• Archives of Craniofacial Surgery
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• v.17 no.3
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• pp.103-110
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• 2016

Fractures of frontal sinus account for 5%-12% of all fractures of facial skeleton. Inadequately treated frontal sinus injuries may result in malposition of sinus structures, as well as subsequent distortion of the overlying soft tissue. Such inappropriate treatment can result in aesthetic complaints (contour deformity) as well as medical complications (recurrent sinusitis, mucocele or mucopyocele, osteomyelitis of the frontal bone, meningitis, encephalitis, brain abscess or thrombosis of the cavernous sinus) with potentially fatal outcomes. Frontal contour deformity warrants surgical intervention. Although deformities should be corrected by the deficiency in tissue type, skin and soft tissue correction is considered better choice than bone surgery because of minimal invasiveness. Development of infection in the postoperative period requires all secondary operations to be delayed, pending the resolution of infectious symptoms. The anterior cranial fossa must be isolated from the nasal cavity to prevent infectious complications. Because most of the complications are related to infection, frontal sinus fractures require extensive surgical debridement and adequate restructuring of the anatomy. The authors suggest surgeons to be familiar with various methods of treatment available in the prevention and management of complications following frontal sinus fractures, which is helpful in making the proper decision for secondary frontal sinus fracture surgery.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.1
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• pp.71-78
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• 2024

Dural arteriovenous fistula (DAVF) is a rare condition affecting approximately 1.5% of 1,000,000 individuals annually. It frequently occurs in the transsigmoid and cavernous sinuses. An isolated sigmoid sinus is extremely rare and is treated by performing transfemoral transvenous embolization along the opposite transverse sinus. A 69-year-old woman presented with asymptomatic Borden type III/Cognard type III DAVF involving an isolated sigmoid sinus. She underwent a staged operation in which a navigation system was used to expose the sigmoid sinus in the operating room before transferring the patient to the angio suite for transvenous embolization. Various modalities have been used to treat DAVF, including surgical disconnection, transarterial embolization, transvenous embolization, and stereotactic radiosurgery. However, treating DAVF cases where the affected sinus is isolated can be challenging because an easily accessible surgical route may not be available. In this case, direct sinus cannulation and transvenous embolization were the most effective treatments.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.563-566
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• 2010

Retrobulbar abscess is a rare, but severe complication of paranasal sinusitis. The clinical presentations are eyelid swelling, erythema, proptosis, conjunctival chemosis, restricted ocular movement, and decreased visual acuity. Diagnostic methods available for evaluating retrobulbar abscess include sinus X-ray, ultrasonography, computed tomography (CT), and bacterial culture. For the treatment of retrobulbar abscess, immediate surgical drainage and systemic antibiotic therapy are needed. Proper diagnosis and treatments are necessary for preventing visual loss, cavernous sinus thrombosis, subdural abscess, and other lifethreatening complications. A patient, a 30-year-old man, was admitted to our hospital because of progressive eyelid swelling, erythema, ptosis and decreased visual acuity on the right eye after endodontic treatment. The sinusitis occurred secondary to the infection from an upper molar tooth. The spread of the infection led to the orbit via ethmoidal sinus and posterior orbital wall. Immediate surgical intervention was performed and systemic antibiotics was administrated. The symptoms and signs are improved after treatments, so we present our case with a brief review of the literature.

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.377-380
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• 2010

The abducens nerve usually travels from the brainstem to the lateral rectus muscle as a single trunk. However, it has been reported that this nerve could split into branches occasionally. We attempted to show the aberrant course of abducens nerve in a specimen with unilateral duplicated abducens nerve and review relevant literatures. The micro-dissections were performed in a head specimen injected with colored latex under the microscope. The abducens nerve was duplicated unilaterally. This nerve emerged from the pontomedullary sulcus as a single trunk and splitted into two branches in the prepontine cistern. These two separate branches were piercing the cerebral dura of the petroclival region respectively. The slender lower branch passed between the petroclinoid and petrosphenoid ligaments and the thick lower one passed under the petrosphenoid ligament. These two branches united just lateral to the ascending segment of internal carotid artery in the cavernous sinus. The fact that there are several types of aberrant abducens nerve is helpful to perform numerous neurosurgical procedures in the petroclival region and cavernous sinus without inadvertent neurovascular injuries.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.18 no.2
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• pp.86-92
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• 2005

Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus/superior orbital fissure has been termed Tolosa-Hunt syndrome(THS). The syndrome is characterized by pain behind, above or around the eye, involvement of the cranial nerves which pass through the cavernous sinus, spontaneous remissions and exacerbations, and a favourable response to steroid therapy. There was the 56 years old man who suffered from painful ophthalmoplegia and facial palsy. The oriental medical treatment without steroids and analgesics reduced the symptoms of the patient remarkably during 5 weeks. There is few report that treat THS with oriental medical method. If more clinical trials like this are proved to be effective, we can expect that oriental medical treatment will be a good method in THS.

