• Archives of Craniofacial Surgery
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• v.24 no.2
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• pp.59-65
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• 2023

Background: Fibrous dysplasia (FD) is a localized bone disorder in which fibro-osseous tissue replaces the normal bone structure. Patients with craniofacial FD often present with gradual swelling, deformity, and compromised vision or hearing. We previously introduced "the core extirpation method," a novel surgical technique that is minimally invasive like traditional bone shaving but has longer-lasting effects. This study presents the long-term outcomes of our core extirpation method. Methods: We conducted a retrospective analysis of patients who underwent core extirpation for FD of the zygomaticomaxillary region from 2012 through 2021. Computed tomography (CT) scans were performed 6 to 12 months before the operation, immediately before and after the operation, and during follow-up visits. We performed all operations using the upper gingivobuccal approach, and we extirpated the core of the lesion while preserving the cortical structures of the zygoma and the maxilla to maintain symmetrical facial contour. Results: In 12 patients with lesions in the growth phase, anteroposterior/mediolateral (AP/ML) length discrepancies and the volume increased between preoperative and immediate postoperative CT scans. All patients' immediate postoperative AP/ML discrepancies were stable up to 12-17 months postoperatively. Postoperative volume showed continuous lesion growth; the median volume growth rate was 0.61 cc per month. Conclusion: In this article, we present our experiences managing FD using the minimally invasive core extirpation technique, which entails small expected blood loss and can be performed as day surgery. It provides similar cosmetic outcomes as traditional bone shaving but with longer-lasting results. Although there are some limitations with the study's retrospective nature and small sample size, our 4-year follow-up results show promising results of the core extirpation method in well-indicated patients.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.33 no.3
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• pp.308-316
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• 2023

Objectives: The aim of this study is to measure and assess the occupational noise exposure levels among construction workers at apartment building construction sites in South Korea. Methods: Noise exposure assessments were conducted for 139 construction workers across 10 different trades at 53 apartment building construction sites in the northern part of Gyeonggi-do. Assessments were carried out using a noise dosimeter set with a 90 dB criterion, an 80 dB threshold, and a 5 dB exchange rate over a period of more than 6 hours(L_MOEL) Results: The mean L_MOEL (equivalent continuous noise level over 8 hours) for the 139 dosimeter samples was 87.8 ± 4.3 dBA. The mean noise exposure level for each construction trade, referred to as the trade mean, was also calculated. Significant differences in noise exposure levels were observed between construction trades (ANOVA, p < 0.001). The highest L_MOEL values were recorded for concrete chippers (93.2 ± 2.6 dBA), followed by ironworkers (88.4 ± 0.7 dBA), concrete finishers (88.3 ± 2.7 dBA), masonry workers (87.7 ± 1.9 dBA), pile driver operators (85.6 ± 1.7 dBA), concrete carpenters (84.9 ± 2.4 dBA), interior carpenters (83.5 ± 2.1 dBA), and other groups (81.4 ± 2.2 dBA). Conclusions: The findings suggest that nearly all construction workers in this study are at risk of Noise-Induced Hearing Loss (NIHL). Moreover, the study establishes that construction trades can serve as a useful metric for assessing noise exposure levels at apartment construction sites.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.37 no.2
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• pp.58-73
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• 2024

