• Korean Journal of Head & Neck Oncology
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• v.32 no.2
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• pp.41-46
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• 2016

Sinonasal undifferentiated carcinoma (SNUC) is an extremely rare, highly aggressive malignancy of the nasal cavity and paranasal sinuses. Patients with SNUC usually being asymptomatic until the tumor has extensively progressed therefore frequently present with invasion of the orbit or cranial vault. Most case series of SNUC report very poor prognosis despite aggressive multimodality therapy. We recently experienced a 78-year-old male patient diagnosed as SNUC occurred from the left sphenoid sinus with invasion to the cavernous sinus and orbital content, which was treated intranasal endoscopic debulking surgery combined with curative radiation therapy successfully, and report this case with a review of literature.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.404-410
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• 2023

Large scalp defects resulting from high-voltage electrical burns require free flaps, preferably skin, to permit optimal coverage and enable future or simultaneous cranial vault reconstruction. The anterolateral thigh permits the harvest of a large area of skin supplied by a reliable perforator. The superficial temporal vessels offer the proximate choice of recipient vessels to enable adequate reach and coverage. The lack of a second vein at this site implies the inability to perform a second venous anastomosis; however, this obstacle can be overcome by using an interposition vein graft, to the neck veins primarily. This assures adequate venous drainage and complete flap survival.

• Archives of Craniofacial Surgery
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• v.14 no.2
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• pp.115-118
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• 2013

Craniosynostosis is a congenital anomaly in which cranial sutures close prematurely and restrict skull growth. In this paper, the case of two siblings, a male and a female, who were both diagnosed as craniosynostosis is reported. They underwent corrective osteotomy for cranial vault remodeling. A 22-month-old female infant who was brought to the department of plastic and reconstructive surgery of the authors' hospital was diagnosed with plagiocephaly. At the same time, her 7-month-old brother was diagnosed with brachycephaly. In the case of the female infant, corrective coronal osteotomy and supraorbital bar advancement were performed. Her brother underwent frontal advancement osteotomy using Tessier's tongue in the groove procedure. After the correction of the craniosynostosis, the two patients recovered in several days later, and the results were good in both cases cosmetically and functionally. They showed normal head circumference increasing curves and no symptom of functional disorder in their last follow-up. Isolated or nonsyndromic craniosynostosis is sporadic but mostly autosomal dominant. This paper presents a case of craniosynostosis with a genetic tendency; and although it occurred between siblings, the affected lesions differed. Thus, appropriate diagnosis and management in patients are needed.

• Archives of Craniofacial Surgery
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• v.17 no.4
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• pp.211-217
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• 2016

Background: Nonsyndromic craniosynostosis is a relatively common craniofacial anomaly and various techniques were introduced to achieve its operative goals. Authors found that by using smaller bone fragments than that used in conventional cranioplasty, sufficiently rigid bone union and effective regeneration capacity could be achieved with better postoperative outcome, only if their stable fixation was ensured. Methods: Through bicoronal incisional approach, involved synostotic cranial bone together with its surrounding areas were removed. The resected bone flap was split into as many pieces as possible. The extent of this 'multi-split osteotomy' depends on the degree of dysmorphology, expectative volume increment after surgery and probable dead space caused by bony gap between bone segments. Rigid interosseous fixation was performed with variable types of absorbable plate and screw. In all cases, the pre-operational three-dimensional computed tomography (3D CT) was checked and brain CT was taken immediately after the surgery. Also about 12 months after the operation, 3D CT was checked again to see postoperative morphology improvement, bone union, regeneration and intracranial volume change. Results: The bony gaps seen in the immediate postoperative brain CT were all improved as seen in the 3D CT after 12 months from the surgery. No small bone fragment resorption was observed. Brain volume increase was found to be made gradually, leaving no case of remaining epidural dead space. Conclusion: We conclude that it is meaningful in presenting a new possibility to be applied to not only nonsyndromic craniosynostosis but also other reconstructive cranial vault surgeries.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.594-606
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• 1996

