전정신경초종 환자의 자기공명영상을 이용한 내이도 수직 재구성 영상의 임상적 유용성

전범조(Beomcho Jun),장기홍(Kihong Chang),김동훈(Dong-Hoon Kim) 대한두개저학회 2012 대한두개저학회지 Vol.7 No.1

Introduction : In vestibular schwannoma, conventional temporal bone MRI is a useful tool of measuring the dimension and location of tumor. However, it is hard to get surgical information about relationship between the tumor mass and anatomical structures such as VII, VIII nerves and vessel. So we tried to confirm the clinical feasibility of perpendicular images to IAC in temporal bone MRI in a case of vestibular schwannoma. Material and methods : Temporal bone MR Imaging was obtained with T2 weighted three dimensional turbospin echo after contrast injection. The thickness of axial slices was 0.6mm and FOV(field of view) was 150x200. Reformatted images were achieved using threedimensional reconstruction software(Vworks 4.0tm) with 0.2mm thickness perpendicular to the axis of IAC from brainstem to the end of cochlear. Results : The reformatted image of IAC gave us information not only about the relationship between the tumor and vascular structure but also about the degree of tumor extent to the facial and cochlear nerve which expected to be preserved during the surgery. Additionally, in case of vascular loop, perpendicular image of IAC told us surgical information helpful to the prevention of unexpected severe bleeding during microsurgery. Conclusions : Reformatted perpendicular image to IAC gives us detail information about nerves and vascular structure in IAC, especially in case of moderate to small sized masses of vestibular schwannoma. However, in case of huge mass of vestibular schwannoma filling entire IAC, it is hard to discern the tumor from the nerves in the canal.

측두골 유양도출정맥의 형태와 임상적 특징

신은혜(Eunhye Shin),전범조(Beomcho Jun) 대한두개저학회 2016 대한두개저학회지 Vol.11 No.2

Introduction & object : Mastoid emissary vein (MEV) complex is one of the superficial venous systems of posterior neck. It could be a potential source of bleeding during flap elevation or might be an obstacle to bone work for hearing device surgery. The objective of this study is to evaluate the morphometric analysis of MEV complex using 3-d reconstruction of temporal bone CT. Materials & Method : From the normal adults TBCT aged from 20 to 60, twenty identifiable MEV cases without history of head trauma, otitis media, neurological disease, and skull surgery including mastoid surgery were evaluated. Morphometric parameter of MEV angle from sigmoid sinus, the length of MEV from the branch of sigmoid sinus to the bony aperture mastoid bone, distance from mastoid tip to the bony aperture of MEV, distance from asterion to the bony aperture of MEV, distance from asterion to mastoid tip, perpendicular length from bon aperture of MEV to the imaginary line which pass asterion and mastoid tip, perpendicular length from bon aperture of MEV to the imaginary temporal line. Conclusions : Preoperative evaluation of MEV is recommended for the retrosigmoid bone work or periosteal flap elevation. Three dimensional reconstruction of MEV might helpful for the imaginary information for the surgeon.

권역외상센터를 통해 의뢰된 측두골 골절 환자의 임상적 분석

전민채(Minche Jeon),전범조(Beomcho Jun),송선화(Sunwha Song) 대한두개저학회 2020 대한두개저학회지 Vol.15 No.2

Background : Early diagnosis and proper treatment of temporal bone fractures after an accident may be recommended. Methods : Forty patients who were diagnosed with a temporal bone fracture among patients who visited Uijeongbu St. Mary’s Hospital Regional Emergency Center were analyzed. Age and sex, cause of the accident, time delay to otolaryngology referral, accompanying diseases, treatment in the intensive care unit, whether or not cranial injuries and cerebral decompression were performed. Radiologic evaluation for the features of temporal bone fracture line was done. Fracture lines were classified from type I to type IV according to the regional involvement. Patient symptoms, hearing and the presence or absence of facial paralysis were also analyzed. Results : Traffic accidents and crashes were the main causes of accidents, and driver accidents and pedestrian accidents were among traffic accidents. The accompanying traumatic region was followed by the skullbase, extremities, face, chest and abdomen. In the regional evaluation of the fracture line on temporal bone, the number of cases of Type I-IV was 9, 19, 40, and 15 each. The mean air conduction of pure tone audiometry of trauma ear was 20.7 dB more decreased than healthy ear. The mean gap of air-bone conduction was 16.2 dB. The cases of facial paralysis were 5. The cases of House-Brackmann grading score (HBGS) II were 3 and HBGS III were 2. Conclusions : It is necessary to proper inform patients of symptom and complications that may occur after a fracture of the temporal bone and prepare for proper surgical treatment and rehabilitation.

