• 대한기관식도과학회지
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• 제17권1호
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• pp.57-60
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• 2011

Spontaneous tonsillar bleeding is a rare condition in ENT unit. Almost reported cases have been related to infection of tonsils. Prior to introduction of antibiotics, spontaneous tonsillar bleeding was usually related to superficial capsular bleeding due to acute or chronic tonsillitis. The presented case is a 36-year old healthy man without history of acute, chronic tonsillitis, and coagulation disorder who complained of dyspnea and oropharyngeal foreign body sensation after vomitting. Examination revealed a reddish polypoid mass of the right tonsil. Furthermore, the mass pushed uvula and tongue base, caused nearly total obstruction of oropharynx. All rountine laboratory test results were within normal limits. Computed tomography (CT) showed low density mass of attached in upper pole of right tonsil without enhancement. We performed tonsillectomy including the reddish polypoid mass under general anesthesia. The pathology revealed lymphoepithelial tissue with reactive hyperplasia. This is the first reported tonsillar hematoma presenting as a large oropharyngeal mass which was caused by vomitting.

• The Korean Journal of Pain
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• 제24권1호
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• pp.7-12
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• 2011

Background: Adenosine has been shown to have a wide spectrum of unique pain-relieving effects in various clinical situations. The aim of this study was to investigate the effects of intraoperative adenosine infusion on acute opioid tolerance and opioid induced hyperalgesia induced by remifentanil in adult patients undergoing tonsillectomy. Methods: For this study, ninety patients were randomly allocated into groups that receive either adenosine (adenosine group) or saline (remifentnail group) intravenously under remifentanil based anesthesia and saline (sevoflurane group) under sevoflurane anesthesia. The patients in adenosine group received adenosine at dose of $80\;{\mu}g$/kg/min, and those in remifentnail group and sevoflurane group received an equal volume of saline 10 minutes after the induction of anesthesia until the end of surgery. Intraoperative evaluation included time weighted mean remifentanil dose, and postoperative evaluations included degree of pain severity at 1, 6, 12, and 24 hours, time to first postoperative requirement, and analgesic dose required during 24 hours after operation. Results: Time weighted mean remifentanil dose during intraoperative period in adenosine group was significantly lower than that of remifentnail group (P = 0.00). The first postoperative analgesic were required earlier in remifentanil group than sevoflurane group or adenosine group (P = 0.00). Pethidine requirement during 24 hours in sevoflurane group and adenosine group was significantly lower than that of remifentnail group (P = 0.00). The visual analog scale scores for pain in sevoflurane group and adenosine group were significantly lower than those of remifentnail group for 12 hours after operation (P = 0.00). Incidence of hypotension (P = 0.024) and number of ephedrine administered (P = 0.011) in adenosine group were significantly higher than those of sevoflurane group. Conclusions: The above results suggest that intraoperative adenosine infusion prevent acute opioid tolerance and opioid induced hyperalgesia induced by remifentanil.

• Child Health Nursing Research
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• 제4권2호
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• pp.286-293
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• 1998

The purpose of this study was to investigate the level of anxiety for the mothers of leukemic children and to provide the fundamental data for the better performance of caring to them. The subjects were 292 mothers : 100 mothers whose children had a leukemia, 80 mothers whose children had taken a tonsillectomy, 112 mothers whose children with medical disease except cancer. The data were collected through The State-Trait Anxiety Inventory of Spilberger and analyzed by t-test, ANOVA Scheffe test. The results were as follows ; 1. The state anxiety mean score of mothers with leukemic children was 54.16. 2. The state anxiety of mothers with leukemic children was higher than that of the rest (F=8.00, P=0.0004). 3. There was no significant difference in anxiety of mothers with leukemic children in relation to leukemic children's and their mother's general characteristics.

• 대한두경부종양학회지
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• 제23권2호
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• pp.178-180
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• 2007

Tortuosity of the internal carotid artery is not a rare condition. A 68-year-old woman presented with a 3 years' history of a pulsatile tinnitus and throat abnormal sensation. On physical examination, a soft pulsatile mass on the left posterior oropharyngeal wall was noted. By neck CT and neck MRI the tortuous internal carotd artery was visualized. Otolaryngologists should recognize this anomaly and the patient should be made aware of their condition, because it may cause a fatal or near-fatal hemorrhage during surgical procedures in the pharynx, especially tonsillectomy and adenoidectomy and drainage of peritonsillar abscess. We report a case of a left internal carotid artery tortuosity as an oropharyngeal mass.

• 대한기관식도과학회지
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• 제5권1호
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• pp.96-101
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• 1999

For many years it has been reported that seemingly benign neck cysts may contain carcinoma. Cystic metastases have often mistaken for either branchial cleft cysts or benign mass. Authors experienced two cases which presents cystic cervical metastatic cancer One was a tonsillar carcinoma and the other was a tongue carcinoma. Patients with a cystic squamous carcinoma in the neck likely have a primary in upper aero-digestive system and It is known that the tonsil is most common site. Radiologic examination and fine needle aspiration biopsy of the cyst proved to be non-diagnostic. The development of cervical lymph node metastases before clinical signs of carcinoma of the tonsil is also well recognized. So, in old patients, thorough head If neck examination, panendoscopy and ipsilateral tonsillectomy is mandatory to identify a primary carcinoma prior to cyst excision.

