돼지에서 내시경수술이 부비동과 안면골 성장에 미치는 영향

박성국,안희,박춘근,최석진 인제대학교 1998 仁濟醫學 Vol.19 No.2

소아 부비동염의 치료에 기능적 부비동내시경술은 약물치료에 반응이 없는 소아의 재발성 또는 만성 부비동염에 시행되어 왔으며 효과와 안정성이 보고되고 있다. 그러나 본 시술이 성장하고 있는 소아 부비동과 안면골격에 어느 정도의 영향을 미치는지에 대해서는 명백히 밝혀져 있지 않다. 저자들은 내시경 절제술이 부비동과 안면골 성장에 어떤 영향을 미치는지 알아보기 위해 3 마리의 새끼 돼지를 이용하여 일측 전사골동에 내시경 절제술을 시행하였다. 6개월후 나선식 CT를 이용한 3차원 영상 재구성을 시행하여 양측 사골동 및 상악동의 부피를 측정하여 수술한 부위와 수술하지 않은 부위를 비교하였다. Background: Functional endoscopic sinus surgery has gained increases acceptance and popularity in the treatment of young children with recurrent and chronic sinusitis unresponsive to medical management. It is undeterminded whether pediatric functional endoscopic sinus surgery affects facial and sinus development. Objectives: To determine the effect of functional endoscopic sinus surgery on sinus and facial skeletal growth in pediatric patients. Materials and methods: Three newly weaned farm piglets weighing 7.5 to 8.0Kg were used in this experiment. An unilateral functional endoscopic sinus surgery was performed on a randomly selected side. The procedure consisted of an infundibulotomy and anterior ethmoidectomy. Six months after surgery, the operated animals were killed. For evaluation of the facial bones and sinuses, spiral computed tomography was performed on the heads of the piglets. The spiral CT was used 3mm of collimation, 5mm of table speed, and 2mm of increment of the reconstruction images. Three dimensional reconstruction of the facial bones and volume measurement of the sinuses were done by using Somaris-2program in Somatom Plus CT scanner(Siemens, Erlangen, Germany). Volume of anterior ethmoid sinuses and maxillary sinuses was measured and the operated sides were compared with normal ones. Results: Spiral CT images, three dimensional reconstruction images, and volume measurement of the sinuses revealed diminished facial growth on the operated sides. Mean ratios of sinus area, surgical to nonsurgical, were 0.77 for the maxillary sinuses. 0.88 for ethmoid sinuses. The three dimentional reconstruction images showed diminished midface growth on the operated sides. However, the pigs revealed no apparent facial asymmetry. Conclusion: This study shows that even limited surgery in the anterior ethmoid region can affect sinus and facial growth in the piglet. If endoscopic sinus surgery in the young child is required, a limited surgical technique with maximal preservation of all living mucosa, periostium, and bone is advisable.

Objective and Subjective Evaluation of Treatment Outcomes of Chronic Sinusitis : Comparison of Endoscopic Surgery and Conventional Surgery

Lee, Bong-Jae,Kim, Hyung-Suk Korean Rhinologic Society 1997 Journal of rhinology Vol.4 No.2

만성 부비동염 환자에서 부비동 내시경수술 후 후각기능의 호전

나기상,신광철,김용민 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.2

Few studies on the outcome of endoscopic sinus surgery have assessed the effect of this treatment on the sense of smell. We have collected data prospectively on 30 patients with bilateral chronic sinusitis, before and 8 weeks after surgery. Patients were asked after surgery whether their sense of smell was normal, better, a little better, the same, or worse. Olfactory detection thresholds were obtained using butanol sniff bottles. Subjective sensation of olfaction was improved in 70%, the same in 30% of patients. However, olfactory threshold score was improved in 50%, the same in 32%, and worse in 18% postoperatively. Normosmic nose was found in 10% before surgery. 26.7% showed hyposmic, and 63.3% were anosmic before surgery. The postoperative butanol test showed that 11.7% was normosmic, 50% hyposmic and 38.3% anosmic. Preoperative butanol threshold scores were lower as the severity of sinusitis increased while the degree of postoperative improvement showed no correlation with the severity of sinusitis. Cases of primary surgery showed higher preoperative butanol threshold scores and more pronounced postoperative improvement than cases of revision surgery. The results of this study suggest that impairment of olfaction in chronic sinusitis may be significantly improved following endoscopic sinus surgery.

진균성 부비동염의 임상적 양상과 내시경수술의 치료 결과

이봉재,김혁,김재호,김용재 대한이비인후과학회 1998 대한이비인후과학회지 두경부외과학 Vol.41 No.3

성인 만성 부비동염에서 내시경적 부비동 수술 전·후의 증상 호전도와 음향비강통기도 검사 결과

김용대,김재열,장근영,이형중,송시연,윤석근 영남대학교 의과대학 2002 Yeungnam University Journal of Medicine Vol.19 No.1

Background: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paransal sinusitis with or without polyp. Materials and Methods: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. Results: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. Conclusion: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.

