• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.358-368
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• 2018

Objectives: To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography. Methods: We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group. Results: Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group. However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness. In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so. Conclusions: Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.92-95
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• 2016

Neuroblastomas are sometimes associated with abnormal constitutional karyotypes, but the XYY karyotype has been rarely described in neuroblastomas. Here, we report a case of an esthesioneuroblastoma in a boy with a 47, XYY karyotype. A 6-year-old boy was admitted to our hospital because of nasal obstruction and palpable cervical lymph node, which he first noticed several days previously. A polypoid mass in the right nasal cavity was detected through sinuscopy. Biopsy of the right nasal polyp was performed. Based on the result, the patient was diagnosed with a high-grade esthesioneuroblastoma. Nuclear imaging revealed increased uptake in both the right posterior nasal cavity and the right cervical IB-II space, suggesting metastatic lymph nodes. Cytogenetic analysis revealed a 47, XYY karyotype. Twelve courses of concurrent chemotherapy were administered. Three years after the completion of chemotherapy, the patient had had no disease recurrence. He manifested behavioral violence and temper tantrums, so we started methylphenidate for correction of the behavior.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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• pp.17.5-18
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• 1983

혈관섬유종은 비교적 희귀하며 주로 성장기 남성의 비인강에 발생되고 있으며 병리조직학적으로는 양성이나 임상적으로는 해부학적 위치와 주위조직으로 침윤해 들어가는 파괴성 및 적출시의 출혈성, 불완전한 적출로 인한 재발 때문에 악성으로 알려져 왔다. 흔히 사춘기 이전에서 호발되고 사춘기를 지나서는 발생율이 적은 종양의 하나이며 대부분 비인강에 나타나며 비중격에 생긴 예는 아주 희귀하다. 저자들은 최근에 비중격에 발생한 혈관섬유종 1예를 치험하였기에 보고하는 바이다. 환자는 37세 된 남자로서 1개월 전부터 비폐색과 빈번한 비출혈을 호소하여 본원 이비인후과에 내원하였다. 국소소견상 좌측 비강을 거의 폐쇄하고 있는 종물이 보여 1983년 1월 21일 국소마취하에서 경비적으로 판전적출술을 시행하였다. 술후 3 일째 퇴원하여 현재까지 관찰중이나 별 이상 없이 경과하고 있다.

• 대한한방소아과학회지
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• 제19권2호
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• pp.31-40
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• 2005

Objectives: This study was performed to investigate the character of childhood common cold according to four seasons. Methods: We made an investigation into medical record of 432 children under fifteen years of age who visited pediatrics or emergency room suffering from common cold. We analyzed the principal and secondary symptoms of the children classifying four seasons by $SPSS^{\circledR}$ 12.0 for windows. Results: Male to female ratio were 1.42:1, the average of age was 3.86 years old. Distribution of principal symptoms was that nasal discharge was 231(56.1%), cough was 233(54.1%), nasal obstruction was 162(39.3%), secretion and sputum were 126(30.6%), fever was 121(29.4%), and headache was 13(3.2%). Out of these fever occurred in high frequency during spring and summer, nasal obstruction occurred in high frequency during spring and autumn. Distribution of secondary symptoms was that throat pain was 93(22.6%), otalgia was 39(9.5%), vomiting was 35(8.5%), abdominal pain was 30(7.3%), anorexia was 23(5.6%), sweating was 21(5.1%), diarrhea was 19(4.6%), and startle was 11(2.7%). Out of these otalgia occurred in high frequency during spring and summer, diarrhea occurred in high frequency during autumn and winter. Conclusions: A few symptoms can be the character according to four seasons.

• 대한두개안면성형외과학회지
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• 제19권1호
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• pp.41-47
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• 2018