Objectives : This study was designed to review and analyze domestic research trends of Korean medicine treatment on otitis media, and present data for further research and treatment of otitis media. Methods : Two researchers used six search engines to search for papers on Korean medicine treatment for otitis media published from January 1, 2000 to December 31, 2023. A total of 16 papers were searched, and bibliographic information, main and accompanying symptoms, treatment period, treatment method, evaluation scale, and treatment results of each study were analyzed. Scottish Intercollegiate Guidelines Network was used to evaluate the evidence level. Results : The most common otitis media symptom was hearing loss (12 times). The most frequently mentioned herbs were Ledebouriella seseloides (22 times) and Angelica gigas (20 times), which are the ingredients of the most commonly used prescriptions, Hyunggyeyungyo-tang (5 times), Takrisodok-yeum (4 times), and Bojungikgi-tang (3 times). All the clinical trial papers were conducted on Kamihyunggyeyungyo-tang, which showed improvement in otitis media-related indicators. The most frequently mentioned meridians were the Triple Energizer (44 times), Clinical trials were conducted on the Triple Energizer, the Gall Bladder, and the Small Intestines meridians. The most frequently used acupoints were SI19 (10 times), TE21 (9 times), TE17 (9 times). In clinical trials, acupuncture treatment with TE05, GB15, TE06, SI05, GB38, and KI02 showed a significant improvement in otitis media symptoms. Conclusions : It is believed that more efficient otitis media treatment and follow-up research can be performed by using the above-mentioned research results.

• Korean Journal of Radiology
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• v.20 no.5
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• pp.823-829
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• 2019

Objective: To summarize the high-resolution computed tomography (HRCT) and magnetic resonance imaging (HRMRI) features of duplicated internal auditory canals (DIACs). Materials and Methods: Ear HRCT data of 64813 patients with sensorineural hearing loss (SNHL), obtained between August 2009 and November 2017, were reviewed. Among these patients, 12 (13 ears) were found to have DIACs, 9 of whom underwent HRMRI. Their images were evaluated by two otoradiologists. Results: The rate of occurrence of DIAC among SNHL patients was 0.019% (12/64813). The internal auditory canals of 13 ears were divided into double canals by complete (n = 6) and incomplete (n = 7) bony septa, with varied orientations ranging from horizontal to approximately vertical. All of the anterosuperior canals extended into the facial nerve (FN) canal, except for 1, which also extended to the vestibule. The posteroinferior canals ended in the cochlea and vestibule, except for 2, which also connected to the FN canals. Magnetic resonance images revealed that 77.8% (7/9) and 22.2% (2/9) of vestibulocochlear nerves (VCNs) were aplastic and hypoplastic, respectively. Furthermore, 88.9% (8/9) of FNs were normal, except for 1, which was hypoplastic. All of the affected ears also had other ear anomalies: a narrow, bony cochlear nerve canal was the most common other anomaly, accounting for 92.3% (12/13). Malformations of other systems were not found. Conclusion: Double-canal appearance is a characteristic finding of DIAC on HRCT, and it is usually accompanied by other ear anomalies. The VCN usually appears aplastic, with a normal FN, on HRMRI.

• Journal of Yeungnam Medical Science
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• v.41 no.3
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• pp.207-212
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• 2024

Background: Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery. Methods: This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 ㎍/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores. Results: The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group. Conclusion: Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

• Journal of Veterinary Clinics
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• v.20 no.1
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• pp.26-32
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• 2003

The clinical results of 10 consecutive total ear canal ablation combined with lateral bulla osteotomy (TECA-LBO) in six dogs with chronic otitis externa and media were evaluated by the postoperative recovery and long-term follow-up. All dogs were selected for TECA-LBO on the basis of following five clinical symptoms. First, medical treatment couldnt improve clinical signs at least for eve. 2 months. Second, tympanic membrane was completely disappeared. Third, radiopacity was increased in tympanic cavity. Forth, petrous temporal bone was sclerosed. Fifth, ear canal calcification was progressed. And all cases were satisfied all five clinical symptoms. At 14. days after operation, the preoperative symptoms of chronic otitis externa and media which were scratching ear, pain, and hardening ear canal were resolved, and postoperative swelling, erythema, head tilt, and exudate from Penrose drainage were not existed In all cases. Loss of eye blink was happened in 4 cases, but these were disappeared between 14 days a(ter operation except one case on 3 months. All dogs were discharged form hospital at 14 days after operation. Between 3.5 and 6.5 months after discharging from hospital, para-aural abscessation was happened only in all Cocker spaniels. But this complication was solved by ventral bulla osteotomy (VBO). The dogs which didn't show para-aural abscessation after TECA-LBO didn't show scratching, pain, hardening of ear and hearing ability was improved, at 7.5 months after TECA-LBO. And the dogs which showed para-aural abscessation after TECA-LBO also didn't show scratching, pain, hardening of ear and hearing ability was also improved, at 7.5 months after VBO. In conclusion, After TECA-LBO, all dogs were recovered well without complication within 2 weeks except Cocker spaniel. And loss of eye blink can be cured naturally within 2 weeks after surgery. And para-aural abscessation can be happened between 4 and 7 months after TECA-LBO, so surgeon must follow-up until 8 months.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.14 no.2
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• pp.134-145
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• 2001

