OBJECTIVE: The surgical clipping of paraclinoid segment internal carotid artery aneurysms is considered difficult because of the complex anatomical location and important neighboring structures. Our experiences of pterional craniotomy and extradural anterior clinoidectomy (EAC) to clip paraclinoid aneurysms are reported herein. METHODS: We present two patients with paraclinoid aneurysms who underwent surgical clipping using pterional craniotomy and EAC. The clinical results and operative techniques were reviewed from the patients' medical records. RESULTS: EAC improves the surgical field in the suprasellar and periclinoid regions. Clinically, a good outcome was obtained in both cases. No surgical complications directly resulting from the EAC were observed. CONCLUSION: Favorable surgical results can be obtained with pterional craniotomy and EAC for the clipping of paraclinoid aneurysms. EAC is advocated for the clipping of paraclinoid aneurysms.
Aminocaproic Acids ; Aneurysm ; Carotid Artery, Internal ; Craniotomy ; Humans ; Surgical Instruments

During maxillofacial surgery, the infraorbital and mental nerves are blocked at eac foramen to induce local anesthesia. This study examined the relative locations of the infraorbital foramen (IOF) and mental foramen (MF) based on soft-tissue landmarks. Twenty-eight hemifacial cadavers were dissected to expose the IOF and MF. The distances between the bilateral IOFs, the bilateral MFs, the alae of the nose (alares), and the corners of the mouth (cheilions) were measured directly on cadavers by using a digital vernier caliper. The vertical and horizontal distances of the IOF and MF relative to the alare and cheilion were measured indirectly on digital photographs using Adobe Photoshop (Adobe, CA, USA). The distance between the bilateral IOFs (58.09 +/- 4.04 mm) was longer than the distance between the bilateral MFs (50.32 +/- 1.93 mm). The distances between the bilateral alares and cheilions were 41.22 +/- 3.44 mm and 58.43 +/- 6.62 mm, respectively. The IOF was located 12.92 +/- 3.75 mm superior and 7.88 +/- 2.56 mm lateral to the alare, and the vertical angle (Angle 1) between these structures was 31.67 +/- 13.36degrees superolaterally. The MF was located 21.83 +/- 3.26 mm inferior and 5.56 +/- 3.37 mm medial to the cheilion, and the vertical angle (Angle 2) between these structures was 14.05 +/- 10.12degrees inferomedially. In conclusion, these results provide more detailed information about the locations of the IOF and MF relative to soft-tissue landmarks.
Aminocaproic Acids ; Anesthesia, Local ; Cadaver ; Mouth ; Nose ; Surgery, Oral

A bony defect of the external auditory canal (EAC) and herniation of the temporomandibular joint (TMJ) can be caused by tumorous conditions, inflammation, trauma, and otologic procedures. Spontaneous TMJ herniation into the EAC can be caused by a congenital bony defect known as patent Huschke's foramen, which is a very rare condition. In our case, an objective clicking sound was produced when the patient opened his mouth. A protruding mass was found in the anterior wall of the EAC during mouth closing, and herniation of the TMJ was confirmed with computed tomography. Therefore, we thought the clicking sound of our case could have resulted from spontaneous TMJ herniation through the patent foramen of Huschke.
Aminocaproic Acids ; Ear Canal ; Humans ; Inflammation ; Mouth ; Temporomandibular Joint ; Tinnitus

Tumors occurring in the external auditory canal (EAC) are rare. In particular, tubular adenoma (TA) is an extremely rare sweat gland neoplasm occurring in the EAC and is generally considered as benign. Up to now, less than one hundred cases of TA have been reported in the English literature. In fact, a comprehensive review of literature shows that TA in the EAC has seldom been reported. Herein, we report a case of a 35-year-old man with TA that occured in the EAC, together with characteristic histopathological findings.
Adenoma ; Aminocaproic Acids ; Apocrine Glands ; Ear Canal ; Sweat Gland Neoplasms

Erythema annulare centrifugum (EAC), first described by Darier in 1916, is characterized by annular, circinate, gyrate or serpiginous lesions. Although the pathogenesis of EAC is not fully understood, it is considered to be a hypersensitivity reaction to a wide variety of etiological factors, including autoimmune diseases, internal malignancies, drugs, infections, and pregnancy. To the best our knowledge, no case of EAC associated with Candida guilliermondii infection has ever been published in the Korean medical literature, and there have been a few reported cases associated with Candida albicans in other countries. Herein, we report on a rare and interesting case of EAC in a 62-year-old female patient with Candida guilliermondii infection.
Aminocaproic Acids ; Autoimmune Diseases ; Candida ; Candida albicans ; Erythema ; Female ; Humans ; Hypersensitivity ; Middle Aged ; Pregnancy

