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Clinical Usefulness of Modified Bondy Operation for Management of Cholesteatomas
정연훈,Eun Hwang,임혜진,Han-Bin Lee,Sung Yeal Kim,KeehyunPark,Hun Yi Park 대한청각학회 2011 Journal of Audiology & Otology Vol.15 No.2
Introduction The surgical methods for chronic otitis media proposed by the American Society of Otolaryngology in 1964 included (and remain to the present day) radical mastoidectomy, modified radical mastoidectomy, mastoid obliteration, myringoplasty, tympanoplasty, and tympanoplasty with mastoidectomy. In 1910, Gustave Bondy reported on a modified radical mastoidectomy technique applicable to patients with an attic cholesteatoma who had only perforation of pars flaccida without ossicle and pars tensa lesions, and attempted removal of the mastoid cell inflammation to preserve hearing.1,2,3)In the Bondy operation, the operation window is made through an external auditory canal via removal of superior and posterior walls without managing the middle ears.4,5,6,7) To date, there have been only a few reports of the use of the procedure in Korea. Berrettini, et al.8) and Sanna, et al.9) reported the results of modified Bondy operation, and also reported that good functional results and low recurrence in cases where pre-operative hearing is good and when the cholesteatoma is confined to the epitympanum without ossicle and pars tensa lesions.10,11,12)The present study was undertaken to analyze the clinical features and the results of hearing through cases of modified Bondy operation in our clinic for last 13 years. The aim was to suggest appropriate indications for the operation and its usefulness. Materials and Methods This study was a retrospective chart review of 15 patients who had undergone the modified Bondy operation in our tertiary hospital between 1996 and 2010. The operation for all patients involved an open cavity mastoidectomy including the superior and posterior wall of the bony external auditory canal without manipulation of middle ear structures such as the ear drum and ossicle. All operations were carried out in case of cholesteatoma with little modification of ear drum, ossicle, and middle ear structure, and when the hearing on one side of the lesion was better than the opposite side or when hearing was only on one side. The operational procedure involved elevation of the tympanomeatal flap to the tympanic ring to confirm the lesion of epitympanum, middle ear, and ossicular chain by lifting up the posterior part of the ear drum, with no further tympanotomy conducted. Mastoidectomy and atticotomy were done to remove all air cells, all cholesteatoma in attic and mastoid were removed, but pars flaccida was preserved to maintain the ossicular chain (Fig. 1). Data concerning patient age, gender, chief complaint, diagnosis, hearing level, endoscopic findings, temporal bone computed tomography findings, and recurrence were analyzed, and especially pure tone average (PTA; 0.5, 1, 2, 3 kHz) was compared between pre-operative and post-operative hearing levels at 2-3 months. SPSS version 12.0 software (SPSS, Chicago, IL, USA) was used for analyses. Significance was determined using Wilcoxon signed rank test and a p value<0.05 was considered significant. Results Fifteen 15 patients (nine males, six females, mean age 35.3 ±14 years, range 18-65 years) underwent the modified Bondy operation at our center from 1996-2010 (Table 1). The chief complaints of the patients were otorrhea (n=12, involving nine cases of purulent otorrhea and three cases of bloody otorrhea), hearing impairment (n=1), and accident (n=2). The lesion was located in the left-side in four patients and on the right-side in 11 patients. Post-operative diagnoses were attic cholesteatoma (n=9; involving one case of huge cholesteatoma with lateral sinus thrombophlebitis), three cases of external auditory canal cholesteatoma, one case of sinus cholesteatoma, and two cases of recurrent cholesteatoma (Fig. 2). Pre-operative hearing tests were performed in all 15 cases and post-operative (8-12 weeks) PTA was determined in 10 cases. Pre-operative and post-operative mean air conduction was 27.4±18.3 dBHL and 26.0±10.7 dBHL, respectively (p=0.... Background and Objectives: Bondy operation is a type of modified radical mastoidectomy whose operation window is through an external auditory canal via removal of superior and posterior walls without management of the middle ears. However, the usefulness of this operation is unclear. This study aimed to review our clinical experience of modified Bondy operations and to clarify its usefulness. Materials and Methods: Fifteen patients underwent a modified Bondy operation at the Department of Ajou University Hospital between 1996 and 2010. Their clinical data were retrospectively reviewed including age, gender, chief complaint, diagnosis, pure tone average (PTA, a mean threshold of 0.5, 1, 2, and 3 kHz before and 3 months after the operation), otoscopic finding, temporal bone computed tomography, and recurrence rate. Results: The mean age of the 15 patients was 35.3±14 (range 18-65) years. Post-operative diagnosis of all cases was cholesteatoma (nine attic, three external auditory canal, one sinus, and two recurrent). Pre- and postoperative PTAs were 27.4±18.3 dBHL and 26.0±10.7 dBHL, respectively (p=0.72). No postoperative recurrence or complications were noted over at least a 3- month follow-up. Conclusions: Modified Bondy operation is a good option to preserve hearing and prevent recurrence after operations in cases of cholesteatoma with relatively preserved middle ears.
