• 대한치과교정학회지
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• 제19권3호
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• pp.67-78
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• 1989

This study was designed to investigate the difference of teeth and craniofacial complex between normal occlusion and Angle's Class II, div. 1 malocclusion in Korean children. The sample was divided into 2 groups, the 66 subjects with normal occlusion and 96 subjects with Angle's Class II, div. 1 malocclusion in both sexes. The results obtained were as follows: 1. No significant differences were observed in ant. cranial base length & cranial flexure (saddle) angle) between normal occlusion & Angle's Class II, div. 1 malocclusion group, but posterior cranial base length of Class II, div. 1 malocclusion group was larger than that of normal occlusion group. 2. No significant difference was observed in the anteroposterior position of Maxilla to cranial base between two groups, but mandibular position in Class II, Div. 1 malocclusion was posterior and interior to that of normal occlusion. 3. The length of maxilla (ANS-PSN) was larger in Class II, div. 1 malocclusion than normal occlusion. The length of mandibular body (Go-Me) was nor different between Class II, div. 1 malocclusion and normal occlusion. 4. Maxillary incisor position of Class II, div. 1 malocclusion to cranial base was more protrusive than that of normal occlusion, but there was no difference in mandibular incisor position between two groups.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.469-478
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• 2022

Objective : Cranial base chordomas are rare, but their treatment is challenging. Tumor recurrence is still common despite improvements in microsurgical techniques and postoperative radiotherapy. We retrospectively analyzed the course of treatment, overall survival, and recurrence/progression of chordomas over the past 10 years. Methods : We retrospectively reviewed 50 patients who underwent surgery at Tianjin Huanhu Hospital between 2010 and 2020 and were pathologically diagnosed with chordomas. Tumor resection was performed within the maximum safe range in all patients; the extent of resection was evaluated by imaging; and the incidence of complications, recurrence or progression, and overall survival were assessed. Results : Fifty patients were divided into the low-risk group (LRG) and high-risk group (HRG) based on the cranial chordoma grading system (CCGS). The Karnofsky Performance Scale scores and gross total resection rate of the LRG were significantly higher than those of the HRG (p<0.05). The incidence of complications and mortality in the LRG were lower than those of HRG. The analysis of cumulative survival and cumulative recurrence free survival/progression free survival (RFS/PFS) showed no statistical differences in the extent of resection for survival, recurrence, or progression. Univariate and multivariate analyses showed that Ki-67 was significantly associated with tumor recurrence and was an independent hazard factor (p=0.02). Conclusion : The CCGS can help neurosurgeons anticipate surgical outcomes. Pathological results are important in evaluating the possibility of tumor recurrence, and postoperative radiotherapy improves overall survival and RFS/PFS.

• 한국임상수의학회지
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• 제22권3호
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• pp.281-283
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• 2005

A 3-month-old male, Cocker Spaniel with persistent regurgitation immediately after weaning and stunted growth was referred. Radiographic findings on the lateral view include ventral deviation of the thoracic trachea caused by draping of the dilated esophagus and a distinct interface of the dorsal wall of the esophagus silhouetting with the cranial thoracic hypaxial muscles. On the ventrodorsal view, the cranial mediastinum was widened with soft tissue opacity. The trachea was deviated to the right. In an esophagogram, the segmental dilation of the esophagus with constriction of the lumen just cranial to the heart base was identified. In a fluoroscopic examination, the contrast medium was massively accumulated in the cranial portion of the constricted esophagus. At surgery, it was confirmed that the esophageal tract was constricted at the cranial to the base of the heart by aberrant right subclavian artery. It was ligated and divided surgically. Current state of the referred is maintained normal condition from the surgical repair.

• Investigative Magnetic Resonance Imaging
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• 제25권4호
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• pp.281-292
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• 2021

Cranial-nerve disorders can be caused by a wide spectrum of diseases, including congenital, inflammatory, and tumorous diseases, and are often encountered in practice. However, the imaging of cranial-nerve disorders is challenging, and understanding the anatomical differences of each region is essential for conducting the best protocols and for detecting subtle changes in cranial nerves during magnetic resonance imaging (MRI) examinations. In this review we discuss which MRI techniques are best for observing normal and pathologic appearance, according to the different regions of the cranial nerves.

