• Title/Summary/Keyword: 신경외과

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A Case of Sensorineural Hearing Loss and Vertigo during Epidural Nerve Block (경막외 신경차단술 시행 중 발생한 감각신경성난청과 어지럼 1예)

  • Lee, Byeong Min;Noh, Jin hong;Ahn, Seong Ki;Park, Hyun Woo
    • Research in Vestibular Science
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    • v.17 no.4
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    • pp.170-174
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    • 2018
  • Epidural anesthesia has significantly advanced in neuraxial anesthesia and analgesia. It is used for surgical anaesthesia and treatment of chronic pain. Hearing loss during or after epidural anesthesia is rare, and it is known to occur by the change of the intracranial pressure. Cerebrospinal fluid is connected with perilymph in the cochlear and vestibule that is important to hearing and balance. If the intracranial pressure is abruptly transferred to the inner ear, perilymph can be leak, that called perilymphatic fistula, dizziness, and hearing loss can occur suddenly. We report a 65-year-old woman who presented with acute onset dizziness and hearing loss during the epidural nerve block for back pain, wherein we speculated a possibility of perilymphatic fistula as the mechanism of hearing loss and dizziness. The mechanism of dizziness and hearing loss was suspected with perilymphatic fistula.

A Case of Early Malignant Change from Neurofibroma to Malignant Peripheral Nerve Sheath Tumor (제1형 신경섬유종증, 신경섬유종, 악성 말초신경초종)

  • Poo Reum Kang;Yeong Joon Kim;Sun Ju Oh;Hyoung Shin Lee
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.45-48
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    • 2023
  • Malignant peripheral nerve sheath tumor (MPNST) is one of the soft tissue sarcoma believed to originate from neural crest cells. The patients with neurofibromatosis type I (NF1) have about 8-13% of the lifetime risk of the malignant transformation. Neurofibroma on patients with NF1 can be surgically resected and has good prognosis if approach to the tumor is possible. We experienced a case of a 50-year-old woman with NF who had incompletely resected neurofibroma, which presented a rapid malignant transformation to MPNST, 3 months after the first surgery. We reported this case with a brief review of literature.

Efficacy of Intraoperative Neural Monitoring (IONM) in Thyroid Surgery: the Learning Curve (갑상선 수술에서 수술 중 신경 감시의 효용성: 학습곡선을 중심으로)

  • Kwak, Min Kyu;Lee, Song Jae;Song, Chang Myeon;Ji, Yong Bae;Tae, Kyung
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.130-136
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    • 2018
  • Background and Objectives: Intraoperative neural monitoring (IONM) of recurrent laryngeal nerve (RLN) in thyroid surgery has been employed worldwide to identify and preserve the nerve as an adjunct to visual identification. The aims of this study was to evaluate the efficacy of IONM and difficulties in the learning curve. Materials and Methods: We studied 63 patients who underwent thyroidectomy with IONM during last 2 years. The standard IONM procedure was performed using NIM 3.0 or C2 Nerve Monitoring System. Patients were divided into two chronological groups based on the success rate of IONM (33 cases in the early period and 30 cases in the late period), and the outcomes were compared between the two groups. Results: Of 63 patients, 32 underwent total thyroidectomy and 31 thyroid lobectomy. Failure of IONM occurred in 9 cases: 8 cases in the early period and 1 case in the late period. Loss of signal occurred in 8 nerves of 82 nerves at risk. The positive predictive value increased from 16.7% in the early period to 50% in the late period. The mean amplitude of the late period was higher than that of the early period (p<0.001). Conclusion: IONM in thyroid surgery is effective to preserve the RLN and to predict postoperative nerve function. However, failure of IONM and high false positive rate can occur in the learning curve, and the learning curve was about 30 cases based on the results of this study.

Endoscopic Treatment of Latrogenic Chylothorax after Thoracic Symphathicotomy -A Case Report- (교감신경다발 차단술 후 발생한 유미흉의 내시경적 치료 -1례 보고-)

  • 이선훈;김재욱;정재일;윤찬식;윤영철;구본일;이홍섭;김문철
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.988-990
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    • 2000
  • 흉강경을 이용한 교감신경다발 차단술은 다한증 치료에 아주 효과적이다. 술 후 유미흉과 같은 합병증은 발생은 적으나 아주 위험할 수 있다. 흉관 근접 부위의 좌측 2번째에서 4번째 흉부 교감신경다발 차단술 후 발생한 유미흉을 흉강경을 이용한 전기 응고법으로 치료하였기에 보고하는 바이다.

