경추성 어지럼증의 진단과 치료

김주영,김위황,이장수,오현명,김대웅,최동진 대한이비인후과학회 2015 대한이비인후과학회지 두경부외과학 Vol.58 No.3

Background and Objectives Vertigo is an illusion of environmental movement due to various causes, thus it is hard for medical doctors to determine the exact kind of dizziness in the final diagnosis. Recently, cervical vertigo was reported from several vertigo cases. Cervical vertigo is defined as sensation of rotation, resulting from an alteration of the neck proprioceptive afferents of the upper cervical spine. The aim of our study is to document the clinical features and the treatment outcomes in vertigo patients with myofascial pain syndrome (MPS). Subjects and Method A total of 488 patients, excluding 18 patients who received other diagnosis, were examined to investigate the reasons for dizziness. We evaluated 34 patients, who were diagnosed with cervical vertigo by questionnaire after MPS treatments. Clinical evaluations for cervical vertigo were performed on all subjects, and vestibular function tests were also performed in patients with vertigo symptoms. All patients received a total of 4 treatments including trigger point injection, physical therapy or medication, and then followed up, respectively. The symptom changes of dizziness, patient satisfaction and cervical pain were checked before and treatment 1, 2, 4 times by Visual Analogue Scale (VAS) score. Results There were significant improvement in the VAS score of dizziness, patient satisfaction and cervical pain after treatment for MPS. Conclusion Treatment for MPS could improve dizziness in cervical vertigo with MPS patients, but further study is needed to clearly confirm the cervical vertigo with MPS for improving patient’s quality of life.

진행성 핵상 마비 환자에서 발생한 양측성대마비 1예

백홍인,김위황,오기준,최동진 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.1

Bilateral vocal cord paralysis generally arises from trauma, tumor compression of the recurrent laryngeal nerves, surgery on neck and neurological diseases. Progressive supranuclear palsy is a rare degenerative disease showing supranuclear ophthalnoplegia, rigidity, bradykinesia, dysarthria and dementia. Bilateral vocal cord paralysis in patients with progressive supranuclear palsy can be found only in a few cases reported in literature. The finding of bilateral vocal cord paralysis is important because it can be life threatening. We managed a patient with the laterofixation of vocal cord for preventing respiratory failure due to glottic airway compromise. We report this case with a review of literature. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:102-4)

협부에 발생한 다형성 선종 치험 1예

손원상,박병철,김위황,최동진 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.8

Pleomorphic adenoma are benign neoplasms that typicaly occur in the major salivary glands. Uncommonly, they arise in minor salivary glands, which account for only 10% of all reported salivary gland pleomorphic adenomas. Minor salivary gland tumors , lips and gingiva are rare sites of occurrence. We experienced a case of a 68-year-old woman who presented a 45-years history of a left chek mas. The pathologic diagnosis was pleomorphic adenoma. We removed the mas intraoraly and obtained good postoperative results. We report this case with a review of literature. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 : 719-22)

급성 접형동염에 의해 속발한 중두개와 경막외농양 치험 1예

유진,김남걸,김위황,손원상 대한비과학회 2006 Journal of rhinology Vol.13 No.1

Acute or chronic sinusitis is common disease of ENT. Most cases usually respond to appropriate treatment; however, some cases occasionally progress to the development of serious complication and poor prognosis. The orbital complications are most common complication fallowed by intracranial complications. The incidence of sinogenic intracranial complications is about 3.7-11.0% and these complications are progressively decreasing however the complications occur due to incorrect use of antibiotics, antibiotics resistant pathogens, decreasing host immunity, improper diagnosis and delayed surgical treatment. Therefore the case of epidural abscess in anterior portion of middle cranial fossa secondary to acute sphenoid sinusitis, which was treated with transnasal endoscopic sphenoidotomy and intravenous antibiotics, is being reported.

일측 중비갑개에 발생한 해면상혈관종 치험 1예

한기훈,김남걸,김위황,손원상 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.7

Hemangiomas are common benign soft tissue tumors in the head and neck, but they occur infrequently in the sinonasal cavity. Most of nasal hemangiomas arise from the nasal septum or vestibule and are of capillary type. Only a few arise from the lateral wall of the nose, and these usually are cavernous. Chief symptoms are recurrent epistaxis and nasal obstruction;if the tumor becomes large, it may cause adjacent bony erosion. Cavernous hemangioma shows essentially little tendency to regress, and in adults, it is more common than capillary hemangioma. Consequently, the majority of cavernous hemangiomas require surgery in contrast to their capillary counterparts. We report a case of cavernous hemangioma of middle turbinate in an adult female, together with a review of the literature.