• Journal of Korean Neurosurgical Society
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• 제30권9호
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• pp.1079-1085
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• 2001

Objective : We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. Methods : In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. Results : Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. Conclusion : Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.

• Journal of Korean Neurosurgical Society
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• 제45권2호
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• pp.103-106
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• 2009

Intracranial schwannomas preferentially arise from the vestibular branch of the eighth nerve, and rarely from the trigeminal nerve, facial nerve, and lower cranial nerves. Anterior cranial fossa schwannomas are extremely uncommon and few details about them have been reported. The patient was a 39-year-old woman whose chief complaints were anosmia and frontal headache for 2 years. The gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) showed an extra-axial mass from ethmoid sinus to right frontal base region near the midline, with solid enhancement in lower portion and multicystic formation in upper portion. The tumor was totally resected via basal subfrontal approach. At operation, the tumor had cystic portion with marginal calcification and the anterior skull base was destructed by the tumor. The olfactory bulb was involved, and the tumor capsule did not contain neoplastic cells. The histopathological diagnosis was schwannoma. We report a rare case of anterior cranial fossa schwannoma with literature review.

• 대한치과교정학회지
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• 제22권1호
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• pp.205-227
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• 1992

This study was aimed to investigate the characteristics & the causative areas of the adult skeletal class III malocclusions with different facial divergency. The lateral cephalograms of 80 subjects with skeletal class III malocclusion from 17 to 29 years of age were classified into 3 groups according to SN-MP angle; hypodivergent group $(21.65{\pm}3.52^{\circ})$, neutrodivergent group $(30.50{\pm}2.29^{\circ})$ and hyperdivergent group $(40.02{\pm}3.98^{\circ})$. The data were gathered by digitizing of the traced cephalograms and were statistically analyzed. The results were as follows: 1. The anterior cranial base of the hyperdivergent group was shortest & tipped upwardly to the FH plane. 2. The maxilla of hyperdivergent group was shortest anteroposteriorly and positioned posteriorly to the anterior cranial base. 3. The degree of the mandibular prognathism in hyperdivergent group was less than the hypodivergent group. The hyperdivergent group showed the downward & backward rotated mandible. 4. The mandibular ramus & body was short & slender in the hyperdivergent group and the gonial angle was greatest in the hyperdivergent group. 5. The temporomandibular joint was positioned more superiorly to the anterior cranial base in the hyperdivergent group. 6. The cranial base, palatal plane, occlusal plane and mandibular plane were diverged in the hyperdivergent group. And this group had a great anterior total facial height, especially anterior lower facial height. 7. The craniofacial characteristics of skeletal class III malocclusion were critical in the vertical structure than the horizontal.

• 대한치과교정학회지
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• 제20권3호
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• pp.427-446
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• 1990

The objective of this study was to understand the major changes of craniofacial dimensions and spatial growth pattern during the late embryonic and fetal period of human fetures. This study was performed with the selective materials of normal fetuses received from the Registry of Congenital Malformation of Seoul National University Hospital. The specimens consisted of nineteen embryos and sixty-six fetuses. The photomicrographs from mid-segittal sections of embryos were used for angular measurement, and the lateral cephalograms taken with soft X-ray were also measured in liners and angular aspects. All of the anatomical landmarks for the tracing of the photomicrographs and cephalograms were referred to the previous reports on literature. The sequential changes of prenatal craniofacial dimensions and agles were analysed statistically and discussed on the focus about the developmental growth directions of human ore-facial structure arised from heterogeneous origins. The results are as follows, 1) Cranial base angle was almost formed at about 6 weeks old embryos with the average angle of $127.4{\pm}6.33^{\circ}$ (n=3) and it was almost constant onwards. 2) The linear increase rates of anterior cranial base length and anterior facial height exceeded those of the posterior cranial base length and posterior facial height, and the maxilla grows more rapidly on the horizontal dimension than the vertical dmension during the fetal period. 3) The angular relationship between the anterior cranial base and palatal plane decreasedslightly during the fetal period, disclosing $11^{\circ}$ at 12th week gestation and $5^{\circ}$ at 41th weeks gestation. 4) Genial angle was maintained almost constantly at about $130^{\circ}$ during the fetal period from 12 weeks to 41 weeks of gestation.