Background: The number of surgical risks recalled by a patient after surgery can be used as a parameter for assessing how well the patient has understood the informed consent process. No study has investigated the usefulness of a self-developed mobile application in the traditional informed consent process in patients with a nasal bone fracture. This study aimed to investigate whether delivery of information, such as surgical risks, through a mobile application is more effective than delivery of information through only verbal means and a paper. Methods: This prospective, randomized study included 60 patients with a nasal bone fracture. The experimental group (n=30) received preoperative explanation with the traditional informed consent process in addition to a mobile application, while the control group (n=30) received preoperative explanation with only the traditional informed consent process. Four weeks after surgery, the number of recalled surgical risks was compared for analysis. The following six surgical risks were explained: pain, bleeding, nasal deformity, numbness, nasal obstruction, and nasal cartilage necrosis. Results: The mean number of recalled surgical risks among all patients was $1.58{\pm}0.56$. The most frequently recalled surgical risk was nasal deformity in both groups. The mean number of recalled surgical risks was $1.72{\pm}0.52$ in the experimental group and $1.49{\pm}0.57$ in the control group. There was a significant association between mobile application use and the mean number of recalled surgical risks (p=0.047). Age, sex, and the level of education were not significantly associated with the mean number of recalled surgical risks. Conclusion: This study found that a mobile application could contribute to the efficient delivery of information during the informed consent process. With further improvement, it could be used in other plastic surgeries and other surgeries, and such an application can potentially be used for explaining risks as well as delivering other types of information.

• 대한한방소아과학회지
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• 제17권2호
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• pp.149-160
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• 2003

Objective : Essential oil inhalation and He-Ne laser treatment has become increasingly available in children with nasal diseases. But the reports on the effect and prognosis have been poor. In this study, we analyzed the treatment effect, recurrence rate and the degree of recurrent symptoms. Materials/Methods: 23 children(2-10 year-old) with nasal diseases, who received essential oil inhalation with He-Ne laser treatment at least 10 times in our hospital from January 1st 2001 to December 31th 2002 were studied. Result : Ten cases are male & thirteen cases are female. The average of age was 4.91 year-old. The most frequency symptoms are nasal discharge (82.6%), nasal obstruction (78.3%), cough (47.8%), secretion sound (39.1%), sneezing (17.4%). Average numbers of treatment period, interval and treatment times are 71.79 days, 4.06 days, 18.13 times respectively. Of the 23 children, 14 children were in 'all symptom improved' at the remedial ends, and 22 children relapsed. In the degree of recurrent symptoms, 15 children were in 'more improved then before-treatment and not equal to directly remedial ends'. No case was in 'worse than before-treatment'. The final result of treatment, 6 children keep the degree of remedial ends, on the other hand 17 children are not. Conclusions : Even though, the recurrence rate was high, this combined treatment improve nasal symptoms. The final assessment is good, when the treatment-result is good, when the treatment interval is regular and when parent's are cooperative. If the symptoms continue a whole year, the result is not so good.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.788-791
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• 2009

Purpose: Reconstruction of full - thickness defects of the nasal ala has always been a challenge. Local flaps can be used easily, and good result can be achieved when it is indicated. But local flaps often result in facial scars and bulky ala that require secondary revisions. Composite auricular chondrocutaneous graft may matches nasal alae well in terms of contour, color and texture, however, the size of composite graft is limited. We performed free vascularized helical root flaps for reconstruction of nasal ala. Methods: Bilateral ala were excised and the defects were reconstructed with a chondrocutaneous free helical root flap. Each side of ala was reconstructed in 3 months interval. Superficial temporal vessels of vascularized helical root flap were anastomosed to facial vessels. Great saphenous vein was used for interpositional vascular graft. Results: Flaps were survived successfully. The contour, texture and color match were satisfactory. Functional problem of nasal obstruction caused by scar stenosis of nostrils was also resolved. Conclusion: The free vascularized helical root flap is a reliable method in reconstruction of nasal alar defects. The donor deformity was minimal.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.93-96
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• 2011

Purpose: In most cases of nasal bone fracture, closed reduction with internal or external splint fixation approach is selected. However, because of indiscriminate insertion of the internal splint without considering of anatomical difference or deformity, insufficient fixation happens frequently that need additional fixation. Therefore, we suggest a new method for providing adequate support in reduced nasal bone by carving $Merocel^{(R)}$ that is fixed for the anatomical structure. Method: Closed reduction and internal fixation with carved $Merocel^{(R)}$ was performed in 15 nasal bone fracture patients from March, 2010 to July, 2010. Each patient was evaluated by physical examination, facial photographic check, simple X-ray, and computerized tomography. On the first day post-operation, location of packing and amount of reduction were checked by follow up X-ray and computerized tomography. In addition, patients' symptoms were evaluated. During the 3-month post-op follow up at out-patient clinic, operator, 2 doctors in training and one assistant performed the objective evaluations by physical examination on nasal dorsal hump, nasal deviation, nasal depression, nasal breath difficulty, and nasal airway obstruction. A survey of subjective patients' satisfaction in 4-stages was also performed. Results: The results of follow-up computerized tomography of the 15 patients revealed that 11 patients had good reduced state. Three patients with combined maxillary frontal process fracture had over reductions. A survey performed on the first day post-operation showed that 14 of 15 patients answered that their current symptoms were more than tolerable. At the 3-month follow-up physical exam, one case had a dorsal hump. However, there were no nasal deviations, nasal depressions, nasal breath difficulties, or nasal airway obstructions. Twelve of the 15 patients answered more than moderate on the 3-month survey. Conclusion: Intranasal packing after carving the $Merocel^{(R)}$ considering anatomical structure is a new effective method to promote proper-reduction, maintain stability, and minimize patients' symptoms by addition of a simple procedure.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.81-85
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• 2011

