• Title/Summary/Keyword: Nasal Obstruction

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DENTAL TREATMENT OF THE PATIENT WITH ACHONDROPLASIA UNDER GENERAL ANESTHESIA (연골무형성증 환아의 전신마취하 치과치료)

  • Jeon, Eun-Kyung;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.2
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    • pp.119-122
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    • 2011
  • Achondroplasia is one of the most common types of dwarfism and is inherited as an autosomal dominant trait. Clinical features of achondroplasia include disproportionate short stature with normal trunk length, shortening of the extremities, bowing of the lower extremities, short stubby trident hands, spinal stenosis and lumbar lordosis. Characteristic craniofacial features include macrocephaly, prominent forehead, depressed nasal bridge, maxillary hypoplasia, otolaryngeal system dysfunction, and foramen magnum stenosis. These characteristics may lead to number of complications including hydrocephalus, apnea, upper-airway obstruction, otitis media, sinusitis and dental malocclusion. Apart from these features, the affected children have good general health and normal intelligence. Dentists should be aware of the clinical characteristics of achondroplasia and the complications that may arise as a result of this disorder. This case report is to present dental treatment of a patient with achondroplasia under general anesthesia and discuss special considerations.

Diagnosis and Treatment of Unilateral Maxillary Sinus Hypoplasia (편측 상악동 저형성증의 진단과 치료)

  • Kim, Soung-Min;Kim, Min-Keun;Kwon, Kwang-Jun;Lee, Suk-Keun;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.2
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    • pp.127-132
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    • 2012
  • Maxillary sinus hypoplasia (MSH) is an uncommon clinical disease that represents a persistent decrease in sinus volume, which results from centripetal reaction of the maxillary sinus walls. We present a unilateral MSH case of a 46-year-old male patient with a history of nasal obstruction and headache for 3 years. He had a history of Caldwell Luc operation (CLOP) 10 years ago, and no enophthalmos, hypoglobus or facial asymmetry. After confirming the right diagnosis of MSH, filled with bone in the computed tomography scan, hyperplastic bone was removed by the CLOP approach. The uncinate process and infundibular passage were found to be degenerated and ostium was also examined to be obstructed under endoscopic confirmation. MSH can be mistaken for chronic maxillary sinusitis because of the plain x-ray appearance, so the aggravated state of MSH can be the result of surgeon's misjudgment. With additional literature reviews, this rare experience is first introduced in our Korean oral and maxillofacial surgery field.

Maxillary Sinus Mucocele as a Late Complication in a Patient Underwent Lefort I Procedure (Lefort I 술식 후 후기 합병증으로 발생한 상악동 점액낭종 1례)

  • Cho, Sang Hyun;Park, Beyoung Yun;Lee, Jung Kwon
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.501-503
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    • 2007
  • Purpose: The authors report unusual one case of a patient presenting with maxillary sinus mucocele who had underwent Lefort I procedure 7 years ago. Methods: Case report and literature review Results: A 25 year old man came to us with fullness, pain and nasal obstruction on his left cheek area. He had a history of multiple operations due to cleft lip and palate since birth. Two jaw surgery was performed for correcting class III malocclusion 7 years ago. Computed tomography showed haziness, and fluid filled cystic mass on left maxillary sinus. Nasoendoscopy revealed the bulging of inferior turbinate and mucosa coincided in medial wall of maxillary sinus. Antrostomy with Caldwell-Luc approach was performed. Mucin contaning brownish exudate was leaked out. Severe inflammation of maxillary inner wall and exposure of 2 screws fixed previously were noticed. The curettage and marsupialization were accomplished. The symptoms of patient were improved after that procedure. Conclusion: Maxillary sinus mucocele is related with Lefort I procedure and it may occur even long after that procedure.

Airway foreign body occurs unintentionally during anesthetic management of patient with asthma

  • Cho, Woo Jin;Yun, So Hui;Choi, Yun Suk;Lee, Bang Won;Kim, Mi Ok;Park, Jong Cook
    • Journal of Medicine and Life Science
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    • v.16 no.2
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    • pp.43-45
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    • 2019
  • Intraoperative delivery of salbutamol (${\beta}_2$ agonist) through a breathing circuit may be performed in asthma patient. A 28-year-old woman with a history of asthma was diagnosed with chronic sinusitis and bilateral nasal polyps, and an endoscopic sinus surgery was performed. The patient was recommended salbutamol nebulization every 4 hours during the perioperative period because of the risk of asthma attack. At the end of the operation, when salbutamol was sprayed through the tube before extubation and the connector tip went inside the tube during injection. The patient was immediately referred to the pulmonary medicine department for bronchoscopy, where the foreign body was removed safely without any complications. When general anesthesia is performed on a patient who usually uses an inhaler for asthma, caution is required because the tip that connects the inhaler and the breathing circuit can aspirate into the endotracheal tube and enter the lungs when applying the inhaler before waking up the patient.