소아 상악동후비공 폴립의 부비동내시경 수술이 부비동 성장에 미치는 영향

신승헌,김창균,예미경,신동원,김우석 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.5

Background and Objectives:Pediatric endoscopic sinus surgery (ESS) has become widely used for the treatment of chronic or recurrent rhinosinusitis that is unresponsive to medical management. But the effect of pediatric ESS on facial growth or sinus growth are controversial and not well understood. The object of the present study was to determine whether pediatric ESS causes the volumetric restriction of the sinuses. Subjects and Method:Fifteen cases of patients who underwent unilateral endoscopic sinus surgery for antrochoanal polyp were reviewed retrospectively. Postoperative maxillary and ethmoid sinus volumes were measured by computed tomography at 73.5 (51-101) months after surgery, and these were compared with non-operated sinus volumes. Results:The mean volume of the operated and non-operated maxillary sinuses were 18.9±6.4 ml and 21.7±5.3 ml. and the mean volume of the operated and non-operated ethmoid sinuses were 4.1±1.2 ml and 3.7±1.2 ml. There was no significant difference in sinus growth between operated and non-operated sinuses. Conclusion:There was no evidence that pediatric ESS affected maxillary and ethmoid sinus growth.

만성 부비동염에서 부비동 내시경수술후 기간별 추적 조사 -수술전 전산화 단층촬영 분류와 수술후 경과기간에 따른 분석-

김종남,홍순관,박미향 대한이비인후과학회 1998 대한이비인후과학회지 두경부외과학 Vol.41 No.2

흡연이 부비동 내시경 수술에 미치는 영향

이주상,장은석,김해영,김진영,맹진우,고일주 대한비과학회 2009 Journal of rhinology Vol.16 No.2

Background and Objectives:This study is designed to assess the effect of smoking on the outcome of endoscopic sinus surgery. Materials and Methods:A total of 66 patients who underwent endoscopic sinus surgery with the diagnosis of chronic sinusitis were evaluated. They were divided into 3 groups; non-smoking, quit-smoking and still-smoking groups. Preoperative and postoperative visual analogue scale (VAS), Sinonasal Outcome Test (SNOT), and endoscopic score for each group were obtained and compared. Results:There were statistically significant correlations between VAS, SNOT score and smoking. However, all patients showed a similar degree of improvement on the subjective symptoms regardless of smoking or nonsmoking. And, postoperative relief of subjective symptoms was not apparent after smoking cessation. In objective findings, postoperative endoscopic scores were 1.6 in non-smoking group, 1.8 in quit-smoking group and 2.7 in still-smoking group. Stillsmoking group had the worst endoscopic result, However, these differences did not reach a statistical significance. Conclusion: This study suggests that smoking had a negative effect on subjective symptoms but not in objective endoscopic findings. In addition, the cessation of smoking after sinus surgery may have no meaningful benefit on the outcome of surgery. Background and Objectives:This study is designed to assess the effect of smoking on the outcome of endoscopic sinus surgery. Materials and Methods:A total of 66 patients who underwent endoscopic sinus surgery with the diagnosis of chronic sinusitis were evaluated. They were divided into 3 groups; non-smoking, quit-smoking and still-smoking groups. Preoperative and postoperative visual analogue scale (VAS), Sinonasal Outcome Test (SNOT), and endoscopic score for each group were obtained and compared. Results:There were statistically significant correlations between VAS, SNOT score and smoking. However, all patients showed a similar degree of improvement on the subjective symptoms regardless of smoking or nonsmoking. And, postoperative relief of subjective symptoms was not apparent after smoking cessation. In objective findings, postoperative endoscopic scores were 1.6 in non-smoking group, 1.8 in quit-smoking group and 2.7 in still-smoking group. Stillsmoking group had the worst endoscopic result, However, these differences did not reach a statistical significance. Conclusion: This study suggests that smoking had a negative effect on subjective symptoms but not in objective endoscopic findings. In addition, the cessation of smoking after sinus surgery may have no meaningful benefit on the outcome of surgery.

부비동 내시경 수술 중 발생한 안구심반사 1예

백홍인,오기준,유진,김영인 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.4

Endoscopic sinus surgery has been used popularly for treatment of chronic paranasal sinusitis. Sometimes endoscopic sinus surgery is complicated by narrow visual field and anatomical variations. Oculocardiac reflex is developed by surgical or nonsurgical procedures to the eyeball. It occurs because of decreasing of heart rate and other arrhythmia including atrioventricular block, ventricular premature beat and cardiac arrest. Oculocardiac reflex during endoscopic sinus surgery is unusual and it is potentially a life threatening complication. The authors report the first case of oculocardiac reflex experienced during endoscopic sinus surgery in Korea with a review of the literature. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:387-9)

비내시경 전두동 수술

김경래,강석영 대한이비인후과학회 2014 대한이비인후과학회지 두경부외과학 Vol.57 No.10

Surgery on the frontal sinus or frontal recess remains a challenge for rhinologist because of its variability and complex anatomy. Its location, relatively complex and narrow frontal recess also make visualization difficult and predispose it to stenosis. Significantly, serious complications are possible due to the anterior ethmoidal artery, orbit and anterior cranial fossa. An understanding of frontal sinus and frontal recess anatomy is essential to perform endoscopic frontal sinus surgery. This paper examines frontal sinus anatomy and then variable procedures of endoscopic frontal sinus surgery. The selection of less invasive procedure as possible after assessment of the patient’s history, diagnostic endoscopy, and the CT scan makes successful endoscopic treatment of frontal sinus diseases. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(10):657-63