• Title/Summary/Keyword: 비강수술

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Glottic and subglottic airway obtruction

  • 김영모
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.113-113
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    • 2003
  • 성문과 성문하부의 기도 폐쇄는 위치 정도 원인 기간 등은 환자에 따라 다르고 그 치료방법 역시 다양하다. 주 원인으로는 기관내 삽관, 각종 외상 및 화상 등 을 들 수 있다. 이러한 질환의 치료 목적은, 기관내 튜브나 기관 캐뉼러 를 통하지 않고 비강을 통하여 자연스럽게 호흡할 수 있도록 기도를 유지 하면서 발성이 가능하고 기고 흡인 없이 연하가 가능하도록 하며 기침 반사가 원활하게 되도록 하는데 있다. 치료목적의 달성을 위하여 협착의 경우, 단계 즉 초기 단계 또는 성숙단계 여부, 위치, 정도, 범위 환자의 연령 전신상태 등을 술전에 잘 평가하고 수술도중의 소견과 술자의 경험이나 기호에 따라 적절한 치료법을 선택하여 치료해야 한다. 후두 외상에 의한 기도 문제는 다른 외상에 비해 흔하지 않은데 이는 연골의 유연성과 후두의 가동성 그리고 후두가 하악과 흉골사이에 위치하여 외상시 보호받게 되는 해부학적 특성에 기인한다. 여러 요인으로 인하여 진단이 늦어질 수도 있는데 이러한 경우 심각한 증상이 초래 되거나 치료가 의 시기가 지나 후두 또는 기관 협착, 발성장애등의 후유증이 유발 될 수 있다.

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Postoperative Change in Hypertrophic Rhinitis(Study Using Nasometer, CSL and Acoustic Rhinometer) (비후성 비염환자에서 음성검사 및 음향비강통기도검사를 이용한 수술전후 비교)

  • 유영삼;우훈영;윤자복;최정환;조경래
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.12 no.1
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    • pp.34-38
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    • 2001
  • Background and Objectives : With the development of computerized systems, an objective evaluation methods of nasal speech and nasal geometry have become readily available by means of a simple, noninvasive technique. In this study, we assessed the nasality, nasal formant, nasal volume and nasal area in patients with hypertrophic rhinitis before and after turbinate surgery. Material and Method : With the nasometer, we measured nasalance, which reflects the ratio of acoustic energy output of nasal sounds from the nasal and oral cavities. With CSL 4300B, we measured nasal formants. We used acoustic rhinometer to measure nasal area and nasal volume. Postoperative changes of above factors were compared with preoperative values. Paired t-test and Pearson's correlation were used for statistical analysis. Results : The first nasal formant frequency, nasalance scores of three passages(baby, mamma and rabbit passages), minimal cross sectional area(MCA) of narrow side, nasal volume of narrow side and nasal volume of wide side had increased significantly after turbinate surgery (p <0.05). The MCA and nasal volume of narrow side and MCA of wide side showed significant correlation with nasalance score of rabbit passage and baby passage showed significant correlation with nasal volume of narrow side(p<0.05). Conclusion : There were significant increases in nasalance scores, first nasal formant frequency, MCA and nasal volume after turbinate surgery. Thus, we must consider the possibility of voice changes postoperatively in professional voice users.

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Treatment of skeletal Class II adult patient with vertical and transverse problems caused by nasal airway obstruction using microimplant anchorage (비강기도 협소에 의한 수직 및 횡적 문제를 가진 골격성 II급 성인환자에서의 마이크로임플란트를 이용한 증례보고)

  • Chae, Jong-Moon;Chang, Na-Young;Cho, Jin-Hyoung;Kang, Kyung-Hwa;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.39 no.4
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    • pp.257-272
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    • 2009
  • This case report describes the treatment of an adult patient with a Class I canine and molar relationship but a convex profile with a retrognathic mandible and marked lip protrusion, as well as an excessive lower anterior facial height and reduced transverse width on both arches due to a nasal airway obstruction. The constricted arches were expanded by surgically-assisted rapid palatal expansion and the application of a Schwarz appliance to the maxilla and mandible. Acceptable facial balance was obtained using contemporary directional force technology with microimplant anchorage (MIA), which provided horizontal and vertical anchorage in the maxillary and mandibular posterior teeth, as well as intrusion and torque control in the maxillary anterior teeth, resulting in a favorable counterclockwise mandibular response. The total treatment period was 29 months and the results were acceptable for 13 months after debonding.

