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성대마비 예후판단을 위한 후두 근전도 간섭파형의 신뢰도 평가
문광하,오나래,백민관,김동영,우주현 대한이비인후과학회 2018 대한이비인후과학회지 두경부외과학 Vol.61 No.3
Background and Objectives Laryngeal electromyography (LEMG) is valuable for theprognosis of vocal fold paralysis (VFP). However, there is a lack of reliable data to apply it toclinical practice. The aim of this study is to evaluate the reliability of interference pattern ofLEMG in order to predict the prognosis of VFP by comparing interference pattern and vocalcord mobility. Subjects and Method A retrospective chart review was performed for patients who underwentLEMG from January 2012 to October 2015. Gender and age of patients, cause and treatmentof VFP, vocal cord mobility, and result of LEMG were analyzed. The interference patternof LEMG was used as a predictive marker of prognosis, which is compared with vocalcord mobility during the last follow-up. Results F ifteen patients were enrolled in this study. Among them, five patients were predictedby LEMG evaluation to have good prognosis, and 10 patients were predicted to havepoor prognosis. All of the five patients with good prognosis showed improvement in vocalcord mobility, while seven out of 10 patients predicted with bad prognosis showed vocal foldfixation at the last follow-up. The reliability of prognostic prediction through interference patternwas 80%. Conclusion Interference pattern of LEMG is reliable data to predict the prognosis of VFP,especially it showed perfect consistency for good prognosis.
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후향적 방법을 통한 후각장애환자의 임상적 특성및 Steroid 효과 분석
최성호,김선태,박형민,문광하,정주현,차흥억 대한비과학회 2016 Journal of rhinology Vol.23 No.1
Background and Objectives: Olfactory dysfunction is a common sensory disorder, but there are currently no standard diagnostics or therapeutic methods. We analyzed the effects of systemic steroid therapy in patients with olfactory dysfunction. Materials and Method: We analyzed patients who visited our ENT department with olfactory dysfunction for 3 years. We reviewed their charts and classified the patients according to age, sex, etiology of olfactory dysfunction, degrees of olfactory dysfunction and the effect of systemic steroid therapy. Results: The mean age was 44.3 years old and there were 50 males and 55 females; 55 patients had inflammatory disease and 50 patients had non-inflammatory disease. The distribution of degrees of olfactory disorder according to cause was not significantly different (p=0.120). In 105 patients, 20% experienced improvements after systemic steroid therapy, and the response of systemic steroid therapy was better among patients with inflammatory causes. In cases of inflammatory disease, there was a larger amount of severe hyposmia patients, and their response to systemic steroid therapy was significant (p=0.015). Patients with mild and moderate hyposmia were more responsive to systemic steroid therapy than patients with severe hyposmia (p=0.382). Conclusion: In cases of hyposmia due to inflammatory disease, systemic steroid therapy with proper operative management may increase therapeutic effects.
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우주현,백민관,김동영,박형민,안상희,문광하,차흥억,Woo, Joo Hyun,Baek, Min Kwan,Kim, Dong Young,Park, Hyoung-Min,An, Sanghee,Moon, Kwang Ha,Cha, Heung Eog 대한후두음성언어의학회 2016 대한후두음성언어의학회지 Vol.27 No.1
Background and Objectives : The clinical reports for the treatment of vocal fold scar and sulcus vocalis are limited, also there is no best one for the treatment of them. This study is to evaluate the effect of Injection laryngoplasty (IL) for the treatment of vocal fold scar and sulcus vocalis. Materials and Methods : from January 2013 to May 2015, the Nineteen patients who were diagnosed as vocal fold scar, sulcus and atrophy, and underwent IL, were engaged in this study. Clinical information and voice parameters were analyzed by retrospective chart review. Pre and post voice parameters were compared. Results : Subgroups of diagnosis were classified into sulcus vocalis for 12 patients, vocal fold scar for 5, and atrophy for 2. IL was performed under local anesthesia through cricothyroid membrane except one patient. Atesense$^{(R)}$, Radiessess$^{(R)}$, and Rofilan$^{(R)}$ were used as injected materials in 9, 9, and 1 patients respectively. Maximal phonation time (p=0.0124), dynamic range (p=0.0028), pitch range (p=0.0141), voice handicap index (p=0.028), glottal closure (p=0.0229), and mucosal wave (p=0.0132) had significant improvement for post-IL voice assessment than Pre-IL. While GRBAS, Mean flow rate, Jitter, Shimmer, Harmony to Noise ratio didn't have improvement. Conclusion : IL is a feasible option for the treatment of glottis incompetence with normally mobile vocal folds such as sulcus vocalis and vocal fold scar.
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