• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.27 no.4
• /
• pp.367-369
• /
• 2001

The lateral rhinotomy signifies only an incision and not on operation and a lateral rhinotomy incision with osteotomy of the nasal bones provides access to the entire nasal cavity and maxillary, ethmoid, and sphenoid sinuses as well as the frontal sinus if the floor is removed, permitting removal of benign lesions at these sites and en bloc resection of the ethmoid labyrinth and the party wall between the nasal cavity and antrum with infiltrating tumors. The authors treated a tumor patient and a midfacial bone fracture patient via lateral rhinotomy approach and had a good result. So we report the cases with literature review.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.1
• /
• pp.81-84
• /
• 2001

Pneumocephalus is exceedingly rare in the absence of trauma or recent surgery. It is most commonly seen after severe head injury, with disruption of the dura and subsequent cerebrospinal fluid leakage. Intracranial air has also been reported as a complication of shunting. This may be secondary to intermittent shunt failure or a persistent communication between the extracranial and intracranial space that permits the entrance of air. In the present case, air appeared to enter the ventricular system through the fistula that connected the frontal sinus. This air replaced the CSF being drained into the peritoneal cavity by the shunt. The decrease of intracranial pressure after a shunt might play a role in causing pneumocephalus. We report a case of tension pneumocephalus after shunting for hydrocephalus as a life-threatning complication.

• Korean Journal of Veterinary Pathology
• /
• v.3 no.1
• /
• pp.55-59
• /
• 1999

Metastatic squamous cell carcinoma was described in two female Pere David's deer reared at Everland zoo. Both deer with chronic emaciation had the mass on right maxilla(9$\times$11$\times$15cm or 20$\times$17cm) which was composed of miliary tan creamy contents and encapsulated by connective tissue. The undulating contents in the mass was a1so extended in the underlying or adjacent soft palate, maxillary and frontal sinus causing severe bone destruction. In one deer, two fistula were also noted in the right periocular area. Histologically, the neoplastic masses of both deer consist of anastomosing cords or nests of squamous epithelial cells with intercellular bridge or keratin pearl formation. The neoplastic cells invade deep into the subcutis and bony tissue. Mitotic figure was rare. Multifocal areas of necrosis and hemorrhages were also noted in the dermis. Metastasis to maxilla and ethmoid bones and/or to submandibular lymph node was noted in both cases. The diagnosis was based on the results of histopathology.

• Archives of Craniofacial Surgery
• /
• v.18 no.2
• /
• pp.117-121
• /
• 2017

Typical transcranial approaches are insufficient for adequate visualization and resection of skull base tumors. Different approaches with multiple modifications have been attempted. Here, we describe a new approach for a lesion that is central and hard to treat by conventional craniotomy and successful reconstruction with calvarial bone graft and titanium mesh plate. A 69-year-old female patient presented with recurrent meningioma. The tumor had invaded the frontal lobe, right supraorbital rim, and ethmoidal bone. We performed a modified anterior craniofacial approach that fully exposed the tumor and invaded bone. In consideration of the patient's age and cosmetic result, the tumor and invaded bone was resected and the defect area was reconstructed with titanium mesh and calvarial bone graft. At 6 months postoperative the patient had no complications and was satisfied with the esthetic result. We report this case to demonstrate the successful approach and reconstruction using this technique.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.12
• /
• pp.1570-1576
• /
• 2000

Objective : To evaluate objectively the sites of injury in patients with posttraumatic olfactory deficits and to suggest the diagnostic procedure for evaluation of posttraumatic anosmia. Methods : Ten patients with posttraumatic olfactory dysfunction were examined by means of olfactory testing, sinoscopy, contrast filled paranasal sinus computed tomography(contrast filled PNS CT) and magnetic resonance imaging(MRI). Five normal persons without olfactory dysfunction were also evauluated. The aerodynamic patency of olfactory cleft was examined by contrast filled PNS CT. The olfactory system(oflactory bulbs, olfactory tracts, inferior frontal region, hippocampi, or temporal lobes) was investigated in detail with MRI. The difference in the size of the olfactory bulb between normal volunteers and anosmic patients was evaluated by Student's t test. Results : Contrast filled dynamic CT scan was useful method for the evaluation of dynamic patency of the olfactory cleft. Paranasal CT scan of the all anosmic patients showed dynamic reflux of contrast media in olfactory cleft on valsalva maneuver. For the largest cross-sectional area and great height, the difference in olfactory bulb size between normal volunteers and patients was statistically significant(p<0.001) in MRI study. Conclusion : Posttraumatic anosmia was completely evaluated by olfactory testing, sinoscopy, and contrast filled CT scan for differentiation between conductive type and neurogenic type. Neurogenic anosmia was confirmed by perfect localization with MRI study.

