상악동 기원의 기질화 혈종

변장열,이재용 순천향의학연구소 2010 Journal of Soonchunhyang Medical Science Vol.16 No.1

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비순부 종물 형태로 발현된 피하 해면상 혈관종 1예

변장열,김규훈,박동욱,이재용 대한이비인후과학회 2010 대한이비인후과학회지 두경부외과학 Vol.53 No.6

Hemangiomas are the most common vascular tumor of the head and neck region, but rarely involve the sinonasal cavity. The majority of these lesions present as a benign tumor of the skin and mucosa. Moreover, most nasal hemangiomas occur in the nasal septum or vestibule. The authors experienced a case of subcutaneous cavernous hemangioma that occurred from right nasolabial fold in a 40-year-old man, which was successfully treated by sublabial approach. We expected the tumor as a radicular or nasolabial cyst because of its location, clinical feature, and radiologic findings. However, the final pathologic diagnosis was cavernous hemangioma. We present the clinical characteristics, radiologic findings, and treatment of a subcutaneous hemangioma with a review of the literature. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:386-9

Frequency of Nasal Septal Perforation at the Suture Fixation Site of a Silastic Sheet Inserted during Nasal Surgery

변장열,박영주,이재용 순천향대학교 순천향의학연구소 2011 Journal of Soonchunhyang Medical Science Vol.17 No.2

Objective: This study was performed to evaluate the frequency of nasal septal perforation at the suture fixation site of a silastic sheet inserted during nasal surgery. Methods: Seven hundred and twenty-one patients with silastic sheet insertion during common nasal surgeries were examined. The frequency of perforations and subjective symptoms of the patients were evaluated. Results: Nasal septal perforation at the suture fixation site occurred in seven patients (0.97%). In three patients, perforations occurred immediately after removal of the sheet, while four patients developed perforations 2 to 4 weeks later. In most cases, perforations were small and did not exceed 2 to 3 mm in diameter. No patient complained of nasal symptoms related to the septal perforation postoperatively. Conclusion: The frequency of the septal perforation at the suture fixation site of a silastic sheet was very low and subjective symptoms were absent.

사골동에서 발생한 사구맥관혈관주위세포종 1예

변장열,이유재,고은석,이재용 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.4

Glomangiopericytoma, a new term referring to the sinonasal type hemangiopericytoma, is a rare sinonasal tumor arising from modified perivascular glomus-like myoid cells. It is a borderline, low grade malignancy tumor, which has good prognosis following a complete surgical resection. Recently, we experienced a case of a glomangiopericytoma in a 68-year-old woman who presented with epistaxis and unilateral nasal obstruction. Endoscopic examinations revealed polypoid mass with bleeding tendency in the left middle meatus. The tumor was located mainly in the left ethmoid sinus and we removed it successfully by endoscopic approach. Histological examination and immunohistochemistry confirmed the diagnosis of glomangiopericytoma. We present the clinical and histological characteristics, therapeutic principles, and prognosis of this rare disease entity with a literature review.

폐경과 수면관련 호흡장애

변장열 ( Jang Yul Byun ),이재용 ( Jae Yong Lee ),정수호 ( Soo Ho Chung ) 대한폐경학회 2012 대한폐경학회지 Vol.18 No.1

폐경이후 여성에서 수면관련 호흡장애의 빈도는 증가한다. 여성호르몬의 감소와 체중의 증가에 따른 상기도의 폐쇄로 인해 수면의 단절이 발생하게 된다. 폐경 후 수면에 어려움을 겪는 여성에서 다른 수면장애와의 감별이 필요하며 수면관련 호흡장애가 의심되면 정확한 진단과 치료가 필요하다. 정확한 병력청취와 자세한 이학적 검사를 통해 예측이 되면 수면다원검사를 시행하게 되며 이를 통해 진단을 하게 된다. 또한 폐쇄부위 결정을 위한 여러 가지 검사를 시행하게 된다. 치료는 비수술적 치료와 수술적 치료법으로 크게 나뉘며, 환자의 선호도, 연령, 임상 검사 소견과 생활 환경 등의 사회적 여건을 고려하여 신중히 선택해야 한다. Women after the menopause appear to be more susceptible to sleep related breathing disorders (SBDs). The increased prevalence of SBDs in postmenopausal women may be related to weight gain and the decline in female sex hormones levels. These conditions may cause upper airway obstruction, which can result in sleep disruption. Other sleep disorders, such as insomnia, depression, and fi bromyalgia must be ruled out with SBDs in postmenopausal women with sleep diffi culties. Once SBD is strongly suspected through medical history and precise physical examinations, polysomnogram is required for confi rmatory diagnosis. In addition, other examinations besides polysomnogram should be performed to detect obstructed regions. Treatment of SBD can be classifi ed into surgical method and non-surgical method. Treatment options must be carefully selected by considering the patient`s clinical examinations, patient`s preference, age and life style.

