• 제목/요약/키워드: middle ear

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항공승무원의 기압성 중이염 (Barotits Media in Aircrews)

  • 권영환
    • 항공우주의학회지
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    • 제29권3호
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    • pp.93-95
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    • 2019
  • Middle-ear barotrauma is a common problem reported by aircrew members and passengers. Studies have shown that 20~50% of passengers report ear complaints during the flight or after landing. Barotitis media is defined as an acute or chronic inflammation caused by a pressure differential between the tympanic cavity and the surrounding atmosphere. The Problems caused by otitis media or sinusitis of aircrew during landing and take-off can be a threat to aviation safety. Therefore, the aviation medical examiner should know about barotitis media of aircrews. In this paper, we aimed to learn what is barotitis media and how much it could affect aircrews. Also, we aimed to evaluate how barotitis media could make an impact on crews during flight, and how to manage these problems.

외이도 및 중이 편평상피암의 방사선치료 (Role of Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear)

  • 강현철;우홍균;이지혜;박찬일;김종선;오승하;허대석;김동완;이세훈
    • Radiation Oncology Journal
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    • 제27권4호
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    • pp.173-180
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    • 2009
  • 목 적: 본 연구에서는 외이도 및 중이에 생긴 편평상피암의 치료에 있어서 방사선치료의 역할에 대해 알아보고자 한다. 대상 및 방법: 1981년부터 2007년까지 외이도 및 중이에 생긴 편평상피암으로 치료 받은 총 35명의 기록을 후향적으로 분석하였다. 13명은 방사선치료 단독, 4명은 수술 단독, 18명은 수술 방사선 병용 요법으로 치료하였다. 방사선치료 단독군에서 조사된 중앙 방사선량은 66 Gy (범위, 39~70 Gy)이었고, 수술 방사선 병용 치료군에서는 61.2 Gy (범위, 44~70 Gy)를 조사하였다. 치료 방법에 따른 질병특이생존율 및 무국소진행생존율을 비교하였으며 추적관찰기간은 0.2~14.6년(중앙값 2.8년)이었다. 결 과: 3년 질병특이생존율 및 무국소진행생존율은 각각 80%, 63%이었다. 질병특이생존율에 관한 단변량 분석에서 전신수행상태 및 잔여 종양의 유무가 통계적인 유의성을 보여주었고, 무국소진행생존율에는 전신수행상태 및 조직학적 등급이 유의하였다. 치료 후 잔여 종양은 방사선 단독 치료군(69%)에서 수술 방사선 병용 치료군(28%)에 비해 많이 관찰 되었다. 비록 양군간에 질병특이생존율은 통계학적인 차이를 보이지 않았지만 방사선 단독 치료군에서 병용 치료군에 비해 조기 국소 재발의 빈도가 높았다. 결 론: 외이도 및 중이의 편평상피암 환자에서 방사선 단독 치료는 질병특이생존율에 있어서 수술 방사선 병용 치료와 유사한 결과를 보여주었다. 그러나 낮은 국소 제어율을 높이기 위한 치료 방법의 향상이 있어야 할 것으로 생각된다.

구순열과 구개열의 발생요인 및 치료 경향 (RECENT TRENDS IN INCIDENCE AND MANAGEMENT OF CLEFT LIP AND PALATE)

