• 제목/요약/키워드: Sinusitis treatment

검색결과 145건 처리시간 0.028초

Use of the facial dismasking flap approach for surgical treatment of a multifocal craniofacial abscess

  • Ishii, Yoshitaka;Yano, Tomoyuki;Ito, Osamu
    • Archives of Plastic Surgery
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    • 제45권3호
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    • pp.271-274
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    • 2018
  • The decision of which surgical approach to use for the treatment of a multifocal craniofacial abscess is still a controversial matter. A failure to control disease progress in the craniofacial region can potentially put the patient's life at risk. Therefore, understanding the various ways to approach the craniofacial region helps surgeons to obtain satisfactory results in such cases. In this report, we describe a patient who visited the emergency department with a large swelling in his right cheek. A blood test and computed tomography revealed odontogenic maxillary sinusitis. The patient developed sepsis due to a progressive multifocal abscess. An abscess was seen in the temporal muscle, infratemporal fossa, and interorbital region. To control this multifocal abscess, we used the facial dismasking flap (FDF) approach. After debridement using the FDF approach, we succeeded in obtaining sufficient drainage of the abscess, and the patient recovered from sepsis. The advantages of the FDF approach are that it provides a wide surgical field, extending from the parietal region to the mid-facial region, and that it leaves no aesthetically displeasing scars on the face. The FDF approach may be one of the best options to approach multifocal abscesses in the craniofacial region.

Pott's puffy tumor of the upper eyelid misdiagnosed as simple abscess: a case report and literature review

  • Kuylhee Kim;Donghyun Lee;Soyeon Jung;Chul Hoon Chung;Yongjoon Chang
    • 대한두개안면성형외과학회지
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    • 제25권3호
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    • pp.141-144
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    • 2024
  • A 76-year-old woman, initially thought to have a simple abscess on her right upper eyelid, presented to our department of plastic and reconstructive surgery. Enhanced three-dimensional facial computed tomography (CT) revealed an abscess on the right upper lid, with a pyomucocele present in the right frontal sinus, accompanied by bone erosion in the superior wall of the right orbit. Based on the results of the CT scan, we diagnosed an atypical Pott's puffy tumor (PPT) with an abscess on the upper lid originating from the frontal sinusitis. First, surgical incision and drainage were performed in our department, and a percutaneous vacuum drain was placed. To provide a more definitive treatment, endoscopic sinus surgery (ESS) was subsequently performed by otorhinolaryngologists. The patient was discharged without any complications 5 days after ESS. At a 1-year follow-up, no recurrence or notable neurological symptoms were observed. In the case we observed, the patient presented with an upper eyelid abscess and cellulitis, indicating possible orbital involvement. For such patients, a CT scan is necessary. Given the possibility of PPT, it is critical to perform a comprehensive differential diagnosis rather than defaulting to a straightforward approach involving abscess treatment.

비용(鼻茸)환자에 대한 임상적 연구 (A Clinical Study on the Patients with Nasal Polyps)

  • 이상문;홍승욱
    • 한방안이비인후피부과학회지
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    • 제19권2호
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    • pp.180-191
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    • 2006
  • Objectives : The purpose of this clinical report was to investigate the general characteristics of the patients with nasal polyps and estimate the efficacy of the oriental medical treatment on nasal polyps. Methods : We performed a clinical analysis of 50 patients who visited Kabsan oriental clinic due to nasal polyps. We inquired into distribution of age, sex, operation history related to nose, grade of nasal polyps, efficacy of treatment, etc. Results and Conclusions : 1. The sex ratio was 2.3 : 1. The average age was 40.02 years. 2. In the nasal operation history, inexperienced patients were 35 cases and experienced patients were 15 cases. 3. In the region of nasal polyps, there were 35 cases of bilateral types of nasal polyps, which is mon than in unilateral types. In the number of nasal polyps, multicentric types of 26 cases were similar in the number with solitary type of 24 cases. 4. In the predisposing or concomitant diseases, chronic sinusitis was the most frequent followed by allergic rhinitis, chronic rhinitis, septal deviation chronic otitis media, asthma, tonsilitis and allergic dermatitis. 5. In the main symptoms, nasal obstruction was the most important. In the concomitant symptoms, patients had frequent rhinorrhea, smell disturbance, postnasal drip, headache, etc. 6. The average treatment period was 3,58 months and the average number of treatment was 12.94 sessions. 1. In the amount of herbal medicine, 2 and 3 Ji(劑) were the most. The most frequently used herbal medicine to treat was Hyangbujamogeuntanggagam(香附子茅根湯加減) 8. In the change of grade after treatment, Grade I was the most. In the efficacy of treatment, 'good' was the most, followed by 'excellent' and 'uneffective'.

