• Title/Summary/Keyword: Petrous bone

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Primary Glioblastoma of the Cerebellopontine Angle : Case Report and Review of the Literature

  • Lee, Ji-Hye;Kim, Jong Hyun;Kwon, Taek-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.380-384
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    • 2017
  • Glioblastoma multiforme (GBM) is located most frequently in the cerebral hemispheres. Glioblastoma presenting as an extraaxial mass of cerebellopontine angle (CPA) is very rare in adults. We report a rare case of GBM arising in the CPA. The patient was a 71-year-old female, who complained of progressive gait disturbance and poor memory. Initial magnetic resonance imaging (MRI) revealed a $1.4{\times}1.3cm$ mass in the left CPA, with broad base to the petrous bone, showing homogenous enhancement. Follow-up MRI showed a rapid increase in size of mass ($2.7{\times}2.2cm$) with a necrotic portion. A stereotactic biopsy was done under the guidance of navigation system, and the histopathologic diagnosis was GBM, World Heath Organization grade IV. Further surgical resection was not performed considering her general condition, and the patient underwent concurrent chemotherapy with radiation therapy. Although rare, the possibility of glioblastoma should be included in the differential diagnosis of atypical CPA tumor.

Management of Skull Base Osteoradionecrosis with Hyperbaric Oxygen Therapy (고압산소요법으로 치료한 뇌기저부 방사선골괴사 1예)

  • Hwang, Eun;Lee, Jong-Joo;Shin, Yoo-Seob;Kim, Chul-Ho
    • 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.

A Study to Acquire Sharp Images in the Haas(Skull PA Axial Projection) (Haas 촬영법에서 선예한 영상 획득을 위한 연구)

  • Ahn, Jun-Ho;Han, Jae-Bok;Song, Jong-Nam;Kim, In-Soo
    • Journal of the Korean Society of Radiology
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    • v.16 no.3
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    • pp.319-325
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    • 2022
  • The Study In order to obtain a sharpness Image from Skull PA axial projection (Haas) in a head axial X-ray Examination, this study changed the posture angle using Skull Phantom and evaluated the image subjectively to 5 radiologists who worked in the Department of Imaging at University Hospital. In the prone position, the head was lowered 4 cm from the back of the head, entered 25° toward the head, and the image evaluation score was high with 20 points, such as the back bone, dorsum sellae projected in the large hole, and posterior clinoid process. In addition, the score significance was verified, and the Cronbach Alpha value was evaluated to have good reliability of 0.789. As a result of calculating the signal-to-noise ratio (SNR) by setting the region of interest (ROI) of the image, it was the highest at 5.957 for 25° incident at the back of the head and 6.430 for 30° incident at the back of the head. As a result of the study, in order to obtain a sharp image of the back of the head bone, dorsum sellae, and posterior clinoid process when shooting in the axial direction after the head, it is filmed by tilting 25° toward the head from 4 cm below the back of the head. In order to obtain a sharp image of rock pyramid symmetry, petrous ridge, sagittal suture, and lambdoid suture, it is thought that it will be helpful for clinical use if you shoot it 8cm down from the back of the head and tilt it 30° toward the head.

Relationship between the condyle and adjacent structures in double temporomandibular joint view using panorama (측두하악관절의 panoramic double TMJ 방사선사진상에서 하악과두와 인접구조의 관계)

