갑상선유두암에서 전이림프절에 대한 적절한 수술 범위

권현근,이병주 대한갑상선학회 2020 International Journal of Thyroidology Vol.13 No.2

Papillary thyroid cancer (PTC) has a good prognosis, but the frequency of regional lymph node metastasis isreported to be up to 90%. In most patients with PTC, nodal metastasis occurs in a stepwise fashion, withmetastasis beginning in the central cervical compartment, continuing to the ipsilateral cervical compartment. Thereare many controversies about the necessity of prophylactic central neck dissection (CND) and extent of therapeuticCND for lymph node metastasis. Ipsilateral CND with intraoperative frozen biopsy in PTC is a very sensitive anduseful tool for the evaluation of nodal status in the central compartment. The right upper para-esophageal lymphnodes should be removed during dissection in patients with right paratracheal lymph node metastasis. Prophylacticlateral neck dissection (LND) is not recommended, and optimal extent of therapeutic LND is still controversial. Further studies on factors and clinical implications related to suprasternal lymph node metastasis are needed.

Clinical Feature of Patulous Eustachian Tube and Correlation with Nasal Cavity Volume

권현근,고의경,오세준,이일우,공수근 대한이비인후과학회 부산,울산,경남 지부회 2013 임상이비인후과 Vol.24 No.2

Background and Objectives:Patulous Eustachian tube (PET) is are caused by abnormal, non-attenuated sound transmission from the pharynx to the middle ear via an open Eustachian tube (ET). Our objective was to identify the causes, clinical feature, medical treatment of PET and analyze the correlation between nasal cavity volume and PET. Materials and Methods:A retrospective chart review was performed on 100 patients with a diagnosis of PET from March 1, 2010, to July 31, 2011. Anti-cholinergic nasal spray (Ipratropium bromide, RhinoventⓇ) was used as the medical treatment. Acoustic rhinometry and paranasal sinus computed tomography (CT) was prospectively performed to examine the correlation between nasal cavity volume. Results:There were 56 males and 44 females, and overall mean age at diagnosis was 38.9 years. Thirty-three patients had bilateral PET and 67 patients had unilateral PET. 77 patients has no identifiable cause and 17 patients has weight loss. Anti-cholinergic nasal spray treatment (RhinoventⓇ) was carried out on 64 of 100 patients and 34 of the 64 patients (53.1%) achieved an improvement. AR, paranasal sinus CT was revealed no statistically significant correlation between nasal cavity volume and PET. Conclusion:Unilateral PET was found to be twice as common as bilateral PET. Weight loss was found to be the most common cause and autophony to be the most common symptom. Anti-cholinergic nasal sprays can be used appropriately for early treatment. No correlation was found between nasal cavity volume and PET occurrence.

Nano Patterning Functional Polymers Using Nano-imprint Technique

권현근,이규태 한국진공학회 2014 한국진공학회 학술발표회초록집 Vol.2014 No.2

구강건조증

권현근,이진춘,이병주 대한이비인후과학회 부산,울산,경남 지부회 2020 임상이비인후과 Vol.31 No.1

외이도 종물로 발견된 사구종 1예

권현근,박성환,고의경,공수근 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.2

Glomus tumors, also called paragangliomas, originate from nonchromaffin cells. They are slow-growing benign lesions and represent the most common primary neoplasm of the middle ear. It is worth mentioning that the most common symptoms are pulsating tinnitus and hearing loss. Imaging studies (CT and MRI) are necessary for diagnosis. Although most of cases are limited to the middle ear, this article reports a glomus tumor presented with a polypoid mass in the external auditory canal.

재발성 자가유발성 이하선 기종 1예

권현근,김동조,전경명,이병주 대한이비인후과학회 부산,울산,경남 지부회 2017 임상이비인후과 Vol.28 No.2

Pneumoparotid is a rare cause of enlargement of the parotid gland. Recurrent pneumoparotid has been described in patients who generate increased intraoral pressure when playing wind instruments. Self-induced pneumoparotid has been reported to be a result of psychosomatic disorder, unintentional habit, and it is sometimes self-induced by patients to achieve secondary gain. We report a case of recurrent self-induced pneumoparotid developed by repeated behavior of insufflation.

원발성 이하선암종의 예후인자에 관한 고찰

권현근,김성동,박영민,이원용,임윤성,이진춘,왕수건,이병주 대한이비인후과학회 부산,울산,경남 지부회 2013 임상이비인후과 Vol.24 No.1

Background and Objectives:Cancer developing in the parotid gland tends to be large variety of histologic types. The relative rarity of parotid cancer makes epidemiologic study more difficult. To develop a rational therapeutic plan for parotid cancer, the surgeon must be fully cognizant of the factors that may affect survival. The objective of this study was to identify the clinical feature and prognostic factors of parotid cancer. Materials and Methods:The authors retrospectively studied 72 patients with histologically confirmed parotid cancer at Pusan National University Hospital between 1995 and 2011. We analyzed 5-year survival rate according to the some prognostic factors. Results:The overall 5-year survival rate was 82.5%. We observed statistically significant differences for patients of different clinical stages (p=0.009), regional lymph node metastasis (p<0.001), preoperative facial nerve involvement (p=0.001), distant metastasis (p<0.001). There was no statistically significant difference in the tumor size, surgical margin, histologic grade. Superficial parotidectomy may be a safe procedure without po-tential morbidity, such as postoperative facial palsy. Conclusions:Clinical stages, regional lymph node metasta-sis, preoperative facial nerve involvement and distant metastasis are the significant prognostic factors, and these factors need to be considered in the treatment of parotid cancer.