Introduction: Noises in the ear, whether real or imagined, are called tinnitus. Subjective causes of tinnitus(which is heard only by the patient) are extremely common and the majority of them are treated conservatively. For certain individuals their tinnitus is a major handicap; for others a trivial concern. The most common from of subjective tinnitus is a rushing, hissing or buzzing noise; it is frequently associated with sensorineural heanng loss. The patient may be unaware of the hearing loss, especially if it is a high frequency deficit of moderate severity. The character of the tinnitus may give a clue to the etiology. But the patient often has difficulty in explaining his/her tinnitus in absolute terms, as they have no other tinnitus with which to compare it but their own Tinnitus, like pain, is a subjective state and trying to objectively assess the severity is problematic. Audiological techniques to match subjective loudness to machine-produced noise may offer some help, in that sound intensity matches can bear little correspondence to subjective complaint. In spite of many studies, most patients presently seen complaining of tinnitus are told by their doctors that there is no treatment and that they will have to learn to live with this symptom. Objectives: To perform a clinical analysis of tinnitus and estimate the efficacy of Oriental Medical treatment according to the Byeonjeung(辨證). Subject: We studied 34 patients with complaints of tinnitus who had visited Pundang Cha Oriental Medicine Hospital Department of Otorhinolaryngology from March 1998 to February 2000. All of them had been treated 2 or 3 times a week with acupuncture treatment and had taken herbs according to the Byeonjeung(辨證) method. It was therefore possible for me to know whether their symptoms improved or not. Parameters Observed and Method: We treated them with acupuncture & herb-medication. Sometimes we gave them moxibustion or negative therapy with bloodletting at the acupuncture points(耳門, 聽宮, 聽會). Parameters Observed 1) Distribution of age & sex 2) Chief complaints 3) The sites of tinnitus 4) The quality of tinnitu 5) The duration of disease 6) The problem induced tinnitus 7) Factors increasing disease severity 8) The classification of the Byeonjeung(辨證) 9) The efficacy of treatments Results: 1. Age and sex distribution: The most common occurrence was found in males in their twenties: 6 males($17.7\%$), and in females in their thirties and over sixty: 8 females($23.5\%$). Total patient numbers for men and women were 20 men($58.8\%$), 14 women ($41.2\%$). 2. The most frequent major complaints were hearing disturbances related to tinnitus; and dizziness with tinnitus; each comprising 10 cases($29.4\%$). There were also 7 patients($20.6\%$) with only tinnitus. 3. Tinnitus sites: 13($38.2\%$) said that they felt tinnitus in both ears, equally. In the right ear, 9($26.5\%$), in the left, 6($17.7\%$). 4. The most frequent descriptive symptoms of tinnitus were: humming, hissing, buzzing etc. 5. The duration of disease. 14cases($41.2\%$) had a duration of less than 1 year. 6. 15cases($44.1\%$) complained that it was hard to watch TV or make a phone call because of tinnitus. 10 cases($29.4\%$) complained about depression. 7. Factors increasing severity of tinnitus: ⅰ) fatigue: 18cases($52.9\%$) ⅱ) stress/ tension: 10 cases($29.4\%$) ⅲ) alcohol and tobacco: 5cases($l4.7\%$) 8. Classification through Byeonjeung : ⅰ) 19 cases($55.9\%$) were classified as showing Deficiency syndrome. ⅱ) 15 cases($44.l\%$) were classified as showing Excess syndrome. The deficiency of Qi was 7($20.6\%$), deficiency of Xue, 8($23.5\%$) and insufficiency of the Kidney Yin & Yang, 4($11.8\%$). The flare of Liver fire was 8($23.5\%$) and phlegm-fire, 7($20.6\%$), 9. The efficacy of treatments showed: an improvement in 17cases($50.0\%$); no real improvement or changes in 13 cases($38.2\%$); and some worsening in 4 cases($11.8\%$). In the group with deficiency in Qi, 4($57.1\%$) improved, 1($14.3\%$) showed no change and 2($28.6\%$) were aggravated. In the cases of deficiency in Xue, 6($75.0\%$) improved, 2($25.0\%$) showed no change. In the cases of insufficiency of Kidney Yin & Yang, 3($75.0\%$) showed no change and 1($25.0\%$) were aggravated. In the group of flare of Liver fire, 4($50.0\%$) improved, 3($37.5\%$) no change and 1($12.5\%$) were aggravated. In the cases of phlegm-fire, 3($42.9\%$) improved, 4($57.1\%$) showed no change. Conclusion: We would recommend that any further studies of tinnitus utilize trial treatments of longer than 2 months duration, as any positive effects observed in our study showed that improvement occurred fairly slowly. And we suggest that this study could be utilized as a reference for clinical Oriental Medical treatment of tinnitus. If we try to apply music or sound therapy treatment properly combined with ours, we expect it to provide psycological stability in addition to inducing masking effects, even though it may not directly decrease or completely remove tinnitus.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.2
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• pp.62-67
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• 2018

