원저

만성중이염 환자에서 술전 이루에서의 세균학적 검색의 임상적 의의

김행재1, 김해송1, 조원1, 김은주1, 조용범1
Haeng Jae Kim1, Hae Song Kim1, Won Cho1, Eun Ju Kim1, Yong Bum Cho1
Author Information & Copyright
1전남대학교 의과대학 이비인후과 학교실
1Department of Otolaryngology, Chonnam University Medical School, Kwangju, Korea

© Copyright 1996 The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: May 31, 2020

ABSTRACT

The clinical significances of the preoperative bacteriologie study from otorrhea in patients with chronic otitis media were evaluated by review of 396 cases who underwent the middle ear surgery in Chonnam University Hospital from Jan. 1992 to Dec. 1994. During that period 480 operations were performed and 159 bacterial cases in 125 patients were cultured. Among the 159 bacterial cases, the 139 bacterial cases which ranked 1st to 5th grade were included for analysis of the clinical significances of the preoperative bacteriologie study. The clinical significances were obtained according to the age, sex, duration of disease, eustachian tube (E- tube) patency, status of middle ear mucosa, status of ossicular chain at the time of surgery, and postoperative resuks based on review of the patient’s charts and operation records.

The results are as follows:

  1. Overall operation success rate was 87% in cholesteatoma group and 90% in noncholesteatoma group.

  2. In non-cholesteatoma group, the operation failure rate was high in the Staphylococcus aureus group. There were no significant relations between operation failure and both of E-tube patency and status of middle ear mucosa. But there were high relations between operation failure and both of age distribution especially in 2nd decade group and duration of disease especially in 1∼5 year duration group.

  3. In cholesteatoma group, the operation failure rate was high in the Proteus mirabilis group. And significant relations between operation failure and both of duration of disease especially over 10 year duration group and pathologic middle ear mucosal status were present.

These results suggested that when Staphylococcus aureus in non-cholesteatomatous patient and Proteus mirabilis in cholesteatomatous patient is cultured, otolarygologists should be cautious and provide meticulous preoperative, operative, and postoperative care for the higher success rate of surgery.

Keywords: Clinical significances; Preoperative bacteriologie study; Chronic otitis media


(최종) 35권 4호 Quiz 및 정답, 해설


*공지* 

출제 지문 오류로 인해 35권 4호 Quiz 문제를 다시 알립니다.

정답은 최종 1번으로 기존 출제된 지문에는 정답이 없으나,

참여와 관심에 감사의 마음을 담아 응모하신 모든 분들께 상품은 

지급해 드리도록 하겠습니다.  감사합니다.

 

다음은 갑상선 로봇수술 사진이다. 다음 설명 중 틀린 것은?

 

1. 이 접근법은 Mental nerve injury의 가능성이 있어 mental nerve를 찾아 위치를 확인 후 수술한다.

2. 일반적으로 이산화탄소를 주입해서 공간을 확보하므로 합병증으로 CO2 embolism 발생 가능성이 있다.

3. 다른 부위로의 접근법에 비해 절제하고자 하는 부위에 빨리 도달할 수 있다.

4. 합병증으로 다른 부위로의 접근법에 비해 수술 부위 감염 가능성이 있다.

5. 합병증으로 다른 부위 접근법에 비해 구강이나 턱, 경부 등에 피부 천공이나 화상 등이 드물게 발생할 수 있다.

 

정답 ①

해설

Transoral thryoidectomy의 합병증으로 다른 접근법보다 CO2 embolism,
surgical site infection, skin perforation,burn risk rate 가 높다.
Metal nerve injury risk가 있어 구강전절절개를 safety zone에 해야 한다.

Ref

Kyung Tae, Clin Exp Otorhinolaryngol. 2021; 14(2): 169-178.
Complications of Transoral Thyroidectomy: Overview and Update


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