• Archives of Plastic Surgery
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• v.39 no.4
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• pp.345-351
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• 2012

Background Cranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction. Methods Between April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability. Results The mean follow-up period was 11.8 months and the mean operation time for reconstruction was $8.4{\pm}3.36$ hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures. Conclusions The reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

• Anatomy and Cell Biology
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• v.57 no.3
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• pp.468-472
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• 2024

In this report, atlantooccipital assimilation (AS), anterior arch defect (AAD), and posterior arch defect (PAD) of the atlas, and several variations around the craniocervical junction were identified on computed tomography (CT) of a patient of unknown sex and age. Coronal and sagittal CT scans showed AS and bilateral fusion of the atlas and the base of occipital bone. Axial CT scan at the atlas revealed PAD type B on the left side and midline AAD. Morphometric measurements indicated a potential ventral spinal cord compression. In addition, mid-sagittal CT revealed the presence of fossa navicularis magna and incomplete formation of the transverse foramen on the right side. This study reports an extremely rare AS associated with AAD, PAD, and other variations of the clivus and the atlas. To our knowledge, no similar case has been reported in the literature.

• Imaging Science in Dentistry
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• v.46 no.4
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• pp.285-290
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• 2016

In this report, we describe the incidental finding of an oropharyngeal mass in a patient who presented with a chief complaint of temporomandibular pain. The patient was initially evaluated by an otorhinolaryngologist for complaints of headaches, earache, and sinus congestion. Due to worsening headaches and trismus, he was further referred for the management of temporomandibular disorder. The clinical evaluation was uneventful except for limited mouth opening (trismus). An advanced radiological evaluation using magnetic resonance imaging revealed a mass in the nasopharyngeal/oropharyngeal region. The mass occupied the masticatory space and extended superioinferiorly from the skull base to the mandible. A diagnostic biopsy of the lesion revealed a long­standing human papilloma virus (HPV­16)­positive squamous cell carcinoma of the oropharynx. This case illustrates the need for the timely radiological evaluation of seemingly innocuous orofacial pain.

• Korean Journal of Head & Neck Oncology
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• v.5 no.1
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• pp.15-20
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• 1989

There is a difficulty in complete removal of tumor developing at the parapharyngeal space or infratemporal space where they are just under the skull base. We have experienced 3 cases of malignant tumors and 5 cases of benign tumors arising from the parapharyngeal spaces and/or infratemporal space since 1976. We hereby present 8 cases of primary tumors arising in these spaces with a review of anatomical relationship between above spaces, the characteristic symptoms, diagnostic technics, and surgical approaches which should be considered in their management.

• The korean journal of orthodontics
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• v.6 no.1
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• pp.79-82
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• 1976

This study was undertaken to investigate the values of the cephalometric standards of Korean children which consisted of 57 boys and 61 girls with normal occlusion and harmony of the facial musculature. The following conclusions were obtained. 1) The relatively vertical inclination of nasal bone and flat contour of the frontal bone contribute to the flattening of the upper face. 2) Slight lack of chin prominence characterizes the lower face while procumbent incisors and their alveolar bone dominate the middle face. 3) A caudal skull base inclination is probably the most specific feature for Korean.

• Journal of Trauma and Injury
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• v.25 no.1
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• pp.28-31
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• 2012

Pencils are common instruments for children to use and play with. This report describes an unusual penetrating orbitocranial injury in a 5-year-old girl who was struck in her facewith a pencil. She was holding it at a desk, and her friend pushed her back. The pencil penetrated the left lower eyelid and went deep into the right frontal lobe through the base of the skull. It was removed at the emergency room, after which brain CT was performed to detect the development of an intracranial hematoma. No complications occurred after conservative management with antibiotics and an antiepileptic drug. Pencils can be hazardous to children, and a penetrating head injury with a pencil may be managed without cranial surgery.

• Journal of Korean Neurosurgical Society
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• v.44 no.5
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• pp.285-294
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• 2008

Objective: Jugular foramen schwannomas are uncommon pathological conditions. This article is constituted for screening these tumors in a wide perspective. Materials: One-hundred-and-ninty-nine patients published in 19 articles between 1984 to 2007 years was collected from Medline/Index Medicus. Results: The series consist of 83 male and 98 female. The mean age of 199 operated patients was 40.4 years. The lesion located on the right side in 32 patients and on the left side in 60 patients. The most common presenting clinical symptoms were hearing loss, tinnitus, disphagia, ataxia, and hoarseness. Complete tumor removal was achieved in 159 patients. In fourteen patients tumor reappeared unexpectedly. The tumor was thought to originate from the glossopharyngeal nerve in forty seven cases; vagal nerve in twenty six cases; and cranial accessory nerve in eleven cases. The most common postoperative complications were lower cranial nerve palsy and facial nerve palsy. Cerebrospinal fluid leakage, meningitis, aspiration pneumonia and mastoiditis were seen as other complications. Conclusion: This review shows that jugular foramen schwannomas still have prominently high morbidity and those complications caused by postoperative lower cranial nerve injury are life threat.

• Journal of Korean Neurosurgical Society
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• v.53 no.3
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• pp.180-182
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• 2013

We describe a case of intracranial carotid artery occlusion due to penetrating craniofacial injury by high velocity foreign body that was relieved by decompressive surgery. A 46-year-old man presented with a penetrating wound to his face. A piece of an electric angular grinder disc became lodged in the anterior skull base. Computed tomography revealed that the disc had penetrated the unilateral paraclinoid and suprasellar areas without flow of the intracranial carotid artery on the lesion side. The cavernous sinus was also compromised. Removal of the anterior clinoid process reopened the carotid blood flow, and the injection of glue into the cavernous sinus restored complete hemostasis during extraction of the fragment from the face. Digital subtraction angiography revealed complete recanalization of the carotid artery without any evidence of dissection. Accurate diagnosis regarding the extent of the compromised structures and urgent decompressive surgery with adequate hemostasis minimized the severity of penetrating damage in our patient.

• Journal of Korean Neurosurgical Society
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• v.40 no.1
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• pp.54-57
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• 2006

Central nervous system[CNS] involvement of acute lymphoblastic leukemia may occur. However, CNS involvement as a first manifestation of leukemia is very rare. An 8-year-old girl complained of a backache after playing in the water. Neurological examination detected progressing paraparesis. Magnetic resonance imaging[MRI] of the thoracolumbar spine showed a well-circumscribed homogeneous posterior extradural mass lesion extending from T7 to T9. MRI of the brain showed diffused fatty marrow replacement of the calvarium and the skull base. We report a patient with epidural Burkitt's lymphoma of the thoracic and lumbar vertebra causing compression of the spinal cord after pathologic evaluation. The tumor consisted mainly of lymphoblastic cells, which were identical to those originally seen in the bone marrow aspiration and biopsy. After decompressive laminectomy she began consolidation chemotherapy.

• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.72-77
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• 2000

The authors describe the experience with the interactive image-guided Zeiss SMN system, which has been applied to 20 patients with various intracranial lesions during one year. Preoperative radiologic evaluation was CT scan in 6 cases, MRI in 14 cases. In all except one case, average fiducial registration errors were less than 2mm. There was no statistical difference in registration error between CT and MR image. This system considered to be relatively stable with respect to soft and hardware. Also it was useful for the designing of the scalp incision and bone flap and assessing the extent of resection in tumors, especially in gliomas. Moreover, it was helpful to evaluate complex surgical anatomy in skull base surgery.