후두 백반증의 임상적 양상 및 장기간 추적관찰 결과

허성재,조인지,안동빈,김재혁,박준식,손진호 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.8

Background and Objectives Leukoplakia is a clinical term solely designating a white patch or a plaque of the mucosa without considering its histological feature. Leukoplakia ranges microscopically from a hyperplasia to an invasive squamous cell carcinoma. This study attempted to find out the clinical progress and characteristics of leukoplakia in the larynx. Subjects and Method Included in the study were 154 patients clinically diagnosed as leukoplakia from 1997 to 2010. We reviewed their medical records retrospectively for age, sex, smoking and drinking history, medical record, histopathologic finding, treatment method, and the follow-up records. Results Histopathologic findings of leukoplakia in the larynx showed hyperkeratosis (101 patients), invasive carcinoma (19 patients), dysplasia (14 patients), nodule (9 patients), papillomatosis (4 patients), chronic inflammation (4 patients) and tuberculosis (3 patients). Of the 128 patients, 39 patients who were diagnosed as hyperkeratosis, dysplasia, nodule or chronic inflammation in the larynx had recurrence and received re-biopsy over 2 times. Eight patients of these 39 who had recurrence had progression to invasive carcinoma. The mean interval between diagnosis of leukoplakia and invasive carcinoma was 53 months (ranged 7-114 month). Heavy smoking (more than 20 pack year) and drinking were significantly associated with recurrence or progression to invasive carcinoma. Age, gastroesophageal reflux disease and treatment method were not associated with recurrence. Conclusion Leukoplakia in the larynx led to various histopathologic diagnoses, high recurrence rate, and progressed to invasive carcinoma even after 5 years. Smoking and drinking should be managed and longterm follow-up is needed.

30년동안 상악동에 존재한 유리 이물에 의해 발병한 진균구 1예

허성재,김정수,이재호 대한비과학회 2017 Journal of rhinology Vol.24 No.2

The fungal ball is the most frequent non-invasive form of fungal sinusitis. Some authors have reported opportunistic fungus infections caused by retained foreign bodies in the maxillary sinus. Whereas previously reported foreign bodies were almost always metal materials, we report the case of a fungus ball caused by retained pieces of glass for 30 years. The patient complained of unilateral nasal obstruction. Computed tomography revealed fungal sinusitis and foreign bodies in the left maxillary sinus. The fungus ball and foreign bodies were removed via an endoscopic sinus surgery. After surgical removal, the patient became free from nasal symptoms.

약물치료에 반응이 있는 알레르기비염 환자에서 Coblation 하비갑개 축소술의 효과

허성재,박창묵,김정수 대한이비인후과학회 2018 대한이비인후과학회지 두경부외과학 Vol.61 No.7

Background and Objectives The effectiveness of turbinate surgery has been well demonstratedin allergic rhinitis refractory to medication. On the contrary, the efficacy of surgery inallergic rhinitis that responds to medication has not been assessed. The aim of this study wasto determine the surgical outcomes in patients with allergic rhinitis responsive to medication. Subjects and Method Patients with allergic rhinitis responsive to medication and thosewho had undergone coblation turbinate reduction were enrolled in this study. The visual analogscale was used to assess the allergic symptoms before treatment, during medication treatmentas well as postoperatively at 6 and 12 months. In addition, the degree of patient satisfactionregarding the surgery was investigated postoperatively at 12 months. Results Twenty-four patients (mean age=33.6±14.9 years; men-to-women ratio=1:1) wereincluded in this study. During the pretreatment period, all allergic symptoms significantly improvedafter treatment with both medication and surgery. At 6 months postoperatively, the degreeof patients’ allergic symptoms was lower than in those treated with medication. However,when compared at 12 months postoperatively, all the symptoms, excluding nasal obstruction,were not significantly different from those who received medication. Surveyed postoperativelyat 12 months 54.2% of patients advocated for surgical treatment. Conclusion Although surgery yielded better outcome than did medication during the earlypostoperative period, there was little difference in the outcome at 12 months postoperatively. Therefore, we need to be careful when choosing surgical intervention for patients with allergicrhinitis responsive to medication.