Hunter syndrome, also known as mucopolysaccharidosis Type II (MPS II), is one of the lysosomal storage diseases caused by a lack of the enzyme iduronate 2-sulfatase (I2S). Lack of the I2S enzyme activity leads to accumulation of the glycosaminoglycans (GAG), causing dysfunction of multiple organs and systems. MPS II is an X-linked recessive disease due to mutation of IDS gene located on long arm of the X chromosome (Xq28). To date, more than 350 mutations of IDS gene have been identified in Hunter syndrome. Phenotypes of MPS II are classified as either severe or attenuated depending on the degree of cognitive impairment. Because the phenotype of MPS II is related to the type of mutation, identifying mutations is useful in predicting prognosis. We recently had a case of MPS II diagnosed by exome sequencing in a 7 month old boy with infantile spasm uncontrolled by AED. He was diagnosed with hearing loss at 2 months of age, and he took vigabatrin and prednisolone to control infantile spasms diagnosed at 3 months of age. At 6 months of age, whole exome sequencing was performed to evaluate the infantile spasm and hearing loss in this patient, and the mutation c.851C>T (p.Pro284Leu) inherited from hemizygous mother was revealed. The results of urine Cetylpyridinium Chloride (CPC) precipitation test, which were negative until 8 months of age, were positive from 9 months of age. We report a case of MPS II diagnosed by exome sequencing and treated through enzyme replacement therapy from 9 months after birth.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.32 no.1
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• pp.16-31
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• 2019