구강작열감 증후군 환자의 임상적 특징 및 스테로이드 가글 치료의 예비결과
정연훈,조민정,김철호,이진석,강성욱 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.6
Background and Objectives:Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory abnormal findings. BMS is not an uncommon disease that ENT doctors can encounter in the OPD clinics. However, the causes, pathophysiology, and treatment of BMS are not known yet, and there are just a few reported articles. The aim of this study was to analyze the characteristics of BMS and to evaluate the effects of steroid gargle treatments. Subjects and Method:We reviewed 18 patients with BMS who visited the Department of Otolaryngology, Ajou University Hospital. The patients were analyzed according to the sites, duration of their burning sensations and associated symptoms. Furthermore, the interview included inquiries regarding current diseases, on-going medications, smoking history and psychological factors. The change of symptoms after steroid gargle treatment with/without other drugs was carefully analyzed. Results:The average age of patients with BMS was 56.4 years old, and the male to female ratio was 8:10. The most frequently involved site was tongue (94.4%), followed by lower lip, gingiva, palate, and floor of mouth. We found that the causes of BMS were psychogenic factors for 4 patients, and diabetes mellitus and hypertension for 2 patients each. Approximately 80.0% (8/10 patients) of the women was menopausal. Six (50.0%) of 12 patients treated only with steroid gargle and 3 (75.5%) of 4 patients treated with steroid gargle and other medications showed relieved symptoms. Conclusion:Burning mouth syndrome is not an uncommon disease in the ENT field, and has complex etiology. Although the definitive treatment for BMS is not known yet, we think that steroid gargle may be helpful in the treatment of BMS.
도금폐수내 유리시안과 착염시안 및 중금속의 처리특성 (II) - aldehyde와 polysulfide첨가에 따른 영향 -
정연훈,이수구 한국물환경학회 2010 한국물환경학회지 Vol.26 No.4
The objective of this study is to investigate the effect of aldehyde compounds and ploysulfide as accelerating agents on removal of heavy metals and CN in plating wastewater. As a results of the experiments, the removal efficiency of cyanide using the formaldehyde type of aldehydes was the highest at pH 9. Next types were sodium formaldehyde bisulfite addut> paraldehyde> paraformaldehyde. Also, optimum pH and dosage for treating the residual heavy metals by using polysulfide were pH 9 and 30 mg/L, respectively. The removal efficiencies of cyanide, chromium, zinc and copper were above 96.7% at optimum condition.
A Case of External Auditory Canal Stenosis in Langerhans Cell Histiocytosis
정연훈,Inkyung Sohn,Han-Bin Lee,Sung-Yeul Kim 대한청각학회 2011 Journal of Audiology & Otology Vol.15 No.2
Langerhans cell histiocytosis (LCH) refers a group of disorders of the reticuloendothelial system characterized by a proliferation of histiocytes, which includes eosinophilic granuloma, Lettere-Siwe diseases, and Hand-Schuler Christian disease. The clinical presentation of LCH depends on the site of involvement. It can range from multifocal lesions to a solitary lesion. Tissues characteristically involved in LCH are bone, skin, lung, liver, spleen, bone marrow, lymph nodes and the hypothalamic-pituitary region, although the involvement of other organs such as the bowel can occur. We experienced a case of external auditory canal stenosis in LCH of multiple organ involvement in a 28-year-old male, and report it with a review of the relevant literature.