• Title/Summary/Keyword: Skull Base

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Surgical Treatment of the Nasopharyngeal Carcinoma (비인강암의 수술적 치료)

  • Lee Won-Sang;Chun Young-Myoung;Choi Heung-Seek
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.92-99
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    • 1996
  • The primary treatment of the nasopharyngeal carcinoma is at this time, mainly based on radiotherapy. In most studies for patient treated with radiotherapy, overall 5-year survival rate is in the range of 35 to 55%. Obviously, these therapeutic results may be influenced by various factors such as clinical stages, histopathological types and radiation techniques, etc. Though the radiotherapy had a good therapeutic result, there is a limitation to apply the radiotherapy only in cases of the advanced nasopharyngeal carcinoma. Anatomical complexity of the skull base and difficulties in complete surgical intervention were the trouble of the surgery but in the case of radiation failure, there is no adequate choice of other curative modalities. So it is appropriate to investigate whether surgical resection may improve the outcome of treatment of nasopharyngeal carcinoma. The purpose of this papaer is to report our surgical experience of the nasopharyngeal carcinoma, then to take into consideration of the new model of treatment strategy of nasopharyngeal carcinoma.

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Postoperative Systemic Dissemination of Injected Elemental Mercury

  • Kang, Suk-Hyung;Park, Seung-Won;Moon, Kyung-Yoon
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.245-247
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    • 2011
  • There were only a few reports of mercury on pulmonary artery. However, there is no data on surgery related mercury dissemination. The objective of the present article is to describe one case of postoperative injected mercury dissemination. A 19-year-old man presented severe neck pain including meningeal irritation sign and abdominal pain after injection of mercury for the purpose of suicide. Radiologic study showed injected mercury in the neck involving high cervical epidural space and subcutaneous layer of abdomen. Partial hemilaminectomy and open mercury evacuation of spinal canal was performed. For the removal of abdominal subcutaneous mercury, C-arm guided needle aspiration was done. After surgery, radiologic study showed disseminated mercury in the lung, heart, skull base and low spinal canal. Neck pain and abdominal pain were improved after surgery. During 1 month after surgery, there was no symptom of mercury intoxication except increased mercury concentration of urine, blood and hair. We assumed the bone work during surgery might have caused mercury dissemination. Therefore, we recommend minimal invasive surgical technique for removal of injected mercury. If open exposures are needed, cautious surgical technique to prohibit mercury dissemination is necessary and normal barrier should be protected to prevent the migration of mercury.

Bony Protuberances on the Anterior and Posterior Clinoid Processes Lead to Traumatic Internal Carotid Artery Aneurysm Following Craniofacial Injury

  • Cheong, Jin-Hwan;Kim, Jae-Min;Kim, Choong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.49 no.1
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    • pp.49-52
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    • 2011
  • Traumatic intracranial aneurysms are rare, comprising 1% or less of all cerebral aneurysms. The majority of these aneurysms arise at the skull base or in the distal anterior and middle cerebral arteries or their branches following direct mural injury or acceleration-induced shearing force. We present a 50-year-old patient in whom subarachnoid hemorrhage (SAH) was developed as a result of traumatic aneurysm rupture after a closed craniofacial injury. Through careful evaluation of the three-dimensional computed tomography and conventional angiographies, the possible mechanism of the traumatic internal carotid artery trunk aneurysm is correlated with a hit injury by the bony protuberances on the anterior and posterior clinoid processes. This traumatic aneurysm was successfully obliterated with clipping and wrapping technique. The possibility of a traumatic intracranial aneurysm should be considered when patient with SAH demonstrates bony protuberances on the clinoid process as a traumatic aneurysm may result from mechanical injury by the sharp bony edges.