A Case of Mucoepidermoid Carcinoma Mixed with Osteosarcoma of the Parotid Gland Extending to the Parapharyngeal Space

권현근,신성찬,이진춘,이병주 대한이비인후과학회 2019 대한이비인후과학회지 두경부외과학 Vol.62 No.10

Carcinosarcomas, also known as true malignant mixed tumors, are rare tumors of the salivarygland and are composed of both malignant epithelial and malignant mesenchymal elements. They may occur in pre-existing pleomorphic adenomas or arise de novo. Here we report thefirst case of carcinosarcoma of the parotid gland composed of mucoepidermoid carcinoma andosteosarcoma. The tumor had originated from the parotid gland and extended into the parapharyngealspace. To the best of our knowledge, there have been no reports on mucoepidermoidcarcinoma mixed with osteosarcoma ex pleomorphic adenoma in the parotid gland.

Application of an Intraoperative Neuromonitoring System Using a Surface Pressure Sensor in Parotid Surgery: A Rabbit Model Study

성의숙,권현근,신성찬,전영일,이정우,박다희,최성욱,김화빈,박혜진,이진춘,노정훈,이병주 대한이비인후과학회 2021 Clinical and Experimental Otorhinolaryngology Vol.14 No.1

Objectives. Facial nerve monitoring (FNM) can be used to identify the facial nerve, to obtain information regarding its course, and to evaluate its status during parotidectomy. However, there has been disagreement regarding the efficacy of FNM in reducing the incidence of facial nerve palsy during parotid surgery. Therefore, instead of using electromyography (EMG) to identify the location and state of the facial nerve, we applied an intraoperative neuromonitoring (IONM) system using a surface pressure sensor to detect facial muscle twitching. The objective of this study was to investigate the feasibility of using the IONM system with a surface pressure sensor to detect facial muscle twitching during parotidectomy. Methods. We evaluated the stimulus thresholds for the detection of muscle twitching in the orbicularis oris and orbicularis oculi, as well as the amplitude and latency of EMG and the surface pressure sensor in 13 facial nerves of seven rabbits, using the same stimulus intensity. Results. The surface pressure sensor detected muscle twitching in the orbicularis oris and orbicularis oculi in response to a stimulation of 0.1 mA in all 13 facial nerves. The stimulus threshold did not differ between the surface pressure sensor and EMG. Conclusion. The application of IONM using a surface pressure sensor during parotidectomy is noninvasive, reliable, and feasible. Therefore, the IONM system with a surface pressure sensor to measure facial muscle twitching may be an alternative to EMG for verifying the status of the facial nerve.

일차성 부갑상선기능항진증으로 수술적 치료를 받은 환자들에 대한 임상적 고찰

천용일,권현근,정다운,김재욱,김성동,신성찬,안상정,이진춘,이병주,김인주 대한이비인후과학회 부산,울산,경남 지부회 2017 임상이비인후과 Vol.28 No.2

Background and Objectives:To evaluate the accuracy of ultrasound (US), computed tomography (CT) and 99Tc sestamibi scan (MIBI) for preoperative localization of solitary parathyroid mass in patients with primary hyperparathyroidism and analyze our surgical outcomes. Materials and Methods:In a retrospective study of 57 consecutive patients with primary hyperparathyroidism, all patients underwent parathyroidectomy from Jan. 2003 through Dec. 2013. Patients were performed ultrasound, computed tomography and Technetium-99m sestamibi scan before surgery. We also reviewed serum calcium, serum parathyroid hormone (iPTH), associated symptoms and pathologic results through electronic medical records (EMR). Results:All 57 patients were enrolled and they had single solitary parathyroid mass. In final pathologic results, 45 patients had solitary parathyroid adenoma, 7 patients had nodular hyperplasia and 5 patients were diagnosed as parathyroid cancer. In adenoma and carcinoma as a single nodule, accuracy of US was 95.2% (40/42), CT was 91.7% (44/48), MIBI was 81.5% (31/38). The most common symptoms were general weakness and nausea. Interestingly, asymptomatic hypercalcemia, incidentaloma were over the half patients. Postoperative numbness was observed in 4 patients and they were treated with calcium supplementation but not persisted longer than 4th day postoperatively. Conclusions:Our results show that the combination of US, CT, MIBI has benefits for preoperative localization of parathyroid mass in primary hyperparathyroidism and parathyroidectomy was useful for patients with primary hyperparathyroidism.