Objective : The purpose of this study is to analyze the charcateristics of inpatients in Ophthalmology, Otolaryngology & Dermatology Clinic by gender, age, season, and department of medical care after hospitalization from March, 2012 to February, 2018. Method : From March 1, 2012 to February 28, 2018, patients who were admitted to the Ophthalmology, Otolaryngology & Dermatology Clinic of Korean Medical Hospital were classified by gender, age, department, and season, and their relationship, hospitalization period, number of outpatient visits Differences were analyzed objectively using various statistical methods using IBM SPSS 18.0. Results : 1. The number of inpatients was 432, including duplication. Of these, 317 were female and 115 were male. The number of female patients was 2.8 times higher. 2. The average age of the inpatients was 43.9 years and the number of middle-aged 40-50 patients was 48.6%. 3. The number of inpatients in the departments was in the order of dermatology, otology, laryngology, rhinology, and ophthalmology. The most hospitalized diseases were eczema in the dermatology department, sudden hearing loss in the otology department, tonsillitis/peritonsillar abscess, rhinitis in the rhinology department, and dry eye syndrome in ophthalmology. 1) The effect of gender on the difference in the number of inpatients by subdivision was statistically significant. 2) The effect of age on the difference in the number of inpatients by subdivision was statistically significant. 3) The effect of seasons on the difference in the number of inpatients was not statistically significant. 4. The number of inpatients by season was in the order of winter, spring, summer, autumn, and the number of inpatients decreased significantly in autumn. 1) The effect of gender on the difference in the number of hospitalized patients by season was not statistically significant. 2) The effect of age on the difference in the number of hospitalized patients by season was not statistically significant. 5. The average length of hospital stay for inpatients was 10.7 days. 1) The effect of gender on length of hospital stay was not statistically significant. 2) The effect of age on hospital stay was not statistically significant. 3) The effect of the subdivision on hospital stay was statistically significant. 4) The effect of the season on hospital stay was not statistically significant. Conclusion : As a result of this study, the most distinctive feature of the present study was the high rate of inpatients with otic disease like idiopathic hearing loss and Meniere 's syndrome and the high rate of female patients. This may be related to the increased prevalence of the disease and the severity of the disease. In addition, the high rate of female patients suggests that women are more likely to be affected by illnesses, as well as to have more medical use and severe symptoms requiring hospitalization. In the future, it would be better to provide various treatment plans and policies for patients with otic diseases and female patients. Also it would be good if studies on these fields are made in the future.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.24 no.4
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• pp.547-555
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• 2014

Objective: This study was conducted to investigate the association between subjective distress symptoms and argon welding among workers in Gyeongnam Province shipyard. Method: 31 argon and 29 non-argon welding workers were selected as study subjects in order to measure concentrations of personal dust, welding fumes and other hazardous materials such as ZnO, Pb, Cr, FeO, MnO, Cu, Ni, $TiO_2$, MgO, NO, $NO_2$, $O_3$, $O_2$, $CO_2$, CO and Ar. An interviewer-administered questionnaire survey was also performed on the same subjects. The items queried were as follows: age, height, weight, working duration, welding time, welding rod amounts used, drinking, smoking, and rate of subjective distress symptoms including headache and other symptoms such as fever, vomiting and nausea, metal fume fever, dizziness, tingling sensations, difficulty in breathing, memory loss, sleep disorders, emotional disturbance, hearing loss, hand tremors, visual impairment, neural abnormality, allergic reaction, runny nose and stuffiness, rhinitis, and suffocation. Statistical analysis was performed using SPSS software, version 18. Data are expressed as the mean ${\pm}SD$. An ${\chi}^2$-test and a normality test using a Shapiro wilk test were performed for the above variables. Logistic regression analysis was also conducted to identify the factors that affect the total score for subjective distress symptoms. Result: An association was shown between welding type (argon or non-argon welding) and the total score for subjective distress symptoms. Among the rate of complaining of subjective distress symptoms, vomiting and nausea, difficulty breathing, and allergic reactions were all significantly higher in the argon welding group. Only the concentration of dust and welding fumes was shown to be distributed normally after natural log transformation. According to logistic regression analysis, the correlations of working duration and welding type (argon or non-argon) between the total score of subjective distress symptoms were found to be statistically significant (p=0.041, p=0.049, respectively). Conclusion: Our results suggest that argon welding could cause subjective distress symptoms in shipyard workers.