내이도내 전정신경종의 임상적 특징 및 수술적 방법에 따른 결과 비교

김종양,정종우,이광선 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.3

Background and Objectives:Modern imaging and surgical techniques have made intrameatal vestibular schwanoma (IMVS) surgery safe and have allowed for good outcomes with respect to facial nerve function and hearing outcome. This study aimed to analyze clinical features and to compare the results of the middle fossa approach (MFA) and translabyrinthine approach (TLA) used during IMVS surgery. Subjects and Method:We reviewed retrospectively 10 patients who were operated for IMVS from November 1995 to May 2005. This study analyzed chief complaint, size of tumor, audiological studies, caloric test, imaging study, and treatment modality. Results:The main symptom for IMVS patients is vertigo. But, in our study, patients having only vertigo was rare;disturbance in PTA and unilateral weakness in the Caloric test. In terms of mean operation time, it took 7.5 hours in MFA and 4 hours in TLA. Postoperative hearing loss and facial nerve palsy occurred in early MFA operation cases. With respect to facial nerve function, the MF approach group had a higher rate of development of facial neuropathy than did the TL approach group. Conclusion:We think patients with vertigo and tinnitus will progress to hearing loss. We should suspect IMVS if patients com-plain of vertigo and tinnitus. But, further evaluation should be needed. If postoperative hearing preservation is not important, the To use the MFA method, otolaryngologic surgeons need more direct and indirect experiences, considering the low incidence of acoustic schwannoma surgery and that the MFA method requires longer mean operation time than TLA. (Korean J Otolaryngol 2007 ;50 :203-8)

미국경찰활동에 있어서 다문화사회적 특징의 고찰

김종양 한국민간경비학회 2004 한국민간경비학회보 Vol.4 No.-

타액선 질환에 대한 세침흡인검사의 임상적 유용성

김종양,배기훈,최승호,김상윤,남순열 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.6

Background and Objectives:Fine-needle aspiration biopsy (FNAB) has been used as a diagnostic instrument in patients with salivary gland lesions. This article is aimed at defining the exact role of FNAB in the diagnostic workup of patients. Materials and Method:A retrospective study design was used to evaluate the accuracy of FNAB for salivary gland diseases. From January 1997 to June 2004, FNABs, confirmed histologically after surgery, were carried out on 419 patients with salivary gland diseases. Cytopathologic and histologic findings were categorized as malignant, suspicious, benign neoplastic, or nonneoplastic. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of FNAB were calculated using histologic diagnosis of the surgical specimen as the criterion standard. Results:FNAB was performed in all of 419 salivary gland lesions undergoing surgical procedures. A total of 321 lesions were in the parotid gland and 98 in the submandibular gland. There were 417 FNAB specimens (99%) that were satisfactory for evaluation. The FNAB diagnosis of malignant or suspicious lesions had positive and negative predictive values of 77% and 91%, respectively. Fine-needle aspiration biopsy diagnosis of a benign neoplasm had positive and negative predictive values of 93% and 77%, respectively. A cytopathologic diagnosis of a nonneoplastic lesion was predictive in only 59% of the cases. Conclusion:Although an FNAB diagnosis of malignant or neoplastic major salivary gland disease is generally predictive of the final histologic diagnosis, the predictive value of a negative FNAB finding is low. A negative FNAB finding should not supersede clinical judgment in the management of aclinically suspected malignant or neoplastic lesion of the major salivary glands. (Korean J Otolaryngol 2006;49:639-43)