Bony defects of the external auditory canal (EAC) may arise from a tumor, infection, inflammation, trauma, complications from ear surgery, or congenital disease. Congenital bony defects of the EAC are known as a patent Huschke's foramen. Here, we describe a 76-year-old male patient who presented an otalgia in his right ear. Physical examination revealed a dome shaped swelling of the anterior EAC wall, which repeated swelling and retraction as the patient's mouth closed and opened. Computed tomography revealed a bony defect of the anterior EAC wall. We believe that the patent Huschke's foramen allowed spontaneous herniation of the temporomandibular joint into the EAC.
Aged ; Aminocaproic Acids ; Ear ; Ear Canal ; Earache ; Humans ; Inflammation ; Male ; Mouth ; Physical Examination ; Temporomandibular Joint

Malignant tumors of the external auditory canal (EAC) are very rare. Squamous cell carcinoma, adenoid cystic carcinoma and basal cell carcinoma on the decreasing frequency are the most common pathologic forms of EAC malignancy. Mucoepidermoid carcinoma (MEC) of the EAC is extremely rare. Only three cases of MEC occurring in EAC were reported to date in the English literature. We present a case of MEC occurring in the EAC with the review of related literatures.
Aminocaproic Acids ; Carcinoma, Adenoid Cystic ; Carcinoma, Basal Cell ; Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Ear Canal

Tumors that develop from external auditory canal (EAC) are very rare. Adenoma that originates from apocrine is also a rare entity found in the EAC. Nevus sebaceous, syringocystadenoma papilliferum (SCAP), tubular apocrine adenoma (TAA), and fibroadenoma are known to originate from apocrine. Among them, SCAP is believed to be a benign tumor that is manifested as papule and plague on the scalp and the face. However, TAA is a rare intradermal eccrine tumor and it mostly manifests as an isolated single nodule within the scalp area. Generally, these tumors are considered as two separate entities. Many articles have reported on the prevalence of TAA or SCAP with nevus sebaceous on the body, extremities, and scalp; but only 2 articles were reported on tumors that developed from EAC. In this article, we report on a patient who presented a mass in EAC, with both SCAP and TAA pathohistologic finding without nevus sebaceous.
Adenoma ; Aminocaproic Acids ; Apocrine Glands ; Ear Canal ; Extremities ; Fibroadenoma ; Humans ; Nevus ; Plague ; Prevalence ; Scalp

Tubular apocrine adenoma (TAA) and syringocystadenoma papilliferum (SCAP) are uncommon cutaneous adnexal neoplasms often found in the head, perianal area, but rarely in external auditory canal (EAC). SCAP in EAC generally presents itself with a mass in the EAC along with conductive hearing loss. We present here a case of a 50-year-old man presenting TAA with SCAP confined to EAC, which was surgically removed. The clinical and histopathological features were described. The patient has been well without relapse or metastasis.
Adenoma ; Aminocaproic Acids ; Apocrine Glands ; Ear Canal ; Head ; Hearing Loss, Conductive ; Humans ; Neoplasm Metastasis ; Recurrence

BACKGROUND AND OBJECTIVES: The change of pH in the external auditory canal (EAC) is an important factor in the pathogenesis of otitis externa. However, there is a lack of study focused in this area. Thus, we investigated the differences in the pH in the EAC between several different patient groups of otitis externa and the control group. SUBJECTS AND METHOD: There were 100 patients with otitis externa and 150 normal controls participated in this study. Patients with otitis externa were divided into 3 groups; acute or subacute infective otitis externa, chronic infective otitis externa and chronic allergic otitis externa. The pH of the EAC was measured in otitis externa patients and control subjects on their first visit. RESULTS: The mean EAC pH of the normal control subjects was significantly higher than that of the skin of other parts of the body. The pH difference among the 3 patient groups was statistically significant (the pH of acute or subacute infective otitis externa=6.83+/-0.64; the pH of chronic infective otitis externa=6.16+/-0.67 and the pH of chronic allergic otitis externa=5.78+/-0.59). CONCLUSION: The change in the pH of EAC can be considered as a predisposing factor of otitis externa. We quantified the level of pH at the EAC among three groups of otitis externa patients, and the results showed that the pH difference among the three patient groups was statistically significant. This study warrants a further investigation focusing on the proper choice of eardrops for otitis externa patients according to their pH at the EAC.
Aminocaproic Acids ; Ear Canal ; Humans ; Hydrogen-Ion Concentration ; Otitis ; Otitis Externa ; Skin