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근거중심으로 살펴본 수평반고리관 이석증 치료의 최신 지견
심대보 대한평형의학회 2017 Research in Vestibular Science Vol.16 No.2
Horizontal canal benign paroxysmal positional vertigo (HC-BPPV) can be classified as either the geotropic or apogeotropic subtype by the pattern of nystagmus triggered by supine head roll test. Most studies have reported the geotropic subtype as a more common pathophysiology in HC-BPPV than the apogeotropic subtype. According to the BPPV clinical practice guideline provided by the American Academy of Otolaryngology-Head and Neck Surgery and American Academy of Neurology in 2008, variations of the roll maneuver (Lempert maneuver of barbecue roll maneuver) are the most widely published treatments for HC-BPPV. In addition, various treatment techniques including Gufoni maneuver, Vannuchi-Asprella liberatory maneuver and forced prolonged positioning have been applied for HC-BPPV. However, the guideline failed to provide specific treatment guidelines for HC-BPPV based on evidence-based researches since only Class IV data on HC-BPPV treatment were available at the point of 2008 when the BPPV clinical practice guideline was published. This review article focused on the evidences of the efficacy of various maneuvers in the treatment of HC-BPPV published after the BPPV clinical practice guidelines of 2008.
심대보,고경민,송미현,송창은 대한청각학회 2014 Journal of Audiology & Otology Vol.18 No.3
Acute peripheral vestibulopathy, of which the chief complaint is positional vertigo, comprises benign paroxysmal positional vertigo (BPPV), labyrinthitis, labyrinthine fistula, and cerebellopontine angle tumors. Since the typical presentation of labyrinthine fistulas may be sensorineural hearing loss, positional vertigo, or disequilibrium, it is often difficult to distinguish from BPPV or Meniere’s disease. Herein we report a 61-year-old female patient with typical symptoms and signs attributable to geotropic type variant of the lateral semicircular canal BPPV on the left side, who eventually was confirmed as having a labyrinthine fistula from chronic otitis media with cholesteatoma on the left side. This is another case where, even in the presence of isolated vertigo showing typical findings of acute peripheral vestibulopathy, other otologic symptoms and signs must not be overlooked.
심대보 대한평형의학회 2020 Research in Vestibular Science Vol.19 No.4
Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent vertigo that is characterized by sudden onset of vertigo elicited by positional change. American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and American Academy of Neurology provided clinical practice guideline for BPPV in 2008. Since then, Bárány Society has published BPPV diagnostic criteria in 2015, and AAO-HNS has revised BPPV clinical practice guideline in 2017 to publish update version. This article reviewed recent diag-nostic criteria for BPPV included in the International Classification of Vestibular Disorders of Bárány Society and updated practice guideline in the BPPV diag-nosis presented by AAO-HNS.
Benign Paroxysmal Positional Vertigo with Simultaneous Involvement of Multiple Semicircular Canals
심대보,송창은,정은정,고경민,박진우,송미현 대한청각학회 2014 Journal of Audiology & Otology Vol.18 No.3
Background and Objectives: Benign paroxysmal positional vertigo (BPPV) generally involves a single semicircular canal (single canal BPPV) but it has been reported that more than one semicircular canal on either the same or the opposite side can be involved in 6.8-20% of the cases (multiple canal BPPV). In this study, the clinical characteristics of multiple canal BPPV were analyzed and compared to those of single canal BPPV. Subjects and Methods: Retrospective analysis was performed on 1054 consecutive patients diagnosed with BPPV. Multiple canal BPPV was diagnosed when the combination of typical nystagmus was provoked by the Dix-Hallpike and supine head roll tests. Canalith repositioning maneuver was performed sequentially starting with the semicircular canal causing more severe nystagmus or symptoms. Clinical characteristics and the treatment course were statistically compared between single canal BPPV and multiple canal BPPV. Results: Among the 1054 patients, single canal BPPV was diagnosed in 1005 patients (95.4%) while multiple canal BPPV was diagnosed in 49 patients (4.6%). BPPV involving semicircular canals on the same side was more common (79.6%) than BPPV with bilateral involvement. The most common combination of the involved canals was ipsilateral posterior and horizontal semicircular canals (63.3%). Multiple canal BPPV was significantly more associated with underlying otologic diseases, especially labyrinthitis. Multiple canal BPPV required more treatment sessions and longer duration of treatment to achieve resolution of nystagmus and symptoms. Conclusions: As all cases of multiple canal BPPV were treated successfully although a longer duration of treatment and more treatment sessions were required compared to single canal BPPV, the results of our study could aid in making an accurate diagnosis and providing appropriate treatment of multiple canal BPPV.
PCD 공구를 이용한 초경합금의 V자형 미세 채널 가공
심대보,양찬영,김보현 한국정밀공학회 2022 한국정밀공학회지 Vol.39 No.10
Microchannels machining can be used to make micro molds for microfluidic chips. The fluid flow in the channel can be controlled, by changing the cross sectional shape of the channel. V-shaped channels with a specific angle are not easily made with the etching process. This study presents the mechanical machining of microchannels of V-shaped cross section, on cemented carbide (WC-Co). In this study, to reduce tool wear in the process of machining, the micro conical tool was fabricated using polycrystalline diamond (PCD). The tool wear of the conical tool and form accuracy of channels, were investigated during V-shaped microchannel machining.
심대보,임영창,신향애,김진국 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.4
Hereditary angioneurotic edema (HAE) is an autosomal dominant disease that results from the deficiency of C1 esterase inhibitor (C1-INH) function. Urgent proper intervention of the upper airway is warranted to save the life of patients with the disease, which often causes acute airway obstruction. We present, with a review of literature, a case of 37-year old woman with HAE of larynx. (Korean J Otolaryngol 2006;49:464-7)
심대보,송미현,박계천,송창은 대한이비인후과학회 2014 대한이비인후과학회지 두경부외과학 Vol.57 No.8
Pseudo-vestibular neuritis is a central pathology of acute vestibular syndrome, characterized by unidirectional nystagmus mimicking acute peripheral vestibulophaty. We report a 39-year-old female patient who developed cerebellar infarction with isolated vertigo, spontaneous nystagmus, a positive head thrust test, and unilateral canal paresis in the contralesional side. The patient had no vascular risk factors. A diffusion-weighted image of the brain showed infarction of medial branch of posterior inferior and superior cerebellar artery on the left side. A magnetic resonance angiography of neck disclosed a wide range of diffused severe stenosis and narrowing of right and left vertebral arteries, respectively. This case suggests the possibility of vestibular ischemia masking the central pathology in isolated vertigo. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(8):552-5