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알레르기성 비염을 포함하는 과민성 비염 환자에 관한 임상적 연구 (A Clinical Study of Hypersensitive rhinitis including Allergic rhinitis)

  • 최인화
    • 한방안이비인후피부과학회지
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    • 제15권2호
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    • pp.169-182
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    • 2002
  • Background: Allergic rhinitis(AR) is a heterogeneous disorder that despite its high prevalence is often undiagnosed. It is characterized by one or more symptoms including sneezing, itching, nasal congestion, and rhinorrhea. And it is frequently accompanied by symptoms involving the eyes, ears, and throat, including postnasal drainage. There are many different causes of rhinitis in children and adults. Approximately 50$\%$ of all cases of rhinitis are caused by allergy. In the case of rhinitis caused by allergens, symptoms arise as a result of inflammation induced by a gamma globulin E-mediated immune response to specific allergens such as pollens, molds, animal dander, and dust mites. The immune response involves the release of inflammatory mediators and the activation and recruitment of cells to the nasal mucosa. AR is similar to 鼻?, hypersensitive rhinitis in Oriental Medicine. I think hypersensitive rhinitis is including of AR, vasomotor rhinitis and non-allergic rhinitis related with eosinophil increased and so on. Purpose: To perform a clinical analysis of hypersensitive rhinitis including allergic rhinitis and estimate the efficacy of Oriental Medical treatment. Objective: We studied 96 patients who had visited our hospital with complaints of nasal symptoms from March 2000 to February 2002; they had the signs more than 2 - nasal obstruction, watery discharge, sneezing and eye or nasal itching. Parameters Observed & Methods: We treated them with acupuncture & herb-medication. Sometime they used aroma oil or external medicine. 1) the distribution of sex & age groups 2) the clinical type based on duration & the severity of symptom 3) the breakdown of complication & pasl history of Otolaryngologic or allergic disease 4) the clinical assessment and classification of rhinitis(sneezers and runners & blockers) 5) the associated symptoms and signs 6) the classification of Byeonjeung 7) the classification of prescriptions and 8) the efficacy of treatment. Result: 1. In the clinical type of based on duration, the intermittent type was 42.7$\%$ and the persistent was 57.3$\%$. 2. We observed the severity of symptoms based on the quality of life. The mild type was 24.0$\%$ and the moderate-severe was 76.0$\%$. 3. In the clinical assessment and classification of rhinitis, the sneezers and runners type was 69.8$\%$ and the blockers was 30.2$\%$. 4. The most common family history with otolaryngologic or allergic disease were allergic rhinitis(17.7$\%$), urticaria, paranasal sinusitis and T.B.(3.1$\%$). 5. The most common past history with otolaryngologic or allergic disease were paranasal sinusitis(14.6$\%$), atopic dermatitis and asthma(8.3$\%$). It was 31.3$\%$ they had a family history and 44.8$\%$, past history. 6. The most common complication was paranasal sinusitis(15.6$\%$). In decreasing order the others were otitis media with effusion(9.4$\%$), GERD and headache(6.3$\%$), asthma, bronchitis, nasal bleeding and allergic dermatitis(5.2$\%$). 7. Classification through Byeonjeung : ⅰ) 39 cases(34.9$\%$) were classified as showing Deficiency syndrome. The insuffficiency of Qi was 17.7$\%$, deficiency of Kidney-Yang, 12.5$\%$ and Lung-Cold, 10.4$\%$. ⅱ) 57 cases(59.4$\%$) were classified as showing Excess syndrome. The Fever of YangMing-meridian was 35.4$\%$, Lung-Fever, 24.0$\%$. 8. The efficacy of treatments showed: an improvement in 22cases(22.9$\%$); an improvement partly in 24 cases(25.0$\%$); no real improvement or changes in 16 cases(16.7$\%$); and couldn't check the results 18cases(18.6$\%$). Conclusion: We suggest that this study could be utilized as a standard of clinical Oriental Medical treatment when we treat hypersensitive rhinitis including allergic rhinitis.

