<Illustration by 유진수, 메디컬일러스트 그리닥>

삼성서울병원 이비인후과와 함께 작업한 일러스트입니다. 이 논문은 2016년 Acta Oto-laryngologica에 accept되었습니다. 흔히 얘기하는 달팽이관과 전정기관이 있는 내이(inner ear) 내부에는 외림프 (perilymph)와 내림프(endolymph)가 있는데, 기압외상성 (barotraumatic) 요인으로 새어나온다는 개념에 대해서 설명하는 논문입니다.

perilymph1

실제 논문에는 아래와 같이 흑백 일러스트가 실렸습니다. 아쉽죠. 컬러가 들어가면 보통 인쇄비를 내줘야하기 때문에 그렇습니다. 사실, Figure 4의 내용은 논문의 핵심이라기 보다는 논문에서 나온 자료들을 설명하는 가설과 같은 것입니다. 따라서 이런 그림은 실제 어디에서도 찾아볼 수 없는 ‘the only’ 일러스트인거죠.

perilymph2

perilymph-fistula-copy

이 그림은 실제 논문에 실린 그림의 또 다른 버전입니다. 왼쪽 아래에 세반고리관 (semicircular canal) 중 하나를 그렸다면, 실제 논문에 실린 그림은 crista가 있는 부위만 확대했죠.

<Illustration by 유진수, 메디컬일러스트 그리닥>

CONCLUSIONS:

Patients with sudden hearing loss and dizziness after barotrauma should be suspected of barotraumatic perilymph fistula (PLF). Early surgical repair of PLF showed better hearing outcomes. Therefore, diagnostic criteria should help surgical indications of barotraumatic PLF.

OBJECTIVES:

The aim of this study was to establish diagnostic criteria for barotraumatic PLF.

METHODS:

Twenty-four patients (26 ears) underwent surgery on suspicion of barotraumatic PLF. The causes of barotrauma and clinical symptoms were analyzed by surgical findings. Diagnostic criteria of PLF were proposed according to its clinical manifestations.

RESULTS:

Definite PLF (17 subjects) was confirmed by any evidence of perilymph leak through oval and round windows. For the other seven subjects (probable PLF), even though there was no evidence of perilymph leak, their clinical manifestations were similar to definite PLF. High frequency hearing loss occurred as an early symptom after barotrauma. Positional dizziness occurred a few hours after auditory symptoms (67%). Positional nystagmus was observed in 10 cases. The characteristics of positional nystagmus were multi-directional, longer in duration, smaller in amplitude, no reversibility, and no response to repositioning maneuver. Regarding the surgical outcomes, hearing was significantly improved in the early repaired PFL group, and dizziness was improved in 96% of patients.

http://www.tandfonline.com/doi/full/10.1080/00016489.2016.1213419