No abstract available.
Intracranial Arteriovenous Malformations* ; Radiosurgery*

Septoplasty is one of the most commonly performed operations in Otolaryngology. It is often considered an easy operation. Yet it is still accompanied by a relatively high rate of failure and complications. It is definitely not an operation in which one surgical technique can suffice for all circumstances. Rather it requires a variety of techniques in accordance to the various septal pathologies in order to achieve a favorable outcome. This study provides a comprehensive review of septoplasty including current concepts, historical background, classification, updated surgical techniques, and management of complications. In particular, the surgical techniques that ensure a successful correction and minimal complications are highlighted.
Dietary Sucrose ; Nasal Septum ; Otolaryngology

Obstructive sleep apnea is a manifestation of upper airway instability leading to upper airway collapse during sleep. Current diagnostic testing with polysomnography provides information regarding the number of apneas and hypopneas but does not provide any information regarding the level of pharyngeal narrowing or collapse. The identification of the site of obstruction is essential in choosing the appropriate treatment, especially when surgical intervention is considered. In this review we present contemporary methods for localizing obstructive sites with emphasis on two promising airway evaluation modalities. Sleep videofluoroscopy and sleep en-doscopy. Further understanding of the obstructive events occurring during sleep with precise evaluation of the sites of obstruction will eventually guide tailored surgical treatment with improved surgical outcomes.
Apnea ; Diagnostic Tests, Routine ; Endoscopy ; Humans ; Polysomnography ; Sleep Apnea, Obstructive ; Snoring

Palisaded neutrophilic and granulomatous dermatitis (PNGD) is an uncommon skin eruption and characterized histopathologically by the presence of granulomatous inflammation with or without leukocytoclastic vasculitis. PNGD is known to be associated with various immune-mediated connective tissue diseases such as rheumatoid arthritis and lupus erythematosus. However, to our knowledge, a case of PNGD in a patient with Behçet’s disease is extremely rare and only one case has been reported in foreign literature to date. Herein, we report an unusual case of a 60-year-old female with Behçet’s disease who presented multiple erythematous to flesh-colored papules on the extremities, buttocks, and ear lobes and was diagnosed with PNGD. After the treatment of systemic corticosteroids, colchicine and azathioprine, the skin lesions and oral ulcers improved. The patient is under observation without recurrence of skin lesions for 6 months.

Osteoradionecrosis of the skull base (SB-ORN) is a serious potentially lethal complication after radiotherapy in the head and neck region and is therefore considered one of the most challenging clinical entities among skull base lesions. Management options includes nasal irrigation, medications such as systemic antibiotics and anti-inflammatory drugs, hyperbaric oxygen therapy, and surgical debridement. Despite these efforts treatment outcomes are associated with a poor prognosis. Recent studies have shown an increased disease control rate with a more aggressive surgical approach including sequestrectomy. One of the main factors associated with poor prognosis is involvement of the internal carotid artery near the skull base. Spontaneous carotid rupture is frequently associated with death and/or severe morbidity and also poses risk of profuse bleeding during surgery. In this article we will deliver a comprehensive review of SB-ORN, including pathophysiology, clinical features, and an update in treatment strategy.

Shunt malfunctions that require surgical intervention during pregnancy and the postpartum period are rare. Furthermore, no study has reported on an acute shunt malfunction immediately after cesarean section. Here, we describe the case of a 32-yr-old woman who became drowsy 12 hr after cesarean section delivery of her second child. She had a ventriculoperitoneal shunt placed to treat hydrocephalus associated with meningitis at 26 yr of age. Marked ventriculomegaly was seen on brain computed tomography and her consciousness recovered temporarily after aspirating cerebrospinal fluid from the flushing device. At surgery, the distal catheter tip was plugged by a blood clot. We believe that the blood spilled over during the cesarean section. The clogged catheter end was simply cut off and the remaining catheter was repositioned in the peritoneal cavity. Her consciousness recovered fully.
Adult ; *Cesarean Section ; *Equipment Failure ; Female ; Humans ; Hydrocephalus/etiology/surgery ; Meningitis/complications ; Pregnancy ; *Ventriculoperitoneal Shunt/adverse effects/instrumentation

We found an error in our published article: Park KW, Im SB, Kim BT, Hwang SC, Park JS, Shin WH. Neurotoxic manifestations of an overdose intrathecal injection of gadopentetate dimeglumine. J Korean Med Sci 2010; 25: 505-8. The published Fig. 2 C and D are identical with Fig. 2 A and B on page 506 of above article. It was a mistake that occurred during editing process of figures by the publishing company. We have attached a corrected version of the Fig. 2.

Chronic hypertension causes pathologic changes within the tunica media, termed lipohyalinosis. The most prominent changes were seen at bifurcation point within the vessels and middle and distal portion of the vessels. The role of microaneursyms in spontaneous intracerebral hemorrhage (ICH) secondary to hypertension is not well understood. A cerebral amyloid angiopathy is associated with fibrinoid necrosis and affects the small to medium sized vessels and it may account for a higher percentage of spontaneous ICH in the elderly. Neurologic dysfunction secondary to ICH is caused by initial hemorrhage with its associated mass effect, and tissue destruction with hematoma enlargement. Consequently, the further deterioration may be due to cerebral edema. The exact role of CBF changes is not unproved in the pathogenesis of neuronal injury. However, much has been learned about the mechanisms involved the brain edema formation after ICH. A number of components of blood are capable of inducing brain injury and brain edema formation. The hematoma exerts its effects not only by mechanical but also by chemical influences.
Aged ; Brain Edema ; Brain Injuries ; Cerebral Amyloid Angiopathy ; Cerebral Hemorrhage* ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Necrosis ; Neurologic Manifestations ; Neurons ; Tunica Media

The intravenous administration of gadopentetate dimeglumine (GD) is relatively safe and rarely causes systemic toxicity in the course of routine imaging studies. However, the general safety of intrathecal GD has not been established. We report a very rare case of an overdose intrathecal GD injection presenting with neurotoxic manifestations, including a decreased level of consciousness, global aphasia, rigidity, and visual disturbance.
Adult ; Aphasia/etiology/pathology/physiopathology ; Brain/drug effects/pathology ; *Contrast Media/administration & dosage/toxicity ; *Gadolinium DTPA/administration & dosage/toxicity ; Humans ; *Injections, Spinal ; Male ; Muscle Rigidity/etiology/pathology/physiopathology ; *Neurotoxicity Syndromes/etiology/pathology/physiopathology ; Tomography, X-Ray Computed ; Vision Disorders/etiology/pathology

The authors describe a case of pseudoaneurysm arising from internal iliac artery presented with radiculopathy mimicking the symptoms of lumbar disc disease or spinal cord tumor. Among the several preoperative evaluation including CT, MRI, electrophysiologic study and ultrasonography, important diagnostic clue was obtained by ultrasonographic findings of turbulence flow at the core of partially enhanced mass in the pelvic cavity. The patient was managed with endovascular coil embolization successfully. The current case makes us remind that assessment of neurological symptoms on lower extremity should include consideration of extraspinal cause in pelvis.
Aneurysm, False* ; Embolization, Therapeutic ; Humans ; Iliac Artery* ; Lower Extremity ; Magnetic Resonance Imaging ; Pelvis ; Radiculopathy* ; Spinal Cord Neoplasms ; Ultrasonography