• Journal of Korean Neurosurgical Society
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• 제40권2호
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• pp.125-127
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• 2006

Facial nerve schwannomas are uncommon tumors. A 40-year-old female presented with left-side facial weakness. Computed tomography[CT] imaging showed a $3\;{\times}\;2cm$ lesion on the posterior portion of the left middle cranial fossa. The mass abutted the anterior aspect of the left petrous bone with a wide erosive change involving the area of the left facial nerve ganglion [geniculate ganglion]. A well-circumscribed extra-axial mass was seen on magnetic resonance imaging[MRI]. The tumor was completely removed through subtemporal approach and the patient was discharged without additional neurological deficit. This rare case is discussed and a review of the relevant literature is presented.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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• pp.118-125
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• 2000

Objective : Trigeminal neurinomas are rare tumors that may locate in the middle fossa or posterior fossa and straddled both the middle and posterior fossa, according to their origin in the nerve complex. The aim of this study was to analyze the clinical presentation, operative approaches employed and outcome in 15 patients who were treated surgically, with special emphasis on surgical approach. Method : Between 1994 and 1998, a total of fifteen patients were histopathologically identified as neurinomas originating from the trigeminal nerve complex at the tumor clinic in the neuroscience center of the our university. Results : The surgical approach to these tumors depends on their anatomical location and tumor size. Six patients had tumors confined to the middle fossa, five patients had tumors limited to the posterior fossa, and four patients both in middle and posterior fossa components of their tumors. Nine neurinomas were removed via the conventional approach(pterional, subtemporal, suboccipital) and six were excised using skull base approach(transzygomatic subtemporal, orbitozygomatic, transpetrosal). Total resection of the tumor was possible in 10 cases. Total resection of tumor was accomplished in 83% of patients following skull base approach compared with 56% of patients following conventional approach. The surgical outcome was excellent or good in 13 cases, fair in one and, poor in one. There was no operative death. In the immediate postoperative period, aggravation of preoperative facial hypesthesia and 6th cranial nerve palsy were common. Although, these deficits were generally transient, eight patients remained with some degree of trigeminal hypesthesia, two had facial weakness, one neurotrophic keratitis, one diplopia, and one mastication difficulty. Conclusion : Surgical approach to the trigeminal neurinoma depends on the tumor location and tumor size. Skull base approach provides more complete tumor excision without increased morbidity compared to conventional approach. Surgeons have to be meticulous in order to reduce postoperative complication.

• Journal of Korean Neurosurgical Society
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• 제29권7호
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• pp.963-967
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• 2000

The aneurysm arising from the posterior cerebral artery is relatively uncommon, and has been reported in 0.7- 2.2% of whole cerebral aneurysm. Moreover, only a few cases of the giant aneurysm over 2.5cm in diameter arising from the distal portion of the posterior cerebral artery have been reported. Neurologic complications may occur after surgical treatment of this aneurysm due to difficult surgical approach and neurovascular complexity around the brain stem. Authors experienced a case of the thrombosed giant aneurysm with approximately 2.7cm in diameter arising from the P2 segment of the left posterior cerebral artery. Complete removal of the thrombus in the aneurysmal sac and direct neck clipping was performed via left subtemporal approach.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.3.1-3.9
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• 2019

Background: The infratemporal fossa (ITF) is an anatomical lateral skull base space composed by the zygoma, temporal, and the greater wing of the sphenoid bone. Due to its difficult approach, surgical intervention at the ITF has remained a heavy burden to surgeons. The aim of this article is to review basic skull base approaches and ITF structures and to avoid severe complications based on the accurate surgical knowledge. Methods: A search of the recent literature using MEDLINE (PubMed), Embase, Cochrane Library, and other online tools was executed using the following keyword combinations: infratemporal fossa, subtemporal fossa, transzygomatic approach, orbitozygomatic approach, transmaxillary approach, facial translocation approach, midface degloving, zygomatico-transmandibular approach, and lateral skull base. Aside from our Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) trial, there have been very few randomized controlled trials. The search data for this review are summarized based on the authors' diverse clinical experiences. Results: We divided our results based on representative skull base approaches and the anatomy of the ITF. Basic approaches to the ITF include endoscopic endonasal, transzygomatic, orbitozygomatic, zygomatico-transmandibular, transmaxillary, facial translocation, and the midfacial degloving approach. The borders and inner structures of the ITF (with basic lateral skull base dissection schemes) are summarized, and the modified zygomatico-transmandibular approach (ZTMA) is described in detail. Conclusions: An anatomical basic knowledge would be required for the appropriate management of the ITF pathology for diverse specialized doctors, including maxillofacial, plastic, and vascular surgeons. The ITF approach, in conjunction with the application of microsurgical techniques and improved perioperative care, has permitted significant advances and successful curative outcomes for patients having malignancy in ITF.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.328-331
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• 2001

Trigeminal schwannoma is an uncommon intracranial tumor and constitutes less than 0.08-8% of all intracranial schwannoma. Trigeminal shchwannoma is even rarer in childhood and only 11 cases of trigeminal schwannoma under the age of 14 have been reported including our case. We experienced a case of trigeminal schwannoma in a 9 year-old girl without the stigmata of neurofibromatosis. She presented with a 2 week-history of right abducens nerve palsy. Magnetic resonance image demonstrated a dumbbell-shaped tumor extending into right middle and posterior fossas with a size of $60{\times}45{\times}35mm$. The tumor was successfully removed by right transzygomatic subtemporal extradural approach. Pathologic examination of the mass revealed typical features of schwannoma.

• The Korean Journal of Physiology
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• 제2권1호
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• pp.1-8
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• 1968

유두체의 기능을 탐색하기 위하여 외과 수술에 의하여 유두체를 떼어버린 개를 마련하고 수술전에서부터 수술후에 걸쳐 다음의 세가지 실험을 실시하여 그 성적을 비교하였다. 첫째 실험에서는 먹이 먹는 개의 혀에 전기 충격을 가한다음 이어서 동물이 다시 먹이 그릇에 접근하기까지의 시간을 측정하여 동물이 무서움을 타는정도를 짐작하였으며, 둘째 실험에서는 높은 소리 (12,000 cps, 100 db)를 한 시간 동안 동물에게 들려 스트레스로 삼고 혈액 호산구 수의 변동을 추적하여 스트레스에 대한 반응의 지표로 삼았다. 셋째 실험에서는 아침과 저녁 일정한 시간에 항문 온도를 반복 측정하였다. 실험 결과는 다음과 같다. 1. 유두체 제거후의 동물이 유두체 제거전 보다 무서움을 더 혹은 덜 탄다는 증거는 없었다(제 1 표). 2. 유두체가 제거된 후에도 스트레스에 대한 반응은 유두체 제거전과 같은 정도로 현저히 나타나나 스트레스에서의 회복과정은 유두체 제거전에 비하여 유두체 제거후에 유의하게 지연되었다(제 1 도). 3. 유두체가 제거된 동물의 체온은 유두체 제거전에 비하여 떨어지는데 그 정도는 미약하나 통계적으로 유의한 차이를 나타내었다(제 2 표).