Paradoxical Upper Airway Obstruction and Central Sleep Apnea Developed After Anterior Cervical Spine Fusion (전방경추융합술 후 발생한 역설상기도폐쇄 및 중추성 수면 무호흡)

  • Lee, Sang Haak;Choi, Young Mee;Park, Ye Ree;Kang, Ji Ho;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.295-298
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    • 2005
  • We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.

Clinical Study in 22 Cases of Patients for Suffering Allergic Rhinitis (알러지 비염 환자 22례에 대한 임상적 고찰)

  • Song Jae Jin;Kim Dong Hee;Park yang-chun;Kim Cheul Joong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.2
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    • pp.397-402
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    • 2002
  • Clinical studies were done treated with aroma therapy in 22cases of patients for suffering allergic rhinitis. who were treated at Dept of Oriental respiratory internal medicine in the Hospital of Taejeon University from January 2001 to May 2001. The results were as follows. 1. In distribution of sex & age. 45.5% of them were man, and 54.5% of them were woman. Of those who were attached, 2. In distribution of occupation, 59% of them were student, 18% of them were housewife, 18% of them were white color, 9% Of them were blue color. 3. In distribution of the period of the clinical history, under six months was 32%, under 1 year was 9%, under 3 years was 27%, over 3 years was 32%. 4. In distribution of the seasonal contributing factor, most of them were perenial allergic rhinitis, others generally started in spring or winter. 5. In distribution of past history, 59% of them are none, 18% of them are asthma, 18% of them are atopic dermatitis, 5% of them are allergic dermatitis. 6. In distribution of family history, 46% of them are none, 27% of them are sibling line, 18% of them are paternal line, 9% of them are maternal line. 7. In distribution of symptom, the ratio of sneezing was 90%, nasal discharge was 81 %, nasal obstruction was 46%, pruritus was 41 %, headache was 31%, asthma was 22%, digestion disorder was 18%, tears was 9%, nosebreeding was 5%. 8. In distribution of diagnosis in descending order, wind-cold evil was 5%, spleen-lung energy asthnia was 31 %, lung-kidney asthnia was 64%. 9. In distribution of Herb medicine treatment, Tonggyu-tang was the most, the second was hyunggaiyunyo-tang. 10 In emotional change of patients aroma-therapy, only 14% of them felt good. 11. The total remedial value of the 22 patients was revealed 32.9%. 12. In proportion to grow older, the remedial value were decreased. 13. In proportion to the period of the clinical history was longer, the remedial value were decreased.

A Clinical study of Allergic Rhinitis (treated with aroma-therapy) (알레르기성 비염 환자에 대한 임상적 고찰 - 외치요법(吹鼻法)을 응용하여 -)

  • 신진욱;김남권
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.174-182
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    • 2000
  • Objectives : In order to apply herbal medicine to aroma-therapy, we observed clinically remedical effect for allergic rhinitis of aroma-therapy using herbal medicine. Methods : Twenty-four allergic rhinitis patients were treated in the Kun-po Oriental Medical Hospital of Wonkwang University from September 2000 to October 2000. They were treated with aroma-therapy and analyzed clinically. Results : 1. 25.0% (6 cases) of all cases involved pre-teenagers; teenagers 29.2% (7 cases); patients in their 20s, 20.8% (5 cases); patients in their 30s, 12.5% (3 cases); patients in their 40s, 8.3% (2 cases); patients in their 50s, 4.2% (1 cases). 2. The ratio of male to female patients was 58.3%(14 cases) to 41.7%(10 cases). 3. Cases involving patients under the age of six months was 0%; under 1 year 12.5% (3 cases); under 2 years 33.3%(8 cases); under 3 years 16.7%(4 cases); over 3 years 37.5%(9 cases). 4. Past history : The cases of sinusitis were 33.3%(8 cases); otitis media 20.8%(5 cases), bronchitis 16.7%(4 cases), atopic dermatitis 12.5%(3 cases), asthma 8.3%(2 cases). 5. The ratio of allergic onset based on seasons were : spring 16.7%(4 cases), summer 0%, fall 29.2%(7 cases), winter 16.7%(4 cases), and not defined 37.5%(9 cases). 6. The cases of nasal obstruction was 91.7%(22 cases); followed by : sneezing 83.3(20 cases), white rhinorrhea 70.8%(17 cases), eye itching 66.7%(16 cases), nasal itching 58.3%(14 cases), rhinalgia 58.3%(14 cases), postnasal drip 50.0%(12 cases), headache 41.7%(10 cases), yellow rhinorrhea 33.3%(8 cases), cough 33.3%(8 cases), fatigue 29.2%(7 cases). 7. The cases of familial factor was 66.7%(16 cases); the non-familial factor 33.3%(8 cases). 8. The remedical effect of the treatment showed an improvement in 58.4% of the total cases studied. 9. The improvement-rate of the 1st group (mahwang group) was 66.7%; of the 2nd group (hwangkum group) 48.5%, and of the 3rd group (pine group) 55.8%. Conclusions : Considering the above results, we have concluded that the remedical effect for allergic rhinitis of aroma-therapy using herbal medicine showed to be intentional in comparison with aroma-therapy using aroma-oil.