Huge Size Intracranial Plasmacytoma Treated with Surgery and Fractionated Stereotactic Radiotherapy

  • Choi, Woo-Jin;Yee, Gi-Taek;Choi, Chan-Young;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.110-113
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    • 2006
  • Surgery and radiotherapy are mainly used for plasma cell neoplasm which constitutes about $1{\sim}2%$ of human malignancy. The authors carried out Fractionated Stereotactic Radiotherapy[FSRT] on the residual tumor after the subtotal removal of Intracranial plasmacytoma. A huge mass lesion was observed on MRI [magnetic resonance image] in the left anterior and middle cranial fossa of a 63-year-old man with left exophthalmus which lasted for a month, and was suspected as a meningioma with strong contrast enhancement. Extramedullary plasmacytoma was diagnosed on histopathological examination. After the surgery, FSRT was also carried out on the residual tumor which invaded the skull base. One-year follow up after FSRT showed contrast enhancement only in the left sphenoid bone on MRI, which indicated significant decrease in the size of the tumor without any abnormal neurologic deficits. We treated intracranial plasmacytoma which invaded left anterior and middle cranial fossa and surrounded cavernous sinus without cranial nerve deficit through subtotal tumor removal and FSRT.

EVALUATION OF THE AVAILABILITY OF SURGICAL TREATMENT OBJECTIVE(STO) USING SUBMENTOVERTEX(SMV) VIEW (이하두정 방사선 사진을 이용한 악교정수술 계획의 유용성에 대한 평가)

  • Kim, Bum-Soo;Kim, Jong-Wan;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.5
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    • pp.324-328
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    • 2009
  • Submentovertex(SMV) projection shows the base of skull, positions of mandibular condyle and zygomatic arches. We would like to investigate how to use SMV and evaluate its availability for the construction of the plan for orthognathic surgery of mandible prognathism and asymmetry. Preoperative Surgical Treatment Objective(STO) using SMV was performed to 12 patients, who visited to Seoul National University Bundang Hospital with chief complaints like mandible prognathism or asymmetry from Dec 2007 to Feb 2009. Surgical splint was made of stone model repositioned according to STO using SMV. We estimate the change in skeletal midline and the stability of occlusion through superposition between preoperative and postoperative SMV. It was effective on the amount of mandible movement and the correction of mandibular asymmetry, while the facial asymmetry involved with maxilla was excluded. It was concluded that STO using SMV is available and predictable method for not only the setback of prognathic mandible but also the correction of mandible asymmetry accurately.

A Clinical Study of One Patients Suffering Headache after Administering Banhabaekchulcheonma-tang (반하백출천마탕가미방(半夏白朮天麻湯加味方)을 투여한 두통환자(頭痛患者) 1예(例)에 대(對)한 임상보고(臨床報告))

  • Heo, Min;Kim, Yoon-Sik;Seol, In-Chan
    • Journal of Haehwa Medicine
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    • v.14 no.2
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    • pp.127-131
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    • 2005
  • Headache is a term used to describe aching or pain that occurs in one or more areas of the head, face, mouth or neck. Headache can be chronic, recurrent or occasional. The pain can be mild or severe enough to disrupt daily activities. Headache involves the network of nerve fibers in the tissues, muscles and blood vessels located in the head and at the base of the skull. Headache also can result from syndromes involving the eyes, ears, neck, teeth or sinuses. In these cases, the underlying condition must be diagnosed and treated. Recently one patient was come with headache. The patient is a 35-year-old lady with complaints of very severe headache that strike as often as several times a week. She has the throbbing pain on the right side of her head with nausea, vomiting, fatigue, dizziness, coldness of hand and leg, or ringing in the ears sometimes etc. After treatment through Banhabaekchulcheonma-tang, most of the symptoms improved. Therefore, this application of oriental medicine is reported with a plea for further investigation.