Metastatic Renal Cell Carcinoma in the Paranasal Sinus: A Case Report and Literature Review

허성재,권태균,김정수 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.12

Metastatic renal cell carcinoma is very rare, especially in the paranasal sinus. Metastasis to multiple sites and late recurrence frequently occur in renal cell carcinoma. Moreover, typical treatment methods applied to this form of tumor have not produced a good response. Therefore, prognosis of patients with metastatic renal cell carcinoma is typically poor, and a consensus on appropriate treatment methods for these tumors has not been established. Recently, systemic immunotherapy and target therapy were employed to treat the tumor, but they have not been considered as definite treatment methods for metastatic renal cell carcinoma. Since paranasal sinus is surrounded by vital organs, choosing a treatment modality for a tumor in the paranasal sinus is more difficult than in other sites. We present the case of metastatic renal cell carcinoma in the paranasal sinus that was successfully treated by endoscopic surgery with a literature review about treatment methods. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(12):877-81

Vitamin D Levels and Their Relationship with Cardiac Biomarkers in Chronic Hemodialysis Patients

허성재,이종수,박종하,김동민,임경훈,윤선화,정현철 대한의학회 2009 Journal of Korean medical science Vol.24 No.-

Vitamin D insufficiency may be associated with cardiovascular (CV) mortality in HD patients. To test this hypothesis, we cross-sectionally measured 25-hydroxyvitamin D (25D), 1,25-dihydroxyvitamin D (1,25D), cardiac troponin T (cTnT), and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) in chronic HD patients. Sixty-five patients (M:F=31:34, age 52.2±13.2 yr, DM 41.5%) were selected. Along with the expected low levels of 1,25D, 59 (90.8%) patients had 25D insufficiency (<30 ng/mL) among whom 15 (23.1%) were 25D deficient (<10 ng/mL). The 25D levels showed a negative correlation with cTnT levels (Spearman’s ρ=-0.44, p<0.01) but not with NT-pro-BNP levels (Spearman’s ρ=-0.17, p=0.17). The 1,25D levels, however, did not show any relationship with either cTnT or NT-pro-BNP. In multivariate analysis, being male and having low levels of 25D were independent risk factors associated with cTnT elevation (β=0.44, p<0.01 and β=-0.48, p<0.01, respectively). In conclusion, not only 1,25D but also 25D are commonly decreased in HD patients. Lower 25D levels appear to be associated with cTnT elevation, predicting worse CV outcome, and are possible to involve cardiac hypertrophy or coronary artery disease.

골고정법을 이용한 후방 비중격 교정

허성재,차은주,박지혜,김학건,김정수 대한이비인후과학회 2018 대한이비인후과학회지 두경부외과학 Vol.61 No.3

Background and Objectives Various techniques have been reported for the correction ofdeviated nasal septum, most of them for caudal septal cartilage. For deviated posterior septalcartilage, the typical method of the day is the resection of deviated portion. However, we developeda bone anchoring technique that conservatively corrects deviated posterior septal cartilage. The aim of the current study is to determine the efficacy of this bone anchoring technique. Subjects and Method The patients who had undergone septoplasty using bone anchoringtechnique by a single surgeon (J.S.K) between October 2015 and June 2016 were enrolled inthis study. The result of the surgery was evaluated using a visual analogue scale (VAS, ranged0- 10) for nasal obstruction, acoustic rhinometry, and assessment of surgeon. Results A total of 44 patients were included in this study. The VAS of nasal obstruction wassignificantly decreased after surgery from 7.5±1.7 to 2.4±1.4. In acoustic rhinometry, minimalcross-sectional area and volume were increased after surgery from 0.35±0.18 to 0.52±1.40 cm2 and from 3.6±1.1 to 5.8±1.5 cm3, respectively. Most of the deviated septum was wellcorrected, and complication or recurrence did not developed. Conclusion Bone anchoring technique is easy to perform. It enables the preservation ofseptal cartilage, which is useful in revision septoplasty or rhinoplasty. We conclude that thistechnique is a good method for the correction of deviated posterior septal cartilage.

