• 제목/요약/키워드: nasal obstruction

검색결과 196건 처리시간 0.024초

상악동에 발생한 대세포 신경내분비 암종 1례 (A Case of Large Cell Neuroendocrine Carcinoma of the Maxillary Sinus)

  • 이윤재;정진혁;오영하;지용배
    • 대한두경부종양학회지
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    • 제35권2호
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    • pp.45-49
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    • 2019
  • Large cell neuroendocrine carcinoma is a rare epithelial neuroendocrine malignancy and is preferentially located in gastrointestinal tract and pancreas. Cases of large cell neuroendocrine carcinoma have been reported in many other locations, including the thymus, gallbladder, prostate, larynx, salivary glands, nasopharynx, tonsil and mastoid. However, primary sinonasal large cell neuroendocrine carcinoma never have been reported in Korea. We experienced a case of primary large cell neuroendocrine carcinoma arising from left maxillary sinus recently. A 82-year-old male patient presented with nasal obstruction and epistaxis. The biopsy revealed large cell neuroendocrine carcinoma with poor differentiation. After a general evaluation, the patient was staged as cT3N0M0. The patient was treated by combined radiotherapy and chemotherapy. We report this rare case with literature review.

연골무형성증 환아의 전신마취하 치과치료 (DENTAL TREATMENT OF THE PATIENT WITH ACHONDROPLASIA UNDER GENERAL ANESTHESIA)

  • 전은경;이상훈
    • 대한장애인치과학회지
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    • 제7권2호
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    • pp.119-122
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    • 2011
  • 연골무형성증 환아는 작은 키, 짧은 사지, 척추 측만, 아데노이드와 편도 비대 등의 특징적인 소견으로 인해 치과치료시 많은 주의를 요한다. 대부분의 환자들이 구호흡을 하기 때문에 치과 시술시 호흡이 어려우며, 척추 이상으로 인해 체어에 오래 누워있기 힘든 경우가 많아 이번 증례와 같이 다발성 우식증을 치료하기 위해서는 전신마취 하 시술이 필요한 경우도 있다. 연골무형성증 환아의 치과 진료시에는 타과와의 긴밀한 협조 하에 이러한 전신적인 특징을 이해하고 접근해야 할 것이다.

편측 상악동 저형성증의 진단과 치료 (Diagnosis and Treatment of Unilateral Maxillary Sinus Hypoplasia)

  • 김성민;김민근;권광준;이석근;박영욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권2호
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    • pp.127-132
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    • 2012
  • Maxillary sinus hypoplasia (MSH) is an uncommon clinical disease that represents a persistent decrease in sinus volume, which results from centripetal reaction of the maxillary sinus walls. We present a unilateral MSH case of a 46-year-old male patient with a history of nasal obstruction and headache for 3 years. He had a history of Caldwell Luc operation (CLOP) 10 years ago, and no enophthalmos, hypoglobus or facial asymmetry. After confirming the right diagnosis of MSH, filled with bone in the computed tomography scan, hyperplastic bone was removed by the CLOP approach. The uncinate process and infundibular passage were found to be degenerated and ostium was also examined to be obstructed under endoscopic confirmation. MSH can be mistaken for chronic maxillary sinusitis because of the plain x-ray appearance, so the aggravated state of MSH can be the result of surgeon's misjudgment. With additional literature reviews, this rare experience is first introduced in our Korean oral and maxillofacial surgery field.

Lefort I 술식 후 후기 합병증으로 발생한 상악동 점액낭종 1례 (Maxillary Sinus Mucocele as a Late Complication in a Patient Underwent Lefort I Procedure)

