내시경 보조하에 제거한 추체 첨부의 콜레스테롤 육아종 1예

나지나,배소희,이전미,문인석 대한이비인후과학회 2019 대한이비인후과학회지 두경부외과학 Vol.62 No.1

A cholesterol granuloma is the most common primary lesion of the petrous apex, and accountsfor 40% of the pathologies that arise in this region. The primary treatment for symptomatic lesionsis by surgery to decompress and drain or to completely remove the lesion. Here we describethe use of infralabyrinthine approach to access a lesion through the temporal bone andcompletely remove it with the assistance of a 0-degree endoscope. A 43-year-old man visitedour clinic for diplopia. Magnetic resonance imaging revealed a 2.3-cm cholesterol granulomalocated in the left petrous apex that caused deviation of the left abducens nerve. The tumor wascompletely removed using the endoscopic-assisted infralabyrinthine approach; the patient iscurrently being followed up, and there is no evidence of disease recurrence. This case report describesthe successful completion of a petrous apex cholesterol granuloma that preserved thecochlear and vestibular systems.

유전성 난청의 진단과 치료

나지나,정진세 대한이비인후과학회 부산,울산,경남 지부회 2021 임상이비인후과 Vol.32 No.1

Sensorineural hearing loss (SNHL) is the most common sensory disorder in humans. A wide range of genetic and environmental factors that can cause congenital or late-onset, stable or progressive, age-related, drug-related, noise-causing, post-infection, or traumatic hearing loss leads to the SNHL. More and more comprehensive genetic studies have recently been published in patients with hearing loss in the era of target genome and massively parallel sequencing. Although rehabilitation options, to date, typically have focused on amplification with wearables or implantable devices, intriguing new gene therapy-based strategies to restore and prevent SNHL are actively being investigated using an animal model. Correcting or preventing an underlying genetic cause of hearing loss is ready to become a reality. In this article, several methods for diagnosis and treatment strategies for hereditary hearing loss in progress to date are introduced.

내시경 두개저 수술의 최신 지견

나지나(Gina Na),문인석(In Seok Moon) 대한두개저학회 2019 대한두개저학회지 Vol.14 No.1

The start of neurotologic surgery using endoscope dates back to the 1960s, but there has been much debates as to whether or not to replace operative microscope. Therefore, endoscope has been mainly used for diagnostic purposes for a while. Recently, with the increasing interest in minimally invasive surgery, various surgical procedures have been tried in the field of neurotology and their success has been reported. In this review, cases of vestibular schwannoma, facial nerve decompression, glomus tumor, petrous apex cholesterol granuloma, venous malformations of the facial nerve, and perilymph fistula are summarized.

결혼 해체를 경험한 베이비부머 여성의 경제적 노후 준비 여부에 관한 연구

나지나 ( Na Gi Na ),백승애 ( Baek Seung Ae ),신은경 ( Shin Eun-kyoung ),김미혜 ( Kim Mee-hye ) 한국보건사회연구원 2010 保健社會硏究 Vol.30 No.2

본 연구는 노후준비를 통한 여성노인의 빈곤화를 예방하고자, 현재 결혼해체를 경험한 무배우자 베이비부머 여성의 노후준비의 현황과 이들의 노후준비 여부에 어떠한 변수들이 영향을 미치는지를 살펴보았다. 2007년 여성가족패널 1차년 자료를 이용하였으며 독립변인을 소인특성변수와 가용자원변수, 필요변수로 구분하였고 노후준비여부를 종속변수로 하여 로지스틱 회귀분석을 하였다. 주요 결과는 첫째, 결혼해체 유형 중이혼이 가장 높은 비율이었고, 다음으로 사별, 별거 순이었다. 학력은 고졸이 가장 많았으며 주거형태는 월세, 자가, 전세 순이었고 취업 한 경우가 66%를 차지하였다. 둘째, 결혼해체경험 여성들의 23.4%만이 경제적 노후 준비를 하고 있는 것으로 나타났다. 셋째, 교육수준과 월평균가구소득이 높을수록, 그리고 주택을 소유한 경우에 경제적 노후 준비를 할 가능성이 높았다. 노후경제상황에 대한 걱정은 경제적 노후 준비에 있어서 부정적인 영향을 미치는 것으로 나타났다. 이러한 결과를 바탕으로 정책적 제언을 제시하였다. The purpose of this study is to examine their determinants affecting the economic preparation for aging of Korea women in marital dissolution among baby boomers. Data of this study were drawn from the 2007 Korean Longitudinal Survey of Women and Families and the total number of subjects were 238 women widows or in divorce or separation. The analysis of data employed logistic regression analysis method. The conceptual framework for this study was based on Andersen`s behavioral model and Park, Chang Je`s model. Independent variables consists of predisposing characteristics, enabling resources, perceived need and dependent variable consist of preparation for aging. The results of analysis are summarized as follows. First, proportion of the women in marital dissolution among baby boomers with economic preparation for aging was low; 23%. Secondly, education level, monthly family income, housing ownership are positively and significantly associated with economic preparation for aging. Third, the concern of economic condition for aging is the negative factors on preparation for aging. However, the type and duration of marital dissolution did not give a significant effect on it.

