• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.3
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• pp.156-159
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• 2022

The coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus-2 has upended the world of otolaryngology. After COVID-19 infection, patients experience various complication of symptoms due to injury of the larynx and lung/ respiratory system. Regardless of the patient's severity, patients can experience several complications including dysphonia, vocal cord paralysis/paresis and sensory neuropathy. An emerging role for otolaryngologists in the coming weeks and months is the management of laryngeal complications of COVID-19. This review is intended to describe laryngeal complications in patients recovering from COVID-19 infection.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.744-747
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• 2000

Objectives : The purpose of this study was to evaluate the clinical features of the epidermoid tumor of posterior fossa and to assess the surgical outcome. Methods : We reviewed the clinicoradiological records of 10 epidermoid tumor of posterior fossa, treated surgically at our hospital between 1991 and 1996. Results : The mean age of onset was 36 years old and mean duration of symptom was 5.2 years. Six were men and four were women. The location of tumors were cerebellopontine angle(CPA) 5 cases, cerebellum(Cbll)& 4th ventricle 3 cases, foramen magnum 1 case, and pineal region extended to Cbll and 4th ventricle 1 case. Common clinical features were trigeminal neuralgia in 3 cases, cerebellar signs 2 case, headache 2 cases, hemifacial spasm with deafness 1 case, cbll signs and multiple cranial nerve dysfunctions 1 case. One CPA epidermoid had no clinical symptom and sign associated with the tumor. The surgical approaches were suboccipital approach in 9 cases and one transcallosal approach to the tumor of pineal region. The extent of surgical removal was gross total resection in 5 cases and near total or subtotal resection in 5. Two patients with CPA tumor were complicated with facial paresis. One patient with tumor located in cerebellum extended into cisterna magna had postoperative vocal cord paresis. All complicated cases had severe adhesion of tumor capsule with brainstem or cranial nerve. The mean duration of follow up was 26 months. The overall outcome was improvement of symptoms and signs in 6 cases and stationary 4 cases. During follow up, imaging study was done in 7 patients and none of them had finding of tumor recurrence. Conclusion : We conclude that recurrence of tumor is rare in both total and subtotal resected cases, but long-term follow-up is required. Aggressive removal of tumor capsule that adhesed to brianstem or cranial nerve is avoided for preventing severe postoperative complication.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.1
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• pp.14-23
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• 2014

Objectives The objective of this study is to report the effects of acupuncture on neonatal brachial plexus palsy (neonatal brachial plexopathy). Methods We treated the patient with acupuncture for 4 months. Acupuncture was performed on the infant with flaccid paresis of a lower extremity. The effects of neonatal brachial plexus injury were measured by the active movement scale and the electromyographic test. Results 1. In electromyographic test, conduction velocity in left median nerve was elevated. 2. Active movement scale score was increased from 6 to 27 during the 4 months of treatment. 3. Grasping power of the patient's left hand was 60% stronger than the first medical examination. Conclusions This study showed that acupuncture was effective in treating the symptoms of brachial plexopathy. The further studies might be also needed.

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.392-394
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• 2010

Trochlear nerve palsy associated with spontaneous subarachnoid hemorrhage (SAH) is known to be a rare malady. We report here on a patient who suffered with left trochlear nerve palsy following rupture of a right posterior communicating artery aneurysm. A 56-year-woman visited our emergency department with stuporous mental change. Her Hunt-and-Hess grade was 3 and the Fisher grade was 4. Cerebral angiography revealed a ruptured aneurysm of the right posterior communicating artery. The aneurysm was clipped via a right pterional approach on the day of admission. The patient complained of diplopia when she gazed to the left side, and the ophthalmologist found limited left inferolateral side gazing due to left superior oblique muscle palsy on day 3. Elevated intracranial pressure, intraventricular hemorrhage or a dense clot in the basal cisterns might have caused this trochlear nerve palsy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.2
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• pp.99-103
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• 2012

Spasmodic dysphonia is a chronic, focal, movement-induced, action-specific dystonia of the laryngeal musculature during speech. It can have a profound effect on quality of life, severely limiting people's communication, especially via telephone and in noisy backgrounds. Spasmodic dysphonia (SD) is usually of the adductor type characterized by glottic contractions causing tightness and voice breaks with forced-strangled voice, but it may also be abductor type or, much less commonly, mixed. Treatment options for adductor spasmodic dysphonia (ADSD) include voice therapy, surgical procedures, and botulinum toxin injections (Botox). The use of Botox injected into the laryngeal muscles remains the "gold standard" treatment for reducing the vocal symptoms of ADSD and Botox induces a temporary paresis of the laryngeal muscles and provides short-term relief of symptoms. Repeated injections of the laryngeal muscles, generally every 3-4 months, are required for continuous relief of symptoms. Improvement in vocal function has been reported after use of Botox injections, though a completely normal voice is rarely achieved. In this hospital, 1,030 patients have been enrolled for Botox injection therapy so far (May, 2012). In this review article, I'd like to present my personal experience of management of spasmodic dysphonia mainly by Botox injection.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.2
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• pp.87-91
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• 2004

Background and Objectives : Temporary vocal fold injection is not only performed to restore the laryngeal function in temporary unilateral vocal fold paralysis or paresis, but also performed as a test injection prior to the permanent injection. Gelfoam has been safely used for the past several decades for the temporary vocal fold augmentation. Recently, we found a new material, called Radieses Lite, may be used as a temporary injection material. Material and Methods : We report preliminary results of 11 patients who had Radiesse Lite injection with a variety of pathologies. Results : Based on the results from the 6 patients who completed follow-up, the duration of effectiveness of Radiesse Lite seems to be from 2 to 3 months depending on the injection amount. Radiesse Lite satisfies several requirements of the ideal temporary vocal fold injection material in terms of injectability, convenience, duration of effectiveness and safety. Conclusion : The authors concluded that Radiesse Lite might be a good option for temporary vocal fold injection especially in the office setting.

