• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2008년도 춘계학술대회
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• pp.129-129
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• 2008

• Journal of Chest Surgery
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• 제56권5호
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• pp.336-345
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• 2023

Background: The objective of this study was to demonstrate the safety, efficacy, and feasibility of intraoperative monitoring of the recurrent laryngeal nerves during thoracoscopic and robotic 3-field esophagectomy. Methods: This retrospective analysis details our initial experience using intraoperative nerve monitoring (IONM) during minimally invasive 3-field esophagectomy. Data were obtained from a prospectively maintained database and electronic medical records. The study included all patients who underwent minimally invasive (video-assisted thoracic surgery/robotic) transthoracic esophagectomy with neck anastomosis. The patients were divided into those who underwent IONM during the study period and a historical cohort who underwent 3-field esophagectomy without IONM at the same institution. Appropriate statistical tests were used to compare the 2 groups. Results: Twenty-four patients underwent nerve monitoring during minimally invasive 3-field esophagectomy. Of these, 15 patients underwent thoraco-laparoscopic operation, while 9 received a robot-assisted procedure. In the immediate postoperative period, 8 of 24 patients (33.3%) experienced vocal cord paralysis. Relative to a historical cohort from the same institution, who were treated with surgery without nerve monitoring in the preceding 5 years, a 26% reduction was observed in the nerve paralysis rate (p=0.08). On follow-up, 6 of the 8 patients with vocal cord paralysis reported a return to normal vocal function. Additionally, patients who underwent IONM exhibited a higher nodal yield and a decreased frequency of tracheostomy and bronchoscopy. Conclusion: The use of IONM during minimally invasive 3-field esophagectomy is safe and feasible. This technique has the potential to decrease the incidence of recurrent nerve palsy and increase nodal yield.

• 대한후두음성언어의학회지
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• 제30권2호
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• pp.139-141
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• 2019

The causes of vocal cord paralysis include iatrogenic injury during thyroid or cervical surgery, heart and chest surgery, and tumorous lesion such as laryngeal cancer and lung cancer. In addition to these common causes, rarely, cardiovascular disease can also cause vocal fold paralysis. A disease known as Cardiovocal syndrome, or Ortner's syndrome, causes left vocal fold paralysis when the left recurrent laryngeal nerve is compressed by the pulmonary artery and aorta, which is occurred by pulmonary hypertension from heart disease. We report for the first case in Korea the diagnosis of vocal fold paralysis caused by Ortner's syndrome.

• Journal of Chest Surgery
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• 제23권3호
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• pp.522-526
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• 1990

We have experienced 2 cases vocal cord paralysis after open heart surgery. One was a postoperatively developed right unilateral vocal cord paralysis after prosthetic mitral valve replacement with tricuspid valve annuloplasty. The other was a postoperative left unilateral vocal cord paralysis after prosthetic aortic and mitral valve replacement with tricuspid annuloplasty. They were intubated for forty-eight and seventy-two hours but after extubation complained of hoarseness, aphonia, anxiety, and ineffective coughing Indirect laryngoscopy performed at about postoperative one week, revealed partial paralysis and decreased mobility of the vocal cord. After active phonation therapy, symptoms were improved gradually and in the follow up indirect laryngoscopy, the vocal cord paralysis was improved. The symptoms were recovered completely at about postoperative one month in both. The cause of vocal cord paralysis after open heart surgery may be any retraction or stretching injury to the recurrent laryngeal nerve, especially right side, during median sternotomy retraction and open heart operation procedures. As a result, avoid of excessive spread of median sternotomy retractor and excessive manipulation and retraction of the heart during open heart procedures will reduce the occurrence of the vocal cord paralysis.

• Journal of Acupuncture Research
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• 제21권3호
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• pp.43-59
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• 2004

Objective : In Modern society, patients with facial nerve paralysis are increasing because of many factors - irregular life, cold, overwork and stress etc. We have troubles in presuming the prognosis, though how to diagnosis and examine facial nerve paralysis are many. Methods : A clinical study was done on 89 patients who were diagnosed and treated as facial nerve paralysis(Bell's palsy) from January 2001 to May 2003 at the Dep. of Acupuncture and Moxibustion, college of Oriental Medicine, Woo-suk University. We classified 89 patients as the Sasang(四象) constitution, contributing factor, season, age and existence of diabetes items and analyzed, as we would research differences of changing point-Period from on set of Bell's palsy to the day which the change begins to be seen at the face- and improvement -Period which Bell's palsy is improved from on set to H-B grade II. Results : 1. Among the Sasang constitution, Soeumin($10.67{\pm}3.77days$) were faster than other constitutions, but Soyangin($16.25{\pm}6.75days$) were slower than other constitutions in changing point. Taeumin($4.12{\pm}1.49weeks$) were shorter than other constitutions, but Soyangin($4.88{\pm}2.11weeks$) were longer than other constitutions in improvement. 2. Among contributing factors, overwork and stress group were slower than other contributing factors in changing point($13.95{\pm}6.52days$), and longer than others in improvement($4.67{\pm}1.87weeks$). 3. Changing point and improvement of season, age, and existence of diabetes had the difference of the average according to an each item, but they were not statistically significant. 4. In 89 patients with Bell's palsy, average changing-point was $13.11{\pm}5.99$(days) and average improvement was $4.47{\pm}1.82$(weeks). Their correlation was 0.687 and statistically significance(P<0.01), therefore we could decide that their relation is highly correlation.

