제1형 고실성형술에 동반된 유양돌기절제술이 65세 이상 고령 만성 중이염 환자의술후 청력에 미치는 영향

성충만,김희영,박종민,이성수,조형호,조용범 대한이비인후과학회 2017 대한이비인후과학회지 두경부외과학 Vol.60 No.12

Background and Objectives Although canal wall up mastoidectomy (CWUM) has been performed frequently as a treatment for chronic otitis media (COM), the necessity of CWUM for non-cholesteatomatous COM (NCCOM) is still controversial. Since elderly people often have systemic problems, there is a high likelihood of side effects after general anesthesia, so it is important to judge the necessity of mastoidectomy. The purpose of this study was to investigate the effect of CWUM for the treatment of NCCOM in patients over 65 years of age. Subjects and Method Forty-two cases of CWUM with tympanoplasty type I performed as a treatment for NCCOM from 2007 through 2016 were reviewed retrospectively. Pure tone audiometry was performed preoperatively and postoperatively, and preoperative temporal bone CT was used to evaluate the mastoid status. The valsalva maneuver (VM) was used to evaluate the eustachian tube function. Results The total number of patients was 42 and the success rate of eardrum repair was 92.8%. Comparison of hearing results taken preoperatively and postoperatively showed significant hearing improvement in both air conduction and air-bone gap. When hearing results were compared according to the mastoid status and the response of VM, there were no significant differences. Conclusion Mastoidectomy combined with tympanoplasty type I showed a high success rate of ear drum repair and good hearing improvement, with no critical side effects. Therefore, mastoidectomy does not need to be limited by one’s old age. Adequate mastoidectomy after proper consideration of the mastoid status will be helpful in the treatment of the disease. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(12):626-32

Patients’ Characteristics according to Allergic Sensitization in Chronic Rhinitis

성충만,양형채,조형호 대한이비인후과학회 2018 대한이비인후과학회지 두경부외과학 Vol.61 No.2

Background and Objectives Chronic rhinitis is divided into allergic rhinitis (AR) and non-allergic rhinitis (NAR), both of which have similar symptoms but differ in treatment approaches. For the diagnosis of AR, allergen-specific immunoglobulin E (IgE) tests along with characteristic symptoms are required. However, these tests are costly and not always practicable. The purpose of this study was to investigate how symptoms respond differently to different allergen sensitization or sensitized allergen. Subjects and Method We retrospectively reviewed 1661 patients who underwent multiple allergen simultaneous test (MAST) for chronic rhinitis symptoms. The total nasal symptom (TNS) scores of these patients from 2006 to 2014 were assessed for rhinorrhea, nasal obstruction, itching, and sneezing. Patients were classified as AR and NAR according to the results of MAST and their association with symptoms. Results There were 1021 patients designated to the AR group and 640 patients to the NAR. The AR group had lower age, higher TNS, and higher serum IgE levels than the NAR group. In addition, sneezing and itching were more common in the AR group. Furthermore, sneezing was a positive predictor for seasonal allergen sensitization. On the other hand, itching was a positive predictor for perennial allergen sensitization. Conclusion AR and NAR patients showed different demographic characteristics and symptoms. These results may be helpful in classifying and treating patients with chronic rhinitis, especially when the allergen specific IgE test cannot be performed.

Congenital Cholesteatoma of Mastoid Temporal Bone and Posterior Cranial Fossa Treated with Transmastoid Marsupialization

성충만,양형채,조용범,장철호 대한이비인후과학회 2018 대한이비인후과학회지 두경부외과학 Vol.61 No.12

A congenital cholesteatoma is a benign mass formed from the keratinizing stratified squamousepithelium. It usually occurs in young children’s anterosuperior part of the middle ear. A congenitalcholesteatoma which originates from mastoid temporal bone or expands to posteriorcranial fossa is rare. Standard treatment of an intracranial cholesteatoma is surgical removalwith craniotomy. A 69-year-old woman was diagnosed with a congenital cholesteatoma of mastoidtemporal bone that expanded to the posterior cranial fossa, which was successfully treatedwith transmastoid marsupialization without craniotomy. This is a first documented case ofa congenital cholesteatoma of mastoid temporal bone that expanded to posterior cranial fossa, which was successfully treated with transmastoid marsupialization without craniotomy.