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Treatment Outcomes of Septoplasty with Turbinate Surgery in Septal Deviation with Chronic Hypertrophic Rhinitis (비중격 만곡증 및 만성 비후성 비염 환자에서 비중격 성형술고 하비갑개 수술의 치료효과)

  • Kim, Yong-Dae;Suh, Bo-Su;Cho, Gil-Sung;Song, Si-Youn;Yoon, Seok-Keun;Song, Kei-Won
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.199-207
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    • 2001
  • Background: Septoplasty with turbinate surgery is common surgical treatment in patients with septal deviation and chronic hypertrophic rhinitis. The aim of this study was to evaluation objective outcomes of septoplasty with turbinate surgery by analysis of subjective symptom score with objective acoustic rhinometric test before and after surgery, prospectively. Materials and Methods: We reviewed 45 adult patients which were done septoplasty with bilateral turbinectomy or turbinoplasty and followed up at least 3 months by one rhinologist from November 1999 to April 2000, prospectively. We analyzed subjective symptom score, minimal cross-sectional area (MCA), C-notch cross-sectional area, and total volume of both nasal cavity before and after surgery. Correlation test was studied between symptom improvement and acoustic rhinometric results. Results: Twenty nine cases were male and sixteen cases female. The average age was 26.9 year-old (range: 17 to 57 years). There was significantly improvement of symptom score in postoperative 3 months (p<0.05). There was significantly increased C-notch cross-sectional area and total volume in postoperative 3 months. Symptoms improvement were associated with acoustic rhinometric profiles, but, there was not significantly correlation. Conclusion: Septoplasty with turbinate surgery is considered to be effective for nasal obstruction in patients with septal deviation and turbinate hypertrophy. Acoustic rhinometric test is favorable objective test for evaluation of symptom improvement after septal surgery.

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Clincal Effect of Ketotifen in Allergic Rhinitis (알레르기성 비염에 대한 Ketotifen($Zaditen^{(R)}$)의 임상적 효과)

  • Eun, Sun-Jin;Kim, Yang-Dae;Park, Mun-Heum;Suh, Jang-Su;Song, Kei-Won
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.105-112
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    • 1990
  • Ketotifen, a benzocycloheptathiophene, has an orally effective antiallergic as well as antihistaminic properties. In pervious studies, Ketotifen has shown encouraging results in patient with allergic rhinitis, either perennial or seasonal. 39 patients with allergic rhinitis had been treated with Ketotifen 1 mg twice daily for 8 weeks. And we obtained following results. 1) The efficacy rate in sneezing attack was 73.5%, in nasal discharge 71%, in nasal obstruction 58%. 2) Some improvements in at least one of three major symptoms were noted within 1 week in 30.7%, within 2 weeks in 55.8%, within 3 weeks in 66.7%, within 8 weeks in 87.2%. 3) Physical findings such as colour, swelling of turbinate, character of rhinorrhea were not improved significantly. 4) Side effect was observed only in one patient with abdominal pain and diarrhea, which was subsided after interruption of administration. These results suggested that Ketotifen was effective in treatment of allergic rhinitis.

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A clinical study of allergic rhinitis (알레르기 비염에 관한 임상적 연구)

