구개수구개인두성형술 후 음성변화에 관한 음성학적 및 영상학적 연구

명남숙,구수권,한철우,이형주,박범석,권순복 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.1

Background and Objectives:Many people have been concerned about the voice change after uvulopalatopharyngoplasty (UPPP). A number of studies reported acoustic changes after UPPP. However, there have not been any reports regarding the association of anatomic changes and acoustic results after UPPP. The purpose of this study is to analyze changes of the voice and changes in the vocal tract after UPPP and to evaluate whether the anatomical changes of vocal tract have an effect on the voice change or not. Subjects and Method:By using computerized speech laboratory (CSL), we analyzed fourteen UPPP cases on the formant frequencies of six vowels (/a/, /i/, /u/, /∧/, /o/, /e/) and three nasal consonants (/eom/, /eoung/, /kin/). By using MR image, we analyzed the changes of vocal tract four weeks after UPPP with preoperative findings in one case. Results:In acoustic analysis, the second formant frequencies of /i/ and /u/ phonation were significantly reduced postoperatively compared to those of preoperative status. In imaging study of /i/ and /u/, the soft palate were contracted along with the widening of the oropharynx and the tongue was shifted toward posterior pharyngeal wall to compensate. Conclusion:UPPP reduced the second formant of /i/ and /u/, which did not result in serious voice change.

비중격 만곡증 환자에서 전산화단층촬영을 이용한 하비갑개 형태학적 변화의 분석

명남숙,박범석,이형주,구수권,노환중 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.12

Compensatory hypertrophy of the inferior turbinate is frequently observed in case of nasal septal deviation. In case of surgical treatment, some advocate that septoplasty must be accompanied by reduction of inferior turbinate. So, the authors analyzed the structural change of the inferior turbinate in nasal septal deviation using the CT scan. Subjects and Method:The CT films of 154 patients who had undergone septoplasty were reviewed retrospectively. All subjects had only Cshaped septal deviation and had no abnormality. Inferior turbinate was divided equally into three portions as anterior, middle and posterior portions. The thickness of mucosa and bone of the inferior turbinate and the degree of inferior conchal bone medialization were measured. Results:In the anterior and middle portion, the degree of medialization at concave side of inferior conchal bone was significantly increased compared to the convex side. In addition, the thickness of bone and mucosa at the concave side was significantly thicker than those of the convex side (p<0.05). However, no significant differences were found in the posterior portion. Conclusion:In the nasal septal deviation, the degree of medialization of inferior conchal bone and the thickness of bone and mucosa at the concave side were significantly greater than those of the convex side in the anterior and middle portion. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:1104-8)

수면무호흡증 환자에서 시행한 구개근 절제술의 임상적 안전성

구수권,명남숙,최장원,김양재,권순복 대한비과학회 2012 Journal of rhinology Vol.19 No.2

Background and Objectives: The purpose of this study was to analyze clinical safety of PMR(Palatal Muscle Resection) in obstructive sleep apnea patients. Materials and Methods : Fourteen Patients underwent only PMR were reviewed retrospectively. ESS(Epworth Sleepiness Scale) was analyzed after PMR surgery to assess surgical results. Visual Analogue Scale were reviewed to evaluate postoperative pain. Eustachian tube function test, voice analysis, and measurement of forced expiration power were done after two months of surgery. Results : ESS were improved after PMR. There were little postoperative pain. There was no significant change is observed vowel sounds except /u/ nor postoperative nasalization in voice, Eustachian tube dysfunction and change of expiration power. Conclusion : PMR may be regarded clinically safe surgery in obstructive sleep apnea patient.

14년 동안의 편도주위농양의 임상적 양상의 변화

박범석,명남숙,이형주,박홍석,한철우,구수권,Park, Beom-Seok,Myung, Nam-Sook,Lee, Hyoung-Ju,Park, Hong-Seok,Han, Cheol-Woo,Koo, Soo-Kweon 대한기관식도과학회 2009 大韓氣管食道科學會誌 Vol.15 No.2

Background and Objectives : Peritonsillar abscess is one of the most common illnesses m the ENT field, though its prevalence has been drastically reduced with the development of antibiotics and appropriate early treatment. We analyzed recent clinical characteristics of peritonsillar abscess and compared them with ones of 7 and 14 years ago respectively. Materials and Methods : Sixty-six cases of peritonsillar abscess from 2006 through 2008 were investigated retrospectively and compared with results of 7 and 14 years ago on various clinical factors. Results : Peritonsillar abscess was prevalent in men in their 20s and 30s. Mean period from symptom onset to visit to hospital tended to decrease(5.2 days) but admission days has increased(7.4 days). Body temperature on admission was lower than that of previous studies($36.4^{\circ}C$). Bacteria were isolated in 26 cases(74.2%) out of 35 cases in which culture had been performed. The most common cultured organism was a-hemolytic streptococcus and $\beta$-hemolytic streptococcus that had been most frequently cultured 14 years ago wasn't detected in this study. Conclusion : We found some changes of clinical features in peritonsillar abscess when compared with previous researches. Although there were some differences in cultured organism, antibiotics used commonly-cephalosporin, aminoglycoside, quinolone - were still effective for their eradication.

