중두개와 접근법을 이용하여 재수술로 안면신경 및 청력 기능보존을 시행한 청신경종양1예

양원선,변형권,강재정,이원상 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.2

The aim of surgery for vestibular schwannoma is to accomplish complete tumor removal while preserving facial function and hearing ability. The middle cranial fossa approach represents one such surgical approach for resection of vestibular schwannoma with hearing preservation. As more experience has been gained with this approach, hearing preservation rates have increased. However, even if gross tumor removal is done completely, residual tumor can show regrowth microscopically. Such residual vestibular schwannoma may be treated by different options. We present a case of residual vestibular schwannoma treated with revision middle cranial fossa approach to preserve facial function and hearing ability. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:174-7)

아크릴릭 레진계 골시멘트의 기준규격 개발연구

양원선,조은정,신채민,오현주,노혜원,백성인,김민아,정정자,유규하,오현진,조양하 한국생체재료학회 2009 생체재료학회지 Vol.13 No.4

Acrylic resin bone cement is designed to fix artificial joints and implants onto bones. As such, bone cement functions to fill spaces between an implant and a bone, evenly disperse the pressure on the implant across the bone, and deliver antibiotics. This study surveyed the use status and development trends of acrylic resin bone cement and researched into various standards and literature in an effort to induce standard criteria for acrylic resin bone cement. Bone cement consists of powder and liquid; powder contains PMMA, polymerization initiators, and radiopaquer materials, and the liquid consist mainly of MMA monomers. Bone cement polymerization constitutes exothermic reaction, and the physical and mechanical properties of bone cement change according to polymerization conditions. Bone cement aims to couple implants with bones, but in the case of acrylic resin bone cement, tissue necrosis problems are being raised in association with not only such osteoconduction but also exothermic reaction; thus various research institutes are recently striving to develop diverse bioactive materials-based products in a bid to maintain the strength of bone cement and boost the adhesion of cement and bone. These products are producing good results with animal experiments, but, compared with existing PMMA products, they offer inconsistent manipulation and physical properties, and other problems such as unconfirmed internal side effects. A survey of bone cement standards in various nations indicated that there are such standards as ISO, ASTM, FDA Guidance and KS; ISO, ASTM, and KS offer similar test methods and test standards, while the FDA Guidance offers various methods designed to analyze physical, chemical and mechanical properties of bone cement. With an analysis of these standards, this study tested bone cement's compressive strength, bending strength, bending modulus, maximum temperature, and setting time by conducting physical and mechanical tests of bone cement. An extractable test was also conducted through chemical tests. In addition, for the verification of biological safety, pyrogen test, intracutaneous test, and acute toxicity test were conducted. Various test methods specified in each standard thus were verified, and finally the bone cement standards were determined. The suggested standards for bone cement offer results of the test of acrylic resin bone cement's physiochemical and mechanical properties, and biological safety, and the research findings are intended to lend themselves to the public notification of medical device standards in an effort to be used in reviewing technical files.

양성발작성체위성현훈 환자에서 구형낭의 평가

양원선,심대보,이원상 대한평형의학회 2008 Research in Vestibular Science Vol.7 No.1

Objectives: To investigate the vestibular evoked myogenic potentials (VEMP) results in benign paroxysmal positional vertigo (BPPV) patients and to verify its clinical applications in BPPV. Subjects and Methods: Forty-one patients with diagnosis of BPPV and 92 healthy volunteers who underwent VEMP testing. Patients were treated by canalith repositioning maneuvers according to the affected canal, and testing of VEMP was performed at diagnosis and after treatment. Results: VEMP results of BPPV patients showed prolonged p13 and n23 latencies compared with those of the control group, and we could not find any significant difference in VEMP latencies between patients with posterior and horizontal canal type of BPPV. The number of times that the maneuver was repeated did not correlate with the degree of latency prolongation, but in the “no response” group, the number of times was considerably greater than those in the “response” group. Conclusions: We found that VEMP latencies are increased in BPPV patients, which may signify neuronal degenerative changes in the macula of the saccule. When an extensive neuronal damage was suspected by VEMP results such as “no response” in VEMP, the disease progress showed a chronic and resistive course. Therefore, we propose that VEMP could be a useful method to determine a clinical prognosis of patients with BPPV. Objectives: To investigate the vestibular evoked myogenic potentials (VEMP) results in benign paroxysmal positional vertigo (BPPV) patients and to verify its clinical applications in BPPV. Subjects and Methods: Forty-one patients with diagnosis of BPPV and 92 healthy volunteers who underwent VEMP testing. Patients were treated by canalith repositioning maneuvers according to the affected canal, and testing of VEMP was performed at diagnosis and after treatment. Results: VEMP results of BPPV patients showed prolonged p13 and n23 latencies compared with those of the control group, and we could not find any significant difference in VEMP latencies between patients with posterior and horizontal canal type of BPPV. The number of times that the maneuver was repeated did not correlate with the degree of latency prolongation, but in the “no response” group, the number of times was considerably greater than those in the “response” group. Conclusions: We found that VEMP latencies are increased in BPPV patients, which may signify neuronal degenerative changes in the macula of the saccule. When an extensive neuronal damage was suspected by VEMP results such as “no response” in VEMP, the disease progress showed a chronic and resistive course. Therefore, we propose that VEMP could be a useful method to determine a clinical prognosis of patients with BPPV.

