• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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• pp.66-69
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• 2011

Skull base osteoradionecrosis(ORN)is a rare complication of radiotherapy for nasopharyngeal carcinoma, but is one of the most severe and possibly fatal condition followed by radiotherapy. However, the treatment of skull base ORN has seldom been thoroughly described yet. Here we report a case of skull base ORN that was successfully treated with hyperbaric oxygen therapy(HBO). A 52-year-old man visited our department complaining of trismus and foul odor. He was diagnosed with nasopharyngeal cancer with multiple lymph node metastasis one year ago and underwent concurrent chemoradiotherapy. On the physical examination, mucopus and crusts with exposed necrotic bone was seen in the right nasopharynx. On the paranasal sinus magnetic resonance imaging, osteoradionecrosis which was extending from the right nasopharynx to the clivus, petrous apex, and cavernous sinus was noted. Nasopharynx biopsy resulted of ulcer with no malignant cells. HBO therapy was performed with debridement of nasopharynx for 3 months. There was no sign of recurrence or residual ORN 18 months after HBO therapy.

• Journal of Korean Neurosurgical Society
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• v.30 no.2
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• pp.244-249
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• 2001

Dural arteriovenous malformations(AVM) are not uncommon. Reports of intracranial dural AVM have been increasing but most of them deal with dural AVM in the region of the cavernous sinus, posterior fossa and tentorium, but those of the anterior cranial fossa are very rare. Recently, we experienced two cases of right frontal dural arteriovenous malformation fed mainly by both ethmoidal arteries. The angiographic appearance in these two cases is quite uniform. The nidus was located in the frontal dura, although their main feeders were dural arteries. They were drained through an intracerebral cortical vein associated with aneurysmal dilatation of proximal portion into superior sagittal sinus. Spontaneous intracerebral hematoma was the cause of the clinical symptoms. We report two cases of intracerebral hematoma, caused by dural AVM, which was successfully managed by surgical treatment.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.152-155
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• 2009

A 43-year-old woman presented with dizziness, ataxia and right hearing difficulty. Her magnetic resonance images demonstrated an inhomogeneously contrast-enhanced large tumor growing into right cavernous sinus and Meckel's cave located totally within intradural retroclival region. She underwent retromastoid suboccipital craniotomy to resect the tumor mass and adjuvant gamma knife radiosurgery for remnant tumor at 1 month after operation. Adjuvant radiosurgery after surgical excision seems to be effective for the treatment of intradural extraosseous chordomas.

• Korean Journal of Bronchoesophagology
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• v.13 no.1
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• pp.47-50
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• 2007

Foreign bodies of the parapharyngeal space can cause severe complications such as descending suppurative mediastinitis, jugular thrombophlebitis, cavernous sinus thrombosis and carotid erosion. Therefore, early diagnosis and surgical intervention are needed to reduce morbidity and mortality. We present a case of a toothbrush as foreign body in the parapharyngeal space in 28-year-old male patient. The tooth brush was broken and the remnant of that was left in the patient's mouth. Under general anesthesia, intraoral approach was undertaken and successfully the toothbrush was removed, and then incision and drainage was done by transcervical approach. We report this case with review of literature.

• Journal of Acupuncture Research
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• v.18 no.5
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• pp.179-184
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• 2001

The Tolosa-Hunt syndrome(THS) consists of a painful ophthalmoplegia related to a granulomatous inflammatory process in the cavernous sinus, which may be documented by cerebral magnetic resonance imaging with gadolinium enhancement. Generally, it has been reported that 2 weeks steroid therapy relieves the symptoms(periorbital pain, ophthalmoplegia) of THS. In this case, there had been no improvement of symptoms by western medical treatments(steroid & analgesics). but, the symptoms were resolved clearly by acupuncture therapy during 6 weeks(5 times/week). If more clinical trials like this are proved to be effective in THS, we can expect that acupuncture will be another therapeutical modality in THS.