• Archives of Craniofacial Surgery
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• v.25 no.4
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• pp.187-191
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• 2024

A 59-year-old woman presented to our clinic with a 3.5×3-cm protruding mass on her forehead. A skull X-ray revealed a radiolucent osteolytic lesion on the left side of the frontal bone. Additionally, computed tomography showed a 3.1×1.7×3.6-cm mass exhibiting a "sunburst" pattern situated between the outer and inner tables of the skull, just superior and lateral to the left frontal sinus. This pattern suggested the presence of an intraosseous vascular malformation (IVM). The lesion was approached via a bicoronal incision. En-bloc resection was performed, removing the mass along with approximately 0.5 cm of the surrounding normal bone without injury to the exposed frontal sinus mucosa. The exposed mucosa was reinforced with a galeal flap, and cranioplasty with bone cement was performed to repair the resulting bony defect. Pathological examination confirmed a diagnosis of intraosseous cavernous-type malformation with mixed cavernous and capillary histological features. We report this case of IVM and review the existing literature, highlighting the satisfactory functional and aesthetic outcomes after surgery.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.598-602
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• 2022

Development of de novo dural arteriovenous fistula (DAVF) at a different site after resolution of an initial DAVF, is rare. Here we report two cases, which we encountered in our hospital. A 68-year-old woman presented with pulsatile tinnitus on the left side. Cerebral angiography demonstrated a left anterior condylar confluence (ACC) DVAF and she underwent transvenous embolization. Four years after this treatment, she presented with tinnitus on the left side, and cerebral angiography revealed a right DAVF around the sinus of the lesser sphenoid wing. Another 69-year-old woman presented with left-sided orbital bruits, chemosis, and conjunctival hyperemia. Cerebral angiography showed left cavernous sinus (CS) DAVF, for which she underwent transvenous embolization for CS DAVF. One year later, she developed a left ACC and transverse-sigmoid sinus (TSS) DAVF.

• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.65-69
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• 2023

We report a unique case of hemangioma of the nasal cavity in von Hippel-Lindau (VHL) syndrome. A 26-year-old female with VHL syndrome who had previously undergone surgery for pancreatic and adrenal mass presented with a 4-month history of left-sided nasal obstruction. The patient had an expansile mass lesion in the left nasal cavity and an imaging test demonstrated the mass in the left maxillary sinus extending to the nasal cavity. The tumor was removed with an endoscopic prelacrimal recess approach considering the possibility of not only a benign tumor such as hemangioma but also a malignant tumor of the maxillary sinus and histopathologic examination confirmed cavernous hemangioma. This case is the rarely reported manifestation of the paranasal sinus in VHL disease.

• Journal of Oral Medicine and Pain
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• v.1 no.1
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• pp.14-23
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• 1973

眼球의 紅彩, 毛樣體 및 脈絡膜은 相異한 機能을 하나 이의 發生, 構造,血管 및 神經系등의 共通點이 많으므로 炎症發生時 어느 한 部分에 局限되지 않으므로 選括하여 葡萄膜炎이라하며, 隣接器官의 炎症및 波及은 內因性感染 卽 肺炎 등 흔한 原因이며 口腔과는 葡萄官 및 Cavernous Sinus 등을 通한 Uveoparotid fever, Mikulicz's Disease 또는 Sjogrene Syndrome등과 깊은 關係가 있으며, 一般 및 特殊治療에도 大部分 完治되나 例外가 있는 바 저자는 六個月餘에 걸친 眼科的 治療의 結果 아무런 好展이 없는 葡萄膜炎 患者에 病巢感染說을 뒷받침하여 口腔內病巢를 完全除去한 結果 좋은 豫後를 觀察, 이에 報告하는 바이다.

• Archives of Plastic Surgery
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• v.42 no.6
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• pp.791-793
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• 2015