• 제목/요약/키워드: Skull base

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Evaluation of canalis basilaris medianus using cone-beam computed tomography

  • Syed, Ali Z.;Zahedpasha, Samir;Rathore, Sonali A.;Mupparapu, Mel
    • Imaging Science in Dentistry
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    • v.46 no.2
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    • pp.141-144
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    • 2016
  • The aim of this report is to present two cases of canalis basilaris medianus as identified on cone-beam computed tomography (CBCT) in the base of the skull. The CBCT data sets were sent for radiographic consultation. In both cases, multi-planar views revealed an osseous defect in the base of the skull in the clivus region, the sagittal view showed a unilateral, well-defined, non-corticated, track-like low-attenuation osseous defect in the clivus. The appearance of the defect was highly reminiscent of a fracture of the clivus. The borders of osseous defect were smooth, and no other radiographic signs suggestive of osteolytic destructive processes were noted. Based on the overall radiographic examination, a radiographic impression of canalis basilaris medianus was made. Canalis basilaris medianus is a rare anatomical variant and is generally observed on the clivus. Due to its potential association with meningitis, it should be recognized and reported to avoid potential complications.

Anterior Cranial Base Reconstruction in Complex Craniomaxillofacial Trauma: An Algorithmic Approach and Single-Surgeon's Experience

  • Shakir, Sameer;Card, Elizabeth B.;Kimia, Rotem;Greives, Matthew R.;Nguyen, Phuong D.
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.174-183
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    • 2022
  • Management of traumatic skull base fractures and associated complications pose a unique reconstructive challenge. The goals of skull base reconstruction include structural support for the brain and orbit, separation of the central nervous system from the aerodigestive tract, volume to decrease dead space, and restoration of the three-dimensional appearance of the face and cranium with bone and soft tissues. An open bicoronal approach is the most commonly used technique for craniofacial disassembly of the bifrontal region, with evacuation of intracranial hemorrhage and dural repair performed prior to reconstruction. Depending on the defect size and underlying patient and operative factors, reconstruction may involve bony reconstruction using autografts, allografts, or prosthetics in addition to soft tissue reconstruction using vascularized local or distant tissues. The vast majority of traumatic anterior cranial fossa (ACF) injuries resulting in smaller defects of the cranial base itself can be successfully reconstructed using local pedicled pericranial or galeal flaps. Compared with historical nonvascularized ACF reconstructive options, vascularized reconstruction using pericranial and/or galeal flaps has decreased the rate of cerebrospinal fluid (CSF) leak from 25 to 6.5%. We review the existing literature on this uncommon entity and present our case series of n = 6 patients undergoing traumatic reconstruction of the ACF at an urban Level 1 trauma center from 2016 to 2018. There were no postoperative CSF leaks, mucoceles, episodes of meningitis, or deaths during the study follow-up period. In conclusion, use of pericranial, galeal, and free flaps, as indicated, can provide reliable and durable reconstruction of a wide variety of injuries.

Craniometric studies on the skull of Korean native goat (한국재래산양 머리뼈에 대한 두개계측학적 연구)

  • Yi, Seong-joon;Lee, Heungshik S
    • Korean Journal of Veterinary Research
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    • v.34 no.4
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    • pp.705-714
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    • 1994
  • This study was carried out to identify the craniometric characteristics of the skull of Korean native goat. The results were as follows; The skull index, cranial index, facial index, right orbital index and left orbital index were $55.86{\pm}2.14$, $59.97{\pm}3.68$, $107.03{\pm}5.71$, $92.22{\pm}4.54$and $90.47{\pm}5.48$, respectively. The ratio of facial length to cranial length was 1:1.15 and the ratio of length of cranial base to palatal length was 1:1.35. The skull length was more correlated to the facial length than to the cranial length(p<0.01). The skull width was more correlated to the width between foramina supraorbitales than to the width between foramina infraorbitales. It also showed negative correlation to the medial width between bases of processus cornualis but positive correlation to the lateral width between bases of processus cornualis(p<0.01). The width between tips of both horns showed high positive correlation to the medial width between processus cornualis, but negative correlation to the lateral width(p<0.01).

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Right-to-Left Displacement of an Airgun Lead Bullet after Transorbital Entry into the Skull Complicated by Posttraumatic Epilepsy : A Case Report

  • Chao-bin Wang;Hui Wang;Jun-shuang Zhao;Ze-jun Wu;Hao-dong Liu;Chao-jia Wang;An-rong Li;Dawei Wang;Juntao Hu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.5
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    • pp.598-604
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    • 2023
  • Penetrating head injury is a serious open cranial injury. In civilians, it is often caused by non-missile, low velocity flying objects that penetrate the skull through a weak cranial structure, forming intracranial foreign bodies. The intracranial foreign body can be displaced due to its special quality, shape, and location. In this paper, we report a rare case of right-to-left displacement of an airgun lead bullet after transorbital entry into the skull complicated by posttraumatic epilepsy, as a reminder to colleagues that intracranial metal foreign bodies maybe displaced intraoperatively. In addition, we have found that the presence of intracranial metallic foreign bodies may be a factor for the posttraumatic epilepsy, and their timely removal appears to be beneficial for epilepsy control.