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알레르기 비염을 포함하는 과민성 비염 환자 580례에 대한 임상적 고찰sdf (A Clinical Study of 580 Cases on Hypersensitive Rhinitis including Allergic Rhinitis)

  • 신상호;김자혜;김미보;고우신;윤화정
    • 한방안이비인후피부과학회지
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    • 제20권1호통권32호
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    • pp.218-227
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    • 2007
  • Objective : The purpose of this study is to investigate outpatients of hypersensitive rhinitis including allergic rhinitis who had visited to Hospital of Oriental Medicine. Method : We analyzed statistics study in 580 patients, who had visited to the Dept. of dermatology, ophthalmology & otorhinolayngology Hospital of Oriental Medicine Dongeui University from March, 1998 to December, 2006. Results : The results were as follows. 1. There is more male(53.28%) than femal(46.72%). The age distributions of patients showed highest in 20-29 years, followed by 10-19 years, 30-39 years in order. 2. The yearly distributions of patients showed highest in 2004, followed by 2001, 2005 in order. The seasonal distributions of patients showed highest in fall, followed by winter, summer, spring in order. The monthly distributions of patients showed highest in September, followed by August, October in order. 3. The distributions of number of times in treatment showed highest in 1-5 times. The distributions of duration of treatment showed highest in 1 week. In the treatment method, a major portion of treatment methods was acupuncture, followed by herbal medicine treatment, aroma therapy in order. 4. The Frequency of use of Prescriptions showed highest in Bojungikgi-Tanggami. The Frequency of use of Extract showed highest in Sochungryong-Tang. 5. The distribution of past history showed highest in Atopic dermatitis. The distribution of Rhinologic Complication showed highest in Paranasal sinusitis.

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소아천식에 대한 임상적 고찰 (A Clinical study on Pediatric Bronchial Asthma)

  • 김윤희
    • 대한한방소아과학회지
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    • 제16권1호
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    • pp.133-148
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    • 2002
  • Objective : This study was to investigate more effective oriental medical treatment for Pediatric Bronchial Asthma Method : Aroma therapy and Herbal medicine was given to 28 pediatric bronchial asthma patients(19 males and 9 females) for about 5months from the First, August 1999 The Fifth, January 2002. Results: 1. Demographic factor : The sample consisted of 28 persons among whom 19 were male, 9 were female. The age ranges from 1 year old to 6 year old. Less than 2 year old were 4 and 2-6 year old were 20. 2.Residence : Apartment and villar dwellers were 19(67.9%), Residential street divellers were 9(32.1%). 3.Age distribution at on set : 6(21.4%) fell ill befor 1 year old and 22(78.6%) fell ill after 1 year old 4. The period of illness : 9(32.2%) suffered during 1-3 year and 6(21.4%) suffered during 6 mouth-1year and 6(21.4%) suffered during more than 3 year. 5. Frequency of the symptoms : The symptoms appeared 2-3 times a year in the case of 16(57.2%), one time a year in the case of 1, 4 times a year in the case of 6(21.4%). 6. Concomitance symptoms : All experienced coughing sign, wheezing, 23(82.1%) experienced epistaxis, nose dripping, 13(46.4%) got fever, anorexia. 7. Past history of illness : 16(57.1%) got brochiolitis, brochitis, 12(42.9%) suffered pneumonia, 9(32.1%) had allergic rhinitis. 2 had allergic rhinitis, sinusitis, atopic dermatitis, bronchial asthma, 3 got atopic dermatitis, bronchial asthma and 7 had allergic rhinitis, sinusitis, bronchial asthma, 8. Family disease : In the case of family disease, 21(75%) had allergic dermatitis, 9(42.9%) had bronchial asthma, 8(38.1%) had allergic dermatitis. 9. The symptoms became very severe in the change of season in the case of 13(46.4%) and in the case of 11(39.3%), the change of season made no difference 10. Associated caused of induction symtoms : 28(100%) got sick by common cold, infectional disease, 8(28.6%) got sick by cold food, cold air 11.The kind of therapy : 15(53.6%) got oriental therapy after occidental therapy, 11(39.3%) took only oriental therapy. 12. Improvement degree of each symptoms : In the case of cough and wheeze that are the main symptoms of bronchial asthma, 78.6% and 64.3% of the patients replied < improvement > and in the case of dyspnea, tachypnea 41.7% of the patients replied . In other symptoms, all replied 13. Degree of satisfaction : 19(67.9%) replied , 2(7.1%) replied . Conclusion : Herbal medicine and aroma therapy proved to be a very effective oriental medical treatment for pediatric bronchial asthma.

