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Intraorbital Cysticercosis Treatment with Lateral Orbitotomy.

Seung Jaee LEE ; Dae Hwan PARK ; Chul Hong SONG

Journal of the Korean Cleft Palate-Craniofacial Association.2005;6(1):98-102.

A 33-year-old female from Uzbekistan visited our hospital with symptoms of right blurred vision, ocular pain which were exacerbated by ocular movement, and exophthalmosis for 2 months. Preoperative facial CT scan showed 3.2x2.4cm-sized cystic mass at the right retrobulbar area. The mass was located at temporal aspect of retrobulbar area and displaced optic nerve medially. Right eyeball was anteriorly displaced at the degree of 7mm than left one and intra-ocular pressure was raised as 32 mmHg compared with left one which estimated at 15 mmHg. Removal of cytic mass was performed using lateral orbitotomy. After incision was made through Stellard- Wright incision, dissection was done to lateral outer orbital periosteum then the periosteum each side of lateral orbit were dissected for lateral orbitotomy. Removal of lateral orbital wall, which was enough to removal cystic mass, by lateral orbitotomy, was done then lateral rectus muscle was divided without cutting. Cystic mass could be resected after lateral rectus muscle was divided and resected lateral orbital bone piece was re-located and fixed by absorbable miniplate. A satisfactory result could be obtained by this procedure. Postoperative intra-ocular pressure was lowerd as 15mm Hg and exophthalmosis was corrected at the degree of 1mm on Hertel's exophthalmometery and visual acuity improved at the degree of 1.0 on optomety compared with preoperative one which estimated 0.04. Preoperative symptoms such as ocular pain, foreign body sensation, headache were disappeared without any complication just like retrobulbar hemorrhage, infection etc.
Adult ; Cysticercosis* ; Female ; Foreign Bodies ; Headache ; Humans ; Optic Nerve ; Orbit ; Periosteum ; Retrobulbar Hemorrhage ; Sensation ; Tomography, X-Ray Computed ; Uzbekistan ; Vision, Ocular ; Visual Acuity

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Clinical Two Cases of an Angiosarcoma on the Scalp.

Se Jin KIM ; Jong Hwan KIM ; In Pyo HONG

Journal of the Korean Cleft Palate-Craniofacial Association.2005;6(1):93-97.

Angiosarcoma is very rare malignant tumor originated from endothelial cells. Angiosarcoma has four clinical types that are in the scalp and face of old age people, in chronic lymphedema, in irradiating therapy and in malignant proliferative angioendothelioma. We report two cases of angiosarcoma developed in the scalp. A 66-year-old male in whom angiosarcoma developed in the occipital area. The lesion was 4.0x4.5cm sized dark-red colored, ill-defined mass. We performed wide excision with partial removal of outer table of skull, and subsequently covered with local flap and split-thickness skin graft. There was an evidence of metastasis to the lung, rib and lumbar vertebral area after postoperative 8 months. The patient died in 11 months after operation due to metastasis to the lung. A 79-year-old male patient with similar history; lesions in the left frontal scalp(4.5x5.0cm), left temporal area (3.5x5.0cm) were brownish, and ulcer was noted in the left temporal scalp lesion. We performed wide excision with partial removal of outer table of skull, and subsequently covered with superficial temporalis fascia rotation flap and split-thickness skin graft. Postoperatively the patient underwent radiotherapy for recurrence prevention, but the patient died in 7 months after operation due to metastasis to the lung and liver. The prognosis of angiosarcoma is very poor because of frequent local recurrence and early metastasis. Important factors to consider in prognosis are the size of mass and prompt surgical excision.
Aged ; Endothelial Cells ; Fascia ; Hemangiosarcoma* ; Humans ; Liver ; Lung ; Lymphedema ; Male ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Recurrence ; Ribs ; Scalp* ; Skin ; Skull ; Transplants ; Ulcer

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A Case of Malignant Proliferating Trichilemmal Tumor with Spindle Cell Carcinoma.

Won Suk CHOI ; Tae Bum KIM ; Wang Kwang HONG ; Wan Suk YANG ; Bong Soo BAIK ; Sun Yung KIM

Journal of the Korean Cleft Palate-Craniofacial Association.2005;6(1):89-92.

Proliferating trichilemmal cyst(proliferating trchilemmal tumor, PTC) most commonly occurs in the scalp and is generally benign. Malignant transformation of PTC is rare, and the appearance of a spindle cell(sarcomatoid) carcinoma is extremely rare. The authors experienced a case of malignant proliferating trchilemmal tumor with spindle cell carcinoma on the scalp in a 41-year-old male. The tumor was widely resected and covered with split thickness skin graft after Terudermis(R) graft. Imaging studies and fine needle aspiration cytology showed no regional lymph node involvement or distant matastasis.
Adult ; Biopsy, Fine-Needle ; Humans ; Lymph Nodes ; Male ; Scalp ; Skin ; Transplants

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Nonspecific Traumatic Carotid-Cavernous Fistula Presented as Naso-Orbital Mass.