Fabrication of implant-associated obturator after extraction of abutment teeth: a case report (지대치 발거 후 임플란트 연관 상악 폐색장치 제작 증례보고)

  • Ki-Yeol Jang;Gyeong-Je Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.229-236
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    • 2023
  • Maxillary bone defects may follow surgical treatment of benign and malignant tumors, trauma, and infection. Palatal defects often lead to problems with swallowing and pronunciation from the leakage of air into the nasal cavity and sinus. Obturators have been commonly used to solve these problems, but long-term use of the device may cause irritation of the oral mucosa or damage to the abutment teeth. Utilizing implants in the edentulous area for the fabrication of the obturators has gained attention. This case report describes a patient, who had undergone partial resection of the maxilla due to adenocarcinoma, in need of a new obturator after losing abutment teeth after long-term use of the previous obturator. Implants were placed in strategic locations, and an implant-retained maxillary obturator was fabricated, showing satisfactory results in the rehabilitation of multiple aspects, including palatal defect, masticatory function, swallowing, pronunciation, and aesthetics.

Functional repair of the cleft lip and palate using Delaire method (Delaire 법을 이용한 구순구개열 환자의 구순 및 코 교정수술)

  • Song, In-Seok;Yi, Ho;Lee, Su-Yeon;Lee, Il-Gu;Myoung, Hoon;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin;Seo, Byoung-Moo
    • Korean Journal of Cleft Lip And Palate
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    • v.9 no.2
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    • pp.93-100
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    • 2006
  • Although the delayed type of rhinoplasty is currently acceptable in the correction of cleft lip and nasal deformity, Delaire tried to achieve the simultaneous nasolabial reconstruction and muscular rearrangement that affect the subsequent skeletal growth of the face. the anatomic muscular reconstruction can be achieved by making the anchorage of the nasolabial muscles of the cleft side to the nasal septum and muscles on the non-cleft side. Two cleft lip patients of 6 and 7 year-old without any previous operation history were treated with the functional cheilorhinoplasty. One patient with incomplete cleft lip underwent a cheiloplasty along with the rearrangement of orbicularis oris muscle. The other patient had a complete cleft lip and palate with accompanying nasal deformity, who underwent the functional cheilorhinoplasty with the reconstruction of anterior nasal base. All the operation was done under the general anesthesia and patients healed without any significant complications. In the incomplete case, the shapes of Cupid's bow was restored, and the length of columella was regained comparable to the non-affected side. In the complete cleft lip and palate case, the depressed nostril was reconstructed with acceptable symmetry by complete releasing of deformed alar cartilage undermined with a dissecting scissors. In summary, the functional repair of cleft lip and nose could be possible at the same time by using Delaire method. This method is effective to correct the primary nasolabial deformity, which results in the restoring favorable anatomy and its function.

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Correction of Secondary cleft lip-nasal deformity; secondary rhinoplasty in children and adults (구순열 이차비기형의 교정; 아동과 성인에서의 이차 비성형술)

  • Song Gin-Ah;Myung Hoon;Hwang Soon-Jung;Seo Byoung-Moo;Lee Jong-Ho;Choung Pill-Hoon;Kim Myung-Jin;Choi Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.1
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    • pp.17-25
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    • 2003
  • Correction of the cleft-lip nasal deformity is a difficult task that requires clear understanding of the associated complex anatomy and function as well as the operation time, the selection of an operation method, On the expectation that it helps enhance understanding the current trend of cleft-rhinoplasty, authors analyzed secondary rhinoplasty between 1999 and 2002, In both the unilateral and bilateral cleft lip rhinoplasty, we reviewed the timing of repair, site of correction and it's major technique, incision or approach method, autogenous cartilage graft method, All patients with a septal deviation did not have a septal surgery, We were active in alar and nasal tip surgery and passive in septal and dorsal deformity correction, And for children, we used a conservative method but for adults, we used radical approach, Most surgeries are focused on esthetic goal and we thought that objective evaluation for nasal obstruction was needed for bener and predictable outcome.

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The Effect of Ethanol Inhalation on Postoperative Nausea in Patients using Patient Controlled Analgesia (에탄올 비강흡입이 수술 후 자가통증조절기 사용 환자의 오심에 미치는 효과)

  • Oh, So-Young;Park, Kyung-Sook;Hwang, Yoon-Young
    • Korean Journal of Adult Nursing
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    • v.21 no.4
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    • pp.379-390
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    • 2009
  • Purpose: The study was done to investigate the effect of ethanol inhalation on postoperative nausea in patients using Patient Controlled Analgesia (PCA). Methods: The data were collected from June 1st 2006 to September 30th, 2007. The subjects were 70 patients who had had orthopedic surgery under general anesthesia. The levels of the Visual Analogue Scale (VAS) was used to measure postoperative nausea. The experimental group was given ethanol inhalation using ethanol pads and the control group received normal saline pads. All participants were instructed to take two deep sniffs with the pad one inch from the nose. This was repeated every five minutes for three doses. The collected data were analyzed using SPSS/WIN 12.0 program. Results: The study supported all hypotheses. "The experimental group given first dose of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -5.900, p = .000). "The experimental group given second doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -7.507, p = .000). "The experimental group given third doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -6.685, p = .000). Conclusion: According to these results, the ethanol inhalation can be considered an effective nursing intervention for relieving the postoperative nausea in patients using PCA.

