Vestibular neurectomy is known as an effective procedure in the management of intractable peripheral vertigo from Meniere's disease and other episodic peripheral vertigo disorders. Various approaches have been developed for selectively sectioning the vestibular nerve, in order to preserve hearing and avoid facial nerve injury. Vestibular neurectomy is performed in two patients with Meniere's disease to control intractable episodic vertigo through retrolabyrinthine approach. Vertigo was improved with preserving their hearing. We report the surgical technique and advantages of retrolabyrinthine vestibular neurectomy in the treatment of vertigo.
Facial Nerve Injuries ; Hearing ; Humans ; Meniere Disease ; Vertigo* ; Vestibular Nerve

OBJECTIVE: The purposes of this study are to compare imaging features with operative findings and to determine significance of imaging studies for early detection of craniosynostosis(CS). METHODS: Plain radiograph of skull and three-dimensional(3D) CT reconstruction were analyzed in 10 consecutive patients with CS to assess the presence and the extent of synostosis. The radiological findings were investigated and compared with operative findings. RESULTS: The locations of lesion were coronal suture in 6, sagittal suture in 3 and multiple sutures in one patient, and the age ranged 1 to 53 months(mean age: 17.4 months). Reconstructive procedures with or without advancement of supraorbital rim were performed in coronal CS patients and PI-procedures or synostectomy were done in sagittal CS patients. Radi-ological abnormalities such as sutural indistinctness or sclerosis, bony ridge, bossing and other bony deformities were nearly consistent with surgical findings. CONCLUSION: The interpretation of imaging study are very important for early detection of craniosynostosis, especially, the plain radiographs of skull. Also 3D CT imaging is helpful in diagnosis and surgical planing of craniosynostosis. There are no significant differences between imaging features and operative findings in CS patients.
Congenital Abnormalities ; Craniosynostoses* ; Diagnosis ; Humans ; Sclerosis ; Skull ; Sutures ; Synostosis

The purpose of this study is to evaluate the regenerative capacity of reconstruction in the atrophied posterior maxilla by comparing bone graft procedures and alveolar distraction osteogenesis (ADO) techniques. We performed the autogenous iliac bone graft (AGB group, 5 specimens in 3 patients), and the combination (Mixed group, 3 specimens in 3 patients) of the autogenous and deproteinized bovine bone (Bio-Oss(R), Geistlich Co., Switzerland) as the ratio of 2:1 in the sinus floor elevation procedures. ADO procedures using TRACK(R). (KLS Martin Co., Germany) were also performed to augment vertical alveolar height in atrophied posterior maxilla (ADO group, 5 specimens in 4 patients). Newly generated bone tissues were obtained with the 2.0mm diameter trephine bur (3i Co., USA) during implant fixture installation after 5-7 months. Routine histolomorphological observation, immunodot blot assay for quantitative evaluation, and immunohistochemical staining with antibodies to MMP-1, -9, -10, TIMP-1, -2, and BMP-2, -4 were all carried out. Lamellar bone formation was well shown in all specimens and new bone formations of ADO group increased than those of other procedures. In immunohistochemical staining, the strong expression of BMP-2 was shown in all specimens, and immunodot blot assay showed that bone formation is accompanied by the good induction of factors associated with angiogenesis and appeared more increased amount of osteogenic and angiogenic factors in ADO group. ADO is the most effective technique for new bone formation compared to sinus floor elevation with autogenous or mixed bone graft in the atrophied posterior maxilla. In the quantitative immunodot blot assay, the regenerated bone after ADO showed more increased products of VEGF, BMP-2, PCNA and MMP-1 than those after the other procedures, and these findings were able to be confirmed by immunohistochemical stainings.
Angiogenesis Inducing Agents ; Antibodies ; Bone and Bones ; Dental Implants* ; Evaluation Studies as Topic ; Maxilla* ; Osteogenesis ; Osteogenesis, Distraction ; Proliferating Cell Nuclear Antigen ; Tissue Inhibitor of Metalloproteinase-1 ; Transplants ; Vascular Endothelial Growth Factor A