Eun Soo PARK ; Young Mann LEE ; Yong Bae KIM

Journal of the Korean Cleft Palate-Craniofacial Association.2005;6(1):85-88.

Traumatic carotid-cavernous fistulae(TCCF) are rare but can cause potentially lethal complications such as visual loss and subarachnoid hemorrhage after craniomaxillofacial trauma. This represents aberrant vascular communication in skull base between the carotid artery system and the venous channels within the cavernous sinuses of a sphenoid bone. The symptoms are mostly related with ophthalmic problems such as pulsatile proptosis, chemosis, and diplopia. The standard diagnostic method is cerebral angiography. CT and MRI can be also useful. The main current treatment is endovascular detachable balloon occlusion. The clinicians who treat patients with craniofacial injuries should have complete understandings of this pathological entity, so that early diagnosis and urgent intervention can be done to avoid serious complications and to get successful results. We report the experience of treating a 25-year-old female with nonspecific traumatic carotid-cavernous fistula presented as naso-orbital mass using intravascular detachable balloon catheter embolization.
Adult ; Balloon Occlusion ; Carotid Arteries ; Catheters ; Cavernous Sinus ; Cerebral Angiography ; Diplopia ; Early Diagnosis ; Exophthalmos ; Female ; Fistula* ; Humans ; Magnetic Resonance Imaging ; Skull Base ; Sphenoid Bone ; Subarachnoid Hemorrhage

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Clinical Experience of Malignant Fibrous Histiocytoma in Maxillary Sinus.

Seung Oh HAN ; Seok Chan EUN ; Suk Joon OH ; Young Soo RHO

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):93-97.

Malignant fibrous histiocytoma is a connective tissue tumor containig fibroblast-like cells and histiocyte. It is one of the most common types of soft tissue sarcoma of late adult life but, the involvement of head and neck area is relatively rare. Although adequate modalities of treatment is performed, the prognosis of the tumor itself is not clear. Because of its highly malignant property and, as in cases of other regions of the body, devastating result would occur and aggressive treatment is required. Malignant fibrous histiocytoma shows variable histologic appearance, and may be classified into several subtypes(storiform- pleomorphic, myxoid, giant cell, inflammatory, angiomatoid) and the storiform-pleomorphic type is the most common type. The authors have recently experienced a case showing good clinical result to the present, after total maxillectomy and split thickness skin graft and postoperative radiotherapy(6400cGy) in the malignant fibrous histiocytoma involving the right maxillary sinus, so report this case with a review of literature.
Adult ; Connective Tissue ; Giant Cells ; Head ; Histiocytes ; Histiocytoma ; Histiocytoma, Malignant Fibrous* ; Humans ; Maxillary Sinus* ; Neck ; Prognosis ; Sarcoma ; Skin ; Transplants

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A Case of Basal Cell Nevus Syndrome with Symmetric Basal Cell Carcinomas on Neck.

Sae Hwan KIM ; Han Koo KIM ; Seung Han KIM ; Seung Hong KIM ; Tae Jin LEE

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):89-92.

Basal cell nevus syndrome is an autosomal dominant disorder characterized by developmental and skeletal anomalies, palmo-plantar pits, odontogenic keratocysts, ectopic calcification, and occurrence of various types of tumors including basal cell carcinoma. Within our country, 9 cases at dentistry and 3 cases at dermatology were reported. The patient was a 66-year-old woman. Chief complaint was multiple dark brownish colored papules which were symmetrically distributed around the neck. Excision and biopsy were done under general anesthesia and the wound was healed without complication. Histological examination of the lesion revealed 'basal cell carcinoma'. During the evaluation of metastasis of basal cell carcinoma, at PNS CT we found odontogenic keratocyst on the left alveolar process of maxilla by accident. Physical examination revealed pits of the palm and sole. These are consistent with the major diagnostic criteria for basal cell nevus syndrome. Hereby we report one case of basal cell nevus syndrome.
Aged ; Alveolar Process ; Anesthesia, General ; Basal Cell Nevus Syndrome* ; Biopsy ; Carcinoma, Basal Cell* ; Dentistry ; Dermatology ; Female ; Humans ; Maxilla ; Neck* ; Neoplasm Metastasis ; Odontogenic Cysts ; Physical Examination ; Wounds and Injuries

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A Case of Scalp Angiosarcoma.

Jong Gu KIM ; Duck Ho KO ; Nam Hoon KIM ; Chang Hoon JEONG

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):86-88.