하비도에서 발생한 후각신경 아세포종 1예

이재용,변장열,조성훈,김희경 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.1

Olfactory neuroblastoma is a rare tumor of nasal cavity arising from the olfactory neuroepithelium. It is usually presented as a polypoid mass high in the nasal vault including cribriform plate, superior turbinate, and superior portion of nasal septum. Recently, we experienced a case of olfactory neuroblastoma occurred from very atypical location. An 89-year-old man visited our department with symptoms of occasional left nasal bleeding and obstruction. On the endoscopic examination, a polypoid mass with bleeding tendency was observed in the left inferior meatus, but other portions of nasal cavity showed normal appearance. Biopsy was performed and the final pathologic report turned out as olfactory neuroblastoma. We report this unusually presenting case of olfactory neuroblastoma with a review of the literature. (Korean J Otolaryngol 2006;49:113-7)

Nasopharyngeal Hemangioma in Adult: A Case Report

길은경,변장열,홍현숙,박지상,장기현,김희경 대한영상의학회 2013 대한영상의학회지 Vol.68 No.5

Nasopharyngeal masses are usually malignant, and benign nasopharyngeal tumors such as hemangioma are unusual. In adults, hemangiomas do not involute spontaneously, but progress. Imaging modalities are useful to rule out other malignancies and vascular lesions and to evaluate the lesion. Most hemangiomas require no therapy, but certain factors such as age of the patient and location and size of the lesion may make treatment necessary. We report a case of an unusual nasopharyngeal hemangioma treated with endoscopic excision in an adult who complained of hearing loss.

Comparison of Conventional Excision via a Sublabial Approach and Transnasal Marsupialization for the Treatment of Nasolabial Cysts: A Prospective Randomized Study

이재용,백병준,변장열,장혁순,이병돈,김동욱 대한이비인후과학회 2009 Clinical and Experimental Otorhinolaryngology Vol.2 No.2

Objectives. Surgical excision via a sublabial approach is considered the standard treatment for nasolabial cysts. Although transnasal marsupialization has been proposed as an alternative method, no prospective study has compared the effectiveness of these techniques. We thus compared the surgical procedure, operating time, postoperative pain, complications, and recurrence rate between the two surgical methods. Methods. Twenty patients diagnosed with nasolabial cysts were allocated randomly into two groups according to the surgical technique. In the sublabial approach group, the cysts were excised completely using a sublabial approach, while in the transnasal marsupialization group, the cysts were marsupialized transnasally under the guidance of nasal endoscopes. The pure operating time was measured and postoperative pain was evaluated using a visual analog scale. Complications after the procedure were assessed and recurrence was determined according to the clinical symptoms and postoperative radiologic findings. Results. The transnasal marsupialization group had significantly shorter operating times, less postoperative pain, lower complication rates, and shorter duration of side effects than the sublabial approach group. No recurrence occurred in either group after a 1-yr follow-up period. Conclusion. Although both methods are effective for treating nasolabial cysts, the transnasal marsupialization of nasolabial cysts has many benefits over the conventional sublabial approach. Therefore, we propose that transnasal marsupialization be the treatment of choice for nasolabial cysts. Objectives. Surgical excision via a sublabial approach is considered the standard treatment for nasolabial cysts. Although transnasal marsupialization has been proposed as an alternative method, no prospective study has compared the effectiveness of these techniques. We thus compared the surgical procedure, operating time, postoperative pain, complications, and recurrence rate between the two surgical methods. Methods. Twenty patients diagnosed with nasolabial cysts were allocated randomly into two groups according to the surgical technique. In the sublabial approach group, the cysts were excised completely using a sublabial approach, while in the transnasal marsupialization group, the cysts were marsupialized transnasally under the guidance of nasal endoscopes. The pure operating time was measured and postoperative pain was evaluated using a visual analog scale. Complications after the procedure were assessed and recurrence was determined according to the clinical symptoms and postoperative radiologic findings. Results. The transnasal marsupialization group had significantly shorter operating times, less postoperative pain, lower complication rates, and shorter duration of side effects than the sublabial approach group. No recurrence occurred in either group after a 1-yr follow-up period. Conclusion. Although both methods are effective for treating nasolabial cysts, the transnasal marsupialization of nasolabial cysts has many benefits over the conventional sublabial approach. Therefore, we propose that transnasal marsupialization be the treatment of choice for nasolabial cysts.

내시경을 이용한 사골동 기원의 거대 연골육종 치료 경험 1예

정동호,진희성,변장열,이재용 대한이비인후과학회 2010 대한이비인후과학회지 두경부외과학 Vol.53 No.2

Chondrosarcoma of the ethmoid sinus is a rare malignant tumor and has a poor prognosis due to the frequent local recurrence and distant metastasis. It has unique and distinctive histologic characteristics, being composed of chondroid tumor cells with spindled cytoplasmic extensions. Wide surgical resection is the treatment of choice and radiation or chemotherapy can be combined with the surgery. The prognosis of chondrosarcoma depends on the anatomical location,resectability, and cytologic differentiation of the tumor. The authors experienced a case of huge chondrosarcoma of the left nasal cavity in a 47-year-old woman, which was resected successfully via endoscopic approach. We present the clinical characteristics, pathology, treatment,and prognosis of the tumor with a review of the literature. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:107-11

비중격에 발생한 유피낭종 1예

이경수,오솔길,변장열,이재용 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.11

Nasal dermoid cysts are rare neoplasms, which are diagnosed frequently in childhood. These lesions are derived from both ectoderm and mesoderm, and have keratinizing epithelium with skin appendages. A fistula, pit, or mass is the common clinical presentation. The diagnosis is primarily based on the medical history, physical examination, clinical symptoms, and radiologic findings. Complete surgical excision is the treatment of choice. A 15-year-old boy presented with a fistula on the nasal vestibule, which existed from birth. Fistulography revealed a contrast-filling fistulous tract and cyst in the caudal portion of the nasal septum. The lesion was removed surgically and pathology confirmed the diagnosis of dermoid cyst. We report, with a review of the literature, a rare case of dermoid cyst that occurred from the nasal septum. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:1057-60)