Intracranial Pseudoaneurysm Misdiagnosed as Recurrent Epistaxis: A Case Report

성충만,김도형,김홍찬,양형채 대한이비인후과학회 부산,울산,경남 지부회 2023 임상이비인후과 Vol.34 No.4

Epistaxis is a relatively common otolaryngological emergency, however, repeated episodes of epistaxis should pay attention to the potential for alternative causes. We report a case of a patient who experienced recurrent epistaxis due to an intracranial pseudoaneurysm. At the initial visit, the patient had no history of trauma or surgery and displayed no neurological symptoms other than repeated epistaxis. Suspecting common causes for epistaxis, we performed a nasal exploration but could not identify the bleeding site. However, after the recurrence of epistaxis, endoscopic exploration revealed an aneurysm within the sinus. Emergency angiography and coil embolization were then performed to treat the condition, but stent-assisted coil embolization was subsequently executed due to symptom recurrence. An intracranial pseudoaneurysm in the sphenoid sinus can manifest solely with epistaxis, and rapid diagnosis can be challenging without a suggestive history. Although epistaxis is relatively common, a differential diagnosis is required if symptoms persist.

소아 돌발성 난청의 임상적 특징과 결과

신동주,정은경,성충만,이성수,조형호,조용범 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.2

Background and Objectives Sudden sensorineural hearing loss (SSNHL) in children can occur just as can in adults; in fact, it may last throughout the entire life of a child, affecting the individual much more than when it does to an adult. As there are only a few studies that have focused on SSNHL in childhood, we investigated the clinical characteristics and hearing outcomes of pediatric SSNHL. Subjects and Method A retrospective review of patients from November 2005 to May 2014 was carried out. Thirty nine patients under the age 15, who were hospitalized due to SSNHL were enrolled. Of these patients, 226 patients over the age of 15 were collected as a comparison group. Age, sex, underlying disease, site of hearing loss and duration from the onset to treatment were analyzed. We evaluated the overall recovery rate as well as the recovery rate according to accompanying diseases. Results Recovery rates were comparable between the pediatric and the adult group. Overall recovery rate was 60% in the pediatric group. Unlike for the adult group, dizziness and tinnitus were not a prognostic factor in the pediatric group. Pediatric patients showed similar overall recovery, whether the treatment initiation was under 7 days or more. Recurrence was seen in 3 patients, of which 2 showed complete recovery. Conclusion The recovery rate for SSNHL was similar for the pediatric and the adult groups. A higher recurrence rate may alert clinicians to be aware of hearing changes after the recovery in pediatric patients. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(2):104-9

Traumatic Brain Injury-Induced Mixed Chemosensory Disorder: a Case Study on Taste and Smell Dysfunction

임영관,김슬기,성충만,김재형 대한안면통증∙구강내과학회 2023 Journal of Oral Medicine and Pain Vol.48 No.4

We present a case report of a 52-year-old male patient who suffered head trauma in a car accident and subsequently experienced taste and smell disorders. Following the accident, the patient reported difficulty detecting salty and sour tastes and diminished olfactory perception. Neurosurgical evaluation revealed subarachnoid and subdural hemorrhages, while otolaryngology investigations revealed hyposmia—a decreased sense of smell. Upon referral to the Department of Oral Medicine, a comprehensive assessment revealed a general bilateral reduction in taste sensation, particularly ageusia for salty taste. Electric taste-detection thresholds significantly exceeded the normal ranges. Integrating our findings from neurosurgery, otolaryngology, and oral medicine resulted in a diagnosis of mixed chemosensory disorder attributed to head trauma. This case highlights the intricate interplay of alterations in taste and smell following head injury, emphasizing the significance of multidisciplinary evaluations in diagnosing mixed chemosensory disorders resulting from traumatic brain injury.

