PURPOSE: To know the normal CT appearance of the anterior skull base and nasal septum after birth. MATERIALS AND METHODS: Coronal CT scans with a helical mode were performed from the nasal bone to the sphenoid sinus in 99 children whose ages ranged from 27 days to 14 years. We investigated the CT appearance of the developing anterior skull base and nasal septum with particular attention to the anteroposterior length of the anterior skull base and the ossification patterns of the cribriform plate, perpendicular plate, crista galli, and vomer. RESULTS: The anteroposterior length of the anterior skull base statistically significantly increased with age. The cribriform plate showed partial or complete ossification in at least one segment at more than 3 months of age and in all three segments at more than 6 months of age. Ossification of the cribriform plate occurred earlier in the middle segment than in the anterior and posterior segments. It began exclusively in the region of the lateral mass of the ethmoid and proceeded medially toward the crista galli. Partial ossification of the perpendicular plate was noted as early as 9 months of age, and complete ossification as early as 13 months of age. All children at 18 months and older showed at least partial ossification of the perpendicular plate. Partial ossification of the crista galli was noted as early as 27 days of age, and complete ossification as early as 3 months of age. CT showed complete ossification of the crista galli in all but two children at 6 months and older. The superior aspect of the vomer exhibited a V- or Y-shape on all CT scans in 66%(65/99) of children at any age. It appeared as an undivided single lump anteriorly and a V or Y posteriorly in 34%(34/99). CONCLUSION: Knowledge of the normal developing patterns of ossification of the anterior skull base and nasal septum could help prevent errors in interpreting CT scans in this region, especially in infants and young children.
Child ; Ethmoid Bone ; Humans ; Infant ; Nasal Bone ; Nasal Septum* ; Parturition ; Skull Base* ; Skull* ; Sphenoid Sinus ; Tomography, X-Ray Computed ; Vomer

Granulocytic sarcoma is a manifestation of myelogenous leukemia, which means a solid mass consisting of primitive precursors of the granulocytic series of white blood cells. We present CT and MR imaging findings of bilateral sino-orbital granulocytic sarcoma in a 22-month-old boy. The mass involved bilateral orbital fossa which resulted in bilateral proptosis. Moreover, the mass extended to the almost skull base including paranasal sinuses, maxilla, temporal bone, zygomatic bone, sphenoid bone, ethmoid, and palatine bone. The adjacent dura was continuously thickened and the lower half of cavernous sinus was also involved. The patient was diagnosed as AML (M5) with t(8,21) translocation through a chromosome study from the bone marrow.
Bone Marrow ; Cavernous Sinus ; Ethmoid Bone ; Exophthalmos ; Humans ; Infant ; Leukemia ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute ; Leukocytes ; Maxilla ; Orbit ; Orbital Neoplasms ; Palate, Hard ; Paranasal Sinuses ; Sarcoma, Myeloid ; Skull Base ; Sphenoid Bone ; Temporal Bone

Granulocytic sarcoma is a manifestation of myelogenous leukemia, which means a solid mass consisting of primitive precursors of the granulocytic series of white blood cells. We present CT and MR imaging findings of bilateral sino-orbital granulocytic sarcoma in a 22-month-old boy. The mass involved bilateral orbital fossa which resulted in bilateral proptosis. Moreover, the mass extended to the almost skull base including paranasal sinuses, maxilla, temporal bone, zygomatic bone, sphenoid bone, ethmoid, and palatine bone. The adjacent dura was continuously thickened and the lower half of cavernous sinus was also involved. The patient was diagnosed as AML (M5) with t(8,21) translocation through a chromosome study from the bone marrow.
Bone Marrow ; Cavernous Sinus ; Ethmoid Bone ; Exophthalmos ; Humans ; Infant ; Leukemia ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute ; Leukocytes ; Maxilla ; Orbit ; Orbital Neoplasms ; Palate, Hard ; Paranasal Sinuses ; Sarcoma, Myeloid ; Skull Base ; Sphenoid Bone ; Temporal Bone