비행청소년 선도를 위한 경찰의 대응방안에 관한 연구

김종양 한국경찰학회 2003 한국경찰학회보 Vol.5 No.2

비행청소년 선도를 위해서는 가정, 학교, 지역사회가 서로 협력하여 지속적인 대안 마련이 필요하다. 경찰은 법·제도의 정비를 비롯하여, 청소년 관련기관의 협력 증대, 문제해결 경찰활동의 강화 등과 같은 비행청소년 선도 프로그램을 실시해야 할 것이다. 오늘날 비행청소년의 문제는 단순히 경찰활동상의 문제가 아니라 학교-경찰 연계프로그램, 지역사회-경찰 연계프로그램과 같이 종합적인 대책마련과 관계당국의 적극적인 의지가 필요하다. 따라서 청소년관계법령의 개선과 함께, 청소년전담기구의 설치와 같은 가시적인 노력이 선행되고, 시민들의 의식전환을 기초로 한 민-경 합동순찰의 강화와 같은 지역사회 경찰활동 프로그램이 마련되어야 할 것이다. Today, juvenile delinquencies have been recognized to be the trouble of home, school, community. The response policing for the juvenile delinquency need to the revision of criminal justice system and law that are concerned about the juvenile, and co-relation with organization. Especially, problem solving policing is trended of juvenile-police program in community. Then citizen patrol will be participated in volunteer for guiding to juvenile activities. At last, police and community must be trusted and assisted for guiding to juvenile activities. The function of home and school has shifted to that of police and community within juvenile delinquencies.

측두골 자기공명영상 와우신경 저형성증 및 무형성증에서의 인공와우 이식술

김종양,이정현,이성원,오수희,정종우,이광선 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.11

Background and Objectives:Identifying cochlear nerve hypoplasia or aplasia is dependent on temporal bone magnetic reso-nance imaging (TBMRI) providing information on the cochlea, internal auditory canal, and the cochlear nerve. The purpose of this study was to review the results of cochlear implantation (CI)TBMRI. Subjects and Method:From April 1999 to April 2005, 321 patients were fited with cochlear implants in our department by two surgeons. The present study focused on four prelingual patients who underwent CI in ears with cochlear nerve hypoplasia or aplasia as sugested by TBMRI. The perceptive and linguistic results were evaluated based on speech perception and production at preimplantation and at 1, 3, 6, 9, 12, and 24 months postimplantation. Results:Pre-operative auditory brainstem responses were ls in 10% and their categories of auditory performance scores were 4 or above. Conclusion:We confirmed cochlear nerve presence in cases of cochlear nerve hypoplasia or aplasia as sugested by TBMRI and made their auditory habilitation posible with cochlear implantation. However, even in cases of cochlear nerve hypoplasia or aplasia suggested by TBMRI, physicians need to confirm coch-lear nerve presence before implantation and to predict the outcome of cochlear implantation. Neck Surg 2007 ;50 :978-82)

갑상선 전절제술 후 이온화 칼슘 변화에 따른영구적 부갑상선 기능 저하증의 예측 시점 및 위험 인자

김종양,박정제,최승호,김상윤,남순열 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.11

Background and Objectives:The aims of this study were to evaluate postoperative change of ionized calcium level in relation to clinical symptoms of hypoparathyroidism after total thyroidectomy and to find risk factors of postoperative permanent hypo-parathyroidism. Subjects and Method:A retrospective study of 118 patients who had underwent total thyroidectomy between tration was obtained daily. Results:The incidence of postoperative permanent hypoparathyroidism was 11% (13/118). In the permanent hypocalcemic group, compared with normocalcemic and transient hypocalcemic group, folowing characteristics were related: increased incidence of hypocalemia from postoperative second day, advanced T stage, anaplastic cancer. Conclusion:found that when the second postoperative days ionized calcium level is below the normal range, daily blood sampling has to be done to detect continuous hypocalcemia.

두경부에 발생한 골수외 형질세포종 3예

김종양,최승호,장용주,이봉재 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.5

The diagnosis and management of extramedullary plasmacytoma require the same range of clinical and laboratory expertise as for multiple myeloma. The primary treatment is radiotherapy, but surgery may also be required. We report three cases of extramedullary plasmacytoma located in the nasopharynx, neck, and nasal cavity respectively. The case of nasopharyngeal plasmacytoma, developed in a 55-year-old man, was associated with multiple bilateral cervical lymphadenopathy. Diagnosis was made with MRI, endoscopic nasopharyngeal biopsy, and bone marrow aspiration biopsy. Radiotherapy of 45 Gy resulted in the partial remission of primary and cervical lesions. The second case presented with cervical and retropharyngeal masses. Radiotherapy had not been successful, so the tumors were surgically excised. The third case was developed in the nose of a 43-year-old man complaining of nasal obstruction and epistaxis. Nasal cavity mass was identified as an extramedullary plasmacytoma. The patient underwent radiotherapy with 50 Gy with complete remission.