  • 윤천주;유선열
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제28권4호
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    • pp.295-309
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    • 2006
  • The present study was aimed to evaluate the incidence, etiological factors, and management of cleft lip and palate. Two hundred and twenty patients with cleft lip and/or cleft palate who were treated at Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital, during the period between January 1994 and December 2003 were reviewed. The ratios of cleft lip : cleft lip with cleft palate : and cleft palate were 0.4:1.1:1. Males were more common than females in cleft lip (1.3:1) and cleft lip and palate (2.5:1), while females were more common than males in cleft palate (1:1.3). In the cleft side, left clefts were more prevalent than right clefts (cleft lip 1.3:1, cleft lip and palate 1.6:1). Unilateral clefts were more common than bilateral clefts in cleft lip (79:21). Cleft lip and cleft palate were more common in those with blood type A (34.5%) than those with other types. There was no significant relationship between birth season and frequency of clefts. The clefts were common in the first-born (48.8%), and in mothers aged between 25 and 29 (51.7%). Medication (24.7%) and stress (16.7%) during the first trimester were noted. Positive familial history was noted in 13 cases (5.9%). Thirty-two cases (15%) were associated with other congenital anomalies, in which tonguetie (40.6%) and congenital heart disease (21.9%) were most common. Among 100 patients with cleft palate, 77 patients had middle ear disease (77%), which occurred predominently in the incomplete cleft palate. Seventy-six among the 77 patients received myringotomy and ventilation tube insertion, and the remaining one received antibiotic medication only. Cleft lips were treated primarily at 3 to 6 months, and cleft palates were at 1 to 2 years. Treatment regimens included modified Millard method mainly in the cleft lip, and Wardill V-Y, Dorrance method, and Furlow method in the cleft palate. The percentage of palatal lengthening as type of cleft palate was greater in the incomplete cleft palate group (11.2%) than in the complete cleft palate group (9.6%). The percentage of palatal lengthening as operating method was no difference between the Furlow method (10.9%) and the push back method (10.7%). As postoperative complications, hypertrophic scar was most frequent in the cleft lip, and oronasal fistula in the cleft palate. In summary, it was shown that medication and stress during the first trimester of pregnancy were frequently associated with cleft lip and cleft palate, adequate timing and selection of method of operation are important factors to obtain morphologically and functionally good results. Furthermore prevention and treatment of middle ear disease are important in cleft palate patients because of its high co-occurrence.

삼출성중이염의 임상적 고찰 -특히 구개인두편도절제술을 요하는 소아와의 관계- (Clinical Observation of Middle Ear Effusion Especially in Relation to Children needed Adenotonsillectomy)

  • 김종애;전병권;배정수;김백순
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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    • pp.15.1-15
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    • 1982
  • 1979년 7월부터 1981년 8월까지 부산 침례병원 이비인후과에 내원한 환자중 삼출성중이염으로 진단된 95례 (159이)에서 임상적인 고찰을 했으며, 고막절개와 중이내 튜브 유치술을 시행한 성인 및 소아군과 T&A를 동시에 시행한 소아군을 비교 검토하여 다음과 같은 결과를 얻었다. 1) 성별 분포는 남자가 48례, 여자가 47례 차이가 없었고 연령 분포는 6∼10세 군이 34례 (35%)로 가장 많았다. 2) T & A를 요하는 소아중 14%가 삼출성중이염으로 진단되어 고막절개 및 중이내 튜브 유치술을 동시에 시행했고 이는 같은 기간중의 삼출성중이염 환자의 19%에 해당했다. 3) 양측성 (67%)이 일측성 (33%)인 경우의 두배 였고, 소아환자에서는 양측성이 88%로 현저했으며 T & A를 요하는 소아군에서는 전부가 양측성이었다. 4 ) 중이내 저류액의 성상은 장액성이 49%, 점액성이 33%, 농성이 5%, 혈성이 3%등이었고 성인군에서는 장액성이 59%였으나 소아군 (15세이하)에서는 장액성(41%)과 점액성(43%)의 빈도가 비슷했다. 5) 술전 Tympanogram은 A형이 6%, B형이 91%, C형이 3%였고 이상 Tympanogram(B형 혹은 C형)의 출현 빈도는 T & A를 요하는 소아군(95%)과 요하지 않은 소아군(95%)에서 동일했으며 성인군에서는 93%였다. 6)고막절개 중이내 튜브 유치술후의 기도청력은 T & A를 동시에 시행한 소아군에서 더욱 개선되었다.