  • Lee Chang-Yul;Kim Jae-Duk
    • Imaging Science in Dentistry
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    • v.31 no.4
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    • pp.209-214
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    • 2001
  • Purpose: To investigate the ability of double TMJ view by multifunctional panorama to view the bony components and the space of the temporomandibular joint. Materials and Methods: Ten dry skulls fitted with resin shims over the articular surface of the condyle were used to reproduce the temporomandibular joint space. Fine metal wires were attached to the three portions of contours of the condylar head and the articular eminence. With 10 dry skulls and 20 cases having TMJ dysfunction, double TMJ views by multifunctional panorama (Planmeca 2002 Proline CC) and transcranial views were taken, analyzed from the anatomical view point, and compared statistically in view of the widths of the posterior joint space and the condylar head. Results: In double TMJ view, the supero-anterior part of the condyle represented the lateral 1/3, the most superior part represented center portion, and the posterior part medial l/3 of the condyle. In maximum mouth opening, no other structures were superimposed with the condyle in double TMJ view. In double TMJ view, petrous bone was moderately superimposed with the superior part of the condyle and the posterior increment of angle exposure made wider the images of the articular eminence and the condyle. The tendency of reduction in the posterior joint space appeared in the side of TMJ dysfunction compared with the normal side. The posterior joint spaces in double TMJ view were statistically wider (p<0.05) than those in transcranial view. The correlation coefficient was 0.5179 between the widths of the posterior joint spaces in two radiographic views. Conclusions: Double TMJ view can be substituted for transcranial view in evaluating the TMJ dysfunction.

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DECISION OF PROPER PROJECTION ANGLE AND EVALUATION OF REPRODUCIBILITY IN TRANSCRANIAL RADIOGRAPH (악관절규격촬영시 적절한 입사각의 결정 및 재현성의 평가)

  • Ryu Jung-Soo;Choi Soon-Chul;Lee Sang-Han
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.1
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    • pp.99-107
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    • 1991
  • The purpose of this study was to decide the proper projection angle that could avoid the superimposition of the petrous portion of temporal bone and posterior clinoid process in cephalometric lateral and basal view of the 10 dry skulls and to analyze the reproducibility of a modified Accurad-100 head holder device from Denar Co. and a cephalostat head holder in 30 transcranial radiographs of the dry skull. The results were obtained as follows: The vertical angle was 24.5±4.1° and the horizontal angle was 3.0 ±5.7°. The distances between arbitrary 3 points which were on the TMJ area were as follows: AB 16.76±0.27㎜, BC 8.79±0.18㎜ in the transcranial radiographs using modified Accurad-100 head holder, AB 29.03±0.14㎜, AC 19.95±0.24㎜, BC 10.08±0.07㎜ in the transcranial radiographs using cephalostat.

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Total Ear Canal Ablation and Lateral Bulla Osteotomy for Chronic Otitis Externa and Media in Dogs: Postoperative Recovery and Long-Term Follow-up (개에서 만성외이염과 중이염에 대한 전이도 적출술과 외측 고포절골술: 수술 후 회복과정과 장기간 예후)

  • Kim, Joon-Young;Jeong, Soon-Wuk;Jeong, Man-Bok;Han, Hyun-Jung;Kim, Je-Sun
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.26-32
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    • 2003
  • The clinical results of 10 consecutive total ear canal ablation combined with lateral bulla osteotomy (TECA-LBO) in six dogs with chronic otitis externa and media were evaluated by the postoperative recovery and long-term follow-up. All dogs were selected for TECA-LBO on the basis of following five clinical symptoms. First, medical treatment couldnt improve clinical signs at least for eve. 2 months. Second, tympanic membrane was completely disappeared. Third, radiopacity was increased in tympanic cavity. Forth, petrous temporal bone was sclerosed. Fifth, ear canal calcification was progressed. And all cases were satisfied all five clinical symptoms. At 14. days after operation, the preoperative symptoms of chronic otitis externa and media which were scratching ear, pain, and hardening ear canal were resolved, and postoperative swelling, erythema, head tilt, and exudate from Penrose drainage were not existed In all cases. Loss of eye blink was happened in 4 cases, but these were disappeared between 14 days a(ter operation except one case on 3 months. All dogs were discharged form hospital at 14 days after operation. Between 3.5 and 6.5 months after discharging from hospital, para-aural abscessation was happened only in all Cocker spaniels. But this complication was solved by ventral bulla osteotomy (VBO). The dogs which didn't show para-aural abscessation after TECA-LBO didn't show scratching, pain, hardening of ear and hearing ability was improved, at 7.5 months after TECA-LBO. And the dogs which showed para-aural abscessation after TECA-LBO also didn't show scratching, pain, hardening of ear and hearing ability was also improved, at 7.5 months after VBO. In conclusion, After TECA-LBO, all dogs were recovered well without complication within 2 weeks except Cocker spaniel. And loss of eye blink can be cured naturally within 2 weeks after surgery. And para-aural abscessation can be happened between 4 and 7 months after TECA-LBO, so surgeon must follow-up until 8 months.