Staging in Vestibular Schwannoma Surgery : A Modified Technique

  • Kim, Eal-Maan;Nam, Sung-Il
    • Journal of Korean Neurosurgical Society
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    • v.43 no.1
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    • pp.57-60
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    • 2008
  • The authors herein propose the staged excision as a novel strategy to preserve facial nerve and minimize complication during microsurgery of large vestibular schwannoma (VS). At the first stage, for reducing mass effect on the brain stem and cerebellum, subtotal tumor resection was performed via a retrosigmoid craniotomy without intervention of meatal portion of tumor. With total resection of the remaining tumor, the facial nerve was decompressed and delineated during the second stage translabyrinthine approach at a later date. A 38-year-old female who underwent the staging operation for resection of her huge VS is illustrated.

A Rare Case of Diffuse Pachymeningeal Involvement of Multiple Myeloma

  • Yoon, Jehong;Kim, Eui Jong;Lee, Kyung Mi;Choi, Woo Suk;Park, Bong Jin
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.4
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    • pp.252-255
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    • 2015
  • Intracranial involvement in multiple myeloma patients takes up around 1%, and is usually known to be present in the parietal bone or skull base in cases of skull vault involvement, while it presents in the dura and parenchyma in cases of intracranial involvement. Primary pachymeningeal invasion is even rarer with extremely rapid progression and very poor prognosis. It is our intent to report a case in which we had to differentiate multiple myeloma with other metastatic tumors, lymphoma, and leukemia with intracranial involvement. Our patient showed an osteolytic lesion of the skull with dural involvement and subdural mass formations.

Skull Base Dermoid Cyst in the Right Infratemporal Fossa Diagnosed Using the Dixon Technique: a Case Report and Review of Literature

  • Kim, Seung Jin;Baek, Hye Jin;Ryu, Kyeong Hwa;Choi, Bo Hwa;Moon, Jin Il;Cho, Soo Buem;Park, Sung Eun;Bae, Kyungsoo;Jeon, Kyung Nyeo;Cho, Eun Bin;An, Hyo Jung
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.2
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    • pp.114-118
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    • 2017
  • Dermoid cysts are benign congenital tumors composed of keratinizing squamous epithelium and dermal derivatives. They account for less than 1% of all intracranial tumors and are rarely exhibited at the base of the skull. To the best of our knowledge, only one case report has presented computed tomography and conventional T1-weighted magnetic resonance (MR) findings that revealed an infratemporal dermoid cyst. In the present study, we report an unusual case of a dermoid cyst in the right infratemporal fossa, which was incidentally detected by MR imaging with the Dixon technique. This article also highlights the importance of meticulous radiological review and the usefulness of the Dixon technique in everyday clinical practice.

Clinical Assessment of Intracranial Mesenchymal Tumors with Relevant to Non-meningothelial Tumors (두개강내 원발성 간엽성 종양에 대한 임상 고찰)

  • Yi, Hyeong Joong;Kim, Choong Hyun;Bak, Koang Hum;Kim, Young Soo;Kim, Jae Min;Ko, Yong;Oh, Suck Jun;Kim, Kwang Myung
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.44-50
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    • 2000
  • Objective : A few anecdotal cases of mesenchyme-derived tumors which grow into a cranial cavity have been reported that disclosed a dismal prognosis, due to their critical location, aggressive biological behavior, and high rate of surgical morbidity. The aim of this study is to search clinical factors related to these tumors. Methods : Eight patients who underwent surgical removal of intracranial mesenchymal tumors between January 1993 and December 1997 were studied retrospectively. The tumors included are three chordomas, two chondrosarcomas, two rhabdomyosarcomas, and one hemangiopericytoma. Authors compared clinical features, treatment, and results of our cases with reported cases. The mean follow-up period was 20.5 months. Results : All cases showed nonspecific, location-related clinical findings and arose from sphenopetroclival region. Single stage operation was performed in 4 cases, and skull base approaches in 3 cases. Adjuvant therapies were done in 2 cases. Recurrence was seen in 3 cases(37.5%), and 3 patients died. Interdisciplinary approach with otologic surgeon was done in 2 cases. Conclusion : Recent advancement of refined tactics has made these tumors amenable and provides prolongation of progression-free survival. These are modified skull base approaches, multi-modality treatment options, and inter-disciplinary team approaches. Good results may be expected for these mesenchymal tumors by aggressive resection and adjuvant therapies according to their biological nature.

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