원저

직경 20 mm이하의 비중격천공 수술

황종호1, 진도순1, 이병화1, 변준영1, 양철민1, 채요한1
Jong Ho Hwang1, Do Soon Jin1, Byeong Hwa Lee1, Jun Yeong Byun1, Cheol Min Yang1, Yo Han Chai1
Author Information & Copyright
1동강병원 이비인후과
1Department of Otorhinolaryngology, Dong Kang Hospital, Ulsant 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 nasal septal perforation is a disease which can be often seen in the field of otorhinolaryngology and management is known to be somewhat difficult.

The causes of nasal septal perforations are numerous, currently, perforation as a complication of septal surgery probably remains the commonest cause.

From June 1989 to September 1996, nine patients suffering from nasal septal perforation were repaired surgically.

The results are as follows:

  1. The common, symptoms were crusting (100%) and nasal obstruction (89%).

  2. The causes of nasal septal perforations were previous nasal surgery in 5 patients, traffic accident in 1 patient, lead and copper intoxication in 1 patient, tuberculosis in 1 patient and unknown etiology in 1 patient.

  3. The sizes of septal perforation were less than 10 mm in 2 patients 10∼15 mm in 5 patients and 15∼20 mm in 2 patients.

  4. Among the operation methods, bipedicled septal mucoperichondrial flap in 2 patients, deep temporalis muscle fascia graft in 5 patients, tragal cartilage with perichondrium graft was used in 2 patients.

  5. Postoperative results showed complete closure in 8 patients (89%) and incomplete closure in 1 patient.

  6. According to different perforation sizes, we used different operation method; Bipedicled septal mucoperichondrial flap was used less than 10 mm, temporalis muscle fascia was used in 10∼15 mm and tragal cartilage with perichondrium graft was used almost 20 mm.

  7. We concluded that bipedicled mucoperichondrial flap, deep temporalis muscle fascia graft and tragal cartilage with perichondrium graft were enough methods for septal perforation surgery below 20 mm diameter.

Keywords: Repair of septal perforation


(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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