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Electrospinning으로 제조된 PMMA/PVA Multilayer bone plate의 생체적합성에 관한 연구

  • Gwak, Gyeong-A;Thai, Van Viet;Lee, Byeong-Taek;Song, Ho-Yeon
    • Proceedings of the Materials Research Society of Korea Conference
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    • 2009.11a
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    • pp.43.1-43.1
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    • 2009
  • Bone plate는 골절된 뼈의 골 유합을 지지하기 위해서 정형외과, 신경외과, 성형외과 및 치과 등에서 널리 사용되고 있다. 하지만 기존의 bone plate는 대부분 금속으로 제작되어 있어 장기간 이식에 따른 부식 및 천연골 강도저하 등으로 인해 1~2년 후 재수술을 해야 하는 문제점을 갖고 있다. 본 연구에서는이런 금속 bone plate의 단점을 개선하고자 생체적합성이 우수한 생분해성 고분자 bone plate를 제작하였다. 사용된 고분자는 생체적합성과 생분해성이우수한 PVA(polyvinly alcohol)와 강도를 유지하기 위한 PMMA(poly methyl methacrylate)를 사용였다. Electrospinning 법으로 PVA와 PMMA fibrous mat를 제작하여 각 mat를 적층시킨 후 열압착을 하여 강도를 증가시킨 PMMA/PVA Mutlilayer bone plate을 제작하였다. 제작된 PMMA/PVA Mutlilayer bone plate의 생체적합성 평가를 위해 MTT assay, 생분해 특성을 관찰하기 위해 Micro-CT와 SBF(simulated body fluid) 내에서의 용해도를 관찰하였다. 또한조골세포의 부착과 분화에 미치는 영향을 SEM(scanning electron microscope)을통해 관찰하였고, 조골세포의 유전자 발현에 미치는 영향을 RT-PCR을통해 확인하였다.

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Schwannoma Arising from the Plantar Digital Nerve of the 2nd Toe: A Case Report (제 2족지 족저측지신경에 발생한 신경초종: 증례 보고)

  • Choi, Jun-Cheol;Song, Woo-Suk;Kim, Jeong-Muk;Kwon, Kye-Won
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.166-169
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    • 2018
  • A schwannoma is a benign tumor that originates from the peripheral nerve sheath. Schwannomas occur most commonly in the head and neck region involving the brachial plexus and the spinal nerves. The lower limbs are less commonly affected. This paper presents a case of a patient with a schwannoma showing atypical localization at the digital nerve of the foot causing neurological symptoms.

Splanchnicotomy and Thoracic Sympathicotomy for Control of Intractable Abdominal Pain -One Case Report- (내장신경 절단 및 흉부교감신경 절단을 통한 난치성 복통의 치료 -1례 보고-)

  • 황정주;김재영;이두연
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.995-997
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    • 2000
  • 내장의 통증은 교감신경을 통하여 척수로 전달된다고 알려져있다. 특히 췌장염이나 췌장암의 통증에 관해서 Mallet-Guy 등이 1943년 큰내장신경 및 요교감신경절 절제술을 시행한 이래로 상기 방법이 이용되어 왔다. 내장신경 절제술은 효과에 비해 수술이 커지고, 긴 바늘을 이용한 복강신경총 차단술이 발달하면서 사장된 방법으로 여겨졌다. 그러나, 최근에 흉강경을 이용한 수술방법이 발달하면서 간단히 큰내장신경 절제술이 가능해져 흉강경을 이용한 큰내장신경 절단술은 난치성 복통치료의 좋은 방법으로 받아 들여지고 있다.

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The Therapeutic Effect of Postganglionic Nerve Block for Symptomatic Schmorl Nodule: A Retrospective Case Series (증후성 쉬모를 결절에 대한 신경절 이후 신경차단술의 치료 효과: 후향적 증례 분석)

  • Son, In Seok;Hwang, Suk Hyun;Lee, Suk Ha;Kang, Min Seok
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.147-153
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    • 2018
  • Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

단 비골건을 이용한 만성 족관절 불안정성의 수술적 치료

  • Park, Yong-Uk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.15-18
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    • 2008
  • Chrisman-Snook 술식은 광범위한 절개 및 비복 신경 손상 우려 등과 함께 기술적으로 복잡하다고 여겨지고 있으나, 단비골건을 전부 희생하지 않고 전거비 인대와 종비 인대를 함께 재건하면서 동시에 이식건의 등장성을 확보할 수 있어 술 후 환자의 만족도가 비교적 높고 재발 가능성이 적은 훌륭한 술식으로 사료된다.

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