  • 조상현;박병윤;이정권
    • Archives of Plastic Surgery
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    • 제34권4호
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    • pp.501-503
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    • 2007
  • Purpose: The authors report unusual one case of a patient presenting with maxillary sinus mucocele who had underwent Lefort I procedure 7 years ago. Methods: Case report and literature review Results: A 25 year old man came to us with fullness, pain and nasal obstruction on his left cheek area. He had a history of multiple operations due to cleft lip and palate since birth. Two jaw surgery was performed for correcting class III malocclusion 7 years ago. Computed tomography showed haziness, and fluid filled cystic mass on left maxillary sinus. Nasoendoscopy revealed the bulging of inferior turbinate and mucosa coincided in medial wall of maxillary sinus. Antrostomy with Caldwell-Luc approach was performed. Mucin contaning brownish exudate was leaked out. Severe inflammation of maxillary inner wall and exposure of 2 screws fixed previously were noticed. The curettage and marsupialization were accomplished. The symptoms of patient were improved after that procedure. Conclusion: Maxillary sinus mucocele is related with Lefort I procedure and it may occur even long after that procedure.

Airway foreign body occurs unintentionally during anesthetic management of patient with asthma

  • Cho, Woo Jin;Yun, So Hui;Choi, Yun Suk;Lee, Bang Won;Kim, Mi Ok;Park, Jong Cook
    • Journal of Medicine and Life Science
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    • 제16권2호
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    • pp.43-45
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    • 2019
  • Intraoperative delivery of salbutamol (${\beta}_2$ agonist) through a breathing circuit may be performed in asthma patient. A 28-year-old woman with a history of asthma was diagnosed with chronic sinusitis and bilateral nasal polyps, and an endoscopic sinus surgery was performed. The patient was recommended salbutamol nebulization every 4 hours during the perioperative period because of the risk of asthma attack. At the end of the operation, when salbutamol was sprayed through the tube before extubation and the connector tip went inside the tube during injection. The patient was immediately referred to the pulmonary medicine department for bronchoscopy, where the foreign body was removed safely without any complications. When general anesthesia is performed on a patient who usually uses an inhaler for asthma, caution is required because the tip that connects the inhaler and the breathing circuit can aspirate into the endotracheal tube and enter the lungs when applying the inhaler before waking up the patient.

전방경추융합술 후 발생한 역설상기도폐쇄 및 중추성 수면 무호흡 (Paradoxical Upper Airway Obstruction and Central Sleep Apnea Developed After Anterior Cervical Spine Fusion)

  • 이상학;최영미;박예리;강지호;김영균;김관형;송정섭;박성학;문화식
    • Tuberculosis and Respiratory Diseases
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    • 제58권3호
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    • pp.295-298
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    • 2005
  • 전방경추융합술을 시행한 후 역설상기도폐쇄와 중추성 무호흡이 발생하였던 증례를 경험하여 이를 보고하고자 한다. 환자는 48세 남자로 본원으로 전원되기 9개월 전에 5번과 6번 경추사이의 추간판탈출증으로 수술을 시행받았으며, 내원 2개월 전에는 가성관절증이 발생하여 자가골이식과 함께 전방접근법으로 5번과 6번 경추의 경추융합술을 시행받았다. 이 수술을 시행 후 환자는 코골이와 과도한 주간 졸음증, 불면증 등의 증세가 생겼으며 호흡시에 상기도부위에서 이상한 소리가 발생하였다. 코인두경 및 자기공명영상으로 호기시 코인두부위의 역설적 협착소견을 관찰할 수 있었고, 철야 수면다원검사에서 무호흡지수는 8.7/시간 (중추성 무호흡, 7.0/시간; 폐쇄성 무호흡, 1.7/시간)이었다. 경비적 지속성 기도양압치료를 시작하였으나 환자가 압력을 못견뎌하여 레이저목젖입천장성형술을 시행하였다. 수술 2개월 경과 후 무호흡과 더불어 임상증세는 현격히 호전되었다. 저자들은 이러한 역설상기도폐쇄가 비록 그 기전이 명확하지는 않지만 전방경추융합술과 관련되어 있다고 추정한다. 또한 이러한 상기도 폐쇄가 중추성 수면 무호흡을 유발할 수 있다는 것을 보여주는 증례라고 생각한다.