• 대한치과의사협회지
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• 제57권5호
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• pp.279-287
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• 2019

Obstructive sleep apnea syndrome (OSAS) is characterized by obstructive events of the upper airway (UAW) during sleep, which can be associated with clinical signs and symptoms such as snoring, excessive daytime sleepiness, impaired memory, and fatigue. It is associated with many problems like psychosocial problems, physiologic alterations in the cardiovascular and respiratory systems as a result of hypoxia and repeated awakenings during sleep. Conservative treatments such as weight loss, sleep positioning, improvement of sleep hygiene, CPAP and MAD can be performed for the obstructive sleep apnea. However, their effect for the OSA is limited and differs by patient's individual properties. Accordingly, surgical reconstructions of the upper airway must be carried out for the treatment of OSA.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.348-355
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• 1994

Styloid process is a slender pointed bone of variable length, which project downward, forward, and slightly medialward from the posteroinferior portion of the tympanic part of the temporal bone. Embryologically, the styloid process is derived from Reichert's cartilage, a structure of second branchial arch origin. Most patients with elongated styloid process remain asymptomatic, but some patients complain pain and sensation of foreign body in the throat, dysphagia, dysphonia, referred otalgia. Recently, we have experienced a case of elongated styloid process in a fifty-nine year old man. He had been suffered from Rt. side sore throat, headache and pharyngeal discomfort during head movement. Through various X-ray examination, Xeroradiography, and palpation of tonsillar fossa, elongated styloid process on Rt. side was confirmed. Under the general anesthesia, it was successfully removed out via transoral approach technique, described by Eagle. The resected styloid process was 2.5cm in it's length and he was freed from the symptoms without further complication.

• Journal of Acupuncture Research
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• 제19권4호
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• pp.101-111
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• 2002

Objective : In order to review the studies related to the treatment of children by aupuncture or mo ibustion Methods : We referred to a Pubmed site by using searching word of "the terms of pediatrics(for e ample child children infant baby pediatrics etc and acupuncture" Results : 40 journals with 63 papers were searched 50 papers were reported Conclusion : 1 We found 63 articles in 40 journals which were Pediatrics J Tradit chin Med Am Fam Physician Anaesthesia linical research was the most of these studies and the pattern of the rest were review or clinical conferences 3 We analy ed articles and found many articles of nocturnal enuresis asthma bronchitis postoperative vomitting constipation etc 4 The result of clinical studies represented the significant cure rate owever the cases of sensorineural hearing loss vomitting after tonsillectomy e ercise induced asthma were not 5 It was ta en to research for laser acupressure bloodletting ear acupuncture etc as well as body acupuncture in the area of pediatric acupuncture treatment as alternative therapy which was composed of the lower stimulation than adult.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권2호
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• pp.162-166
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• 2001

Obstructive sleep apnea syndrome(OSAS) is a complex sleep disorder characterized by intermittent apnea secondary to sleep-induced obstruction of the upper airway. It occurs because of an airway obstruction anywhere between the trachea and the oronasal apparatus. The hallmark of OSAS is snoring, which is caused by vibration of the tissues of the pharynx as the airway narrows. The consequences of OSAS have focused on excessive daytime sleepiness resulting from sleep fragmentation and the cardiovascular derangements producing hypertension and arrhythmias. The primary method of controlling OSAS has been surgery. The current surgical procedures used for OSAS are tracheostomy, tonsillectomy, nasal septoplasty, uvulopalatopharyngoplasty, anterior mandibular osteotomy with hyoid myotomy and suspension, and maxillary, mandibular and hyoid advancement. We report a case of OSAS that was improved by genial advancement with infrahyoid myotomy and suspension. The patient was objectively documented by polysomnography, cephalometric analysis, and physical examination before the surgical procedure. The patient underwent genial advancement with infrahyoid myotomy and suspension. Patient had a good response from surgery.

• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.793-805
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• 1994

Investigating the existence of volume-outcome relationships for specific disease groups relates directly to the policy issue of whether, and how, specific inpatient services should be regionalized. This study examined whether medical costs and lengths of stay as outcomes were affected by changes in volume within hospitals. Based on the claims data obtained from National Federation of Medical Associations, each six disease categories from medical and surgical conditions were selected and 29,720 cases from 1,266 hospitals were analyzed. Main findings of the research can be summarized as follows: 1. Analyzing volume and cost per case relationship, tonsillectomy class 1, hernia procedure class 0, appendectomy and cesarean section class 0,1 in surgical conditions showed negative relationship significantly. In cases of medical conditions, costs per case in respiratory neoplasm class 2, COPD class 1, 2, digestive malignancy were also related to volume negtively. 2. Comparing volume with length of stay per case, lens procedure class 0, hernia procedure class 0, appendectomy class 0,1, cesarean section class 1 in surgical conditions showed negative relationships significantly. In medical conditions, volume of respiratory neoplasm class 2, COPD class 1,2, digestive malignancy class 0 were associated with negatively. 3. Within same disease categories, changes in cost and length of stay per case to volume were more remarkable in severe cases. These results suggested a significant inverse relationship between disease cases and cost, length of stay per case as outcome variables.