BACKGROUND: The appearance of skin lesions at the dermatome of the nasociliary nerve in herpes zoster involving the ophthalmic nerve (Hutchinson's sign) was associated with an increased incidence of ocular complications. OBJECTIVE: This study is aimed to revaluate the clinical usefulness of the original concept of Hutchinson's sign in herpes zoster involving the ophthalmic nerve. METHODS: A total of 70 patients with herpes zoster, involving the ophthalmic nerve, were enrolled in this study at the medical center, Daegu Catholic University from December 2004 to July 2006. Statistical analysis using chi-sqaure test in verified the relationship between the clinical parameters and the development of ocular lesions (p<0.05). RESULTS: Statistical analysis showed that the presence of underlying disease, severity of pain, severity of skin lesions and Hutchinson's sign were the predictive factors of the development of ocular lesions. A strong relationship formed between the Hutchinson's sign and the development of ocular lesions [Relative risk: 6.769 (Confidence interval 95%: 2.310~19.838)]. CONCLUSION: Hutchinson's sign may be a useful predictive factor in the development of ocular lesions in the herpes zoster involving the ophthalmic nerve.
Daegu ; Herpes Zoster ; Humans ; Incidence ; Ophthalmic Nerve ; Skin

In the microsurgical dissection of the lateral wall of the cavernous sinus, interrelationships of its nerves have been studied in 100 Korean adult half heads. And in the serial coronal section of the cavernous sinus in 10 half heads, the structures of the lateral wall have been studied. The relationships of the nerves of the lateral wall were classified to five types according to the course of the trochlear nerve. Each length of the Parkinson's triangle and the angle between trochlear and ophthalmic nerves were measured. There data were compared with those of the other races. The lateral wall of the sinus was composed of two layers. The orientation of the fibers of the deep layer was variable in regions. The oculomotor nerve was enveloped with sheath extended from dura mater and it was connected with deep layer of the lateral wall. The trochlear nerve was enveloped with sheath formed y division of innermost part of the deep layer. The venous sinus was found between the two layers of the lateral wall. The neurosurgical significance of the lateral wall of the sinus was discussed.
Adult ; Cavernous Sinus* ; Continental Population Groups ; Dura Mater ; Head ; Humans ; Oculomotor Nerve ; Ophthalmic Nerve ; Trochlear Nerve

Postoperative maxillary cyst (POMC) is relatively common complication among patients who underwent Caldwell-Luc surgery. Patients with POMC usually have no symptoms, although cyst extension can result in bone destruction or cystic infection with pain. The trigeminal nerve consists of the ophthalmic nerve, maxillary nerve, and mandibular nerve. Among these branches, the maxillary nerve runs to the lateral and frontal sides of the maxillary sinus wall. POMC can rarely lead to trigeminal neuropathy caused by cyst enlargement that compresses some branches of the trigeminal nerve. Recently, we experienced a case with trigeminal neuralgia due to POMC. The patient was successfully treated with inferior meatal antrostomy. We report this rare case with a literature review.
Humans ; Mandibular Nerve ; Maxillary Nerve ; Maxillary Sinus ; Ophthalmic Nerve ; Pro-Opiomelanocortin ; Trigeminal Nerve ; Trigeminal Nerve Diseases ; Trigeminal Neuralgia*

A morphometric study on the trigeminal ganglion and the intracranial portion of the ophthalmic, maxillary and mandibular nerves was done in 50 Korean adult cadavers. The shape of the ganglion was classified into 7 types and semicircular shape was most common (54%). Mean width of the trigeminal root at porus trieminus was 6.08mm. The length of the trigemnal root from porus to the trigeminal ganglion was 8.28mm at ophthalmic portion, 10.16mm at maxillary portion, and 8.90mm at mendibular portion. Maximum width of the ganglion was 15.48mm and the breadth of the ophthalmic, and maxillary portion were 5.25mm and 5.26mm, respectively, and that of the mandibular portion (4.92mm) was narrow than the other portion. Intracranial ophthalmic nerve was 4.30mm of width and 17.89mm of length, and this nerve inclined average 39.7。 (range 14.56。) from sagital plane. It was observed infrequently that the cavernous sinus extended to the lateral border of the maxillary nervw and the emissary sinus ran under the mandibular nerve.
Adult* ; Cadaver ; Cavernous Sinus ; Ganglion Cysts ; Humans ; Mandibular Nerve* ; Ophthalmic Nerve ; Trigeminal Ganglion*

Recently, endoscopic sinus surgery (ESS) has been acknowledged as a standard surgical procedure for the treatment of chronic rhinosinusitis. Orbital complications of varying degrees that may occur during ESS have been widely reported. Blindness, one of the major complications that can occur during or immediately after ESS, is mainly attributed to orbital hematoma or direct injury to the optic nerve. In contrast to such direct mechanical trauma caused during ESS, we report a case of acute loss of vision that followed ESS without a definite cause. A postulated mechanism for idiopathic optic neuropathy is that it is ischema resulted from vasospasm in the branches of ophthalmic artery due to topical use of vasoconstrictive agents. Otorhinolaryngologists should be aware that this condition may occur following an uncomplicated ESS procedure. When loss of sight is diagnosed postoperatively, patients should be given prompt ophthalmological consultation and possible causes should be considered.
Blindness ; Hematoma ; Humans ; Ophthalmic Artery ; Optic Nerve ; Optic Nerve Diseases ; Optic Neuropathy, Ischemic ; Orbit ; Vision, Ocular