알러지 비염 환자 22례에 대한 임상적 고찰 (Clinical Study in 22 Cases of Patients for Suffering Allergic Rhinitis)

  • 송재진;김동희;박양춘;김철중
    • 동의생리병리학회지
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    • 제16권2호
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    • pp.397-402
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    • 2002
  • Clinical studies were done treated with aroma therapy in 22cases of patients for suffering allergic rhinitis. who were treated at Dept of Oriental respiratory internal medicine in the Hospital of Taejeon University from January 2001 to May 2001. The results were as follows. 1. In distribution of sex & age. 45.5% of them were man, and 54.5% of them were woman. Of those who were attached, 2. In distribution of occupation, 59% of them were student, 18% of them were housewife, 18% of them were white color, 9% Of them were blue color. 3. In distribution of the period of the clinical history, under six months was 32%, under 1 year was 9%, under 3 years was 27%, over 3 years was 32%. 4. In distribution of the seasonal contributing factor, most of them were perenial allergic rhinitis, others generally started in spring or winter. 5. In distribution of past history, 59% of them are none, 18% of them are asthma, 18% of them are atopic dermatitis, 5% of them are allergic dermatitis. 6. In distribution of family history, 46% of them are none, 27% of them are sibling line, 18% of them are paternal line, 9% of them are maternal line. 7. In distribution of symptom, the ratio of sneezing was 90%, nasal discharge was 81 %, nasal obstruction was 46%, pruritus was 41 %, headache was 31%, asthma was 22%, digestion disorder was 18%, tears was 9%, nosebreeding was 5%. 8. In distribution of diagnosis in descending order, wind-cold evil was 5%, spleen-lung energy asthnia was 31 %, lung-kidney asthnia was 64%. 9. In distribution of Herb medicine treatment, Tonggyu-tang was the most, the second was hyunggaiyunyo-tang. 10 In emotional change of patients aroma-therapy, only 14% of them felt good. 11. The total remedial value of the 22 patients was revealed 32.9%. 12. In proportion to grow older, the remedial value were decreased. 13. In proportion to the period of the clinical history was longer, the remedial value were decreased.

알레르기성 비염 환자에 대한 임상적 고찰 - 외치요법(吹鼻法)을 응용하여 - (A Clinical study of Allergic Rhinitis (treated with aroma-therapy))

  • 신진욱;김남권
    • 대한한의학회지
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    • 제21권4호
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    • pp.174-182
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    • 2000
  • Objectives : In order to apply herbal medicine to aroma-therapy, we observed clinically remedical effect for allergic rhinitis of aroma-therapy using herbal medicine. Methods : Twenty-four allergic rhinitis patients were treated in the Kun-po Oriental Medical Hospital of Wonkwang University from September 2000 to October 2000. They were treated with aroma-therapy and analyzed clinically. Results : 1. 25.0% (6 cases) of all cases involved pre-teenagers; teenagers 29.2% (7 cases); patients in their 20s, 20.8% (5 cases); patients in their 30s, 12.5% (3 cases); patients in their 40s, 8.3% (2 cases); patients in their 50s, 4.2% (1 cases). 2. The ratio of male to female patients was 58.3%(14 cases) to 41.7%(10 cases). 3. Cases involving patients under the age of six months was 0%; under 1 year 12.5% (3 cases); under 2 years 33.3%(8 cases); under 3 years 16.7%(4 cases); over 3 years 37.5%(9 cases). 4. Past history : The cases of sinusitis were 33.3%(8 cases); otitis media 20.8%(5 cases), bronchitis 16.7%(4 cases), atopic dermatitis 12.5%(3 cases), asthma 8.3%(2 cases). 5. The ratio of allergic onset based on seasons were : spring 16.7%(4 cases), summer 0%, fall 29.2%(7 cases), winter 16.7%(4 cases), and not defined 37.5%(9 cases). 6. The cases of nasal obstruction was 91.7%(22 cases); followed by : sneezing 83.3(20 cases), white rhinorrhea 70.8%(17 cases), eye itching 66.7%(16 cases), nasal itching 58.3%(14 cases), rhinalgia 58.3%(14 cases), postnasal drip 50.0%(12 cases), headache 41.7%(10 cases), yellow rhinorrhea 33.3%(8 cases), cough 33.3%(8 cases), fatigue 29.2%(7 cases). 7. The cases of familial factor was 66.7%(16 cases); the non-familial factor 33.3%(8 cases). 8. The remedical effect of the treatment showed an improvement in 58.4% of the total cases studied. 9. The improvement-rate of the 1st group (mahwang group) was 66.7%; of the 2nd group (hwangkum group) 48.5%, and of the 3rd group (pine group) 55.8%. Conclusions : Considering the above results, we have concluded that the remedical effect for allergic rhinitis of aroma-therapy using herbal medicine showed to be intentional in comparison with aroma-therapy using aroma-oil.