during bone harvesting from the chin.
Anatomic Variation* ; Chin*

No abstract available.
Carcinoma ; Cheek

OBJECTIVE: Most of the studies that have described surgical procedures for moyamoya disease(MMD) have had the aim to improve the blood flow mainly in the middle cerebral artery(MCA) territory. The purpose of this study is to clarify the good indications for a multiple burrhole operation to treat MMD. METHODS: With the patient under local anesthesia, burrhole trephination with a diameter of 1.5 to 2cm at 3 to 5cm lateral to the midline was performed in a total of 18 hemispheres during 12 procedures. The burrholes were opened in the frontal lobe at 19 sites in 10 patients and in the parietal lobe at 22 sites in 12 patients. Revascularization through multiple burrholes and arachnoid openings was performed in 12 patients who suffered from MMD. RESULTS: As seen on the follow up angiograms, good revascularization was achieved in 27 of 41 burrholes, and mainly from the middle meningeal artery and then from the superficial temporal artery. The moyamoya vessels were decreased in four patients. The neovascularization covered 68.4% of the frontal lobe and 63.5% of the parietal lobe. Compared with the preoperative 99mTc-HMPAO-SPECT, 6 patients showed improvement of cerebral blood flow on the postoperative 99mTc-HMPAO-SPECT. Transient ischemic attack disappeared in three of the four patients who presented with this symptom, and the preoperative symptoms improved in both of the patients who presented with headache and cerebral infarction. CONCLUSIONS: A multiple burrhole operation is a simple technique. The results of our series suggest that the revascularization obtained for adult MMD patients who underwent a multiple burrhole operation is similar to that obtained with other indirect surgeries, but long term follow up studies are needed.
Adult ; Anesthesia, Local ; Arachnoid ; Cerebral Infarction ; Follow-Up Studies ; Frontal Lobe ; Headache ; Humans ; Ischemic Attack, Transient ; Meningeal Arteries ; Moyamoya Disease ; Parietal Lobe ; Temporal Arteries

Neurocysticercosis is the most common parasitic disease of the central nervous system in humans, caused by infection of the larval stage of the pork tapeworm, Taenia solium. However, cerebellar involvement is rarely reported. We report of a case of racemose cysticercosis in the cerebellar hemisphere. A 44-year-old man presented with headache and dizziness. Magnetic resonance imaging showed hydrocephalus and an ill-defined, multicystic cerebellar mass with hypersignal on T2-weighted images, hyposignal on T1-weighted images and rim enhancement after gadolinium injection. The patient underwent endoscopic third ventriculostomy and the cyst resection was done through a craniotomy. In surgical field, cysts were conglomerated in a dense collagen capsule that were severely adherent to surrounding cerebellar tissue, and transparent cysts contained white, milky fluid. Histological findings confirmed the diagnosis of cysticercosis. He received antiparasitic therapy with praziquantel after surgery. Racemose cysticercosis is rare in the cerebellar hemisphere but neurocysticercosis should be taken into consideration as a differential diagnosis of multiple cystic lesions in the cerebellum.
Adult ; Central Nervous System ; Cerebellum ; Collagen ; Craniotomy ; Cysticercosis ; Diagnosis, Differential ; Dizziness ; Gadolinium ; Headache ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Neurocysticercosis ; Parasitic Diseases ; Praziquantel ; Taenia solium ; Ventriculostomy

Peripheral scalp T-cell lymphoma is a very rare disease. We report a case of a 22-year-old man who presented an indolent large scalp mass in the right frontal scalp region. The patient’s physical examination demonstrated no palpable mass in the chest, abdomen, and extremities. The brain CT revealed a high-density large scalp mass of the subgaleal layer in the right frontal and a small scalp mass of the subgaleal layer in the left frontal. The brain MRI showed multifocal enhancing masses in the bilateral dura, the subgaleal layer of the scalp, and the skull. The patient underwent removal of the tumor found in the right frontal scalp. The histologic diagnosis was peripheral T-cell lymphoma. Bone marrow aspiration showed the involvement of T-cell lymphoma. The patient received chemotherapy with cyclophosphamide, vincristine, doxorubicin, and prednisolone (CHOP protocol) for 3 cycles. The patient was discharged without neurological deficit. The patient showed no evidence of recurrence 15 months after surgery. We report a rare case of peripheral T-cell lymphoma mimicking benign scalp tumors.