폐쇄성 수면무호흡증 환자에서 수면다원검사 결과와 약물유도수면내시경을 이용해 관찰된 폐쇄 부위의 연관성에 대한 분석

최장원,구수권,명남숙,김양재,이길현,이형주 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.6

Background and Objectives Polysomnography (PSG) is useful for the diagnosis of obstructive sleep apnea (OSA) and the analysis of its occurrence and severity. Nevertheless, physical examination and PSG are not sufficient to localize the obstructed structure before operation. Drug-induced sleep endoscopy (DISE), on the other hand, is expected to provide an accurate diagnosis as it can be used to evaluate the intensity of operative effect and can minimize additional unnecessary procedures. The aim of this study is to analyze correlation between the results of polysomnography and obstructive structure by DISE in OSA Patients. Subjects and Method This study was conducted on 75 patients, who were diagnosed with OSA by PSG and DISE. Obstruction levels and individual structures were classified by modified VOTE classification. The patients were divided into groups according to the results of PSG and BSI; the correlation between DSI results and each of these groups were analyzed. Results There were no statistically significant differences in obstruction levels between PSG data and DISE finding. Obese patients, positional-dependent OSA and sleep stage non-dependent OSA (NREM OSA) groups showed more obstruction on the lateral pharyngeal wall. Severe OSA groups showed more obstruction on tonsils. Obese patient groups revealed more obstruction on tongue base, but did not contribute to statistically significant results. Conclusion In our study, obese patients, severe OSA, positional-dependent OSA and NREM OSA groups tended to exert greater influence on the obstruction of lateral pharyngeal wall. Surgeons should be aware of these findings when performing sleep surgery.

폐쇄성 편도 비대증과 재발성 편도염 환자의편도 중심 조직 내 세균의 비교 분석

한철우,고의경,구수권,김태헌,명남숙,김병국 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.12

Background and Objectives:The purpose of this study was to find whether bacteriological characteristics can affect the sizeand recurrent infections of the tonsil by comparing the type and number of bacteria located in the core of palatine tonsil in obstructivetonsillar hypertrophy (OTH) and recurrent tonsillitis (RT) patients. Subjects and Method:Palatine tonsils of patientswho received tonsillectomy due to OTH and RT were studied. The excised tonsil was dissected into two pieces and one gram ofthe core tissue was obtained for examination. Mixture of normal saline and homogenized tissue was inoculated using variousculture media. The types of isolates and bacterial concentrations in each isolate was compared between the two groups. Results:Commonly isolated aerobic bacteria in the order of frequency for the OTH group were Streptococcus viridans, Staphylococcusaureus, and Neisseria spp., whereas it was Neisseria spp., Streptococcus viridans, Staphylococcus aureus, and Haemophilusinfluenzae for the RT group. Peptostreptococcus spp. was the most frequently isolated anaerobe in both OTH group and RTgroup. There was no statistically significant difference in types of isolates between the two groups except for Haemophilusinfluenzae and Bacteroides spp. The density of cultured bacteria (number of bacteria per 1 gram of tissue) was greater in the RTgroup than in the OTH group. Conclusion:There was no definite difference in the number of isolate types between the OTHgroup and RT group. Bacterial density was higher in the RT group than in the OTH group. Therefore, bacterial density mighthave an influence on the recurrence of tonsillitis. (Korean J Otolaryngol 2006;49:1201-5)

집먼지 진드기 알레르기 비염의 면역치료의 결과에 대한 장기추적

김태헌,구수권,고의경,노환중,명남숙,이형주 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.11

Background and Objectives:This study was to evaluate the long-term efect of immunotherapy on the allergic rhinitis patients to house dust mite (HDM) patients. Subjects and Method:Sixty-five patients were treated for allergic rhinitis in the allergy clinic. Every patient underwent imunotherapy for 3 to 5 years and did not receive any additional treatments after the completion of the initial one. The survey on the symptom improvement and the patients satisfaction was carried out 3 and 10 years after the imunotherapy treatment. The results of skin prick test for each individual were analyzed before, 3 and 10 years after the im-munotherapy, respectively. Results:Overall symptom improvement surveyed 10 years after the imunotherapy decreased compared with that taken after 3 years of the treatment (p<0.05). In particular, symptom improvements on sneezing, itching (p<0.05). Patients satisfaction level was 64.6% after 3 years and 49.2% after 10 years of the imunotherapy treatment. Skin prick test reactivity was significantly decreased after 3 years of the treatment compared to before the treatment. Although skin prick test reactivity measured in 10 years after immunotherapy increased compared with that measured in 3 years after, there was little statistical significance when compared with the reactivity before the treatment. Conclusion:The immunotherapy has long term eficacy on allergic rhinitis to HDM. However, the eficacy (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 : 1006-11)