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이철희,김창우,진재원,김창훈 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.2
Meniere’s disease is diagnosed by excluding other possible causes of symptoms characterized by relapsed vertigo, aural fullness, hearing loss and tinnitus. Several disease entities may mimic Meniere’s disease when the disease does not manifest its own characteristic findings. We present the case of a 40-year-old male patient who was suffering from the spontaneous and repeated onset of vertigo, and complaining of aural fullness, hearing loss and tinnitus in his left ear. A diagnosis of definite Meniere’s disease was made and medical treatment was applied with diuretics. One year later, he complained of a tingling sensation in his face, and MRI revealed an intracranial mass. Mass excision was performed with subtemporal approach and operative findings revealed trigeminal schwannoma. We supposed that the tumor might have compromised his vascularity and altered his CSF dynamics, leading to symptoms mimicking Meniere’s disease. Trigeminal schwannoma should be considered as an exclusion category of Meniere’s disease, and MRI is necessary to exclude the central lesion. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:178-82)
만성부비동염으로 비내시경 수술을 시행 받은 환자에서MRSA 감염에 대한 임상적 분석 및 외래에서의적절한 항생제 치료법
박효진,오소정,진재원,노영수 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.4
Background and Objectives:Methicillin resistant staphylococcus aureus (MRSA) prevalence has increased over the world during past several decades and now it has become a world wide problem. It is especially more serious in domestic situations but unfortunately, until this time, there is no report about MRSA infection treatment after endoscopic sinus surgery (ESS). The objective of our study is to evaluate clinical feature of MRSA infection and to find out what kinds of treatment is the best way to control of the MRSA infection after ESS. Subjects and Method:The medical records of 58 patients who had the evidence tively reviewed. Samples were obtained by sinus endoscopy in the office base. Results:Those of MRSA infected only cases were 26 cases. Co-infected cases with another microorganism were 32 cases. Forty-three cases were treated with oral rifampin alone and 11 cases were treated by a combination with oral quinolone or trimethoprim-sulfimethoxazole. Four cases failed to be treated with oral antibiotic therapy. Conclusion:Rifampin is the useful medication for the treatment of MRSA infected patients who had underwent ESS. Also, Rifampin is a cost effective medication compared with the glycopeptide antibiotics esp (Korean J Otolaryngol 2007 ;50 :314-8)
후두 전적출술 후 발생한 인두피부누공에 대한 임상적 고찰
노영수,김창훈,진재원,김진환,안회영,정철훈 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.11
:Pharyngocutaneous fistula after total laryngectomy is one of the most comon complication in the immediate postoperative period. The objective of this study is to evaluate the variable predisposing factors after total laryngectomy and to investigate the management of pharyngocutaneous fistula. Subjects and Method:One hundred fifty cases who had been performed total laryngectomy were investigated retrospectively. Fifteen of 150 cases (10.0%) developed pha-ryngocutaneous fistula after total laryngectomy. We analyzed clinical parameters such as age, sex, smoking, alcohol intake, DM (diabetes mellitus), hypertension, liver disease, postoperative hemoglobin, albumin etc. Results:Smoking, DM, hypertension, postoperative hemoglobin, postoperative albumin were significant factors asociated with pharyngocutaneous fistula. Nine myocutaneous flap. The average duration of oral feeding was 30 postoperative days in conservative treatment group and 83 postoperative days in surgical intervention group. Conclusion:Pharyngocutaneous fistula may be preventable by correcting the predisposing factors. We must consider the initial size of fistula and the response of conservative treatment to determine me-thodology and timing of surgical management. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 :1023-9)
갑상선 종물로 오인된 Killian-Jamieson 게실 1예
주형로(Hyung Ro Chu),이종선(Jong Sun Lee),한동혁(Dong Hyuk Han),진재원(Jae Won Jin) 대한두경부종양학회 2006 대한두경부 종양학회지 Vol.22 No.1
Killian-Jamieson and Zenker diverticula are both rare pharyngoesophageal diverticula. Both are outpouching of the mucosal and submucosal layers of the esophageal wall, which protrude through a mucosal gap at the level of the pharyngoesophageal esophagus. When these diverticula are large enough, they can be in proximity to the thyroid gland and may mimic a thyroid nodule. We report a case in which a diverticulum was filled with dietary residue and thus simulated a thyroid cyst on CT scan. And it was finally diagnosed as a Killian-Jamieson diverticulum by the surgery.