• The korean journal of orthodontics
• /
• v.30 no.4 s.81
• /
• pp.399-411
• /
• 2000

This study was designed to evaluate the correlations between the morphology and growth of cranial base and the position of nasomaxillary complex and mandible in complete unilateral cleft lip and palate patients. Craniofacial skeletal morphology Pattern was analyzed on the lateral cephalometric radiographs of the 100 subjects of complete unilateral cleft lip and palate group and the 100 normal grower group and each group was divided three sub-groups by age-range like spheno-ethmoidal synchodrosis growing group, spheno-occipital synchondrosis growing group and finished synchondrosis growth group. These data were statistically analyzed to examine significant difference between both groups and between each sub-groups. The results of this study were as follows: 1. In complete unilateral cleft group, the length, thickness of clivus, and the rate of increase in length of clivus showed smaller amount by adolescence. The anterior length of cranial base and the rotation pattern of clivus with age showed no significant difference between two group. 2. In complete unilateral cleft group, nasomaxillary complex were located more posteriorly. This difference between two groups is larger by adolescent group than adult. Vertical position showed no significant difference between two groups. There was significant correlation between the cranial base of cleft group and the horizontal measurements(p<0.01). PtmS showed no significant increment in cleft group. This showed the deficiency of growth in posterior part of maxilla. 3. In mandible, there was no significant difference between normal group and complete unilateral cleft group but articular angle showed significantly smaller in cleft group than in normal one. And the measurements of nasomaxillary complex position, cranial base and the position of mandible had significant correlation(p<0.01).

• The Korean Journal of Cytopathology
• /
• v.12 no.2
• /
• pp.105-110
• /
• 2001

Chordoma is a rare, clinically and morphologically well characterized tumor, which arises from remnants of the notochord, The majority(60%) occurs in the sacrococcygeal region, with 25% in the clival legion, and 15% in the spine. Although most chordomas do not develop metastasis, the long term prognosis is very poor due to local progressive tumor growth and tendency to recur if incompletely excised. The chordoma has characteristic cytologic features which make a preoperative diagnosis possible. We reviewed the cytologic findings of five patients with chordoma(one oropharynx, two clivus, and two sacrum). The patients were three male and two female, aged from 29 to 77 years(mean 60). Of five chordomas, there were local recurrences in two cases and metastasis of lymph node In one case. Four were FNA smears and one was squash smear taken from intraoperative consultation. All five cases show similar cytologic features. The dominating tumor cells were large with round nuclei and pale-stained vacuolated cytoplasm. The small round uniform cells and short spindle-shaped cells were frequently noted. The cells were surrounded by myxoid or mucoid matrix. The chordoma has characteristic cytologic features which make a preoperative diagnosis possible.

• Imaging Science in Dentistry
• /
• v.44 no.2
• /
• pp.165-169
• /
• 2014

An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.

• Korean Journal of Head & Neck Oncology
• /
• v.27 no.1
• /
• pp.66-69
• /
• 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 Academy of Oral and Maxillofacial Radiology
• /
• v.27 no.1
• /
• pp.273-281
• /
• 1997

Patient with complaints of swelling, pain in the maxillaly region and discomfort visited Seoul National University Dental Hospital in August last year. Clinical examination and diagnostic imagings implied he was suffered from fungal hyphal infection but no causative fungus was found by the histopathologic and microbiologic investigation. Therefore he was diagnosed with nonspecific inflammation. But as yet, we do think this case is very similar to some kinds of mucormycosis. So we presented this case for more thorough discussion.Followings are founded in the examination. 1. Patient had suffered from Diabetes mellitus and complained of stuffness, headache, swelling in buccal cheeks and paresthesia And we found more maxillary bony destruction and ulcer with elevated margin in the palate by clinical examination. 2. In the first visit, Plain films revealed general bony destruction of the maxilla, radiopaqueness in the sinonasal cavities. or and MRI showed soft tissue mass filled in the paranasal sinus except frontal sinus and bony destruction in involved bones. 3. No causative bacteria and fungus was found in the biopsy and microbiologic cultures. 4. Caldwell-Luc operation and curettage were carried and antJbiotics were taken for 4 months. But now he was worse than in the past 5. In the second visit, involvement of orbit, parapharyngeal sinus, clivus, cavernous sinus and middle cranial fossa were seen clearly in the or and MRI.