경부에 발생한 캐슬만 병 6예에 대한 임상적 고찰

김종양,최승호,김상윤,남순열 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.11

Castlemans disease is a rare, benign disease of unknown cause that induces reactive lymph node hyperplasia. Head and neck region is the second most affected area after the mediastinum. It has 2 histologic subtypes:hyaline vascular and plasma cellular. It is difficult to differentiate Castleman’s disease from other diseases such as lymphoma, tuberculosis, metastatic papillary thyroid carcinoma, Kaposi’s sarcoma and Kimura’s disease in the neck with CT. The study comprised of 6 patients with lymph node biopsy-proved Castleman disease and solitary involvement. One case favoring neurogenic tumor in MRI and another case with skin adhesion are confirmed histologically as Castlemans disease after surgery. A definitive diagnosis necessitates tissue biopsy. Surgery is the treatment of choice for the solitary form, whereas chemotherapy, radiotherapy, and steroids are proposed for the multicentric type. No recurrences have been reported after complete resection of the hyaline vascular type.

편도 및 아데노이드 수술 후 주관적 음성 변화의 양상과 인자

김종양,최선명,최세준,남순열,김상윤,최승호,Kim, Jong-Yang,Choi, Sun-Myung,Choi, Se-Jun,Nam, Soon-Yuhl,Kim, Sang-Yoon,Choi, Seung-Ho 대한후두음성언어의학회 2004 대한후두음성언어의학회지 Vol.15 No.1

Some patients who have undergone adenotonsillectomy (AT) or tonsillectomy(T) complain of voice change. Research was designed to determine the relationship between subjective voice change and change of parameters in boice analysis and to find the degree of voice change according to age and excised tissue volume. In 34 patients who underwent AT and 17 patients who underwent T, we measured the masalance, the fundamental frequency of /a/phonation and the formants and bandwidths of /a/, /i/, /u/ phonations. These parameters were measured preoperatively and also 7 days after the operation. Excised tissue volume was measured on operation. Postoperative changes were statistically analyzed. Any subjective voice change was asked to be reported at the visit 7 days after the operation. There was analysis for the difference of above parameters between some who answered "voice change" (A group) and the others who answered "no voice change" (B group). 24 patients(71%) who underwent AT and 4 voice change. Nasals nasalance change is an important factor in subjective voice change after AT.

난청 환자에서 청성뇌간반응검사와 순음청력검사 간 주파수별 역치 차이 분석

임태헌,김종양,오주형,주준범,조주은,박보나 대한이비인후과학회 2023 대한이비인후과학회지 두경부외과학 Vol.66 No.1

Background and Objectives There is no clear standard for the difference in the thresholdsof auditory brainstem response (ABR) and pure tone audiometry (PTA) when using ABR toevaluate the reliability of PTA. Therefore, we assessed the difference in the thresholds of ABRand PTA for each frequency. Consequently, we present here the actual difference values betweenthe two tests that can be used as a reference in the clinic. Subjects and Method We retrospectively assessed the audiometry results of 129 ears. Earsin which the hearing thresholds of each frequency continuously declined were classified as thedownward group. We compared the average of differences between the two tests by frequency. The differences were compared for each hearing level from 50 dB or higher. Results For all ears, the appropriate range of difference value was ±5 dB at 2 kHz. At 1 kHz,the ABR threshold was 10 dB higher than PTA, and it was 10 dB less than PTA at 4 kHz. Inthe downward group, the difference value increased by 10 dB at 1 kHz and 4 kHz. In the subgroupsat each hearing level, the difference value showed similar results (p<0.05). Conclusion The difference in the threshold, regardless of the severity or tendency of hearingloss, was the smallest at 2 kHz and the range was ±5 dB. ABR was 10 dB higher at 1 kHz andand 10 dB lower at 4 kHz than PTA. In the downward group, the difference at 1 kHz and 4kHz increased by 10 dB each.