• Journal of Acupuncture Research
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• 제33권1호
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• pp.95-101
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• 2016

Objectives : The aim of this report was to investigate the effects of Korean medical treatment on facial nerve paralysis with sensorineural hearing loss and tinnitus caused by traumatic temporal bone fracture. Methods : We treated a patient with acupuncture, herbal medicine and physiotherapy. The effect of these treatments was evaluated by House-Brackmann facial grading scale, Yanagihara's unweighted grading system and by Digital Infrared Thermographic Image. Results : After 21 days of Korean medical treatment, House-Brackmann facial grading scale changed from III to II and Yanagihara's unweighted grading score increased from 14 to 27. Digital Infrared Thermographic Image also improved. Conclusions : These results suggest that Korean medical treatments were effective in treating facial nerve paralysis with sensorineural hearing loss and tinnitus caused by traumatic temporal bone fracture. We hope that a more efficient application of this treatment will be the result of clinical data accumulated in future studies.

• 사상체질의학회지
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• 제27권1호
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• pp.138-148
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• 2015

Objectives This study was conducted in order to analyze the distribution of Sasang constitution, herbmed, exterior-interior disease and concomitant symptoms of 36 facial nerve paralysis patients. Methods A clinical study was done on 36 patients, treated as facial nerve paralysis. Sasang constitution specialist diagnosed their constitution and gave prescription. Degree of improvement was evaluated by assessment scale or change of patient's complaint. Results 1) Distribution of sasang constituion : Taeeumin 21 patients, Soyangin 8 patients, Soeumin 7 patients. 2) Distribution of exterior-interior disease : Taeeumin and Soeumin were diagnosed as interior disease more than exterior disease, Soyangin was reverse. 3) Hyeongbangdojeok-san and Hyeongbangjihwang-tang (Soyangin), Galgeunhaegi-tang(Taeeumin) and Gwakhyangjeonggi-san(Soeumin) were used the most in each sasang constitution. 4) Seventeen patients had concomitant symptoms : digestive disorder, sleep disorder, tinnitus, hypertension, diplopia, itching, gout, neck-shoulder pain, constipation and dizziness. Conclusions Patients had different Sasang constitution and in the same Sasang constitution, they had different symptomatology.

• 대한두경부종양학회지
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• 제32권1호
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• pp.41-44
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• 2016

The resection of submandibular gland is usually performed via trascervical, transoral approach. The authors suspected the stenosis of Wharton's duct of 54 years old female patient after transoral removal of submandibular stone and the resection of submandibular gland was decided. Because of cosmetic need, the resection was performed transorally. The operation was completed successfully without any injury to unilateral lingual nerve or hypoglossal nerve but contralateral paralysis of hypoglossal nerve was seen. In our knowledge, this is the first report of contralateral hypoglossal nerve palsy during transoral resection of submandibular gland.

• The Korean Journal of Pain
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• 제8권1호
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• pp.156-158
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• 1995

Total spinal anesthesia is a well documented serious life threatening complication which results from an attempted spinal or epidural analgesia. We had an accidental total spinal anesthesia associated with a cranial nerve paralysis and an eventual unconsciousness during epidural analgesia. A 45-year-old female with an uterine myoma was scheduled for a total abdominal hysterectomy under the epidural analgesia. A lumbar tapping for the epidural analgesia was performed in a sitting position at a level between $L_{3-4}$, using a 18 gauge Tuohy needle. Using the "Loss of Resistance" technique to identify the epidural space, the first attempt failed; however, the second attempt with the same level and the technique was successful. The epidural space was identified erroneously. However, fluid was dripping very slowly through the needle, which we thought was the fluid from the normal saline which was injected from the outside to identify the space. Then 20 ml of 2% lidocaine was administered into the epidural space. Shortly after the spinal injection of lidocaine, many signs of total spinal anesthesia could be clearly observed, accompanied by the following progressing signs of intracrainal nerve paralysis: phrenic nerve, vagus nerve, glossopharyngeal nerve and trigeminal nerve in that order. Then female was intubated and her respiration was controlled without delay. The scheduled operation was carried out uneventfully for 2 hours and 20 minutes. The patient recovered gradually in th4e reverse order four hours from that time.

• Journal of Korean Neurosurgical Society
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• 제29권3호
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• pp.426-429
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• 2000

뇌 지주막하출혈에서 흔치않은 임상양상인 양측성 외전신경마비와 두통을 주소로 내원한 46세 여자환자에서 혈관조영술을 시행하여 좌측 후교통동맥 동맥류, 전맥락동맥 동맥류, 그리고 우측 후교통동맥 동맥류등 다발성 뇌동맥류가 발견되어 수술시행 하였다. 양측성 외전신경마비 이외에 시력 및 시야장애는 보이지 않았다. 수술시 상당한 뇌압증가의 양상을 보였고, 좌측 후교통동맥 동맥류 출혈흔적과 기저조에 소량의 혈종이 있었으며, 첫번의 좌측 수술 후 2주 정도에 안구운동장애가 서서히 회복되어 정상화되었다. 저자들은 뇌동맥류 출혈에서 드물게 보는 양측성 외전신경마비 환자를 경험하였기에 문헌고찰과 함께 증례보고 한다.