• Journal of Korean Neurosurgical Society
• /
• v.40 no.2
• /
• pp.125-127
• /
• 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
• /
• v.29 no.1
• /
• pp.118-125
• /
• 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
• /
• v.29 no.7
• /
• pp.963-967
• /
• 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
• /
• v.41
• /
• pp.3.1-3.9
• /
• 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
• /
• v.30 no.sup2
• /
• pp.328-331
• /
• 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
• /
• v.2 no.1
• /
• pp.1-8
• /
• 1968

As a continuation of a series of work on the physiology of the mamillary bodies, 3 experiments were carried out using 8 pointer dogs subjected surgical removal of this hypothalamic structure by subtemporal approach. In the first experiment, animals were tested per- and postoperatively in approach-avoidance situation. Food served as incentive, electric shock to the tongue as punishment, and response latency of postpunishment trial as an index of fear. The second experiment dealt with per- and postoperative tests in stress situation. A high frequency sound (12,000 cycle, 100 db sound for 1 hour) was regarded as a stressor, and decrease in blood eosinophil cell count as an index of response th the stress. Pre- and postoperative measurement of rectal temperature was carried out in the third experiment, using a clinical thermometer with decimal centigrade scale. The results obtained were as follows: 1. Tests in approach-avoidance situation showed no indication of increased or decreased fear response following removal of the mamillary bodies. 2. Postoperative stress response was as marked as that of preoperative period, but the recovery from the stress was significantly retarded after surgery. 3. The body temperature dropped slightly, but significantly following damage to the mamillary bodies.