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상고실 진주종의 형성에 관하여 (Concerning the Formation of the Acquired Cholesteatoma)

  • 장인원;이종원;정종진;조용범;국태진;이정헌;염시경;김종욱;조재식
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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    • pp.39.3-40
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    • 1981
  • 후천적진주종의 형성에 있어서 고막의 Shrapnell부분과 외이도후상부 상피의 상고 실내 침입 및 고막 중심성천공의 margin으로부터 상피가 침입하는 이른바 immigration설과 이밖에 metaplasia설이 있다. 임상적으로 진주종이 상고실에 형성된다는 사실은 알려져 왔으나 그 발생기전에 대한 해명은 충분하지 않는 실정이다. 연자 등은 최근에 중이수술을 시행한 진주종 170례에 대하여 검토를 가하였다. 수술소견에 있어서 진주종의 primary focus가 상고실에 있을 때 Shrapnell부위의 marginal 및 central perforation 2가지 형의 천공이 관찰되었으며 Prussak's space안으로 retraction 및 Rivinus notch의 골벽결손 등을 볼 수 있었고 진주종이 있었던 36례중 Shrapnell부위의 중심성천공을 동반한 경우 5례, Rivinus notch의 골벽이 결손된 경우와 Shrapnell부위의 후상부 marginal perforation이 있고 진주종을 형성한 경우 21례, 그중 Shrapnell부위의 중심성천공을 동반한 경우 3례였다. 결론적으로 상고실 진주종이 잘 생기는 이유는 1) 상고실은 염증성분필물을 배설하는 구씨관입구와의 거리가 있고 2) 고막 Shrapnell부위의 고유층은 collagen fiber가 긴장부에 비해서 엷고 탄력성섬유가 많기 때문에 표피층의 각화증식을 일으킬 경우 Prussak's space내로 retraction을 일으키기 쉽다. 3) Shrapnell부위의 상부에 위치한 Rivinus notch에 부착한 epidermis는 각화증식에 의하여 Rivinus notch margin과 여기에 부착하고 있는 고막연의 margin사이를 파괴하여 상고실로 상피가 침입하게 된다.

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이식형 마이크로폰과 진동체를 갖는 인공중이의 이득 보상을 위한 주파수 특성 고찰 (Study on frequency response of implantable microphone and vibrating transducer for the gain compensation of implantable middle ear hearing aid)

  • 정의성;성기웅;임형규;이장우;김동욱;이정현;김명남;조진호
    • 센서학회지
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    • 제19권5호
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    • pp.361-368
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    • 2010
  • ACROSS device, which is composed of an implantable microphone, a signal processor, and a vibrating transducer, is a fullyimplantable middle ear hearing device(F-IMEHD) for the recovery of patients with hearing loss. And since a microphone is implanted under skin and tissue at the temporal bones, the amplitude of the sound wave is attenuated by absorption and scattering. And the vibrating transducer attached to the ossicular chain caused also the different displacement from characteristic of the stapes. For the gain control of auditory signals, most of implantable hearing devices with the digital audio signal processor still apply to fitting rules of conventional hearing aid without regard to the effect of the implanted microphone and the vibrating transducer. So it should be taken into account the effect of the implantable microphone and the vibrating transducer to use the conventional audio fitting rule. The aim of this study was to measure gain characteristics caused by the implanted microphone and the vibrating transducer attached to the ossicle chains for the gain compensation of ACROSS device. Differential floating mass transducers (DFMT) of ACROSS device were clipped on four cadaver temporal bones. And after placing the DFMT on them, displacements of the ossicle chain with the DFMT operated by 1 $mA_{peak}$ current was measured using laser Doppler vibrometer. And the sensitivity of microphones under the sampled pig skin and the skin of 3 rat back were measured by stimulus of pure tones in frequency from 0.1 to 8.9 kHz. And we confirmed that the microphone implanted under skin showed poorer frequency response in the acoustic high-frequency band than it in the low- to mid- frequency band, and the resonant frequency of the stapes vibration was changed by attaching the DFMT on the incus, the displacement of the DFMT driven with 1 $mA_{rms}$ was higher by the amount of about 20 dB than that of cadaver's stapes driven by the sound presssure of 94 dB SPL in resonance frequency range.

