remnant mass size ≤5 mm) was 96.3%. Surgery was provided for the TCL showing progresion even after the initiation of AC or not responding to AC within 3 months. The necrotic lymph node les than 4 cm in its size did rupture or overt draining sinus, surgical intervention shortened the duration of treatment required for the wound healing. Conclusion:Most of TCL can be effectively controled with AC alone. It would be reasonable to reserve surgical interventions for the TCL with 1) abscess greater than 4 cm in its size, 2) absces not rapidly responding to AC regardles of its size, 3) draining skin wound, and 4) non-necrotic nodes with poor response to AC over 3 months. Gross total removal of TCL would be prefered for shortening the duration of wound care to drainage procedures including curettage, incision and drainage or simple dresing.(Korean J Otolaryngol 2003 ;46 :419-25)
김태욱,강제형,정한신,손영익,백정환 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.7
Background and Objectives:Sialendoscopy was introduced with favorable results in the management of salivary duct stones. We recently attempted this new procedure to diagnose and remove sialoliths for the first time in Korea. In this paper, we aimed to find out the clinical efficacy and limitations of sialendoscopy. Subjects and Method:Nine patients, 2 males and 7 females with the average age of 27, who consented to the trial of a new procedure were enrolled in this study beginning in April 2003. Diagnostic sialendoscopy was performed first, and then intervention was attempted after sialoliths were identified. A retrospective analysis was conducted on the characteristics of sialoliths, preoperative work-up, postoperative complications and outcomes. Results: All but one case had sialoliths in the duct of the submandibular gland. In view of diagnostic sialendoscopy, the success rate was 100%, that is, we could detect sialoliths in all cases. In interventional sialendoscopy, however, the success rate was 44% (4 of 9 cases). In 3 cases, the basket broke down or got caught with the stone. Other complications such as salivary duct perforation, bleeding and nerve injury did not occur. Conclusion:Sialendocopy is a new, less invasive procedure to visualize the entire salivary ductal system for the diagnosis of salivary duct stone. However, interventional sialendoscopy for the removal of sialolith is a delicate and technically challenging procedure, requiring strict size criteria of the sialolith and much experience of the operator.