This study was intended to perform the relationships between mandibualr lateral deviation in facial asymmetry patients and morphology of the cranial vault. In 30 patients(males 14, female 16) using submento-vertical cephalograms that were taken in the pre-operaticve state and posteroanterioir cephalograms that were taken in centric occlusion before, immediate and long term after surgery. 1. Mean mandibular deviation was about $-3.12^{\circ}$and mean of absolute measurement was about $2.50^{\circ}$on the submento-vertical cephalograms. 2. On the submento-vertical cephalograms, there was no significant difference between non-deviation and deviation side but it had tendency that deviation side was larger than non-deviation side on the frontal portion of cranium(Y10 to Y6) and deviation side was smaller than non-deviation on the temporal portion of cranium(Y5, Y-1 to Y-5). 3. Mean mandibular deviation was about $1.40^{\circ}$and mean of absolute measurement was about $3.95^{\circ}$on the posteroanterioir cephalograms. 4. There was statistical significance on the influence of surgical change(PT2A-PT1A) to the relapse(PTLA-PT2A)(p<0.05). The more increasing of the change, the more relapse on the posteroanterioir cephalograms. 5. There was no statistical significance on the influence of degree of mandibular deviation to morphology of the cranium on the submento-vertical cephalograms. But it had tendency that the more mandibular deviation, the larger the non-deviation side on the anterior cranium and deviation side on the posterior cranium(p>0.05). 6. There was statistical significance on the influence of the degree of mandibular deviation on the posteroanterioir cephalograms to the difference between non-deviation and deviation side. The more increasing of mandibular deviation, the larger the non-deviation side on the Y4 to Y-6(p<0.05). 7. There was no statistical significance on the influence of difference between non-deviation and deviation side to the relapse on the posteroanterioir cephalograms. But it had tendency that the more increasing of the differece between non-deviation and deviation side, the more increasing the relapse on temporal of cranium.

• Journal of Life Science
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• v.15 no.4 s.71
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• pp.668-672
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• 2005

Nasal tumors have been reported frequently in dogs and nasal discharge has been the primary presenting complaint in nasal tumor patients. A 10-year-old 7 kg male mixed breed dog was presented to the animal hospital for evaluation of severe bloody nasal discharge. After physical examination, blood examination and X-ray examination, magnetic resonance imaging (MRI) examination was also conducted. Based on MRI nasal tumor which does not extend cranial vault was diagnosed. The nasal tumor was confirmed as adenosquamous cell carcinoma by histopathological examination after necropsy. The invasive characteristics of the neoplasm were documented by MRI. MRI was very valuable diagnostic tool for identifying extracranial and intracranial tumor invasion in a small animal.

• Archives of Plastic Surgery
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• v.46 no.4
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• pp.365-370
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• 2019

The syndrome of the trephined is a neurologic phenomenon that manifests as sudden decline in cognition, behavior, and sensorimotor function due to loss of intracranial domain. This scenario typically occurs in the setting of large craniectomy defects, resulting from trauma, infection, and/or oncologic extirpation. Cranioplasty has been shown to reverse these symptoms by normalizing cerebral hemodynamics and metabolism. However, successful reconstruction may be difficult in patients with complex and/or hostile calvarial defects. We present the case of a 48-year-old male with a large cranial bone defect, who failed autologous cranioplasty secondary to infection, and developed rapid neurologic deterioration leading to a near-vegetative state. Following debridement and antibiotic therapy, delayed cranioplasty was accomplished using a polyetheretherketone (PEEK) implant with free chimeric latissimus dorsi/serratus anterior myocutaneous flap transfer for vascularized resurfacing. Significant improvements in cognition and motor skill were noted in the early postoperative period. At 6-month follow-up, the patient had regained the ability to speak, ambulate and self-feed-correlating with evidence of cerebral/ventricular re-expansion on computed tomography. Based on our findings, we advocate delayed alloplastic implantation with total vascularized soft tissue coverage as a viable alternative for reconstructing extensive, hostile calvarial defects in patients with the syndrome of the trephined.