Externally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction

반명진,나지나,고성철,김주현,허남훈,최은창,박재홍,김원식 대한이비인후과학회 2021 Clinical and Experimental Otorhinolaryngology Vol.14 No.4

Objectives. To compare the surgical outcomes of externally monitored and conventional buried flaps with the goal of determining the usefulness of external monitoring of buried flaps. Methods. In this case-control study with propensity score matching, 30 patients were evenly divided into externally monitored buried flap and conventional buried flap groups. The total operative time for free flap reconstruction, the flap survival rate, the length of hospital stay, the initial time of a reliable visual assessment, complications, the final diet achieved, and the duration until diet initiation were compared between the groups. Results. The mean operative time for reconstruction was 115 minutes (interquartile range, 85–150 minutes) and 142 minutes (interquartile range, 95–180 minutes) in the externally monitored and conventional groups, respectively (P= 0.245). The median length of hospital stay was 24 days (interquartile range, 18–30 days) and 27 days (interquartile range, 20–41 days) in the externally monitored and conventional groups, respectively (P=0.298). The median duration until diet initiation was 15 days (interquartile range, 15–21 days) and 18 days (interquartile range, 15–34 days) in the externally monitored and conventional groups, respectively (P=0.466). The final diet, initial time of a reliable visual assessment, and complications were comparable between the groups, but the external skin paddle provided an excellent visual assessment immediately postoperatively in all cases. Conclusion. The outcomes were comparable between the groups, indicating that externalization of the cutaneous component of a buried flap may be a straightforward and useful technique for monitoring a buried anterolateral thigh free flap in laryngopharyngeal reconstructions. The salvage and false-positive rates of compromised flaps should be compared in large subject groups in future studies to prove that the use of an external skin paddle improves flap monitoring.

Which Patients With a Unilateral Hearing Aid for Symmetric Sensorineural Hearing Loss Have Auditory Deprivation?

이현진,이전미,나지나,문영민,이찬,정진세 대한이비인후과학회 2020 Clinical and Experimental Otorhinolaryngology Vol.13 No.1

Objectives. The aim of study is to find conditions that aggravate auditory deprivation in patients with symmetric hearing loss after unilateral digital, non-linear hearing aid (HA). Methods. In the retrospective case-comparison study, we assessed 47 patients with symmetric sensorineural hearing loss (SNHL), wearing unilateral conventional HAs. Audiological outcomes were assessed >1 year after HA fitting (mean duration, 31.0 months). Pure-tone audiometry in HA-aided and HA-unaided conditions was performed over time. Word recognition score (WRS) was evaluated at the most comfortable listening level. Results. The initial pure tone average of four frequency thresholds at 500, 1,000, 2,000, and 4,000 Hz (PTA4) did not show a difference of >5 dB HL between HA-aided and HA-unaided ears. WRS progressively decreased for both HA-aided and HA-unaided ears although the extent of decrease was significantly greater for HA-unaided (7.6%) than for HA-aided ears (5.1%, P<0.05). Notably, auditory deprivation in HA-unaided ears was significantly greater in patients with an initial PTA4 ≥53 dB HL (P<0.001). Conclusion. Bilateral HAs are strongly recommended, particularly for patients with moderate to severe SNHL to prevent auditory deprivation in the contralateral ear.