PURPOSE: The aim of this study is to investigate the renal ultrasonographic findings in children with vesicoureteral reflux (VUR). METHODS: We retrospectively reviewed the medical records of 83 patients who were diagnosed with VUR and underwent ultrasonography at Ilsan hospital between January 2000 and December 2010. RESULTS: Among 166 renal units, 108 (65.0%) were found to have vesicoureteral reflux (VUR). Fifty-one (73.9%) had VUR in renal units with abnormal ultrasonography (USG), whereas 57 (58.7%) had VUR in renal units with normal USG. Abnormal USG findings were independent risk factors for VUR (Odds ratio, 1.98; 95% CI, 1.01-3.89; P=0.045). In renal units with VUR, the number of normal USG finding was 52.8%, and the abnormal findings were as follows; increased cortical echogenicity 16.7%, hydronephrosis 17.6%, megaureter or ureter dilatation 8.3%, hydronephrosis and ureter dilatation 1.9%, duplication of ureter 1.9%, and atrophic kidney 0.9%. The prevalence of VUR was relatively higher in renal units with hydronephrosis (23/19, 82.6%), ureter dilatation (9/9, 100%), duplication of ureter (2/3, 66.6%), and atrophic kidney (1/1, 100%). CONCLUSION: Our study indicates that VUR was associated with abnormal USG findings. When there are abnormal USG findings such as hydronephrosis, ureter dilatation, duplication of ureter, and atrophic kidney in children with UTI, VCUG is recommended to detect VUR after controlling UTI.
Child ; Dilatation ; Humans ; Hydronephrosis ; Kidney ; Medical Records ; Prevalence ; Retrospective Studies ; Risk Factors ; Ureter ; Vesico-Ureteral Reflux

It has been known that the size of arterial diameter during growth in primates is closely dependent on blood flow. Flow induced arterial size can be influenced by contractile or structual characters of vascular smooth muscle cells. Furthermore it had been confirmed through experimental study that vascular endothelium releases vasoactive substances which adjust smooth muscle tone, and could detect shear stress on the vascular wall by its direct contact with luminal flow. The authors tried to prove it through the angiographic measurement of the major vessel sizes in cerebrovascular diseases with changed blood flow. We measured the major vessel sizes of 36 cases of cerebrovascular diseases:arteriovenous malformation in 14 cases, cerebral infarction in 8, cerebral hemiatrophy in 6 moyamoya disease 5, occlusion of the internal carotid artery in 2, and carotid-cavernous fistula in 1, which may influence cerebral blood flow, on angiography under the same circumstances. Results are as the followings: 1) In the cases of arteriovenous malformation and carotid-cavernous fistula, all of the major vessel sizes of the lesion wite were increased and all became decreased postoperatively. 2) In the cases of major vessel occlusion and cerebral hemiatrophy, the major vessel size of the lesion site was smaller than that of the normal site. 3) In the cases of moyamoya disease, there was no definite size different between both ICA sizes. In conclusion, the change in cerebral blood flow is a determinant factor of the major vessel sizes in the cases of cerebrovascular disorders which an influence cerebral blood flow.
Angiography ; Arteriovenous Malformations ; Carotid Artery, Internal ; Cerebral Infarction ; Cerebrovascular Disorders ; Endothelium, Vascular ; Fistula ; Moyamoya Disease ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Phenobarbital ; Primates