내시경 절제로 치료한 하인두 측벽에 발생한 신경초종 1예

유진,박병철,김위황,손원상 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.3

Neurilemoma is a relatively rare benign tumor originating from the Schwann cells of all nerve fibers outside the central ner-- 40% of neurilemmoma occurs in the head and neck region and the acoustic nerve is most frequently involved. But the tumor rarely affect the hypopharynx. In this paper, authors report a case of neurilemmoma of the lateral wall of the hypopharynx in a 61-year old female patient. The tumor was sucesfully removed via endoscopic approach. So, we report the case with literature.

소아에서 발생한 국한성 Wegener’s Granulomatosis 1예

오기준,박병철,김위황,한기훈 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.10

Wegeners granulomatosis is an uncomon idiopathic, multisystem disease characterized by necotizing granuloma and vasculitis affecting small to medium sized vessels. It is classified into a classic form and a limited (localized) form based on the anatomic ecently, it has been made possible for the diagnosis of this disease to be carried out in an earlier stage by measurement of the ANCA (Antineutrophil cytoplasmic antibodies) and the result of treatment has improved since cyclophosphamide therapy. Wegeners granulomatosis in children has been extremely rare. The authors have observed 1 case of limited form of granulomatosis in a 12 year-old female child and report this with a literature review. (Korean J Otolaryngol 2002;45: )

후두 미세수술 중 미주신경 반사에 의해 발생한 심각한 서맥 1예

최동진,박병철,김위황,이장수 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.4

Laryngeal microsurgery has been used popularly for phonosurgery. Sometimes, this procedure is complicated by cardiovascular changes due to insertion of laryngosope. Tachycardia and elevation of blood pressure are common but bradycardia induced by vagal reflex is very rare. The authors report the case of severe bradycardia induced by vagal reflex experienced during laryngeal microsurgery with a review of the literature.

폐쇄성 수면무호흡증후군 수술 후 잔존 증상이 남아 있는 환자에서 코 수술이 증상 호전에 미치는 영향

김대웅,김남국,김위황,이장수,최동진 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.8

Background and Objectives Obstructive sleep apnea syndrome is one type of sleep disorder breathing. During sleep, in respiration, nasal obstruction causes negative pressure, which in turn causes the pharyngeal airway to collapse during inspiration. We investigated how nasal surgery affects patients who have undergone OSA surgery but still suffer from the remaining symptoms of snoring and sleep disorder breathing. Subjects and Method We reviewed 24 patients, who had undergone obstructive sleep apnea (OSA) surgery only to show no enhancement in snoring and qualities of sleep; they showed nasal septal deviation or inferior turbinate hypertrophy. Septal surgery or inferior turbinoplasty was performed by the same otolaryngologist. Over the period between preoperation and 1, 3, 6, 12 months after operation, we evaluated Apnea-Hypopnea Index (AHI) and oxygen saturation by polysomnography, degree of snoring by Visual Analogue Sacle (VAS) score, satisfaction for quality of sleep by Epworth Sleepiness Scale (ESS), minimal cross section area and volume of nasal cavity by acoustic rhinometry, respectively. Results After nasal surgery, the volume of nasal cavity and MCA increased. There were significant improvements of AHI, oxygen saturation, VAS and ESS score. Conclusion As for OSA surgery, the evaluation of nasal cavity is an indispensible factor for improving the quality of sleep and snoring. When treating OSA patients who have nasal obstruction, nasal surgery including septoplasty and inferior turbinoplasty should be considered. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(8):588-92

후반고리관 양성돌발두위현훈 환자에서 이석치환술 후 잔존하는 어지럼에 대한 DizzyFIX의 효용성

김남국,이장수,오현명,김주영,김위황 대한평형의학회 2013 Research in Vestibular Science Vol.12 No.3

Background and Objectives: Benign paroxysmal positional vertigo (BPPV) is one of the critical life events that can affect physical, emotional, and functional aspects of quality of life. Canalith repositioning procedure (CRP) provides rapid and long lasting relief of symptoms in most patients with BPPV. However, some patients express nonspecific symptoms such as anxiety or discomfort after treatment, The purpose of this study was to assess the residual symptoms after CRP in patients with BPPV using Dizziness Handicap Inventory (DHI) in a questionnaire format and to evaluate the therapeutic efficacy of CRP according to accompanying the DizzyFIX device. Materials and Methods: We performed a prospective investigation in 135 consecutive patients with confirmed posterior semicircular canal BPPV. CRP was performed until nystagmus and vertigo disappeared. Patients were divided into three group using the DizzyFIX (group A), not using the DizzyFIX (group B) and closed observation (group C) after treatment. Then patients were asked to complete the questionnaire for Korean form DHI before treatment, 1, 2, 3, 4, 8 week after treatment. Results: There was a significant improvement in DHI scores when comparing the pre CRP and post CRP three groups (p<0.05), although emotional items showed incomplete improvement at 1 week. But at 2 week after treatment, there were statistically significant differences between group A and other groups in DHI scores specially in emotional items. Conclusion: Even after successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms may remain. For these patients additional follow up and management are necessary and using of the DizzyFIX will be helpful to reduce the incidence of residual dizziness especially emotional aspect.