확장 경미로 접근법을 사용한 청신경종양과 중이병변 동시 제거술

노혜은,이호영,나지나,문인석 대한이비인후과학회 2021 대한이비인후과학회지 두경부외과학 Vol.64 No.5

Unilateral presentation of vestibular schwannoma with concurrent chronic middle ear diseaseor cholesteatoma is rare. We report a series of patients with ipsilateral chronic middle ear diseaseand vestibular schwannoma, which were simultaneously removed via the enlarged translabyrinthineapproach. All tumors were near-totally removed, and middle ear disease wascompletely excised; there were no major postoperative complications such as cerebrospinalfluid leakage, cholesteatoma recurrence, or meningitis. If hearing preservation of the affectedear is not necessary, simultaneous surgical removal of both pathologies is more convenientthan staged treatment. The enlarged translabyrinthine approach can achieve complete treatmentwith one corridor.

Effect of Dexamethasone Combination With Gentamicin in Chemical Labyrinthectomy on Hearing Preservation in Patients With Meniere’s Disease

이유진,배성훈,이전미,이현진,나지나,김성헌 대한이비인후과학회 2022 대한이비인후과학회지 두경부외과학 Vol.65 No.8

Chemical labyrinthectomy may be performed in patients with Meniere’s disease who have intractablevertigo that does not respond to drug. By using aminoglycosides, the surgical procedureablates vestibular type 1 hair cells. However, the risk of hearing loss remains a main concernfor clinicians because gentamicin ablates cochlear hair cells as well as vestibular haircells. To deal with the concern for hearing loss, dexamethasone can be combined with gentamicinduring chemical labyrinthectomy. Herein, we show that chemical labyrinthectomy usinggentamicin combined with dexamethasone preserve hearing at high-frequency compared tothe conventional method.

Saccular Pathology Is Most Commonly Found in Patients With General Vestibular Disorders

이전미,김성헌,이현진,김정기,신승호,나지나,심대보 대한이비인후과학회 2022 Clinical and Experimental Otorhinolaryngology Vol.15 No.3

Objectives. The first purpose of this study was to investigate the difference in the frequency of involvement of the superior vestibular nerve (SVN) and inferior vestibular nerve (IVN) territories in general vestibular disorders, and to identify which IVN territory was more commonly involved in patients with IVN lesions. The second purpose was to investigate the correlation of the degree of each saccular and posterior semicircular canal (PSCC) dysfunction, as represented by the parameters of cervical vestibular evoked myogenic potential (cVEMP) and video head impulse test (vHIT), in patients with pathology of the IVN territory. Methods. In total, 346 patients with dizziness who underwent the caloric test, cVEMP, and vHIT were enrolled. Canal weakness in the caloric test, interaural amplitude difference (IAD) of cVEMP, and vestibulo-ocular reflex gain of the vestibulo-ocular reflex gain of the posterior semicircular canal (p-VOR) in vHIT were analyzed. Results. Among the enrolled patients, 15.6% had total vestibular nerve dysfunction, 14.5% had solely SVN dysfunction, and 29.5% had solely IVN dysfunction. Isolated saccular pathology was most common in patients with IVN pathology, followed by those with total IVN dysfunction and PSCC dysfunction. IAD and p-VOR were statistically well correlated, and the correlation was strongest in patients with both pathologic IAD and pathologic p-VOR (n=23, r=0.944), followed by patients with normal IAD and pathologic p-VOR (n=27, r=0.762) and patients with pathologic IAD and normal p-VOR (n=106, r=0.339). Conclusion. Abnormal results were more common in vestibular tests investigating the IVN than in vestibular tests investigating the SVN in patients with general vestibular disorders. Isolated saccular pathology was more frequent than PSCC or combined pathology in patients with IVN dysfunction. Patients with abnormal p-VOR in vHIT had a higher probability of having both saccular and PSCC pathologies than patients with an abnormal IAD. This study describes the characteristics of vestibular-system subregions and provides guidance for clinically interpreting the combination of cVEMP and vHIT results.