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수면호흡장애 환자에서 구강호흡이 상기도 해부학적 구조에 미치는 영향
최지호,이승훈,전영준,오정인,정종윤,황규호,염건휘,김강우,김연수,권순영 대한비과학회 2012 Journal of rhinology Vol.19 No.1
Background and Objectives :The purpose of this study was to evaluate the impact of open-mouth breathing on the upper airway anatomy of patients with sleep-disordered breathing (SDB) based on polysomnography.Materials and Methods : A total of 114 subjects (101 males and 13 females) with a mean age of 42.7 years and a mean body mass index (kg/m2) of 26.2 were enrolled in this study. All subjects were divided into four groups (simple snoring, mild obstructive sleep apnea syndrome[OSAS], moderate OSAS and severeOSAS) according to the apnea-hypopnea index. Lateral cephalometric radiograms (retropalatal, retroglossal, and hypopharyngeal distance, and pharyngeal length) were taken with the mouth closed and open. Results : The lateral cephalometric variables were compared between the mouth closed and open positions, and it was found that the retropalatal and retroglossal distances and pharyngeal length were significantly changed in all groups. However, the hypopharyngeal distance did not change significantly in any of the groups. Conclusion : Open-mouth breathing significantly reduces the retropalatal and retroglossal distance and lengthens the pharynx in patients with SDB. Since these anatomical changes may worsen SDB or decrease positive airway pressure treatment compliance, ENT doctors should attempt to convert SDB patients from open-mouth breathing to nasal breathing.
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최지호,이흥만,권순영,이상학,신철,이승훈,Choi, Ji-Ho,Lee, Heung-Man,Kwon, Soon-Young,Lee, Sang-Hag,Shin, Chol,Lee, Seung-Hoon 대한수면의학회 2005 수면·정신생리 Vol.12 No.1
Obstructive sleep apnea syndrome(OSAS) is a common disease in the field of otorhinolaryngology and is characterized by repeated upper airway occlusions occurring during sleep. OSAS can occur due to various etiologies of the nasal, oral, pharyngeal and laryngeal airway in adults. Nasal obstruction can be caused by septal deviation, nasal polyps, concha bullosa, choanal atresia, neoplasms, foreign body, postoperative/post-traumatic synechiae, various rhinitis and so on. There are various kinds of surgical treatment of OSAS including nasal surgery, LAUP, UPPP, surgery of tongue base, tracheostomy and so on, but the effect of nasal surgery on snoring and OSAS is controversial. The authors report the case of a patient who had experienced nasal obstruction, moderate snoring and OSAS and who improved after septoplasty and turbinoplasty.
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최지호,Jong Kyu Lee,Seok Hyun Cho 대한수면학회 2018 sleep medicine research Vol.9 No.1
Sleep-disordered breathing (SDB) is characterized by the intermittent narrowing or collapse of the upper airway, including the nasal cavity, pharynx, and larynx during sleep. Nasal obstruction is one of the most frequent presenting symptoms in SDB patients, and therefore, medical treatments such as saline nasal irrigation, antihistamine, and topical nasal spray are the first recommendation. If the issue is not resolved, surgical treatments for nasal congestion are helpful in order to alleviate nasal obstruction, reduce snoring, and improve positive airway pressure compliance. Inferior turbinate surgery is one of the most commonly performed nasal surgeries (e.g., endoscopic sinus surgery, septoplasty, etc) used to improve nasal obstruction. There are various inferior turbinate surgical methods including electrocautery, laser-assisted turbinoplasty, radiofrequency-assisted turbinoplasty, outfracture, submucous turbinoplasty, partial turbinectomy, and microdebrider-assisted turbinoplasty. Despite the development of these numerous approaches, no clear guidelines exist as yet to help determine the most appropriate modality for any individual patient. This is due to variation in pathophysiology and the degree and extent of the turbinate hypertrophy between patients. Consequently, a comprehensive understanding of these techniques, as well as the preservative concept of functional nasal physiology, is critically important for all surgeons. We propose that the ideal inferior turbinate surgery would meet the following criteria: 1) be less invasive, 2) incorporate remodeling rather than excessive resection, 3) entail a submucosal versus superficial mucosal technique, 4) represent an individually selected technique that is best suited to the patient, and 5) address long term considerations rather than acute symptomatic relief.
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최지호,이은상,이승재,정민정 대한비과학회 2019 Journal of rhinology Vol.26 No.2
Epithelial-myoepithelial carcinoma (EMC) is a rare and low-grade malignant salivary gland tumor including epithelial and myoepithelialcomponents. EMC frequently arises in the parotid gland but infrequently originates from the salivary glands of the nasalcavity. Here, we report the case of an EMC arising from the inferior turbinate, one of the most uncommon sites. A 60-year-oldfemale patient presented with left nasal obstruction for several months, and PNS CT showed an about 4×1.4-cm-sized heterogeneouslyenhancing polypoid mass originating from the inferior turbinate of the left nasal cavity. After surgical treatment, the patientwas diagnosed with EMC based on pathologic examinations including histopathological and immunohistochemical tests. We report a case of a patient with EMC in the inferior turbinate who was observed over 18 months without radiation therapy aftersuccessful wide excision.
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