• Journal of the Korean Society of Radiology
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• v.17 no.2
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• pp.243-248
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• 2023

This study aims to analyze the secondary carcinogenesis rate caused by exposure of organs at risk of damage using a glass dosimeter during radiosurgery in vestibular schwannoma disease. Using a pediatric phantom of human tissue equivalent material, the volume of the tumor was set to a total of three volumes: 0.506 cm³, 1.008 cm³, and 2.032 cm³, and a radiosurgery plan was established with an average dose of 18.4 ± 3.4 Gy. After mounting the human body phantom on the table of surgical equipment, glass dosimeters were placed on the right eye, left eye, thyroid gland, thymus, right lung, and left lung to measure the exposure dose, respectively. In this study, the incidence of secondary cancer due to exposure to damaged organs during gamma knife radiosurgery in vestibular schwannoma disease with the largest tumor volume of 2.032 cm³ was measured with a glass dosimeter. This study studies the risk of secondary radiation exposure dose that can occur during stereotactic radiosurgery, and it is considered that it will be used as basic data in the field of radiation damage related to the stochastic effect of radiation in the future.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.20.2-20
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• 1987

신경초종은 비교적 드문 질환으로서1908년Verocay가 이 종양의 특징적 조직소견인 Verocay body를 발견하고 이를 neurinoma라고 명명하였다. 이 종양은 양성종양으로서 뇌신경, 척수신경뿐 아니라 자율신경에서도 발생하여, 약 25%가 두경부에서 발생하고, 단일 부위로서는 청신경에서의 발생빈도가 가장 높으나 인후부 발생은 드물다. 저자들은 피열후두개추벽에 발생한 거대한 신경초종 1례를 치험하였기에 보고하는 바이다.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.11.1-11
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• 1981

Neurilemmoma is a benign tumor which arises generally from the Schwann's cells. It is a slowly growing tumor and treated as surgically. We experienced a case of neurilemmoma of the oropharynx in a 28-year-old female who had noticed a gradual swelling of the left side of the oropharynx with swallowing difficulty for 6 months. The tumor was removed successfully intra-orally under the general endotracheal anesthesia and verified pathologically as neurilemmoma.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.10-18
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• 2003

Purpose : To evaluate the role of fractlonated sterotactic radiotherapy (FSRT) in the management of benign brain tumors, we reviewed the clinical, and radiographic responses of patients treated. Methods and Materials : Between March 1995 and March 2002, 36 patients with benign brain tumors were treated by FSRT. The pathological diagnoses consisted of pituitary adenomas (12 patients), cranio-pharyngiomas (5 patients), meningiomas (10 patients), and acoustic neurinomas (9 patients). Radiotherapy doses of 25 to 35 Gy (3~6 Gy/fraction, 5~10 fractions) were prescribed to the 85~90% isodose line, depending upon the location, size and volume of the tumors. The median clinical and radiographical follow up periods were 31 (range, 2~74) and 21 (range, 4~56) months, respectively. Results : In the 35 patients that could be evaluated for their clinical response, 13 (37.1%) were considered improved, 16 (45.7%) stable and 6 (17.2%) worse. Of the 33 patients who had radiographic studies, tumor shrinkage was noted in 17 (51.5%), tumor stabilization in 13 (39.4%), and tumor progression in 3 (9.1%). Of the 17 tumor shrinkage patients, 7 (21.2%) showed a complete response. Acute radiation-induced complications occurred iin 11 (30.6%) patients. Conclusions : FSRT is considered a safe and effective treatment method for begin brain tumors, but large numbers of patients, with relatively long follow-up periods are needed to assess the exact role or effect of FSRT.

• Korean Journal of Acupuncture
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• v.33 no.1
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• pp.33-36
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• 2016

Objectives : The objective of this clinical case report is to describe an acupuncture treatment for dizziness after acoustic neuroma surgery. Methods : The patient was treated with acupuncture treatment for 4 months, 3 times per week. Duration for every treatment were 30 min by manual acupuncture with De Qi, which was designed to treat the dizziness and accompanied symptoms. Side-lying test was also used to evaluate dizziness and Hamilton Rating Scale for Depression(HDRS) to evaluate depression. We evaluated the clinical result of the treatment by observing the patients symptoms. Results : After acupuncture treatments for 4 months, patient's Side-lying test reduced to 10 second, and Hamilton Rating Scale for Depression reduced 4 points. Conclusions : The clinical case treatment report may suggest that the acupuncture treatment can be a meaningful option for the intractable dizziness after acoustic neuroma surgery, and also able to reduced depression scale.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.325-335
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• 1998