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알레르기성 비염의 임상적(臨床的) 연구(硏究) (A study on Allergic Rhrnitis)

  • 이해자;박은정
    • 대한한방소아과학회지
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    • 제15권2호
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    • pp.167-175
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    • 2001
  • Background : Allergic rhinitis is found in approximately 20% of the general population. And the prevalence of allergic rhinitis in the pediatric population also appears to be rising. Despite allergic rhinitis reportedly occurs very frequently, this disease is often overlooked or undertreated. The oriental medicine, allergic rhinitis is belong to the BiGu, BunChe. The symptoms are watery rhinorrhea, sneezing and nasal obstruction. The cause of disease is the weak of lung, spleen and kidney, and invasion in to nasal cavity of Poong Han etc a wrong air. Objective : To allergic rhinitis patients, we use herbal medicine and acupuncture treated. To demonstrate the effect of oriental medicine therapy in the allergic rhinitis before and after treatment. Materials and methods: Thirty five patients (18 male and 17 female) treated in our hospital between February 2001 and October 2001 were studied. Ages ranged from 10 to 56 years (mean age : 27 years). Seventy seven patients had a underlying family history (allergy or sinusitis of parents or brothers). In the past history, 63% patients have atopic disease. Illness period was from 1 month to 20 years (mean period : 5.7 year). Mean duration of treatment were 39 days. Gamihyunggyeyungyo-tang was administered mainly. Result : The symptoms of allergic rhinitis were nasal obstruction(94%), rhinorrhea(86%), itching(80%), sneezing(60%), eye itching(17%), headache(11%), nose bleeding(8%) and nose pain(6%). Compared with before and after treatment, the fourth symptoms of allergic rhinitis - sneezing, rhinorrhea, nasal obstruction and itching- improved significant statistically. (significant <0.005) Conclusion : We know that herbal medicine therapy and acupuncture were the effective treatment of Allergic rhinitis.

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2급 지적 장애를 가진 환자의 SDA 개념을 적용한 전악 수복 증례 (Full mouth rehabilitation of an oligodontia patient with intellectual disability based on shortened dental arch concept: a case report)

  • 유재욱;허성주;김성균;곽재영
    • 대한치과보철학회지
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    • 제50권4호
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    • pp.330-335
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    • 2012
  • Shortened dental arch(SDA) 개념은 여러 현실적인 이유로 적절한 대안이 없을 경우 제 2 소구치까지만 수복이 이루어져도 안정적인 교합과 저작력을 얻을 수 있다는 것으로 자연치와 임플란트를 이용한 수복시 공히 적용되는 개념이다. 본 증례는 2급 지적장애로 인해 치료시 협조를 구할 수 없으며 우식으로 인해 다수의 치아가 상실된 환자로 대구치 부위의 심한 골흡수와 상악동의 함기화 및 상악동염으로 인해 제 2 대구치까지의 수복이 용이하지 않아 가급적 위험요인을 줄이면서 최소한의 전신마취로 치료를 종결하기 위해 SDA 개념을 적용, 제 2 소구치까지만 수복이 이루어졌다. 치료 결과 심미적, 기능적으로 만족할 만한 향상이 이루어졌고 추가적인 저작력의 요구는 없었으며 주기적인 재내원으로 구강위생이 강화되었다.

