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소아에서 발생한 외안근 감돈을 동반한 안와 외향 골절 2예
정한진,김지환,강영,최영석 대한이비인후과학회 2020 대한이비인후과학회지 두경부외과학 Vol.63 No.11
Orbital blowout fracture is a common result of facial trauma and with the expanded use of endoscopyin orbital blowout fracture surgery, otolaryngologists are participating more oftenblowout fracture surgery. Because orbital blowout fracture may result in sequelae such as diplopiaand enophthalmos, proper diagnosis and timing of repair are crucial. Orbital blowoutfracture with extraocular muscle entrapment is uncommon and almost exclusively seen inchildren. It needs emergent release of entrapped muscle to prevent permanent sequelae (e.g.,diplopia). The authors experienced two cases of orbital blowout fracture with extraocularmuscle entrapment and had good surgical results without any sequelae. We report these caseswith a review of the literature
정한진,심우섭 대한비과학회 2019 Journal of rhinology Vol.26 No.2
Orbital blowout fracture is a common result of facial trauma and is observed more frequently now than in the past as a result ofintroduction of computed tomography and increased incidence of high-energy impact injuries. Because orbital fracture maybe associated with prolapse of the orbital contents into the paranasal sinuses, which results in sequelae such as diplopia andenophthalmos, proper diagnosis and timing of repair are crucial. However, clinical decision-making in the management of patientswith orbital blowout fractures is challenging, and various aspects of orbital fracture management are uncertain. Numerousapproaches have been used for reduction of blowout fracture. Controversies exist regarding indications for surgery, timing ofsurgery, and optimal reconstruction material. Recently, with expanding use of and indications for endoscopy in orbital blowoutfracture surgery, otolaryngologists participate more often in facial trauma surgery, including blowout fracture. In this review, severalcontroversial issues of surgical indication, surgical timing, method of approach, and choice of reconstruction material arediscussed from the perspective of otolaryngology surgeons.
The Role of NF-κB in Chronic Rhinosinusitis With Nasal Polyps
정한진,Yu-Lian Zhang,김동규,이채서,김동영 대한천식알레르기학회 2019 Allergy, Asthma & Immunology Research Vol.11 No.6
Purpose: Whereas the majority of nasal polyps observed in Western populations are eosinophilic, non-eosinophilic nasal polyps are significantly more frequent in Asian countries. Given the importance of nuclear factor-kappa B (NF-κB) in inflammation, this study focused on the role of NF-κB in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNPs) in Asian patients. Methods: A total of 46 patients were enrolled in this study (22 diagnosed with CRSwNPs, 10 with chronic rhinosinusitis without nasal polyps [CRSsNP], and 14 control subjects). Nasal polyps and uncinate tissues (UTs) were collected and the tissues prepared for hematoxylineosin staining and immunohistochemistric (IHC) analysis. Total RNA was isolated for real-time polymerase chain reaction for p65, interleukin (IL)-6, IL-8, intracellular adhesion molecule (ICAM)-1, IL-1β, tumor necrosis factor (TNF)-α, and eotaxin. Results: In the CRSwNPs group, 50% of nasal polyps were non-eosinophilic. IHC revealed a significantly higher fraction of NF-κB p65-positive cells in nasal polyps of the CRSwNPs group than in the UTs of control and CRSsNP groups. No difference in NF-κB p65-positive cell fraction was observed between eosinophilic and non-eosinophilic nasal polyps. The mRNA expression of p65, IL-6, IL-8, and eotaxin was significantly higher in nasal polyps of the CRSwNPs than in the UTs of control and CRSsNP group. However, no difference in expression was observed between eosinophilic and non-eosinophilic nasal polyps, with the exception of IL-1β expression. Conclusions: Elevated expression of NF-κB- and NF-κB-associated inflammatory cytokines suggests NF-κB as the key factor for CRSwNPs pathogenesis in Asian patients. Understanding NF-κB-associated mechanisms will provide a deeper insight into CRSwNPs pathogenesis and ultimately improve therapeutic strategies for CRSwNPs.
A Thyroglossal Duct Cyst Causing Obstructive Sleep Apnea in Adult
정한진,김정훈,이철희,정영준,모지훈 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.3
Obstructive sleep apnea (OSA) is a common disorder. It usually results from the structural compromise of the upper airway. In patients with OSA, the obstruction predominantly occurs along the pharyngeal airway, and also a variety of tumors have been reported to cause such a condition. We present here the case of a thyroglossal duct cyst causing OSA in adult. This case demonstrates that thyroglossal duct cyst or some kind of mass lesions in the airway lesions should be considered in the differential diagnosis of OSA patients.
내이 기형 환아에서 와우이식 후 반복적으로 발생한 뇌막염 1예
정한진,장정훈,장선오 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.2
Cochlear implantation (CI) has been regarded as a safe and effective treatment for patients with severe to profound sensorineural hearing loss. The increase of experience in CI thus has had the effect of leading more children with inner ear anomaly to be considered as cochlear implant candidates. For patients with inner ear anomaly, auditory rehabilitation has been reported to be improved after CI; however, there are several factors such as cerebrospinal fluid leakage, facial nerve injury and abnormal positioning of electrode during surgery and uncertainty of auditory rehabilitation and possibility of the recurrent meningitis after CI that should be considered. Several studies proved that the incidence of otogenic meningitis is higher in patients with inner ear anomaly than in patients with normal inner ear anatomy. We experienced a case of recurrent meningitis due to an unusual cause after cochlear implantation in a patient with inner ear anomaly.
양성자 펌프 억제제가 인후두 역류증과 동반된 만성 비부비동염에 미치는 영향
정한진,김지환,강민혁,이동욱 대한이비인후과학회 2019 대한이비인후과학회지 두경부외과학 Vol.62 No.3
Background and Objectives Laryngopharyngeal reflux (LPR) is a prevalent condition with an increasing incidence, and several recent studies have reported the association of LPR with chronic rhinosinusitis (CRS). In this study, we studied the effect of proton-pump inhibitors (PPIs) on symptom improvement for LPR and comorbid CRS. Subjects and Method Enrolled in the study from January 2017 to December 2017 were 164 patients (54 male, 110 female, mean age 48.8 years) who were diagnosed as LPR by reflux symptom index (RSI) or reflux finding scores (RFS) and comorbid CRS. Sino-Nasal Outcome Test (SNOT)-20 and Lund-Kennedy endoscopic scores were evaluated for CRS severity. The study group was divided into PPI treatment group (Ilaprazole 20 mg, once a day for 8 weeks) and non-treatment group. The RSI, RFS, SNOT-20, and Lund-Kennedy endoscopic scores were repeated at the end of treatment. Results Ninety-two patients were prescribed PPI and 72 patients were not. Initial RSI, RFS, SNOT-20, and Lund-Kennedy score did not differ between the two groups. RSI and RFS decreased significantly after eight weeks of PPI medication (p=0.002 and p<0.001, respectively). In the non-treatment group, only RFS showed statistically significant decrease. SNOT-20 and Lund-Kennedy endoscopic scores decreased significantly in the treatment group (p=0.005 and p<0.001, respectively) compared to the non-treatment group. Conclusion The results of our study suggest that PPI treatment for 8 weeks was effective in reducing signs and symptoms of both LPR and CRS.