This study was performed to evaluate the initial reaction of maxillofacial complex to the Class II intermaxillary and the anterior vertical elastic forces on the six types of arch wires including multiloop edgewise arch wires(MEAW). A human dry skull was used for this purpose and this investigation was done by holographic interferometry. Based on such investigation, the fringe pattern and the number of fringes of each condition were compared and analyzed. The findings of this study were as follows: 1. As the orthodontic forces increased, the amount of displacement increased. 2. As the orthodontic forces were applied, the fringes were shown not only in the teeth and the maxilla but also in the adjacent bones, i.e., temporal bone, zygomatic bone, nasal bone, frontal bone and sphenoid bone. And the direction of fringe pattern and the number of fringes were different from each other by the sutures. 3. As the long Class II elastic forces were applied, the backward-downward displacements of the anterior teeth and the maxilla were shown, and backward displacements of the former were greater than those of the latter. And backward displacements were greater by the long Class II elastic forces than by the short Class II elastic forces. 4. As the anterior vertical elastic forces were applied, downward displacements of the anterior teeth and the maxilla were shown, and the downward displacements of the former were greater than those of the latter relatively. 5. The downward displacements of the anterior area to the anterior vertical elastic forces of the MEAW were greater than those of other arch wires. In addition, the more tip-back bend was applied, the more displacement was seen. 6. As the Class II intermaxillary forces and the enough anterior vertical elastic forces were applied on the MEAW with tip-back bend, there was an intrusive effect of the posterior teeth.
Frontal Bone ; Humans ; Interferometry* ; Maxilla ; Nasal Bone ; Skull ; Sphenoid Bone ; Sutures ; Temporal Bone ; Tooth

The purpose of this study is to examine the initial reaction of craniofacial complex to the traction of headgears which are frequent used in clinical practice by using holographic interference method. Changes In the fringe pattern according to the traction conditions (outer bow length, load amount, direction) were compared. Human dry skull was used as experimental material, the results were as follows. 1. The density of fringes Increased with an increase in load. 2. Maxillary headgear affected circummaxillary bones-temporal bone, zygomatic bone, nasal bone, frontal bone, sphenoid bone as well as maxilla. 3. The most upward-backward displacement was observed in a high pull head gear (30degrees), this is though to be a optimal direction for supressing the growth of the maxilla.
Frontal Bone ; Head ; Holography* ; Humans ; Maxilla ; Nasal Bone ; Skull ; Sphenoid Bone ; Traction*

The injured skull bone may be contaminated in compound frontal skull fracture, so definitely left out for the prevention of infectious complications in the classic concept. The efficacy of primary replacement and resection of the injured bony fragments in the treatment of compound depressed frontal skull fractures was studied in 33 patients who could be followed up over one year during a recent 5-year period. The patients was divided into a group I which took a primary replacement of injured bony fragments and group II which left out the injured bony fragments in immediate operation. The results are summarized as follows : 1) The age incidence was more frequent in the 3th and 4th decades. The sex distribution was more frequent in male(87%). 2) The motor vehicle accident was most frequent in the injury mechanism. 3) The conscious level on admission was 53% in 13~15 GCS group, 12% in 9~12 group, 26.6% in 6~8 group and 8.4% in 3~5 group. 4) The incidence of an extending fractures was 42% to orbital roof, 35% into frontal sinus, 25% into cribriform plate and 16% into nasal bone. 5) The incidence of intracranial injury was 65% in dural laceration and 51% in cerebral laceration. Of cases of dural laceration the cerebral laceration was associated in 78%. 6) The time duration from injury to operation was under 12 hours in most cases(84%). 7) The incidence of a complication was 36.1% in total group, 27.7% in group I and 47.2% in group II. The infectious complication was not a significant difference between group I(14.9%) and group II(16.7%). In conclusion the infectious morbidity of which were most dangerous complications due to compound depressed frontal skull fractures was not a significant difference in two compared group. The author believe that immediate bone replacement for compound depressed frontal fractures with or without extension to frontal sinus, orbit, or cribriform plate os both practical and safe procesures.
Ethmoid Bone ; Frontal Sinus ; Humans ; Incidence ; Lacerations ; Motor Vehicles ; Nasal Bone ; Orbit ; Sex Distribution ; Skull Fractures* ; Skull*