Purpose : Since the mid cranial fossa is composed of various thickness of bone, the tissue inhomogeneity caused by bone would produce dose attenuation in cobalt-60 gamma knife irradiation. The correction factor for bone attenuation of cobalt-60 which is used for gamma knife source is -3.5$\%$. More importantly, nearly all the radiosurgery treatment planning systems assume a treatment volume of unit density: any perturbation due to tissue inhomogeneity is neglected, This study was performed to confirm the bone attenuation in mid cranial fossa using gamma knife. Materials and Methods : Computed tomography was performed after Leksell stereotactic frame had been liked to the Alderson Rando Phantom (human phantom) skull area. Kodak X-omat V film was inserted into two sites of pituitary adenoma point and acoustic neurinoma point, and irradiated by gamma knife with 14mm and 18mm collimator. An automatic scanning densitometer with a 1mm aperture is used to measure the dose profile along the x and y axis. Results : Isodose curve constriction in mid cranial fossa is observed with various ranges. Pituitary tumor point is greater than acoustic neurinoma point (0.2-3.0 mm vs 0.1-1.3 mm) and generally 14 mm collimator is greater than 18mm collimator (0.4-3.0 mm vs. 0.2-2.2 mm) Even though the isodose constriction is found, constriction of 50$\%$ isodose curve which is used for treatment reference line does not exceed 1 mm. This range is too small to influence the treatment planning and treatment results. Conclusion : Radiosurgery planning system of gamma knife does not show significant error to be corrected without consideration of bone attenuation.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.551-558
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• 2004

The purpose of this study is to develop an aproach to diagnosis and treatment of sequelae after removal of vestibular schwannoma through Oriental Medicine. An eighty year-old woman with sequelae after removal of vestibular schwannoma was observed and treated. She had difficulty of hearing, facial nerve palsy, dizziness and was generally weak. She was treated with herb medications for these symptoms. Having been treated for 27 days in hospital her symptoms improved. This report provides evidence for application of herbal medicine in treatment of sequelae. However, more cases are required for an in depth study of oriental treatments for this ailment in order to open this method of treatment to general application.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.218-221
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• 2005

This report describes a case of dizziness in a patient with trigeminal neuralgia that was caused by a vestibular schwannoma. A 60-year-old man with a history of pain on his left cheek, chin, molar and tongue for 5 months was diagnosed as suffering with trigeminal neuralgia of the left mandibular nerve, and this was caused by a left vestibular schwannoma. The diagnosis of the tumor was confirmed with magnetic resonance imaging (MRI), and so gamma knife surgery was performed 1 month later. At that time, the patient had been referred to the pain clinic due to allodynia on the tongue and gingival, and hypesthesia was also present on the left half of the face. Trigeminal nerve block with dehydrogenated alcohol and stellate ganglion block with 1% mepivacaine were performed and oral medication with diphenylhydantoin was started. The symptoms were alleviated after nerve block and oral medication. Dizziness, blurred vision and ataxia then developed from the 13th hospital day. We considered the symptoms as a side effect of diphenylhydantoin and we reduced the dose of diphenylhydantoin. However, the symptoms grew worse. Another brain MRI showed a slight increase of the tumor size and a mass effect with displacement of the adjacent organs, and hydrocephalus was also noted. This case shows the importance of considering the secondary symptoms that are due to brain tumor while treating trigeminal neuralgia. The changes of the brain tumors should also be considered along with the presence of new side effects.

• The Journal of Internal Korean Medicine
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• v.37 no.5
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• pp.893-902
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• 2016

Objective: To describe the effects of traditional Korean medicine on dizziness and gait disturbance arising after removal of a vestibular schwannoma. Methods: The patient was treated using Korean medical treatments, such as herbal medicines (Jaeumkunbi-tang-gagambang and Yookmijihwang-Insamyangyoung-tang-gagambang), acupuncture, and moxibustion. We measured the state and progress of this case with the Korean Vestibular Disorder Activities of Daily Living Scale (K-VADL), Berg Balance Scale (BBS), and a visual analogue scale (VAS). Results: After treatment, the K-VADL score decreased from 167 to 74 and the VAS score decreased from 10 to 5.7, while the BBS score increased from 3 to 42. Conclusion: Jaeumkunbi-tang-gagambang (滋陰健脾湯) and Yookmijihwang-Insamyangyoung-tang-gagambang(六味地黃湯 合 人蔘養榮湯 加減方) appear to be effective for controlling dizziness and gait disturbances occurring after removal of vestibular schwannomas.

• Journal of the Korean Society of Radiology
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• v.9 no.6
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• pp.343-348
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• 2015

The purpose of this study is a comparison of forward planning(FP) and inverse planning(IP) of a radiosurgery procedure. 10 patients of acoustic schwannoma MR image were used for treatment plan. FP-1,2 and IP were established under the same condition. FP and IP were compared by number of shot, conformity index(CI), paddic conformity index(PCI), gradiant index(GI) and treatment time. On average the treatment plan produced by IP tool provided an improved or similar CI, PCI, GI and reduced treatment time as compared to the FP (CI;FP-1:0.85, FP-2:0.86, IP:0.94, PCI;FP-1:0.79, FP-2:0.81, IP:0.78, GI;FP-1:2.94, FP-2:2.94, IP:3.01). The inverse planning system provides a clinically useful plan while reducing the planning time and treatment time.