Diagnostic Value of Susceptibility-Weighted MRI in Differentiating Cerebellopontine Angle Schwannoma from Meningioma

  • Seo, Minkook;Choi, Yangsean;Lee, Song;Kim, Bum-soo;Jang, Jinhee;Shin, Na-Young;Jung, So-Lyung;Ahn, Kook-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.24 no.1
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    • pp.38-45
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    • 2020
  • Background: Differentiation of cerebellopontine angle (CPA) schwannoma from meningioma is often a difficult process to identify. Purpose: To identify imaging features for distinguishing CPA schwannoma from meningioma and to investigate the usefulness of susceptibility-weighted imaging (SWI) in differentiating them. Materials and Methods: Between March 2010 and January 2015, this study pathologically confirmed 11 meningiomas and 20 schwannomas involving CPA with preoperative SWI were retrospectively reviewed. Generally, the following MRI features were evaluated: 1) maximal diameter on axial image, 2) angle between tumor border and adjacent petrous bone, 3) presence of intratumoral dark signal intensity on SWI, 4) tumor consistency, 5) blood-fluid level, 6) involvement of internal auditory canal (IAC), 7) dural tail, and 8) involvement of adjacent intracranial space. On CT, 1) presence of dilatation of IAC, 2) intratumoral calcification, and 3) adjacent hyperostosis were evaluated. All features were compared using Chi-squared tests and Fisher's exact tests. The univariate and multivariate logistic regression analysis were performed to identify imaging features that differentiate both tumors. Results: The results noted that schwannomas more frequently demonstrated dark spots on SWI (P = 0.025), cystic consistency (P = 0.034), and globular angle (P = 0.008); schwannomas showed more dilatation of internal auditory meatus and lack of calcification (P = 0.008 and P = 0.02, respectively). However, it was shown that dural tail was more common in meningiomas (P < 0.007). In general, dark spots on SWI and dural tail remained significant in multivariate analysis (P = 0.037 and P = 0.012, respectively). In this case, the combination of two features showed a sensitivity and specificity of 80% and 100% respectively, with an area under the receiver operating characteristic curve of 0.9. Conclusion: In conclusion, dark spots on SWI were found to be helpful in differentiating CPA schwannoma from meningioma. It is noted that combining dural tail with dark spots on SWI yielded strong diagnostic value in differentiating both tumors.

Idiopathic Vestibular Disease in a Beagle Dog: Clinical Findings and Outcome (비글 견에서 발생한 특발성 전정계 질병 증례: 임상적 발견과 결과)

  • Kang, Byeong-Teck;Jung, Dong-In;Park, Chul;Gu, Su-Hyun;Jeon, Hyo-Won;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.340-343
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    • 2006
  • A 10-year-old, intact female Beagle dog was presented for examination of acute onset of right-sided head tilt and moderate ataxia. Clinical signs were acutely presented 12 days ago and had been progressively alleviated until the admission day. The dog was bright, alert, and responsive. On neurological examinations, mild head tilt to the right and mild ataxia were noted, thus vestibular disorders were suspected. Central vestibular disease was ruled out based on the clinical signs, magnetic resonance imaging(MRI), and cerebrospinal fluid(CSF) analysis. Otoscopic examination showed that the tympanic membranes were intact and normal in appearance. On radiographic and MR examinations, abnormalities were not found in the tympanic bulla and the petrous portion of the temporal bone. Hypothyroidism was ruled out by thyroid-stimulation hormone(TSH) stimulation test. Clinical signs were completely disappeared at 2 weeks after discharge without any therapy. Thus, the dog was definitively diagnosed as idiopathic vestibular disease based on the clinical signs, excluding other causes of vestibular dysfunction, and the alleviation of clinical signs with time.