Hemangioma arising in soft tissue is one of the most common tumors in the head and neck region. However, intraosseous hemangiomas are rare and account for only 0.5% to 1.0% of all osseous neoplasms. Most often, intraosseous hemangiomas are found in the vertebral column or calvarium. With regard to the facial skeleton, these lesions arise primarily in the mandible, maxilla, or nasal bones. For hemangiomas of the orbit or frontal bone, several cases have been reported. We present two cases of cavernous hemangioma arising from the superolateral orbital rim and frontal bone. In one case, the preoperative diagnosis with computed tomography(CT) scan was fibrous dysplasia. The diagnosis and treatment of this rare lesion are discussed.
Diagnosis ; Frontal Bone* ; Head ; Hemangioma* ; Hemangioma, Cavernous ; Mandible ; Maxilla ; Nasal Bone ; Neck ; Orbit ; Skeleton ; Skull ; Spine

Osteomas are most often located in the femur, tibia, humerus, spine, and talus. They are rare in the skull. Osteomas in the head and neck regions are benign bone neoplasms usually found in the frontoethmoid area. The developmental theory postulates that osteomas develop at the sites of fusion of tissues different embryological origin such as occur at the junction of the embryonic cartilaginous frontal and ethmoid bones. Trauma and infection have also been implicated as causative factors, but many patients with osteoma deny any preceding history of these. Osteomas are usually produce symptoms primary to cosmetic problems and secondary to pressure on adjacent structures. The objects of this study are from a 5-year period of April of 2002 to April of 2007, consisting of 48 male patients and 52 female. There were 33 cases of frontal bone osteomas, 5 cases of madibular bone osteomas, 5 cases of occipital bone osteomas, 6 cases of symptomatic paranasal sinus osteomas, 48 cases of asymptomatic paranasal sinus osteomas, and 3 cases of mastoid osteomas. We reviewed medical records of patients to find out their presentations, diagnostic considerations, therapeutic options, and outcomes. Patients were followed up six months postoperatively on the average. The authors experienced 48 cases of osteoma in the head and neck lesion, which were removed via direct approach or endoscopic approach. The 100 cases who came to the hospital with or without symptoms after diagnosis healed completely without sequelae. During the follow-up periods, excellent functional and cosmetic results were observed with an inconspicuous scar. There was no specific complications related to this procedure. Results of surgery in most cases were satisfied. We discussed the surgical procedure and the characteristics of the osteomas, and we report several cases with the review of literatures.
Bone Neoplasms ; Cicatrix ; Cosmetics ; Ethmoid Bone ; Female ; Femur ; Follow-Up Studies ; Frontal Bone ; Head ; Humans ; Humerus ; Male ; Mastoid ; Medical Records ; Neck ; Occipital Bone ; Osteoma ; Porphyrins ; Skull ; Spine ; Talus ; Tibia

The penetrating foreign body of skull base can be occasionally life-threatening. However, the severity and extent of these injuries depend upon the inflicting object, the anatomic site involved, and the force of penetration. Penetrating injuries generally result from gunshots and knife stabs. The authors experienced a rare case of penetrated metalic foreign body which remained for about 5 years in the left nasal cavity through cribriform plate to frontal lobe. The nasocranial foreign body was removed successfully through nasal endoscopy without difficulty.
Endoscopy ; Ethmoid Bone ; Foreign Bodies* ; Frontal Lobe ; Nasal Cavity ; Skull Base

Osseous hemangiomas are uncommon, constituting less than 1% of all osseous tumors. The most frequent sites are the calvaria and the vertebral column. Involvement of the facial bones is rare, and occurs most commonly in the maxilla, mandible, and nasal bones. In nasal cavity, only one case of inferior turbinate involvement has been reported in the English-language literature. We report two cases of osseous hemangioma of the middle turbinate diagnosed by histopathologic confirmation. Because of their infrequent appearance in the nasal cavity, vague symptoms and unknown typical radiologic findings, these tumors can be missed in many cases or may be misinterpreted as other osseous tumors.
Facial Bones ; Hemangioma ; Mandible ; Maxilla ; Nasal Bone ; Nasal Cavity ; Skull ; Spine ; Turbinates