레벨2 장비로 전용가능한 레벨1 장비의 수면다원검사 자동화 판독과 검사자 판독 간의 비교

정수정,성종엽,김지수,박종민,성충만,양형채,임상철 대한이비인후과학회 2021 대한이비인후과학회지 두경부외과학 Vol.64 No.3

Background and Objectives A lack of investigators for polysomnography has risen due toincreased demand since health insurance started to cover the cost of the test. We examined thereliability of the automated scoring of polysomnography, which has been deployed to improvethis imbalance. Subjects and Method We analyzed the data of 20 patients who underwent level 1 polysomnographyfrom April 1 to July 27, 2019. The software from Noxturnal (Nox Medical) was usedfor the scoring of the Polysomnography data. Each of the polysomnographic data was scoredboth by the automated scoring system and by a skilled technician. Results Twenty patients were analyzed. There was no significant difference between automatedscoring and manual scoring in sleep latency, apnea index, and rapid eye movementsleep stage ratio. However, the concordance rate of the sleep stage by epoch was 83.32%, andthere was a significant difference with regards to apnea-hypoapnea index (AHI) and respiratorydisturbance index (RDI). Two obvious errors were noted in the automated scoring that couldbe easily fixed; the failure to recognize wakefulness during sleep and the fragmentation of respiratoryevents. When two errors were corrected, many differences in polysomnography parameters,including AHI and RDI, were eliminated. Conclusion It showed 80% coincidence of epoch in the sleep stage between the automatedscoring and manual scoring. However, there was no difference in AHI and RDI when the fragmentedrespiratory events of the automated scoring were adjusted. Therefore, automated scoringis considered to be useful if only a little modification could be made.

Inflammatory Endotypes of Chronic Rhinosinusitis in the Korean Population: Distinct Expression of Type 3 Inflammation

Min Jin-Young,Kim Jin Youp,성충만,Kim Seon Tae,조현진,문수진,Cho Sung-Woo,Hong Sang Duk,Ryu Gwanghui,Cho Kyoung Rai,Kim Young Hyo,Park Soo-Kyoung,Kim Dong-Kyu,Lee Dong Hoon,Heo Sung Jae,Lee Ki-Il,Kim Su Jin,Le 대한천식알레르기학회 2023 Allergy, Asthma & Immunology Research Vol.15 No.4

Purpose: Cluster analyses on inflammatory markers of chronic rhinosinusitis (CRS) in Asians from multicenter data are lacking. This multicenter study aimed to identify the endotypes of CRS in Koreans and to evaluate the relationship between the endotypes and clinical parameters. Methods: Nasal tissues were obtained from patients with CRS and controls who underwent surgery. The endotypes of CRS were investigated by measuring interleukin (IL)-5, interferon (IFN)-γ, IL-17A, IL-22, IL-1β, IL-6, IL-8, matrix metalloproteinase-9, eotaxin-3, eosinophil cationic protein, myeloperoxidase (MPO), human neutrophil elastase (HNE), periostin, transforming growth factor-β1, total immunoglobulin E (IgE), and staphylococcal enterotoxin (SE)-specific IgE. We performed hierarchical cluster analysis and evaluated the phenotype, comorbidities, and Lund-Mackay computed tomography (LM CT) score in each cluster. Results: Five clusters and 3 endotypes were extracted from 244 CRS patients: cluster 1 had no upregulated mediators compared to the other clusters (mild mixed inflammatory CRS); clusters 2, 3, and 4 had higher concentrations of neutrophil-associated mediators including HNE, IL-8, IL-17A, and MPO (T3 CRS); and cluster 5 had higher levels of eosinophil-associated mediators (T2 CRS). SE-specific IgE was undetectable in T3 CRS and had low detectable levels (6.2%) even in T2 CRS. The CRS with nasal polyps (CRSwNP) phenotype and LM CT scores showed no significant differences between T2 and T3 CRS, while the incidence of comorbid asthma was higher in T2 CRS than T3 CRS. In T3 clusters, higher levels of neutrophilic markers were associated with disease severity and CRSwNP phenotype. Conclusions: In Koreans, there is a distinct T3 CRS endotype showing a high proportion of CRSwNP and severe disease extent, along with T2 CRS.