  • 채병윤
    • The Journal of Korean Medicine
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    • v.21 no.3
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    • pp.149-165
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    • 2000
  • As recent developments of Immunology and Nuclear medicine, serum IgE and IgG values are helpful in the diagnosis and evaluation of the therapeutic effects of nasal allergies. But in Korea, air pollution and the increased use of food additives have become leading factors in nasal allergies, It seems to be induced by environmental change, especially industrialization and urbanization, so allergic rhinitis in our environment has changed in accordance with the changes made in the living environment. Therefore this study is attempted in order to observe a clinical analysis which places more importance on allergic rhinitis. We studied 200 patients who had visited Kyunghee Oriental Medical Center with allergic rhinitis from January 1, 1999 to December 31, 1999 The results were as follows: 1. The sex distribution was 114 males(57%) and 86 females(43%). In age distribution, the average age was 25. In males, ages ranged from 3 to 66 years old and the average was 23.81. In females, ages ranged from 4 to 67 years old and the average was 28.57. The peak age was 30~39 years old(24%); under 9 years old and 10~19 years old were each 18%; 20~29 years old was 22%; 40~49 years old was 11 %; over 50 years old 6.5%. The gulf between males and females showed a statistically significant difference(P<0.025). 2. In the age of onset, male' s maximum was 62.5, minimum was 0.25; female s maximum was 59.5, minimum was 0.2. Under 9 years old was the most with 34%(male 24%, female 10%), 10~19 years old was 18%, 20~29 years old was 22.5%, 30~39 years old was 13.50%, over 40 years old was 12%, The gulf between males and females were showed statistically significant difference.(p<0.014) 3. The average duration of the disease was 5.67 years. In male and female, the maximum was 30, the minimum was 0.05; under 5 years old was the most with 62%(male 34.50%, female 27.50%); 6~10 years old was 23%. So, under 10 years old was 85%. There was no statistically significant difference in the duration of disease. 4. Regarding type of residence, 47.50% of patients with allergic rhinitis lived in apartments, 52.50% lived in houses. In males, 29.50% lived in apartments, 27.50% lived in houses. In females, 18% lived in apartments, 25% lived in houses. There was no statistically significant difference in the residence by T-test and chi-test. 5. In the distribution of season, spring is the most with 29.5% of patients, winter 28%, fall 25.5%, and summer 17%. But there was no statistically significant difference. 6. After observing 200 patients with allergic rhinitis, classifying main symptoms into 5 types, sneezing was the main symptom in 177cases(88.50%), nasal obstruction in 176cases(88%), rhinorrhea in 169cases(84.5%), post nasal discharge in 87cases(43.50%), and itching in I04cases(52%). The Cumulus ration is 98.50% and symptoms overlapped with an average 3.57±0.1 times but in an analysis of variance of these symptoms, the gulf between males and females was not recognized as statistically significant by T-test and ANOVA. 7. Patients whose families have allergic diseases account for 90 cases(45%) : 49cases(24.50%) male and 41cases(20.50%) female. There were 4 cases (71.11 %) whose families have allergic rhinitis, 9cases(10%) of asthma, and 7.78% with allergic dermatitis. There were 61 (67.80%) cases of patients whose parents have allergic diseases; cases wherein the patient s child had allergic diseases numbered 13 (14.45%); and cases with a sibling with allergic diseases totalled 16cases (17.80%). There was no statistically significant difference in allergic disease regarding sex, parents, or siblings by chi-test. 8. Blood type: For males, type A is the most common, with 37cases(18.5%), followed by type B with 32cases(16%), type O 28cases(l4%) and type AB 13cases(6.5%). For females, type B is the most common, with 30cases(15%), followed by type O with 23cases(l1.5%), type A with 18cases(9%) and type AB with 13cases(6.5%). There was no statistically significant difference in blood type by chi-test. 9. In the selection of prefered food, most patients prefer cool food, with 98 such cases(49%), tepid food in 54cases(27%) and warm food in 48cases(24%). These showed a statistically significant difference in the selection of prefered food between males and females by chi-test(p<0.009). 10. The state of Past History was classified into II types. chronic hypertrophic rhinitis is the most common with 11cases (18.64%), tonsil and adenoid hypertrophy is 8cases(l3.56%), sinusitis is 6cases(10.17%), nasal septum deviation is 4cases, nasal polyp is 2cases, others are 10cases(l6.95%). No statistically significant difference in past history between males and females was shown, but a statistically significant difference was shown when males and females were compared with total cases by T-test(p<0.002, P<0.0008). 11. Regarding complications, 37 patients (28.91%) had sinusitis: 22cases(17.19%) in male, 15cases(11.72%) in female. Chronic hypertrophic rhinitis was found in 15cases(11.72%). Others are under 10%. There was no statistically significant difference in the type of complications between males and females, but a statistically significant difference was shown when males and females were compared with total cases by T-test(P<0.00l, P<0.007). 12. In the treatment, medication was used 1691 times, an average of 2.58 times. No.34 was used 370 times for 124 cases, an average of 2.98 times. No. 152 was used 318 times for 106 cases, an average of 3.00 times. No.151 was used 307 times for 97cases, an average of 3.16 times. No. 31 was used 117 times for 33 cases, an average of 3.55 times. No 25 was used 116 times for 33 cases, an average of 3.52 times. 13. In the duration of treatment, the most frequent is 1 week(69cases, 34.50%), the maximum is 20weeks, and the minimum is 1week. A treatment period of 2~3 weeks accounted for 32% of cases, a period of 4~5weeks accounted for 13.5%. The gulf between males and females showed a statistically significant difference in the duration of treatment.(p<0.01). There was a statistical significance when the males were compared with total cases by ANOVA(P<0.03). 14. A comparison between before-treatment and after-treatment showed a statistically significant difference in treatment by T-test (p<0.01) and F-test (p<0.0058).

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