급격한 전신 전이 양상을 보인 편도에 발생한 소세포암종 1예

양원선,박영민,정현필,김세헌 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.9

Small cell carcinoma is a highly malignant tumor that is most commonly of bronchogenic origin and well recognized for its aggressive clinical behavior. Extrapulmonary small cell carcinoma is rare, accounting for 2-5% of all small cell carcinomas, and the head and neck origin of small cell carcinoma is especially uncommon. Small cell carcinomas arising in the head and neck have been reported to date in larynx, salivary glands, palate, base of tongue, sinonasal tract, and tonsil. Only a few cases of small cell carcinoma of the tonsil have been reported worldwide, and it is the first case to be reported here in Korea. With the report of this case, we suggest that systemic chemotherapy should be considered for all patients with small cell carcinoma in tonsil because of its high incidence of extensive local invasion and metastasis. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:825-8)

Plant 소음의 실용적 예측기법

양원선 한국소음진동공학회 2009 한국소음진동공학회 강습회 Vol.2009 No.3

군용 비행장 주변의 항공소음 평가

양원선(Won-Seon Yang),박상규(Sang-Kyu Park),김동욱(Dong-Wook Kim) 한국소음진동공학회 1999 한국소음진동공학회 학술대회논문집 Vol.1999 No.6

갑상선 유두상암의 후인두림프절 전이 2예

박영민,양원선,최은창,홍현준 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.1

Thyroid papillary carcinoma shows 40% of the lymph node metastasis rate, but metastasis to retropharyngeal lymph node is known to be rare. Patients underwent operation via transcervical approach due to retropharyngeal lymph node metastasis of thyroid papillary carcinoma mimicking paraganglioma. Even though retropharyngeal lymph node metastasis is rare, it could go unnoticed with only history taking and physical examination of thyroid papillary carcinoma patients, especially since cervical ultrasonography is not a sufficient modality for the evaluation of retropharyngeal lymph node. Imaging studies such as MRI or CT scan is required to evaluate retropharyngeal lymph nodes.

사차원 엔지니어링(주)를 찾아서

최승복,양원선 한국소음진동공학회 2005 소음 진동 Vol.15 No.5

내이도 아령모양 안면신경 신경초종 1예

전주현,양원선,문인석,이원상 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.10

Schwannoma is a benign neoplasm of the nerve sheath and is the most common neoplasm of the internal auditory canal (IAC) and cerebellopontine angle. A dumbbell-shaped schwannoma is defined as a mass with two bulbous segments, one in the IAC fundus and the other in the membranous labyrinth of the inner ear or the geniculate ganglion of the facial nerve connected to labyrinth segment. This kind of schwannoma should not be missed because it can affect the type of surgery and so the prognosis of the patient. We present one case of dumbbell-shaped facial nerve schwannoma which was completely excised without any complication. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:921-4)

조직학적 확진이 된 이경화증에서의 인공와우 이식술 1예

박세라,양원선,최재영 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.11

Otosclerosis is a localized disorder of bone metabolism involving the endochondral bone of the otic and labyrinthine capsule. Both “advanced” and “very advanced” otosclerosis refer to the state of otosclerotic involvement of the otic capsule, which has progressed to result in profound deafness with undetectable bone and air conduction thresholds. Shea et al. estimated that 1.6% of patients with otosclerosis had developed profound hearing losses, and that hearing improvements after stapes surgeries in these patients were lower than the case of “not-advanced” otosclerosis. Stapedectomy and hearing aid amplification could be tried, but cochlear implantation is an established intervention for patients with profound sensorineural hearing loss due to otosclerosis. Although the reported results of cochlear implantations in otosclerosis patients are not significantly different from those of other cochlear implantees not affected by otosclerosis, in former conditions, potential ossification of cochlea, facial nerve stimulation, and instability of the results might take place. We report a case of otosclerosis histologically diagnosed for the first time here in Korea, and for which cochlear implantation was successfully performed.