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Recurrence Analysis after Video-assisted Thoracic Surgery for the Treatment of Spontaneous Pneumothorax (자연기흉의 비디오흉강경수술 후 재발에 대한 분석)

  • Kim, Sung-Wan;Kim, Duk-Sil;Lim, Chang-Young;Lee, Hyeon-Jae;Lee, Gun;Kong, Joon-Hyuk
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.710-715
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    • 2010
  • Background: Video-assisted thoracic surgery (VATS) became common in the treatment of spontaneous pneumothorax (SP). Therefor we've reviewed the recurrence rate after VATS and analysed the factors affecting recurrent pneumothorax after VATS on this study. Material and Method: This retrospective analysis was performed on 321 patients of SP who had undergone VATS from Jan. 2001 to Dec. 2008. The two groups were divided as follow: group A, non-recurrent group (298 patients: 93%); and group B, recurrent group (26 patients: 7%); the two groups were analysed retrospectively. Result: The average age of the study groups were $20.9{\pm}4.3$ years old in recurrent group vs. $25.9{\pm}11.7$ years old in non-recurrent group with statistical significance (p < 0.05). There were no statistical significance in male to female ratio, height/weight ratio, location of pneumothorax, smoking history, operative time, duration of drain, hospital stay, indication of opertion and incidence rate. Average length of duration in recurrence was 12.9 months. There was 22 (95.7%) recurrent patients after VATS within 4 year period among recurrent group. Treatment methods in 23 of recurrent patients were, 8 (VATS), 2 (Axillary thoracotomy) with 15% or more in amount of pneumothorax and 7 (7 Fr. chest tube), 6 (nasal 02) with 15% or less in amount of pneumothorax. Among 10 cases of reoperation, there were 3 cases of over looking type and 7 cases of new growing type. There was no additional recurrence after these procedures were given. Conclusion: There was higher recurrence rate in younger age after VATS thus for those under 20 yrs old, detailed and possible preoperative warning for recurrence is warranted. Most recurrence occured within 4 year period, thus for this reason, regular interval based follow up with chest x-ray study is suggested during this period.

A human case of internal myiasis in Korea (내부 승저증(internal myiasis) 1례)

  • 정평림;정영헌
    • Parasites, Hosts and Diseases
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    • v.34 no.2
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    • pp.151-154
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    • 1996
  • A 71-year old male patient was admitted in Inha hospital due to right facial palsy, quadriplegia and aphasia. This patient was operated to replace his heart valves 7 years ago and has been treated with Coumarin. an anti-coagulant drug. to prevent the formation of thrombus in the hpart. A number of fly maggots continuoully crawled out from the nasogastric tube set up for supplying a liquid diet and patient's mouth for 2 days until his death in the intensive care unit of hospital. These maggots were about 11.5 mm long on the average and identified as genus Lucilio belonging to family Calliphoridae. The lesion of this myiasis case might be regarded in the castro-intestinal . System of patient. This is the first report of an internal myiasis case in Korea.

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The Effect of Half Day Nasal Packing in Results of Closed Reduction of Nasal Bone Fracture (반나절 비강충전이 비골 골절 수술결과에 미치는 영향)

  • Han, Dong Gil;Kim, Tae Seob
    • Archives of Craniofacial Surgery
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    • v.13 no.2
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    • pp.119-124
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    • 2012
  • Purpose: Closed reduction and nasal packings for 3-7 days is usual procedures in managing nasal bone fracture. Most patients experience several discomfort owing to lack of nasal breathing. There are many reports concerning how to reduce patient's discomforts or complications. But it is obvious that the duration of nasal packing is 3-7 days. The aim of this study is evaluate the effect of half day nasal packing in results of nasal bone fracture. Methods: The study was performed on 97 nasal bone fracture patients who had simple nasal bone fractures from January to June 2012. The incidence, cause, patient's discomfort and satisfaction with half day nasal packing are analyzed according to patient's medical records and questionnaire at each nasal packing removal, postoperative 4 weeks. Results: Young male patients, especially the teenagers and the twenties were the common age group, and physical violence was most common cause of injury. A total of 78 out of 97 patients were male. In 92 cases, closed reduction were applied. Approximately, 87% of the patients were satisfied with the outcomes. Conclusion: Half day nasal packing is considered as an effective method to minimize patient's discomfort owing to prolonged absence of nasal breathing with maintenance of stability.