Infraoptic anterior cerebral artery (ACA) is an extremely rare congenital anomaly. This anomalous artery usually arises from the intradural internal carotid artery (ICA) near the level of the ophthalmic artery (OA) or rarely from the extradural ICA. This anomaly frequently harbors a cerebral aneurysm, and may involve other coexisting vascular anomalies. In the case of this anomaly, surgical treatment of the aneurysm at the proximal ACA or anterior communicating artery (ACoA) may sometimes be difficult, because the veiled proximal ACA by the optic nerve would make proximal control inconvenient and the vertical midline segment of the proximal ACA would frequently form a superiorly directing aneurysm with a relatively high position. We report on an extremely rare case of a ruptured aneurysm at the infraoptic azygous ACA, possibly having an extradural origin, accompanied by contralateral ICA agenesis, and also introduce a feasible method for treatment by Y-stent assisted coil embolization.
Aneurysm ; Aneurysm, Ruptured ; Anterior Cerebral Artery ; Arteries ; Carotid Artery, Internal ; Intracranial Aneurysm ; Ophthalmic Artery ; Optic Nerve

OBJECTIVE: Although removal of the anterior clinoid process (ACP) is essential surgical technique, studies about quantitative measurements of the space broadening by the anterior clinoidectomy are rare. The purposes of this study are to investigate the dimension of the ACP, to quantify the improved exposure of the parasellar space after extradural anterior clinoidectomy and to measure the correlation of each structure around the paraclinoidal area. METHODS: Eleven formalin-fixed Korean adult cadaveric heads were used and frontotemporal craniotomies were done bilaterally. The length of C6 segment of the internal carotid artery on its lateral and medial side and optic nerve length were checked before and after anterior clinoidectomy. The basal width and height of the ACP were measured. The relationships among the paraclinoidal structures were assessed. The origin and projection of the ophthalmic artery (OA) were investigated. RESULTS: The mean values of intradural basal width and height of the ACP were 10.82 mm and 7.61 mm respectively. The mean length of the C6 lateral and medial side increased 49%. The mean length of optic nerve increased 97%. At the parasellar area, the lengths from the optic strut to the falciform liament, distal dural ring, origin of OA were 6.69 mm, 9.36 mm and 5.99 mm, respectively. The distance between CN III and IV was 11.06 mm. CONCLUSION: With the removal of ACP, exposure of the C6 segments and optic nerve can expand 49% and 97%, respectively. This technique should be among a surgeon's essential skills for treating lesions around the parasellar area.
Adult ; Cadaver ; Carotid Artery, Internal ; Craniotomy ; Head ; Humans ; Ophthalmic Artery ; Optic Nerve

The introduction of the operating microscope improved not only the immediate operative management of cerebral aneurysms, but also the knowledge of their topography. The origin and projection of an aneurysm and its relation to the arteries concerned, identification and sparing of small functionally important arteries in the vicinity of the aneurysm, and the recognition of less known anomalies of the vascular system became as important as the dissection and clipping of the neck itself. We have presented 2 patients with aneurysms arising from the carotid artery in the origin of the ophthalmic artery. The origins and projections of aneurysms were analyzed with the aid of angiography, magnification technique, operative drawing and photographs. To facilitate the surgical procedures and results in lowered morbidity we have discussed the technical considerations for medialward directing aneurysm under the optic nerve in the view point of the surgical anatomy. We emphasized preoperatively defined plans concerning the origin, direction and size of the aneurysms, as well as, constant awareness of topographic relations.
Aneurysm* ; Angiography ; Arteries ; Carotid Arteries ; Humans ; Intracranial Aneurysm ; Neck ; Ophthalmic Artery ; Optic Nerve*

Skull base surgery has developed through the evolution of imaging, anatomic research, surgical approach and reconstructive techiques. The basic disciplines of approaching skull base lesions are to provide direct vision, minimize brain retraction, allow excellent exposure and minimal blood loss. Although many advantages listed above are reported, objective long-term follow up results about post-operative complications of this procedures were not introduced. This study was designed to review the complications of skull base approach that we experienced 43 cases by a team approach with neurosurgery-supraorbital rim osteotomy, orbitozygomatic osteotomy, orbitozygom aticoglen-oidotomy, orbitozygomaticoglenoidocondylotomy, and transfrontonasomaxillary osteotomy-through objective evalutation criteria. The result of this study demonstrated that the type of complications were consisted with perioperative infection (5 cases), subdural empyema (1 case), CSF leakage(1 case), hematoma (1 case), meningitis (3 cases), ophthalmic nerve injury (1 case),facial nerve injury (2 cases), T-M joint problem ( 2 cases), & enophthalmos ( 2cases). In conclusion, after performing the different skull base approaches, we analyzed several complications of the above procedures. We analyzed with the purpose of preventing complications in the next skull base approach.
Brain ; Empyema, Subdural ; Enophthalmos ; Follow-Up Studies* ; Hematoma ; Joints ; Meningitis ; Ophthalmic Nerve ; Osteotomy ; Skull Base* ; Skull*

When an eye is exposed to the air due to lagophthalmos caused by facial nerve paralysis, exposure keratitis, conjunctivitis and corneal damages occur. Artificial tears, soft contact lens, ophthalmic ointments, and tarsorrhaphy have been used for treatment of lagophthalmos to relieve exposure keratopathy. But these trials have little continuity and comfortability and have many cosmetic problems, so that the results have not been satisfactory. We obtained good results by implantation of Gold weight in the upper lid for the treatment of lagophthalmos with complications in 7 cases. In conclusion, the author believes that Gold weight implantation will be a good therapeutic modality for treatment of lagophthalmos.
Conjunctivitis ; Contact Lenses, Hydrophilic ; Facial Nerve ; Keratitis ; Ointments ; Ophthalmic Solutions ; Paralysis