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CO2 레이저와 고주파를 이용한 피막내 편도부분절제술의 편도결석 치료결과
문인희 대한이비인후과학회 2015 대한이비인후과학회지 두경부외과학 Vol.58 No.3
Background and Objectives Among the treatment methods used for tonsilloliths, tonsillectomy has a high cure rate but also the disadvantage of adverse effects that include severe postoperative pain and relatively frequent postoperative bleeding. In contrast, CO2 laser cryptolysis causes less pain and bleeding, but also has the disadvantage of the occasional requirement for additional operations. To identify a tonsillolith treatment method that would cause less pain and bleeding as well as decreased rate of recurrence, we used intracapsular partial tonsillectomy under local anesthesia for the treatment of tonsillolith and analyzed the results. Subjects and Method The subjects were 82 tonsillolith patients who had undergone intracapsular partial tonsillectomy with radiofrequency and CO2 laser under local anesthesia between October 2011 and March 2012. Results Tonsilloliths were commonly found in the upper half of palatine tonsil. When selective partial tonsillectomy was performed on the area where the tonsillolith had occurred, a 92.7% success rate was obtained with just a single operation. Postoperative bleeding that needed treatment occurred in 1.2% of the patients. In the case of postoperative pain, moderate pain was most common with significant differences in intensity depending on the depth of the crypt and the extent of the operated area. Conclusion Good results were achieved by treating tonsillolith with intracapsular partial tonsillectomy, utilizing CO2 laser and radiofrequency under local anesthesia, which selectively removed the crypt where the tonsillolith occurred.
건성안 환자들의 주관적인 안구 불편감과 안검염 중증도의 관계
문인희(In Hee Moon),김태임(Tae Im Kim),서경률(Kyoung Yul Seo),김응권(Eung Kweon Kim),이형근(Hyung Keun Lee) 대한안과학회 2016 대한안과학회지 Vol.57 No.10
목적: 건성안 질환을 평가하는 데 여러 가지 임상적 지표들이 알려져 있지만, 그중 어떠한 인자가 임상적인 안구 불편감에 가장 크게 영향을 끼치는지에 대해서는 논란이 있었다. 안검염은 눈물 증발형 건성안의 가장 중요한 원인 중의 하나로 인식되고 있지만, 건성안 증상에 안검염의 중증도가 끼치는 영향을 조사한 연구는 이전에 행해진 적이 없었다. 본 연구의 목적은 안검염을 동반한 건성안 환자들의 주관적 안구 불편감에 영향을 끼치는 인자들을 평가하고 어떠한 지표가 가장 안검염의 심한 정도와 관련이 있는지 분석하는 것이다. 대상과 방법: 본 연구는 단면, 임상 증례 연구로서 연구 대상자는 안검염을 동반한 건성안 환자들로 구성되었다. 22세부터 81세까지(평균 연령 56.36세) 73명의 대상자가 등록되었고 그중 49명(평균 연령 55.44세), 49안이 모든 검사를 마쳤다. 문진, visual analogue scale (VAS) 통증 점수, 건성안 자각 증상 점수 설문 조사(ocular surface disease index, OSDI), 안검염의 정도(score 0-4), 각결막플루오레신 염색 정도(score 0-4), 눈물막 파괴 시간(tear break up time) 측정을 포함한 검사를 진행하였다. 결과: 주관적인 증상과 안검염의 정도가 중요한 연관 관계가 있음이 밝혀졌다. 건성안 환자들이 갖고 있는 안검염의 정도가 심할수록 VAS 통증 점수와 OSDI 점수가 증가하였다(p=0.031, p=0.006). 결막 미란의 정도 또한 VAS 통증과 관련이 있었다(p=0.016). 다른 건성안 측정 지표들은 VAS, OSDI 점수와 통계적으로 유의한 관계를 보이지 않았다. 추가적으로 결막 미란은 안검염의 정도와 연관이 있었지만(p<0.0001) 각막 미란의 정도는 안검염의 정도와 연관이 없었다(p=0.809). 눈물막 파괴 시간 또한 안검염의 정도와 통계적으로 유의한 관계를 보이지 않았다(p=0.593). 결론: 본 연구 결과는 안검염의 정도가 건성안 환자들의 주관적인 안구 통증과 불편감에 영향을 끼치는 중요한 요소이고 안검염의 정도는 건성안의 알려져 있던 임상적 지표인 각막 미란, 눈물막 파괴 시간과는 관련이 있지 않다는 것을 보여주었다. 이는 건성안으로 고통스러워하는 환자들의 삶의 질의 개선을 위하여 건성안 치료에는 안검염의 치료가 병행되어야 함을 시사한다. <대한안과학회지 2016;57(10):1507-1513> Purpose: Although a number of clinical parameters are well known to affect dry eye (DE) disease, it is unknown which factor mostly affects the discomfort of DE. Blepharitis is recognized as one of the leading causes of evaporative-type DE disease, but there have been no large-scale study to investigate the effect of blepharitis on DE symptoms. The purpose of this study was to evaluate the factors influencing subjective ocular discomfort in DE patients with blepharitis and to determine which parameter is most highly related to severity of blepharitis. Methods: This investigation was a cross-sectional, clinical study. The test population consisted of DE patients suffering from moderate blepharitis. Seventy-three subjects aged 22 to 81 years (mean age 56.36) were enrolled, 49 of whom completed the investigation on a total of 49 eyes. A detailed assessment was conducted, including history taking, visual analog scale (VAS) pain scoring, ocular surface disease index (OSDI) questionnaire, blepharitis severity grading (score 0-4), conjunctival, corneal fluorescein staining (score 0-4), and tear break up time (TBUT) assessment. Results: The results revealed significant correlations between subjective symptoms and blepharitis severity. Significant increases in overall VAS score, OSDI score (p = 0.031, p = 0.006) were recorded in DE patients with severe blepharitis. Conjunctival erosion was significantly related to VAS score (p = 0.016). Other parameters were not significantly related with VAS and OSDI scores. Additionally, conjunctival erosion was related with blepharitis severity (p < 0.0001), and corneal erosion was not correlated with blepharitis severity. TBUT also did not show any statistical correlation with blepharitis. Conclusions: Our results showed that blepharitis severity is the main factor influencing subjective pain and discomfort in DE patients, although blepharitis severity was not related with the known clinical parameters of DE such as corneal erosion and TBUT. This study indicates that targeting treatment for blepharitis can significantly improve quality of life for patients suffering from DE disease. J Korean Ophthalmol Soc 2016;57(10):1507-1513
전병훈,문인희,장진순 인제대학교 1992 仁濟醫學 Vol.13 No.4
저자들은 최근 편도 적출술 후에도 지속되는 인두 불쾌감 및 인두통을 호소한 40세 여자 환자의 양측성 이상 경상돌기증 1례를 경험하고 문헌고찰과 함께 이를 보고하는 바이다. The incidence of elongated styloid process is rare and the chance of detecting this elongated styloid process is even rarer due to absence of symptom. However, in rare cases, it may cause sore throat and foreign body sensation as well as referred otalgia, if it compresses the surrounding structures such as vessel and soft tissue. The syndrome associated with the elongated styloid process was first described by Eagle in 1937, so this disease was called as 『Eagle's syndrome』. Recently the authors experienced a case of elongated styloid process in a 40 year-old female patient who was successfully treated with surgical shortening of the styloid process intraorally.