• Title/Summary/Keyword: Skull base tumors

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Neuroendoscopy : Current and Future Perspectives

  • Shim, Kyu Won;Park, Eun Kyung;Kim, Dong-Seok;Choi, Joong-Uhn
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.322-326
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    • 2017
  • Neuroendoscopic surgery is performed because it causes minimal damage to normal structures, carries a lower rate of complications, and achieves excellent outcomes. Surgeons using an endoscope and related instruments can perform complex operations through very small incisions, which is especially useful for minimally invasive procedures for the brain and spine. Neuroendoscopic surgery is now performed in cases of obstructive hydrocephalus, various intraventricular lesions, hypothalamic hamartomas, craniosynostosis, skull base tumors, and spinal lesions. This review discusses the brief history of neuroendoscopy and the current state and future perspectives of endoscopic surgery.

The Diagnostic Value of Computed Tomography in Bead and Neck Cancer fart I : Nasopharyngeal Carcinoma (두경부악성종양에서의 전산화단층촬영의 진단적 가치 -비인두업성종양을 중심으로-)

  • Lee, Yul;Suh, Chang-Hae;Chang, Kee-Hyun
    • Radiation Oncology Journal
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    • v.2 no.1
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    • pp.139-148
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    • 1984
  • The CT findings of 46 cases of nasopharyngeal cancer were analyzed and compared with clinical tumor staging. They are composed of 28 cases $(61\%)$ of squamous cell carcinoma, 13cases $(28\%)$ of undifferentiated carcinoma, 4 cases $(9\%)$of lymphoma and 1 case $(2\%)$ of adenoid cystic carcinoma. The results were as follows : 1. The most common CT findings of nasopharyngeal cancers are air·way asymmetry including obliteration of Rosenmuller fossa, orifice of Eustachian tube and asymmetric obliteration of parapharyngeal fat. 2. Other involved anatomic sites are carotid sheath area, oropharynx, paranasal sinuses especially sphenoid sinus, cervical lymph nodes, nasal cavity and skull base or middle cranial fossa. 3. CT does significantly influence on the tumor staging of the nasopharynx cancers, but has a definite value in evaluating deep tissue invasion of the cancers especially to parapharyngeal space or carotid sheath area. 4. CT seems to be essential for staging work-up, estimating the prognosis, and assessing the effect of radiotherapy of the nasopharyngeal cancer because it clearly shows the whole extent of the tumors including deep tissue invasion.

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Modified Anterior Craniofacial Osteotomy Using Partial Nasal Bone Division and Reconstruction in Frontoethmoidal Sinus Meningioma

  • Park, Eon Ju;Kim, Hong Il;Park, Jin Hyung;Yi, Hyung Suk
    • Archives of Craniofacial Surgery
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    • v.18 no.2
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    • pp.117-121
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    • 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.

Surgical Treatment for a Huge Maxillary Ameloblastoma via Le Fort I Osteotomy: A Case Report

  • Jung, Sang-pil;Jee, Yu-jin;Lee, Deok won;Kim, Hyung Kyung;Kang, Miju;Kim, Se-won;Yang, Sunin;Ryu, Dong-mok
    • Journal of Korean Dental Science
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    • v.11 no.2
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    • pp.86-91
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    • 2018
  • Ameloblastomaa are odontogenic benign tumors with epithelial origin, which are characterized by slow, aggressive, and invasive growth. Most ameloblastomas occur in the mandible, and their prevalence in the maxilla is low. A 27-year-old male visited our clinic with a chief complaint of the left side nasal airway obstruction. Three-dimensional computed tomography showed left maxillary sinus filled with a mass. Except for the perforated maxillary left edentulous area, no invaded or destructed bone was noted. The tumor was excised via Le Fort I osteotomy. The main mass was then sent for biopsy and it revealed acanthomatous ameloblastoma. The lesion in the left maxillary sinus reached the ethmoidal sinus through the nasal cavity but did not invade the orbit and skull base. The tumor was accessed through a Le Fort I downfracture in consideration of the growth pattern and range of invasion. The operation site healed without aesthetic appearances and functional impairments. However, further long-term clinical observation is necessary in the future for the recurrence of ameloblastoma. Conservative surgical treatment could be the first choice considering fast recovery after surgery and the patient's life quality.

Assessment of Cerebral Collateral Circulation Using $^{99m}Tc$-Hexamethyleneamine Oxime (HMPAO) SPECT During Internal Carotid Artery Balloon Test Occlusion (내경동맥 풍선 시험 결찰술(BTO)시 $^{99m}Tc$-HMPAO 뇌 SPECT를 이용한 대뇌 측부 순환의 평가)

  • Ryu, Young-Hoon;Yun, Mi-Jin;Chung, Tae-Sub;Lee, Jong-Doo;Park, Chang-Yun
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.22-30
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    • 1995
  • To predict preoperatively the safety of permanent occlusion of an internal carotid artery with $^{99m}Tc$-HMPAO brain single photon emission computed tomography(SPECT) from an objective point of view, Twenty-four patients underwent balloon test occlusion (BTO) of the internal carotid arteries because of neck and skull base tumors. The authors assessed the uptake of both middle cerebral artery territories before and during BTO with $^{99m}Tc$-HMPAO brain SPECT using semiquantitative analysis method and compared the results with other factors(neurologic examination, arterial stump pressure and electroenceph-alogram). Nineteen patients had not experienced neurological deteriorating or any problem during BTO. Their comparative uptakes of the middle cerebral artery territories were 95 to 101% of the pre-BTO state. The remaining five patients showed severe neurologic symptoms such as transient hemiplegia and unconsciousness. Their comparative uptake of the middle cerebral artery territories were 77 to 85% of the pre-BTO state, and were well matched with other factors. $^{99m}Tc$-HMPAO brain SPECT before and during BTO seems to be a simple and objective method for prediction of permanent neurologic deficits when the comparative uptake of middle cerebral artery territories during BTO is lower than 85% of that before BTO.

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