외관과(外官科) 외래환자의 통계적 고찰 (A Statistics Study of Surgery, Ophthalmology & Otolaryngology)

  • 김윤범
    • 한방안이비인후피부과학회지
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    • 제13권1호
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    • pp.280-290
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    • 2000
  • We analyzed statistics study in 1695 patients, who had visited to the Dept. of surgery, ophthalmology & otolaryngology Hospital of Downtown Orirental Medicine Kyung Hee University from March, 1996 to July, 1998. The results were as follows. 1. Distribution of ophthalmology, otolaryngology and dermatology classification was $43.48\%\;in\;ophthalmology,\;16.70\%\;in\;rhinology,\;5.72\%\;in\;laryngology,\;17.94\%\;in\;dermatology\;and\;16.17\%$ in otiatrics. 2. Ophthalmology group were $31.93\%$ males and $47.90\%$ females in 10 years old within. In treatment term, opthalmology patients who had treated for 1 month within was $59.70\%$. Strabismus and visual disorder was the most common ophthalmo-disease. 3. Rhinology group were $30.00\%$ males in 10 years old within and $21.56\%$ females in 21-30years old. In treatmentm, rhinology patients who had treated for 1 month within was $53.71\%$. Rhinitis and sinusitis was the most common rhinio-disease. 4. Otiatrics group were $30.54\%$ males in 41-50 years old and $31.78\%$ females in 51-60 years old. In treatment term, otiatries patients who had treated for 1 month within was $53.28\%$. Tinnitus, hearing loss and otitis media was the most common otiatrics-disease. 5. Laryngology group were $29.27\%$ males in 31-40 years old and $28.57\%$ females in 51-60 years old. In treatment term. Laryngology patients who had treated for 1 month within was $91.75\%$ Epipharyngitis and abnormal sensation pharyngolarylgeal region was the most common laryngo-disease. 6. Dermatology group were $39.82\%$ males and $39.79\%$ females in 21-30 years old. In treatment term, dematology patients who had treated for 1 month within was $83.55\%$. Acne and Pruritus was the most common ophthalmo-disease.

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편도 및 아데노이드 절제술 후 재발한 폐쇄성 수면 무호흡 증후군 소아 1례 (A Case of Child with Obstructive Sleep Apnea Syndrome Recurred after Adenotonsillectomy)

  • 김규리;김동순;서현주;신홍범;김의중;심현준;안영민
    • 수면정신생리
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    • 제15권2호
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    • pp.94-99
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    • 2008
  • 소아의 폐쇄성 수면 무호흡 증후군은 편도 및 아데노이드 비대가 주된 원인이고, 편도 및 아데노이드 절제술 후 대부분 증세가 호전된다. 편도가 완전히 제거되지 않은 경우, 진단이 정확하지 않은 경우, 해부학적 기형이 동반되었을 때, 부비동염, 알레르기 비염 등의 만성 염증이 있는 경우, 비만이 있거나, 어린 나이에 발병한 경우 등에는 편도 및 아데노이드 절제술 후에도 폐쇄성 수면 무호흡 증후군이 재발할 수 있다. 11세 비만한 남아가 수년 전부터 심한 코골이가 있어서 병원을 방문하였다. 복부 초음파에서 지방간 소견을 보였으며 본원에서 시행한 수면다원검사상 무호흡저호흡지수(apneahypopnea index:AHI)가 70.5로 심한 OSAS 진단 받은 후 편도 및 아데노이드 절제술을 시행하였다. 수술 4개월 후 시행한 수면다원검사상에서는 AHI가 0으로 완전히 회복 되었다. 수술 1년 후 코골이와 코막힘을 다시 호소하여 소아과를 방문하였는데, 수면다원검사상 AHI 43으로 폐쇄성 수면 무호흡 증후군이 중증으로 재발된 소견을 보였다. 환아 진찰 소견상 부비동염이 심하여 항생제, 국소 스테로이드 분무, 항류코트리엔제제 치료를 시작하였고 3개월의 치료 후에 부비동염과 주관적인 증상이 호전되었다. 다시 시행한 수면다원검사에서 AHI는 8.5로 감소하였다. 당시 시행한 복부초음파상 지방간 소견은 보이지 않고 비만도도 정상화되었다. 이러한 증례로 보아 만약 폐쇄성 수면 무호흡 증후군 소아에서 수술을 시행한 후에도 증세가 지속되거나 재발한다면 지속된다면 재발을 의심하고 반드시 수면다원검사를 추적 검사하는 것이 권장되며 여러 위험인자를 고려하여 치료계획을 빨리 세우면 합병증을 예방할 수 있을 것이다.

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