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김주현,박재홍 대한이비인후과학회 2021 대한이비인후과학회지 두경부외과학 Vol.64 No.4
Lymph node metastasis is the single, most powerful prognostic factor in head and neck squamouscell cancer, which means that cervical lymph node management should be consideredeven in treatment of a clinically node-negative neck. More conservative and selective techniquesof neck dissection have been developed ever since radical neck dissection was first introduced. Despite that selective neck dissection provides less functional damage, disfiguringscar after neck dissection still remains inevitable. Recently, surgical endoscopy and roboticsystem was introduced and many clinical trials for aesthetic approach for neck dissection usingendoscopy have shown their feasibility and safety. Hereby, we describe the preparationand surgical procedure for endoscopic selective neck dissection (level I, II, and III) via retroauricularapproach for 41-year-old male patient with clinically node-negative oral tongue cancer.
정상인에서 외안근 전정유발근전위의 특성: 경부 전정유발근전위와의 비교 연구
고일주,홍성광,장은석,이효정,김형종 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.12
Background and Objectives While vestibular evoked myogenic potentials (VEMPs) can be measured from extra-ocular muscle as well as cervical muscle, there are uncertainties about the patterns and discomfort level of ocular vestibular evoked myogenic potentials (oVEMPs). This study is to identify the properties of oVEMPs parameters and degree of subjective discomfort when compared to cervical vestibular evoked myogenic potentials (cVEMPs) in healthy subjects. Subjects and Method Twenty volunteers with normal hearing were enrolled in this study. The oVEMPs were recorded from electrodes placed beneath the eyes using ipsilateral and contralateral acoustic stimulation with 500 Hz short tone bursts with subjects in sitting position and maximal upward gaze. The cVEMPs were measured using 500 Hz short tone bursts with subject in supine position and their head elevated and turned away from the test side. The latency, interlatency and interamplitude of oVEMPs responses were compared to those of cVEMPs. The subjective discomfort levels of oVEMPs and cVEMPs were compared using a questionnaire survey. Results The cVEMPs appeared as positive-negative biphasic responses in all 40 ears whereas oVEMPs were measured in 27 ears (67.5%) with ipsilateral stimulation and 20 ears (85%) with contralateral stimulation which appeared as negative-positive biphasic responses. The oVEMPs had smaller amplitude than the cVEMPs. The oVEMPs thresholds tended to have higher level than the cVEMPs thresholds. The 18 subjects (90%) reported that the discomfort level of oVEMPs measurement was lower or equal to that of cVEMPs measurement. Conclusion oVEMPs test may be used as a complementary and comfortable diagnostic tool for evaluating the integrity of vestibular-ocular system.
인후두 역류질환에서 24시간 이중 탐침 산도 검사와 Reflux Finding Score, Reflux Symptom Index의 연관성
오재호,지용배,송창면,정진혁,진봉준,태경 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.11
Background and Objectives A 24-hour ambulatory dual probe for pH monitoring is the most specific and sensitive test for laryngopharyngeal reflux (LPR) disease. However, the use of this probe is not well tolerated in some patients due to discomfort and the invasive nature of the procedure. Thus, the diagnosis of LPR is usually made according to symptomatic responses to empirical treatment using a proton-pump inhibitor for patients with high score of reflux symptom index (RSI) and reflux finding score (RFS). The aim of this study is to evaluate the relationship between the RSI and RFS and pH monitoring using a 24-hour ambulatory dual probe, and determine the role of RSI and RFS in the diagnosis of LPR. Subjects and Method We studied 100 patients who underwent pH monitoring using a 24-hour dual probe because of laryngopharyngeal reflux related symptoms or laryngoscopic findings. The various parameters of the 24-hour dual probe pH monitoring were compared with the scores of RSI and RFS. Results In 24-hour dual probe pH monitoring, 64 of 100 patients tested positive for LPR. The mean of RSI score was significantly higher in the positive LPR group than in the negative group. However, RFS did not differ between the two groups. RSI scores were significantly associated with the reflux number in the upright position of the 24-hour dual probe pH monitoring. There was no correlation between RFS and the parameters of the 24-hour dual probe pH monitoring. Conclusion RSI can be a reliable diagnostic tool for laryngopharyngeal reflux disease instead of the 24-hour ambulatory dual probe pH monitoring.
최윤석,송시연,김용대,배창훈 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.11
Scrub typhus is an infectious disease caused by Rickettsia tsutsugamushi, and is an acute febrile illness characterized by fever, rash, and myalgia. The complications of scrub typhus are meningitis, acute renal failure, interstitial pneumonia and myocarditis. However, hearing loss as a complication of scrub typhus is very rare. The mechanism of hearing loss in scrub typhus has not yet been explained. We present a case of scrub typhus with bilateral sudden hearing loss.
정용기 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.11
The correction of deviated nose is the most challenging step among various procedures of rhinoplasty. Many effective surgical methods for correction of bony and cartilaginous deviation have been developed since the beginning of rhinoplasty, however it is not easy to choose appropriate surgical method for each patients. Surgical procedure should be personalized depending on patients’ characteristics of nasal framework and covering skin, therefore same method cannot be applied to all patients. Size, strength and thickness of bony and cartilaginous structure, thickness of skin, existence of nasal hump are the essential components which should be considered. Surgical method for correction of deviated nose cannot be applied uniformly to patients, and should be tailored to individual patient. For this reason, rhinoplasty surgeon should be skilled at various techniques of corrective rhinoplasty.
영상유도수술법을 이용한 만성 중이염 수술에서의 후고실개방술 1예
강민영,정성욱,윤시원,강명구 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.11
Posterior tympanotomy is a procedure performed to access the posterior mesotympanum th-rough a mastoid exposure while preserving the posterior external auditory canal wall. It is dangereous to drill the the site of procedure, as it is surrounded by incuidal fossa superiorly, facial nerve posteriomedially, and chorda tympani nerve anterolaterally, and forms a very narrow pa-thway. There is always a risk of surgical trauma involving important surgical structures, especially facial nerve and chorda tympani nerve. The development of image-guided surgery (IGS) has significantly improved the performance of many surgical procedures by aiding the identification of surgical landmarks, improving surgical outcomes, rendering the procedure safer and more efficient, especially for beginner otologic surgery, in revision operations, in cases of massive bleeding and tumor of complex anatomy. To see how IGS could help otologic surgeons to identify fine, important structures during posterior tympanotomy, we report a case of posterior tympanotomy in chronic otitis media, which was done using the image-guided surgical technique.