Skull base surgery has developed through the evolution of imaging, anatomic research, surgical approach and reconstructive techniques. The basic disciplines of approaching skull base lesions are provide direct vision, minimizing brain retraction, excellent exposure and minimal blood loss. The focus of this report is to review the advantages of skull base approach in our cases and suggest some indications. We experienced 20 cases of skull base surgery by a team approach consisting of a neurosurgeon and plastic surgeon. The surgical approach were supraorbital osteotomy(5 case), orbitozygomatic osteotomy(8 case), orbitozygomaticoglenoid osteotomy (5 case ) and orbitozygomaticoglenoidocondylar osteotomy (2 case). In our experience, these approaches provided excellent exposure of the lesion, direct access to lesions and minimal brain retraction thereby better outcome.
Brain ; Osteotomy ; Skull Base* ; Skull* ; Surgery, Plastic*

Endoscopy ; Humans ; Nose ; surgery ; Skull Base ; surgery

In orthognathic surgery, precise analysis and diagnosis are essential for successful results . In facial asymmetric patient, traditional 2D image analysis has been used by lateral and P-A Cephalometric view, Skull PA, Panorama, Submentovertex view etc. But clinicians sometimes misdiagnose because they cannot find exact landmark due to superimposition, moreover image can be magnified and distorted by projection technique or patient's skull position, when using these analysis and method. For overcome these defects, analysis by using of 3D CT has been introduced. In this way we can analysis precisely by getting the exact image free of artifact and finding exact landmark with no interruption of superimposition. So we want to review of relationship between various skeletal landmarks of mandible or cranial base and facial asymmetry by predictable analysis using 3D CT. We select the cases of the patients who visited our department for correction of facial asymmetry during 2003-2007 and who were taken image of 3D CT for diagnosis. 3D CT images were reconstructed to 3D image by using V-Work program (Cybermed Inc., Seoul, Korea). And we analysis the relationship between facial asymmetry and various affecting factor of skeletal pattern. The mandibular ramus hight difference between right and left was most affecting factor that express facial asymmetry. And in this research, there was no relationship between cranial base and facial asymmetry. The angulation between facial midline and mandibular ramus divergency has significant relationship with facial asymmetry
Artifacts ; Facial Asymmetry ; Humans ; Mandible ; Orthognathic Surgery ; Skull ; Skull Base

surgery at Wonkwang University Dental Hospital during April 2004 to October 2010. Patients were divided into 4 groups and the correlation between cranial base and maxillomandibular growth patterns were evaluated.RESULTS: There was a correlation between cranial base and maxillomandibular growth patterns. Positive relationships were found between the occlusal plane, Incisor mandibular plane angle, mandibular plane, positioning of pogonion and the saddle angle, indicating maxillary growth patterns. Negative relationships were found between SNA, SNB, maxillary incisor angle and saddle angle. Positive relationships were found between the ratio of the anterior and posterior cranium, positioning of pogonion and the percentage of cranial depth indicating mandibular growth patterns. Negative relationships were found between the occlusal plane, maxillary incisor angle, mandibular plane, mandibular angle and cranial depth.CONCLUSION: Cranial base and maxillofacial growth patterns were correlated and the classification should be adjusted before orthognathic surgery.]]>
Dental Occlusion ; Humans ; Incisor ; Malocclusion ; Orthognathic Surgery ; Skull ; Skull Base

We analyzed the variability in position, shape, size and incidence of the infraorbital foramen in Indian dry skulls as little literature is available on this foramen in Indians to prevent clinical complications during maxillofacial surgery and regional block anesthesia. Fifty-five Indian skulls from the Department of Anatomy CSM Medical University were examined. The 110 sides (left and right) of the skulls were analyzed by measuring the infraorbital foramina distances from infraorbital margin and the piriform aperture on both sides. The vertical and horizontal dimensions were also measured. All measurements were taken with a compass transferred to calipers and analyzed statistically. The mean distances between the infraorbital foramen and the infraorbital margin on the right and left side were 6.12 mm and 6.19 mm, respectively. The mean distances between the infraorbital foramen and the piriform aperture were 15.31 mm and 15.80 mm on the right and left sides, respectively. The mean vertical dimensions on the right and left side were 3.39 mm and 3.75 mm, respectively. The mean horizontal dimensions on the two sides were 3.19 mm and 3.52 mm. These results provide detailed knowledge of the anatomical characteristics and clinical importance of the infraorbital foramina which are of paramount importance for surgeons when performing maxillofacial surgery and regional block anesthesia.
Anesthesia ; Incidence ; Skull ; Surgery, Oral ; Vertical Dimension

From October 1997 to December 1998, 64 patients with defect of skull vault bone were divided into 2 groups. The 1st group of 33 patients underwent an orthopedic surgery to recreate the defect using their self exploited bone and the 2nd using the carbone composite flap. The technique of use of carbone composite was not complicated and can be applied in any surgical institution which had used to conduct emergency surgery of skull and brain. The priorities in indication must be given to large and very large defect.
Surgery, Plastic ; Therapeutics ; Bone and Bones ; Skull ; Orthopedics

Among 235 operated cases with narrow case of skull, there were 70 (29.8%) cases of skull articular overlap, a cause of narrowness leading to press the brain. This causes the underdevelopment of psychomotor capacity of children. This morbidity is higher in boys than in girls. The rates are as follows: frontal occupital overlap 100% with early close of the fonticulus; head circle measurement less than 1-2.5 cm incomparing with seizure 78.6%, psychomotor under development from mild to severe 86.7%. In electroencephalogram, 42 cases occur the wave od seizure. After operation of correction of deformity of the bone, in 53.4% children normal development restored, in 29.2% part of symptoms reduces, in 17.3% no improvement noted
Child ; Skull ; Arthrometry, Articular ; surgery ; Therapeutics

Humans ; Skull Base ; anatomy & histology ; surgery

OBJECTIVETo explore the possibility of using distraction osteogenesis to repair skull defect.

METHODS17 goats with one year age were chosen randomly. The animals were divided to 3 groups. Group A includes 7 goats, a 3.0 cm x 2.2 cm rectangle skull defect is created on both sides of parietal area. Group B includes 5 goats, a 2.2 cm x 2.2 cm square skull defect was created on right side of parietal area. Group C includes 5 goats, a 3 cm x 1 cm rectangle skull defect was created on both sides of parietal area. Accordingly, different size of transport discs were created on right side of skull and the distraction apparatus is implanted. 3-D CT was done to measure the skull defect on group A. Biomechanical test was done on group B. Process of bone formation illustrated by histological stain, scan and transparent electric microscope was observed on group C.

RESULTSGroup A measured by 3-D CT showed that skull defect of experimental side have been repaired by distraction osteogenesis. There was definitely difference between experimental and control side (P < 0.01). Group B measured by biomechanical test showed no definitely difference between experimental and normal side (maximum load P = 0.235 > 0.05, rigidity P = 0.213 > 0.05). Group C showed that the process of bone formation was typical intramembranous.

CONCLUSIONSThe evidence showed that skull defect of goat can be repaired by distraction osteogenesis.

Endoscopy ; education ; Humans ; Skull Base ; surgery