• Archives of Craniofacial Surgery
• /
• v.16 no.1
• /
• pp.17-23
• /
• 2015

Background: Treatment of skull base tumors is challenging due to limited access and presence of important neurovascular structures nearby. The success of a complete tumor resection depends on the extent of tumor exposure and secure field of view. While these tumors are often removed by transcranial endoscopic access, transfacial approach is sometimes required depending on the location and size of the tumor. This study describes various transfacial approaches in patients undergoing skull base tumor resection. Methods: From March to November 2013, 15 patients underwent skull base tumor resection via transfacial accesses at a tertiary institution. Data were reviewed for patient demographics, type of access used, completeness of tumor resection, surgical outcome, and postoperative complications. Results: Two clivus tumor patients underwent transmaxillary approach; three tuberculum-sellae and suprasellar-hypothalamus tumor patients underwent transbasal approach; three clinoid and retrobulbar intraconal orbital tumor patients underwent orbitozygomatic approach; and seven petroclival-area, pons, cavernous sinus, and lateral-sphenoid-wing tumor patients underwent zygomatic approach. In all cases, the upper and lower margins of the tumor were visible. Complete tumor removal consisted of 10 cases, and partial tumor removal in 5. There were no immediate major complications observed for the transfacial portion of the operations. The overall cosmetic results were satisfactory. Conclusion: Plastic surgeons can use various transfacial approaches according to the location and size of skull base tumors to secure a sufficient field of view for neurosurgeons.

• Journal of Oral Medicine and Pain
• /
• v.24 no.2
• /
• pp.171-179
• /
• 1999

The authors experienced a oral carcinoma involving the medial cortex of the right ramus of mandible and the left side of the maxilla which was metastasized from primary rectal adenocarcinoma based on the comprehensive evaluation of data obtained from (1) the past medical history of primary rectal adenocarcinoma, (2) the computerized tomographic views of the homogeneous mass on the anteromedial region of the right ramus of mandible destructing the medial cortex of the right ramus of mandible, and the irregular mass around the clivus spreading into the sphenoid sinus and destructing the left side of the maxilla ; the bone scanning of hot spots on the nasal region and the left side of maxilla ; the posteroanterior chest radiographic view of multiple nodular radiopacities on the lung, (3) the retrospective review of the sonographic view of a hypoechoic, well-demarcated, target-like mass with central hyperechoic focus on right lobe of liver in a Korean female of 49-year-old who complained the ptosis of left eyelid, the swelling on left zygomatic area, the left facial paralysis, the facial asymmetry and a round-shaped, elevated lesion with a hematoma on the mucosa covering the right ramus of mandible.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.sup1
• /
• pp.30-36
• /
• 2001

Objective : To investigate the postoperative result and prognostic factors in cerebellopontine meningioma. Materials & Methods : During the years 1990 through 1999, a retrospective study of 17 cerebellopontine angle meningiomas was performed. The retromastoid approach was used in all cases : 14 tumors were excised totally and 3 tumors subtotally. Results : Fourteen patents were females with a median age of 58.7 years. The most common presenting complaints were 8th cranial nerve dysfunction and headache. Most of the tumors were large(>4cm) and extended into the tentorial regions. Histological examination revealed benign meningiomas in 16 patients and atypical in one patient. Tumors were located posterior to the internal auditory meatus in 11 cases and anterior in three cases with three cases of en-plaque type. Two of three patients whose tumors were subtotally excised received radiation therapy. Tumor has recurred in one patient. Postoperative result was good in 16 cases with one mortality case. Conclusion : This results suggest that site of 7th-8th cranial nerves complex, en-plaque type meningioma, and petroclival meningioma extended into the clivus were significant prognostic factors. Postoperative radiation therapy is recommended for cases of subtotal resection.