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비중격 만곡증 및 만성 비후성 비염 환자에서 비중격 성형술고 하비갑개 수술의 치료효과 (Treatment Outcomes of Septoplasty with Turbinate Surgery in Septal Deviation with Chronic Hypertrophic Rhinitis)

  • 김용대;서보수;조길성;송시연;윤석근;송계원
    • Journal of Yeungnam Medical Science
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    • 제18권2호
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    • pp.199-207
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    • 2001
  • 1999년 11월에서 2000년 4월까지 본 교실에서 비중격 성형술과 하비갑개 절제술 혹은 하비갑개 성형술을 시행 받고 3개월이상 추적 관찰이 가능하였던 45명의 성인환자를 대상으로 비중격 성형술 및 하비갑개 수술의 결과를 전향적으로 분석하였다. 수술 전 증상접수는 코막힘이 가장 높았으며 수술 후 전체적으로 모든 증상에서 통계학적으로 의미 있게 호전되었다(p<0.05). 수술 전 후의 음향비강통기도 검사에서 비강수축전의 경우에서 최소비강단면적은 큰 변화가 없었으나, C-절혼 면적과 비강체적은 의미 있게 증가되었다. 또한 증상의 호전도와 음향비강통기도 검사치의 변화와는 통계학적 연관성이 없었으나, 증상이 호전됨에 따라 최소비강단면적, C-절혼 면적, 비강체적이 증가하는 경향을 볼 수 있었다. 결론적으로 바중격 성형술 및 하비갑개 수술 후 결과 판정방법으로서 수술 전 후의 환자의 주관적인 증상을 접수화하여 어느 정도 객관성을 부여하였으며 수술 전 후의 음향비강통기도 검사를 이용하여 음향비장통기도 검사결과를 구하고 이를 바탕으로 증상접수의 호전도와 음향비강통기도 검사결과를 비교 분석함으로써 증상의 호전을 객관적으로 증명하였다.

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알레르기성 비염에 대한 Ketotifen($Zaditen^{(R)}$)의 임상적 효과 (Clincal Effect of Ketotifen in Allergic Rhinitis)

  • 은선진;김용대;박문흠;서장수;송계원
    • Journal of Yeungnam Medical Science
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    • 제7권1호
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    • pp.105-112
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    • 1990
  • 저자들은 1988년 5월 1일부터 12월 31일까지 영남대학교 의과대학 부속병원 이비인후과에 내원한 알레르기성 비염환자 39명을 대상으로 Ketotifen 1일 투 2mg씩 8주동안 투여 한 뒤 재채기 발작, 수성비루, 비폐색, 비강내 이학적 소견, 효과 발현시기, 부작용 등을 관찰하여 다음과 같은 결과를 얻었다. 1) 전반적 개선도는 개선 이상이 66.7%, 약간 개선 이상이 87.2%로 유의한 증상의 호전이 있었다. 2) 증상별로 재채기 발작은 73.5%, 수성비루 71%, 비폐색 58%에서 증상의 호전이 있었으며 재채기 발작과 수성비루에 대해 더욱 효과적이었다. 3) 증상의 발현시기는 1주이내 35.7%, 2주이내 53.8%, 3주이내 66.7%, 4주이내 74.4%, 8주이내 87.2%로 나타냈다. 4) 비점막 소견의 유의한 호전은 없었다. 5) 부작용은 1례에서 경한 복통과 설사가 있어서 투약을 중지하였다. 이상과 같이 Ketotifen은 알레르기성 비염의 치료에 효과적이며 비교적 안전하게 사용할 수 있는 약제라고 생각할 수 있다.

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