편도아데노이드 절제술 중 전기수술기에 의한 화상

허성재,나경진,김정수 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.12

Electrosurgical units are frequently employed during adenotonsillectomies to reduce both operation time and the amount of bleeding. Complications related to electrosurgical units have rarely been reported or taken into consideration by the majority of surgeons during operations. We report a case of an electrosurgical unit induced burn injury during an adenotonsillectomy. More specifically, the injury was a second-degree burn that occurred on the right oral commissure and the lip. The exact cause of the burn was not determined despite a close examination of the electrosurgical unit. An ointment was applied frequently to the lesion to prevent the wound from drying; the wound subsequently healed without any permanent scarring. Preventive methods, such as a thorough inspection of devices prior to surgery, the technique of using the third finger, and the use of a cheek retractor, may be necessary to avoid burn injuries caused by electrosurgical units. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(12):873-6

비중격에서 발생한 평활근종 1예

허성재,류진현,김정수 대한이비인후과학회 부산,울산,경남 지부회 2016 임상이비인후과 Vol.27 No.1

Leiomyoma is a benign myogenic tumor arising from smooth muscle cell, which may develop wherever smooth muscle exists. They are commonly encountered in the uterus, skin, and gastrointestinal tract, but rarely exist in the nasal cavity. Nasal leiomyoma does not invade surrounding structures and is rarely discovered at the posterosuperior area of nasal septum. The size of nasal leiomyoma is usually less than 2cm. We have recently experienced a case of nasal leiomyoma of 5cm size at the posterosuperior septum, which destructs neighboring tissues. Here, we present a case of leiomyoma of the nasal septum with a literature review.

혼수 상태의 환자에서 발생한 병원 감염성 비강 구더기증 1예

허성재,이미진,박창묵,김정수 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.10

A 82-year-old female was injured in a car accident and admitted to the emergency department in a comatose state. The patient was intubated and then transferred to the intensive care unit. After 2 days, live maggots were discovered from both nostrils. The maggots were treated by mechanical removal and irrigation with an antiseptic solution. After treatment of maggots, endoscopic examination revealed no remnant maggot and abnormal lesion in the nasal cavity. On the following day, maggots were retrieved from mouth in spite of a continuous appliance of an antiseptic solution into the nostrils. More careful concerns to nasal and oral hygiene were performed and no other maggots were found. We present the case of myiasis with a literature review of treatment methods of maggot.

Learning Curve of Septoplasty with Radiofrequency Volume Reduction of the Inferior Turbinate

허성재,박창묵,김정수 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.4

Objectives. Since few studies on surgical training and learning curves have been performed, majority of inexperienced surgeons are anxious about performing operations. We aimed to access the results and learning curve of septoplasty with radiofrequency volume reduction (RFVR) of the inferior turbinate. Methods. We included 270 patients who underwent septoplasty with RFVR of the inferior turbinate by 6 inexperienced surgeons between January 2009 and July 2011. We analyzed success score, cases of revision, cases of complication, operation time, and acoustic rhinometry. Results. Success score was relatively high and every surgeon had few cases of revision and complication. No significant difference was found in success score, revision, complication case, or acoustic rhinometry values between early cases and later cases. Operation time decreased according to increase in experience. However, there was no significant difference in the operation time after more than 30 cases. Conclusion. We can conclude that 30 cases are needed to develop mature surgical skills for septoplasty with RFVR of the inferior turbinate and that training surgeons do not need to be anxious about performing this operation in the unskilled state.