Angiosarcoma is very rare but highly malignant soft tissue tumor derived from the vascular endothelium. This tumor is most commonly found in the skin and subcutaneous tissues. Angiosarcoma is known to cause early and widespread metastasis leading to a very poor prognosis of less than 24 months. We report a case of angiosarcoma developed in the temporoparietal scalp of a 84-year-old man. The patient was referred for us consultation after failed systemic antibiotic treatment, incision drainage treatment for "cellulitis" by the general physician. We performed excision and biopsy. The histologic finding of the lesion showed that irregular, complex vascular channels in dermis. The tumor cells were positive for Factor VIII-related antigen. The lesion was confirmed as cutaneous angiosarcoma. We recommended a radical surgery and reconstruction followed by adjuvant radiation, but the patient refused. The patient was expired 2 months thereafter because of a massive hemorrhagic pleural effusion by suspicious distant metastasis. Authors reported important aspects of clinical findings, histologic features and therapeutic options of the scalp angiosarcoma.
Aged, 80 and over ; Biopsy ; Dermis ; Drainage ; Endothelium, Vascular ; Hemangiosarcoma* ; Humans ; Neoplasm Metastasis ; Pleural Effusion ; Prognosis ; Scalp* ; Skin ; Subcutaneous Tissue ; von Willebrand Factor

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Parapharyngeal Second Branchial Cleft Cyst Extending to the Skull Base: A Lateral Transcranial Infratemporal fossa Approach.

Sang Yoon KANG ; Kyu Sang YANG ; Jung Yong AHN ; Jun PARK ; Sang Hun CHO

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):82-85.

Branchial cleft cysts, sinuses, and fistulae are classified as first, second, third and fourth branchial cleft anomalies. They represent the congenital anomalies resulting from defects in the normal maturation of the branchial apparatus. Second branchial cleft anomalies occur more commonly than other branchial cleft anomalies. Most branchial cysts from the second branchial cleft are found deep in the sternocleidomastoid muscle or along its anterior border. Recognizing and diagnosing lateral neck cysts correctly are not difficult for an expert physician, although an unusual localization may cause problems in differential diagnosis. Complete excision of branchial cleft cysts is necessary to avoid recurrence. Approaches to the lesions are depending on the location and extent of the lesion. This article presents an unusual case of parapharyngeal branchial cleft cyst extending the skull base. Excision of the lesion was achieved via the lateral transcranial infratemporal fossa approach with zygomato-temporal craniotomy. This approach provides access not only to all of the subcranial tissues that underlie the middle cranial fossa, but to the maxillary or sphenoid sinus.
Branchial Region* ; Branchioma* ; Cranial Fossa, Middle ; Craniotomy ; Diagnosis, Differential ; Fistula ; Neck ; Recurrence ; Skull Base* ; Skull* ; Sphenoid Sinus

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A Case of Primary Malignant Lymphoma of the Parotid Gland.

Kyu Sang YANG ; Sang Yoon KANG ; Jeong Yun SHIM ; Jun PARK ; Sang Hun CHO

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):77-81.

The malignant lymphoma originating in the parotid gland is relatively rare, constituting 0.3% of all reported malignancies. Malignant lymphoma is a neoplastic proliferation of cell in the lymphoreticular system and devided as Hodgkin's disease and non-Hodgkin's lymphoma. Non-Hodgkin's lymphoma occurs primarily in lymph nodes and is rarely found in extralymphatic organs. In general, malignant lymphoma originating in the parotid gland is histologically described as non- Hodgkin's lymphoma, frequently belongs to the B-cell type and rarely relapses into other sites. Recently, we have experienced a malignant lymphoma in the left parotid gland. It was diffuse large B-cell type, stage I. In the imaging examination, exhibited homogeneity of the tumor. It was well defined margin and no infiltration into the adjacent tissue. The patient underwent superficial parotidectomy and combination chemotherapy with CHOP-regimen. He have been followed for 6 months and no relapse occurred. We report this case with a brief review of literature.
B-Lymphocytes ; Drug Therapy, Combination ; Hodgkin Disease ; Humans ; Lymph Nodes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Parotid Gland* ; Recurrence

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Correction of Constricted Ear.

Joo Hwan LIM ; Tai Kyun IM ; Ra Yong KO ; Jang Deog KWON ; Kap Sung OH

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):71-76.

The constricted ear was suggested by Tanzer for the purpose of obviating the confusion involving lop ear, cup ear and prominent ear as defect whose helix turns down, and scapha and fossa triangularis are narrowed. The constricted ear has a spectrum of severity and therefore, requires a graded surgical approach. Tanzer has described the degree of deformities of the constricted ear as falling into three groups. For the correction of constricted ear, there are numerous techniques but we have had difficulties in adopting these techniques in various type. We also describe the various constricted ear as the Tanzer's classification and adopted three methods to each type, banner flap(group I), concha cartilage graft (group II) and rib cartilage graft(group III) for reducing postoperative deformity and confusion in correcting the ear deformities. Constricted ear repairs must be individualized to accomodate each specific deformity. We corrected 22 cases of constricted ear in 20 patients using each optimal method described above according to the degree of deformities. Mild deformities need only reshaping and adjusting of existing tissues, moderate deformities need additional skin and severe deformities require a cartilage graft. For correction of constricted ear, accurate identification of the severity of deformity is essential. The results were satisfactory and we report our experience with relative literatures.
Cartilage ; Classification ; Congenital Abnormalities ; Ear* ; Humans ; Ribs ; Skin ; Transplants

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