• Clinical and Experimental Pediatrics
• /
• v.49 no.2
• /
• pp.208-211
• /
• 2006

Dyke-Davidoff-Masson Syndrome (DDMS) is a rare condition characterized by asymmetry of cerebral hemispheric growth with atrophy on one side, ipsilateral compensatory osseous hypertrophy, and contralateral hemiparesis. We experienced a 17 month-old male who presented with left focal clonic or tonic-clonic seizures accompanied by left hemiparesis and developmental delay. Brain MRIs demonstrated progressive atrophy of the right cerebral hemisphere with dilatation of the lateral ventricle, expansion of the ipsilateral frontal sinus with calvarial thickening, and elevation of the petrous pyramid and orbital roof. Brain SPECT showed a decreased volume of the right hemisphere with reduced blood flow. We therefore report a case of DDMS with a review of the literature.

• Journal of Yeungnam Medical Science
• /
• v.8 no.1
• /
• pp.127-135
• /
• 1991

Successful middle ear surgery requires the availability of al safe, effective bonding material. Side effect caused by synthetic materials have led to the use of biologic adhesive. However, they carry the risk of transmission of infectious diseases if they are prepared from pooled human blood. The adhesive strength of ammonium sulfate fibrin adhesive produce an adhesive strength that is half that of the homologous commercial product. It is, however, good enough for use in several otolaryngological operations, tympanoplasty, facial nerve repair, reconstruction of ossicles, reconstruction of posterior wall of ear canal and obliteration of frontal sinus and mastoid antrum using bone dust.

• Journal of Korean Neurosurgical Society
• /
• v.38 no.1
• /
• pp.54-60
• /
• 2005

The clear cell meningioma[CCM] is a rare and recently described as a histologic variant of meningioma. It has been identified and included in new World Health Organization[WHO] classification of the Central Nervous System[CNS] tumors recently. The CCMs are histologically characterized by sheets of spindled to polygonal cells with clear cytoplasm, which is the expression of high glycogen concentration. The CCMs occur in younger patients and usually are located in the spinal canal and posterior fossa. The most interesting aspect of CCM is the high recurrence rate and aggressiveness. Poor outcome has been shown in intracranial and spinal tumor location, but the indicators that predict outcome have not been established. Until now 22 intracranial CCM cases had been reported in English literature and 3 cases in Korean. The authors report two cases of CCM located at cerebral convexity and one at cavernous sinus those were totally removed [Simpson Grade $I{\sim}II$] by subfrontal, frontal and orbitocranial approaches. The clinical, radiological, histopathological, and neurosurgical features of these cases are discussed with the relevant literatures.

• Archives of Craniofacial Surgery
• /
• v.22 no.5
• /
• pp.232-238
• /
• 2021

Background: Galeal or temporalis muscle flaps have been traditionally used to reconstruct skull base defects after tumor removal. Unfortunately, these flaps do not provide sufficient vascularized tissue for a dural seal in extensive defects. This study describes the successful coverage of large skull base defects using anterolateral thigh (ALT) free flaps. Methods: This retrospective study included five patients who underwent skull base surgery between June 2018 and June 2021. Reconstruction was performed using an ALT free flap to cover defects that included the intracranial space and extended to the frontal sinus and cribriform plate. Results: There were no major complications, such as ascending infections or cerebrospinal leakage. Postoperative magnetic resonance imaging showed that the flaps were well-maintained in all patients. Conclusion: Successful reconstruction was performed using ALT free flaps for large anterior skull base defects. In conclusion, the ALT free flap is an effective option for preventing communication between the nasal cavity and the intracranial space.

• Radiation Oncology Journal
• /
• v.24 no.2
• /
• pp.149-155
• /
• 2006

Meningeal hemangiopericytoma (HPC) is an uncommon dura-based tumor and can recur not only locally but also distantly in the neural axis or extraneural sites. We report our experience of radiation therapy, one preoperative and one elective postoperative, In two patients with meningeal HPC and reviewed the role of radiation therapy. A 41-year-old man (Case 1) presented with a 3-month history of headache and right hemiparesis. The mass was nearly unresectable at the first and second operation and diagnosed as meningeal HPC. Preoperative radiation therapy was given with a total dose of 55.8 Gy/31 fractions to the large residual mass of left frontoparietal area. Follow-up computerized tomography (CT) showed marked regression of tumor after radiation therapy. The third operation was peformed to remove the residual tumor at 6 months after the radiation therapy and a $2{\times}2cm$ sized tumor was encountered. The mass was totally removed. The serial follow-up CT showed no evidence of recurrence and he is alive without distant metastasis for 4 years and 10 months after the first operation. A 45-year-old woman (Case 2) presented with suddenly developed headache and visual impairment. Tumor mass occupying right frontal lobe was removed with the preoperative diagnosis of meningioma. It was totally removed with attached sagittal sinus and diagnosed as meningeal HPC. Elective postoperative radiation therapy was peformed to reduce local recurrence with a total dose of 54 Gy/30 fractions to the involved area of right frontal lobe. She is alive for 5 years maintaining normal activity without local recurrence and distant metastasis.