• Korean Journal of Veterinary Research
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• v.37 no.4
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• pp.817-823
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• 1997

Suckling piglets and weaned pigs showed anorexia, dehydration, severe abdominal breathing, emaciation and paresis from Oct. 1993. to Nov. 1993. Five 2-week-old piglets were submitted for diagnosis in Kangwon National University. At necropsy, the pin-point well demarcated yellowish white foci were scattered on the surface of the lung, heart, liver, spleen and kidney. Histologically, multifocal areas of necrosis with mononuclear cells infiltration were found in the lung, heart, liver, lymph node, spleen, kidney and small intestine. These lesions tended to be associated with blood vessels. Variable round to ovoid tachyzoites were located at the periphery of the lesions. The organisms were demonstrated as Toxoplasma gondii by immunohistochemical staining method. Ultrastructurally, this parasite was surrounded with parasitophorous vacuole in alveolar macrophage. The parasite was crescent-shaped and $6{\sim}8{\times}1{\sim}2{\mu}m$ in size. It was enclosed by an thick outer membrane and an underlying thin inner membrane. Several club-shaped paired organelles and conoids lay in the cytoplasm at the anterior. Numerous round body and one to several mitochondria were presented in the cytoplasm. Based on the gross findings, histopathology, immunohistochemical and electron microscopic findings, this case was diagnosed as toxoplasmosis in piglets.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.124-126
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• 1997

Stellate ganglion block is the most widely practiced procedure in the pain clinics due to its wide range of indications. We experienced a rare case who exhibited severe hematoma in neck following stellate ganglion block. A 58-year-old female patient injured by a traffic accident was admitted to the department of negro surgery for the treatment of cerebral contusion, cervical and lumbar sprain and left arm paresis. Because left sensory neural hearing loss occurred, the patient was referred to the pain clinic for treatment with stellate ganglion block due to her left sensory neural hearing loss. The next day stellate ganglion block was done with a negative aspiration for blood. Three hours later, hematoma in neck was found and the patient complained of pain in the neck and dyspnea. The symptoms and signs of respiratory difficulty were progressively aggravated. The hematoma was removed and ruptured muscular branch of vertebral artery was ligated under surgical exploration. In this case, the needle was apparently in the branch of vertebral artery during or after injection in spite of the negative aspiration for blood. Authors recommend that compression of the injected site over 5 minutes should be necessary to prevent a hematoma formation despite of a negative aspiration for blood.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.420-422
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• 2012

Cerebral aspergillosis is rare and usually misdiagnosed because its presentation is similar to that of a tumor. The correct diagnosis is usually made intra-operatively. Cerebral abscess with fungal infection is extremely rare and few cases have been reported, but it carries a poor prognosis. A 73 year-old man presented with decreased visual acuity and paresis of the right cranial nerve III. Magnetic resonance imaging (MRI) revealed a mass in the right cavernous sinus, extened to the anterior crainial fossa and the superior orbital fissure. During surgery, a well encapsulated pus pocket was found, and histopathological examination of the mass resulted in the diagnosis of aspergillosis. Despite appropriate anti-fungal treatment, the patient eventually died from fatal cerebral ischemic change and severe brain swelling. The correct diagnosis of cerebral aspergillosis can only be achieved by histopathological examination because clinical and radiological findings including MRI are not specific. Surgical intervention and antifungal therapy should be considered the optimal treatment. Early diagnosis and aggressive antifungal treatment provide good results.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.112-114
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• 2013

Bilateral abducens nerve palsy related to ruptured aneurysm of the anterior communicating artery (ACoA) has only been reported in four patients. Three cases were treated by surgical clipping. No report has described the clinical course of the isolated bilateral abducens nerve palsy following ruptured ACoA aneurysm obliterated with coil. A 32-year-old man was transferred to our institution after three days of diplopia, dizziness and headache after the onset of a 5-minute generalized tonic-clonic seizure. Computed tomographic angiography revealed an aneurysm of the ACoA. Magnetic resonance imaging showed focal intraventricular hemorrhage without brain stem abnormalities including infarction or space-occupying lesion. Endovascular coil embolization was conducted to obliterate an aneurysmal sac followed by lumbar cerebrospinal fluid (CSF) drainage. Bilateral paresis of abducens nerve completely recovered 9 weeks after ictus. In conclusion, isolated bilateral abducens nerve palsy associated with ruptured ACoA aneurysm may be resolved successfully by coil embolization and lumbar CSF drainage without directly relieving cerebrospinal fluid pressure by opening Lillequist's membrane and prepontine cistern.