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Treatment of Paranasal Sinus Indolent Mucormycosis
김용완,강명주,이여명,박성국 대한이비인후과학회 부산,울산,경남 지부회 2022 임상이비인후과 Vol.33 No.1
Background and Objectives: Mucormycosis of the nasal cavity and paranasal sinuses is a rare but highly aggressive especially in patients with diabetes or immunosuppressed patients. However, chronic non invastive type of mucormycosis can be observed in immunocompetent patients. In this study, we investigated indolent mucormycosis cases and assessed the clinical and radiological outcomes of indolent mucormycosis of paranasal sinus in healthy patients treated by endoscopic sinus surgery (ESS) alone. Materials and Methods: A retrospective chart analysis of 9 patients with the diagnosis of indolent mucormycosis of paranasal sinus and treated by ESS between 2007 and 2017 was performed. The data were collected from the medical records: age, sex, clinical presentations, pre- and postoperative endoscopic findings, underyling diseases, pathology, pre- and postoperative radiological findings. Radiologic images were reviewd to assess the involved side and sinus, bony sinus wall changes. Results: The histopathologic findings revealed mucormycosis with broad, non-septated, right-angled hyphae. Although the diagnosis of mucormycosis, the patients were not any antifungal agents after surgery. There was no disease progression and recurrence. Conclusion: In the case of paranasal sinus mucormycosis, ESS alone is thought to be sufficient to the treatment for indolent cases in immunocompetent patients without evidence of preoperative computed tomography and endoscopic findings of invasion and antifungal treatment may not be necessary.
갑상선 미세유두상암에서 중심경부림프절 전이의 관련인자와 양상
김용완,왕수건,이진춘,이병주,이진우,김용기,김인주,손석만 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.3
Background and Objectives:Despite the overall excellent prognosis for patients with thyroid papillary microcarcinoma (PMC), PMC is associated with central compartment lymph node metastasis. The aim of this study is to evaluate the effect of clinical and pathological factors affecting the central compartment lymph node metastasis in thyroid PMC. Subjects and Method:We undertook a retrospective study of 161 patients treated between January, 2003 and June, 2007 for papillary thyroid microcarcinoma by total thyroidectomy and central compartment neck dissection (n=161) with or without comprehensive lateral neck dissection. Following factors were included to analyze the relationship of tumor size and central compartment lymph node metastasis; sex, age, extracapsular extension, lymphovascular tumor emboli, multifocality, bilaterality, AMES risk group, lateral cervical lymph node involvement. Results:In 109 of 161 patients (67.7%), tumor size between 5-10 mm was significantly related with extracapsular extension (p=0.027) and also with the AMES high risk group (p=0.007). In 75 of 161 patients (46.6%), central compartment lymph node metastasis were found. By univariate analysis, tumor multifocality, bilaterality, and lateral lymph node involvement were related with central compartment lymph node metastasis. But on multivariate analysis, tumor bilaterality (p=0.008) and lateral lymph node involvement (p=0.018) were significantly related with central compartment lymph node metastasis. Conclusion:Prophylactic neck dissection of central compartment lymph nodes in PMC should be recommended as a routine procedure particularly for patients with tumor bilaterality and metastatic lymph nodes in the lateral neck.