Purpose: Nasal bone fracture is the most common facial fracture. Although nasal bone fractures are considered to be minor injuries, the incidence of post-traumatic nasal deformity remains high. This study is designed to support management and patient satisfaction by classifying the simple nasal bone fracture, and survey the care method and result, which is compared with other studies. Methods: From May 2008 to April 2010, 334 patients with simple nasal bone fractures visited our hospital. The incidence, cause, types of nasal bone fracture, treatment, and complications are analyzed according to clinical examination, patient's record and radiographic images. Results: The mean age of patients was 30 years old, with 74% of the patients having been male, and 26% were female. The highest incidence of this fracture was between late teens to late twenties. The causes of nasal bone fracture were the following: having slipped or fallen down (39%), violence (16%), sports accident (14%), traffic accident (11%), industrial accident (6%), and others (16%). Patient's radiographic images were analyzed by Stranc and Robertson classification, frontal impact plane I was 38%, plane II was 16%, plane III was 1%, lateral impact plane I was 21%, plane II was 21%, and plane III was 3%. On average, surgical treatment was performed 7.2 days after trauma under general anesthesia. Closed reduction of nasal bone fracture was performed in 99% of patients. In patients with septal injuries, septal management was performed in 76.7% of cases. Aesthetic surgery was done on same time in 24% of patients. There were some complications, such as residual nasal deformity (7.2%), nasal obstruction (0.9%) and hyposmia (0.3%). Conclusion: According to this study, nasal bone fractures occurred commonly in physically active age groups (age 15~29 years), as a result of having slipped or fallen down, at afternoon and at night time. And it could be treated successfully by closed reduction and septoplasty by 7 days after trauma.

• 한방안이비인후피부과학회지
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• 제19권3호통권31호
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• pp.75-89
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• 2006

Background & Objectives : Rhinitis is an inflammation of nasal mucosa and the symtoms are watery rhinorrhea, sneezing, itchy nose, and nasal obstruction. Rhinitis is classified into allergic rhinitis and nonallergic. Allergic rhinitis is an immune reaction by allergen, and vasomotor rhinitis which is nonallergic noninfectious hypersensitive reaction. The incidence of allergic rhinitis has increased and the rate of vasomotor rhinitis is high. However there have been no studies about vasomotor rhinitis compared with allergic rhinitis. And there have been no studies so far performed on the effect of Tongkwansan. Therefore this study is aimed to find out the effects of Tongkwansan on allergic rhinitis and vasomotor rhinitis. Materials and Methods : Fifteen BALC/c mouses divided into three groups : normal group, control group and sample group. To induce the allergic rhinitis in control group and sample group, mouses were sensitized intrapertioneally 0.1 % ovalvumin solution three times at intervals of 1 week. Then intranasal sensitization was performed by diffusing 0.1 % ovalbumin solution 3 times at intervals of 2 days. After that time, mouses in the sample group were oral and administration treated by Tongkwansan for 28 days. We observed changes in nasal mucosa and submucosa; also changes in the segment of leucocyte, erythrocyte, neutrophil, lymphocyte, monocyte, eosinophil, IL-4 and $IFN-{\gamma}$ in blood. We used the statistical methods of ANOVA test(p<0.05). Results : There were no significant changes statistically in leucocyte, erythrocyte, neutrophil, lymphocytem, monocyte, eosinophil, IL-4 and $IFN-{\gamma}$ in blood(p<0.05). Hypertrophy of epithelium in nasal mucosa and expansion of glandular cells in nasal submucosa were decreased in treated group when compared with control group. Conclusion : According to above results, it is supposed that Tongkwansan has significant effects on vasomotor rhinitis which is nonallergic and noninfectious.