• Annals of Clinical Neurophysiology
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• v.18 no.1
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• pp.11-13
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• 2016

Idiopathic hypertrophic cranial pachymeningitis (ICHP) is diffuse inflammatory process of the dura mater. ICHP can produce similar presentation with Tolosa-Hunt syndrome (THS) if it involves cavernous sinus. A-29-year old male with persistent headache and no definite neurologic dysfunction was noted. Two weeks later, he complained of ophthalmoplegia, and his symptoms were thought to be manifestations of THS. Brain magnetic resonance images revealed diffuse thickened, enhanced pachymeninges in left tentorium. The patient was diagnosed with IHCP. We report a IHCP patient who showed very similar presentation as THS.

• Proceedings of the KAIS Fall Conference
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• 2011.12a
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• pp.326-329
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• 2011

Mortality associated with maxillofacial infection is relatively low due to the development of antibiotics, and improved oral care. However, inappropriate treatment, delayed treatment, old age, underlying systemic disease, and drug-resistant micro-organisms can potentially result in life threatening situations such as cavernous sinus thrombosis, mediastinitis, and sepsis. Sepsis is the most dangerous state with high mortality, ranging from 20~60%. The treatment of sepsis involves properly monitoring vital functions, fluid resuscitation, surgical drainage, and empirical use of high doses of antibiotics until culture results are available. Ventilatory support maybe be required as well. We encountered a 64-year-old patient who died from sepsis that developed as the result of an odontogenic infection. The initial diagnosis was right temporal, infraorbital, buccal, pterygomandibular space abscess. Despite surgical and medical supportive care, the condition progressed to sepsis and after four days the patient died due to multiple organ failure.

• Journal of Korean Neurosurgical Society
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• v.38 no.1
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• pp.65-67
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• 2005

Intracranial chloroma may occur in leukemia, although they are rare. A 23-year-old female complained diplopia. Brain magnetic resonance MR imaging showed tumors in the both cavernous sinus, both tentorial and anterior falx. Gamma-Knife radiosurgery was performed with maximal dose; 20Gy, marginal dose; 10Gy. Peripheral blood smear revealed leukemia, and bone marrow aspiration biopsy showed acute lymphocytic leukemia. Two weeks later, MR image for the stereotactic biopsy noticed markedly decreased tumor size. Biopsy result was lymphocytic leukemia. She received conventional radiation therapy, chemotherapy, and bone marrow transplantation. Brain involvement by acute lymphocytic leukemia is very rare. Even though chloroma are sensitive to radiation therapy, prognosis is poor because of the gravity of the underlying disease and association with impending blast transformation. The authors reports a intracranial chloroma by acute lymphocytic leukemia.

• Journal of Korean Neurosurgical Society
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• v.41 no.6
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• pp.425-428
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• 2007

Hemangiopericytoma [HPC] is a rare tumor with uncommon location in the central nervous system. We report a rare case of sellar and suprasellar HPC mimicking pituitary adenoma in a patient initially seen with the symptoms of bitemporal hemianopsia, headache, and panhypopituitarism. Magnetic resonance imaging of the brain revealed a contrast-enhancing soft tissue mass arising from the pituitary fossa, with apparent compression of the chiasm and involving the cavernous sinus. Subtotal resection of the tumor was achieved via a pterional approach. Histopathological examination identified the tumor as a HPC. Nine years later, the tumor recurred. To our knowledge, this is the first reported case of sellar and suprasellar HPC in Korea.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.16 no.1
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• pp.220-225
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• 2003

The Tolosa-Hunt syndrome is a symptom complex with unilateral painful ophthalmoplegia associated with retro-orbital pain, proptosis and Ⅲ, Ⅳ, Ⅴ-1, Ⅵ cranial nerves palsy due to nonspecific granulomatous inflammation in the superior orbital fissure or cavernous sinus. We experienced a 50 years old female patient with Tolosa-Hunt syndrome who had several clinical signs and symptoms such as ocular pain, headache, sensory loss of face, diplopia, and visual disturbance. In the point of Differentiation of Syndrome(辨證). this subject was diagnosed as Deficiency of yin in liver and kidney(肝腎陰虛), and was administrated with Yangyeummyungmoktang-Gamibang. After treatment of acupuncture and herbal medicine above symptoms were improved.