A determination of occlusal plane comparing different levels of the tragus to form ala-tragal line or Camper's line: A photographic study

  • Kumar, Sandeep;Garg, Sandeep;Gupta, Seema
    • The Journal of Advanced Prosthodontics
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    • 제5권1호
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    • pp.9-15
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    • 2013
  • PURPOSE. The purpose of this study was to determine accurately the part of the tragus to be used to form the Ala-Tragal line or Camper's line in orthognathic profile patients. MATERIALS AND METHODS. 150 dentate subjects with age of 18-40 years with orthognathic profile were sampled. Life-size lateral digital photographs of the face with fox plane were taken in natural head position. Different angles between Eye-Ear plane and occlusal plane ($OT_1$-OP), Eye-Ear plane and ala-superior border of tragus ($OT_1-AT_1$), Eye-Ear plane and ala-middle border of tragus ($OT_1-AT_2$) and Eye-Ear plane and ala-inferior border of tragus ($OT_1-AT_3$) were calculated using computer software package, AutoCAD 2004. From the three angles formed by the Eye-ear plane ($OT_1$ or FH plane) and the ala-tragal lines, the one closest to the angle formed between Eye-Ear plane ($OT_1$) and occlusal plane (OP) was used to determine the occlusal plane of orientation. The obtained results were subjected to ANOVA F test, Tukey's Honestly significant difference test, followed by Karl Pearson coefficient of correlation test. P values of less than 0.05 were taken as statistically significant. RESULTS. The mean of base line angle i.e. $OT_1$-OP angle ($11.96{\pm}4.36$) was found to be close to $OT_1-AT_2$ angle ($13.67{\pm}1.93$) and $OT_1-AT_3$ angle ($10.31{\pm}2.03$), but $OT_1$-OP angle was found to be more closer to $OT_1-AT_3$ angle. Comparison of mean angles showed that $OT_1$-OP angle in both males (11.68) and females (12.51) is close to $OT_1-AT_3$ angle (males- 11.01, females- 11.95). CONCLUSION. The line joining from ala to the lower border of the tragus was parallel to the occlusal plane in 53.3% of the subjects. There was no influence of the sex on the level of occlusal plane.

완전 이식형 인공중이를 위한 체외 및 체내 제어시스템 구현 (The Design of an Infrared Transcutaneous Control Unit for Totally Implantable Middle Ear System)

  • 정의성;강호경;박일용;윤영호;김민규;송병섭;원철호;조진호
    • 전자공학회논문지SC
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    • 제41권5호
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    • pp.71-78
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    • 2004
  • 체내에 이식되는 완전 이식형 인공중이 시스템의 제어를 위해 저전력 마이크로프로세서인 MSP430을 이용한 적외선 리모컨형 외부제어기를 설계하였고, 수신된 신호 해석을 위한 제어 알고리즘을 설계하여 전원 ON/OFF와 소리크기 UP/DOWM 동작을 수행하도록 하였다. 먼저 피부 투과시 발생하는 적외선 신호의 반사 및 투과모델을 이용하여 시스템에 필요한 적외선 LED 방사강도를 계산하고, 인반 적외선 리모컨과의 오작동을 방지하기 위해 고유의 데이터 프로토콜을 설정하였다. 이식되는 수신부의 적외선 수신모듈은 자체 소비전류를 줄이기 위해 마이크로프로세서의 내부 타이머에 의한 25% 듀티비를 갖는 출력신호를 전원으로 사용하였다. 4mm 두께의 돼지피부를 이용한 피부투과 전송실험을 실시하여 구현된 송수신 장치로 신호가 전달됨을 확인하였다.

구개열 환자에 있어 중이염의 치료 (Treatment of Otitis Media in Cleft Palate)

  • 방강미;지영민;김성민;명훈;최진영;이종호;정필훈;김명진;황순정
    • 대한구순구개열학회지
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    • 제10권2호
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    • pp.89-96
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    • 2007
  • Otitis media with effusion is known to be very common among children with cleft palate and is the common cause of acquired hearing loss in childhood. The purpose of the present study was to examine the anatomic variances, incidence and treatment of middle ear disease in children with cleft palate. In Korea, before 4-year-old age, the prevalence of otitis media was as high as 91.7%. Common treatments for otitis media were conservative or surgical treatment. The medical treatment options include the use of decongestants, antihistamines, antibiotics and mucolytics. Surgical treatment options include grommet insertion, myringotomy. Unlike the case for children without clefts, cleft patient has a higher incidence of recurrence, so surgical treatment between the age of 3 month and 6 month was recommended. The effect of palatoplasty on middle ear disease has remained controversial. Early and periodic evaluation on the symptomatic infection or significant of hearing loss was recommended.

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