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Management of the Intractable Huge Intracranial Osteoma Based on the 3D Printing Model

  • Choi, Jong-Woo
    • Journal of International Society for Simulation Surgery
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    • v.3 no.2
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    • pp.77-79
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    • 2016
  • Osteoma is one of the benign tumor that occurs on the bones all over the body. Mostly the simple excision is known to be enough. However, sometimes we encounter the troublesome situation where the osteoma is located in very challenging area, which results in the recurrence. 26 year female presented with the intractable intracranial osteoma. Given the disease entity of the osteoma, the simple excision would be enough or conservative management. But this osteoma turned out to be huge and recurrent in spite of the endoscopic resections, which causes the facial disappearance accompanied by the orbital vertical dystopia. Moreover, the patient's main concern was the pain. We performed the intracranial resection of the whole lesion and reconstructed the skull base and frontal bone as well as the part of the orbital wall. In order to restore the original bony anatomy, the 3D printing model was used based on the titanium mesh. I report this unusual case of the intractable intracranial huge osteoma. This report may be helpful for the other surgeons to make a decision on their similar cases in the future.

A Case of Telangiectatic Osteosarcoma of the Skull Base (두개저의 혈관확장형 골육종 1례)

  • Kim, Yong-Jin;Oh, Hoon-Kyu
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.364-368
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    • 1999
  • A rare case of telangiectatic osteosarcoma of the sphenoid bone was reported. The patient was a 27-year-old male and had suffered from left eye protrusion and diplopia for three months. Radiologically, a lobulated osteolytic lesion was located between sphenoid and left temporal bone. Pathologically, the tumor had multiloculated blood filled cystic vascular spaces and osteoid formation by malignant spindle osteoblast cells. The differential diagnosis of this rare entity from aneurysmal bone cyst was important radiologically and pathologically. This case is the second case of telangiectatic osteosarcoma of the sphenoid bone followed by a case of Whitehead RE and Melhem ER in 1998.

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Surgical Treatment of the Nasopharyngeal Carcinoma (비인강암의 수술 치험)

  • Lee Won-Sang;Chun Young-Myoung;Youn Jung-Sun
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.2
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    • pp.200-209
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    • 1993
  • The primary treatment of the nasopharyngeal carcinoma is, at this time, mainly based on radiotherapy. In most studies for patient treated with radiotherapy, overall 5-year survival rate is in the range of 35 to 55%. Obviously, these therapeutic results may be influenced by various factors such as clinical stages, histopathological types and radiation techniques, etc. Though the radiotherapy had a good therapeutic result, there is a limitation to apply the radiotherapy only in cases of the advanced nasopharyngeal carcinoma. Anatomical complexity of the skull base and difficulties in complete surgical intervention were the trouble of the surgery but in the case of radiation failure, there is no adequate cholice of other curative modalities. So it is appropriate to investigate whether surgical resection may improve the results of treatment of nasopharyngeal carcinoma. The purpose of this paper is to report the surgical experience with nasopharyngeal carcinoma, then to take into consideration of the new model of treatment strategy of nasopharyngeal carcinoma.

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Traumatic cerebrospinal fluid leakage following septorhinoplasty

  • Youssef, Ahmed;Ahmed, Shahzad;Ibrahim, Ahmed Aly;Daniel, Mulvihill;Abdelfattah, Hisham M.;Morsi, Haitham
    • Archives of Plastic Surgery
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    • v.45 no.4
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    • pp.379-383
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    • 2018
  • Septoplasty/septorhinoplasty is a common ear, nose and throat procedure offered for those patients with deviated septum who are suffering from nasal obstruction and functional or cosmetic problems. Although it is a basic and simple procedure, it could lead to catastrophic complications including major skull base injuries which result in cerebrospinal fluid (CSF) leaks. We describe two different cases of traumatic CSF leaks following septoplasty/septorhinoplasty at two different sites. The first patient suffered a CSF leak following septoplasty and presented to Alexandria University Hospital. The leak was still active at presentation and identified as coming from a defect in the roof of the sphenoid sinus and was repaired surgically. The second patient presented 4 days after her cosmetic septorhinoplasty with a CSF leak and significant pneumocephalus. She was managed conservatively. Understanding the anatomical variations of the paranasal sinuses and implementing proper surgical techniques are crucial in preventing intracranial complications when performing either septoplasty or septorhinoplasty. A good quality computed tomography of the nose and paranasal sinuses is a valuable investigation to avoid major complications especially CSF leaks following either procedure.