• 대한치과교정학회지
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• 제27권4호
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• pp.633-641
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• 1997

성장 또는 치료로 인한 악안면골의 변화는 두부 방사선을 중첩 함으로써 판단할 수 있다. 중첩에 대한 평가는 중첩방법에 따라 변화되므로 좀더 정확한 중첩 방법을 선택하는 것은 치료 효과에 대한 분석이나 성장 변화에 대한 평가를 정확히하는 선결 요건이 될것이다. 3년 정도의 비교적 짧은 성장기간을 가진 11세 전후의 여자 환자 19명을 대상으로, 가장 널리쓰이는 중첩 방법인 Nasion-Sells line중첩과 Bjork가 주장하는 Anteirior cranial base (ACB)중첩을 비교하여 다음과 같은 결론을 얻었다. 1 Nasion-Sells line중첩과 ACB중첩은 중첩오차(registration error)의 크기가 거의 같아서 reliability에 있어서 큰차이가 없는 것으로 나타났다 2. 검사자간 차이(interobserver difference)에 있어서 Nasion-Sells line중첩은 7개의 측정 항목 모두에서 두 검사자간에 차이가 없었으나 ACB중첩은 7개의 측정 항목중 4개의 측정 항목에서 두 검사자간 유의성 있는 차이가 나타났다. 3. 중첩방법의 차이 (intermethod difference)에 있어서 Nasion-Sella line중첩으로 측정한 계 측치와 ACB 중첩으로 측정한 계측치가 유의성있게 차이가 나지 않았다.

• 대한치과교정학회지
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• 제27권5호
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• pp.743-760
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• 1997

두개저의 크기, 형태 및 두부자세가 지니는 두개안면구조의 공간적 수평, 수직적 위치간의 상관성을 파악해 보고자 남자 51명, 여자 49명으로 구성된 표본으로부터 촬영된 100장의 측모 두부방사선사진을 이용, 12개의 계측항목과 37개의 기준점을 설정하고 계측항목에 대한 계측치와 기준점의 수평, 수직 위치를 산출한 다음,이들 간의 상관관계를 통계적으로 분석하였으며 계측항목에서 얻은 계측치의 크기가 크거나 작은 군을 각각 10개 표본씩으로 분류하여 mean facial diagram을 작성, 비교함으로서 다음과 같은 결론을 얻었다. 1. 두개저의 형태변수인 n-s-ba 및 n-s-ar각은 경추의 기준점 cv4ip, cv2ip, cv4tg 그리고 cv2ap의 수평, 수직적 위치 모두에 높은 통계적 유의성의 상관관계를 보였다($0.1\%$ 유의수준). 2. 두개저의 형태변수인 n-s-ba및 n-s-ar각은 안면구조에 있는 대부분의 기준점의 수평적 위치와 상관관계를 보였으나($1\%$ 유의수준), 수직적 위치는 통계적 유의성이 없었다($5\%$ 유의수준). 3. 두개저의 크기변수인 n-s, n-ba, n-ba및 n-ar의 크기는 두개안면구조내 기준점의 위치와 다양한 양상의 상관관계를 보였으나, 대체로 치아, 치조와 관련된 중안면구조의 수평, 수직적 위치와 상관관계가 높았다. 4. 두개저와 경추의 기울기가 이루는 자세변수인 NSL/CVT, NSL/OPT각은 두개안면구조내 기준점의 수평적 위치에 높은 상관성을 지니고 있었으며 통계학적 유의성이 인정되었으나($1\%$유의수준), 수직적 위치와는 통계적 유의성이 없었다($5\%$ 유의수준). 5. 진수평선(true horizontal line)과 경추의 기울기가 이루는 자세변수인 OPT/HOR 및 CVT/HOR각은 두개안면구조내 기준점의 수평, 수직적 위치 모두와 통계적으로 유의성이 인정되는 상관성을 보이지 않았다($5\%$ 유의수준). 6. 연조직에 존재하는 기준점의 수평, 수직적 위치는 모든 변수와의 상관성에서 대부분 경조직의 관련 기준점에 준하는 양상을 보였다.