일측 특발성 안면마비를 주소로 내원한 헤르페스 뇌염 환자 1예

박소희(Sohee Park),김효정(Hyojung Kim),전범조(Beomcho Jun) 대한두개저학회 2023 대한두개저학회지 Vol.18 No.1

Herpes simplex encephalitis (HSE) is a rare, but lethal infectious disease characterized by inflam-mation of the brain parenchyma. The annual incidence rate is reported as one case per 250,000- 500,000 population. Patients present with various non-specific symptoms including headache, fever, decreased consciousness and many other focal neurologic deficits, which often lead to difficult and delayed diagnosis. In the absence of proper management, prognosis is very poor with a mortality rate of about 70%. Here, we discuss about a case of HSE diagnosed after brain magnetic resonance imaging scan, who initially presented with facial paralysis with hearing loss and dizziness.

측두골 CT의 3차원 영상 합성을 이용한 외이도에 대한 S상 정맥동의 위치

김민주(Minju Kim),이승훈(Seunghoon Lee),장기홍(Kihong Chang),전범조(Beomcho Jun) 대한두개저학회 2013 대한두개저학회지 Vol.8 No.2

Background/Purpose : This study is for the evaluate the location of sigmoid sinus relating to the external auditory canal using three-dimensional (3D) reconstruction image of temporal bone CT. Methods : Twenty well pneumatized twenty temporal bone CT aged between 20 and 50 were selected. Three-dimensional reconstruction image were obtained with V-works 4.0 software program (Cybermed, Seoul, Korea) using axial scan of high-resolutional temporal bone CT. The horizontal length from suprameatal spine of Henle to anterior and posterior border of sigmoid sinus were measured. The horizontal length from bony inferior lateral external auditory canal to anterior and posterior border of sigmoid sinus were measured. The angle between horizontal suprameatal line and imaginary line acquired from two points which cross the center sigmoid sinus from above two horizontal lines was measured. The angle between bony inferior lateral external auditory canal and imaginary line acquired from two points which cross the center sigmoid sinus from above two horizontal lines was measured. Results : The mean horizontal length from suprameatal spine of Henle to anterior and posterior border of sigmoid sinus were 16.24mm(±3.5) and 26.31mm(±4.1). The mean horizontal length from bony inferior lateral external auditory canal to anterior and posterior border of sigmoid sinus were 17.97mm(±5.8) and 29.47mm(±4.3). The mean angle between horizontal suprameatal line and imaginary line acquired from two points which cross the center sigmoid sinus was 80.82˚(±14.0). The mean angle between bony inferior lateral external auditory canal line and imaginary line acquired from two points which cross the center sigmoid sinus was 90.53˚(±0.36). Conclusion : The preoperative well understanding of sigmoid sinus location gave us a imaginary hint which avoid massive bleeding or morbidity before otologic or neurosurgery.

실험적 고실개방술로 진단된 중이 강 내 부신경절종 1례

조예선(Yesun Cho),유수현(Su Hyun Yoo),강윤진(Yoon Jin Kang),전범조(Beomcho Jun) 대한두개저학회 2016 대한두개저학회지 Vol.11 No.2

Tympanic paraganglioma is the most common neoplasm in the middle ear. There are several distinctive signs and radiologic findings which is supportive to diagonosis. The most common initial symptom is pulsatile tinnitus. In this study, we present a case of the middle ear paraganglioma of a patient with tinnitus and hearing difficulty. We also discussed current surgical approach and precautions when diagnose and treatment of this tumor.