• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.283-288
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• 1998

Recurrent meningitis in children is not only a potentially life threatening condition, but often involves the child in the trauma though repeated hospital admissions and multiple invasive investigations to find the underlying causes. Symptoms and signs of CSF rhinorrhea or otorrhea are infrequent in these patients and difficult to diagnose in young children. All young children treated for meningitis should then be administered an evoked potential audiometry as a post-treatment test. If sensorineural hearing loss is identified, the clinician should be alerted to the possibility of CSF leakage as the cause of the meningitis. Radiologic studies should be performed to rule out preexisting congenital, or acquired, abnormalities requiring surgical exploration. Two young children with recurrent meningitis due to a right cochlear aplasia and a cribriform plate defect caused by trauma are presented to illustrate the problems of diagnosis and management. A review of literatures will also be presented briefly.

• Journal of Veterinary Clinics
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• v.40 no.2
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• pp.139-146
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• 2023

Three dogs were referred with epistaxis and facial deformity. Computed tomography (CT) scan identified masses in the bilateral nasal cavity with soft tissue attenuation and contrast enhancement. These masses had caused adjacent bones lysis, especially lysis of cribriform plate that extended to the intracranial region. Base on histopathology and CT imaging results, tumors were diagnosed as nasal carcinomas at stage 4. Three dogs were treated with stereotactic radiation therapy (SRT). These dogs received 30-35 Gy from 3-5 daily treatments (7-10 Gy per treatment). The sizes of tumors decreased the most on follow-up CT images at one month after treatment. Recurrence was confirmed between 3 and 5 months after completing SRT. The survival time of dogs treated with SRT were 110, 190, and 210 days, respectively. This study confirmed that SRT could treat canine nasal carcinomas with cribriform plate lysis without causing serious radiation toxicities. Follow-up CT examination is considered at 1 month and 3 to 6 months after SRT to accurately evaluate the prognosis and the timing of recurrence.

• The Journal of Korean Society for Radiation Therapy
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• v.11 no.1
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• pp.53-59
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• 1999

The aim of this study is to improve the accuracy of field placement and junction between adjacent fields and block shielding through the use of a computed tomography(CT) simulator and virtual simulation. The information was acquired by assessment of Alderson Rando phantom image using CT simulator (I.Q. Xtra - Picker), determination of each field by virtual fluoroscopy of voxel IQ workstation AcQsim and colored critical structures that were obtained by contouring in virtual simulation. And also using a coronal, sagittal and axial view can determine the field and adjacent field gap correctly without calculation during the procedure. With the treatment planning by using the Helax TMS 4.0, the dose in the junction among the adjacent fields and the spinal cord and cribriform plate of the critical structure was evaluated by the dose volume histogram. The pilot image of coronal and sagittal view took about 2minutes and 26minutes to get 100 images. Image translation to the virtual simulation workstation took about 6minutes. Contouring a critical structure such as cribriform plate, spinal cord using a virtual fluoroscopy were eligible to determine a correct field and shielding. The process took about 20 minutes. As the result of the Helax planning, the dose distribution in adjacent field junction was ideal, and the dose level shows almost 100 percentage in the dose volume histogram of the spinal cord and cribriform plate CT simulation can get a correct therapy area due to enhancement of critical structures such as spinal cord and cribriform plate. In addition, using a Spiral CT scanner can be saved a lot of time to plan a simulation therefore this function can reduce difficulties to keep the patient position without any movements to the patient, physician and radiotherapy technician.

• Anatomy and Cell Biology
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• v.56 no.2
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• pp.179-184
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• 2023

The Functional endoscopic sinus surgery through transnasal approach is a common modality of treatment for disorders of the nasal cavity, paranasal air sinuses as well as cranial cavity. The olfactory fossa (OF) is located along the superior aspect of cribriform plate which varies in shape and depth. This variable measurement of the depth of OF is mostly responsible for greater risk of intracranial infiltration during endoscopic procedures in and around the nasal cavity. The morphology of frontal and ethmoid sinus (ES) vary from simple to complex. This cadaveric study is planned to improve the ability of the otolaryngologist, radiologist to understand the possible morphological variations and plan steps of less invasive "precision surgery" to have a safe and complication free procedures. A total of 37 human head regions were included in the study. For classification of OF, Modified Kero's classification was used. The size, shape and cells of frontal and ES were noted. We found, type II (60.8%) OF was more common followed by type I (29.7%) than type III (9.5%). The shape of frontal sinus was comma shaped (55.4%) followed by oval (18.9%) than irregular (16.2%). Most common two cells type of ES was seen in 50.0% of both anterior and posterior ES. Out of 74 ES, 8.1% of Onodi cells and 14.9% of agger nasi cells were seen.

• Journal of Korean Neurosurgical Society
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• v.39 no.2
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• pp.156-158
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• 2006

We present a case of olfactory schwannoma in a 16-year-old boy with headache and diplopia. Brain computed tomography[CT] scan and magnetic resonance[MR] imaging showed a huge mass in the subfrontal area resembling an olfactory groove meningioma. We performed a bifrontal craniotomy and found out the mass was attached to cribriform plate but was not related to the olfactory tract or bulb. The histopathological diagnosis of schwannoma was confirmed by immunohistochemical staining for S-100, vimentin and others. We describe the clinical manifestations, radiological characteristics, histological aspects, and differential diagnosis of this tumor with literature review.

• Korean Journal of Veterinary Research
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• v.48 no.3
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• pp.369-374
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• 2008

A neutered male, 8-year-old, Pekingese, weighing 4.3 kg with a history of anorexia, sneezing, nasal discharge, and epistaxis for one month was referred. Soft tissue swelling around the nasal bone and small defects of the hard palate with a tiny round dark red mass were found on physical examination. The laboratory tests represented mild leukocytosis. On skull radiographs, soft tissue swelling and osteolytic change of the incisor bone, nasal bone, and maxilla were found. On computed tomography scan images, there was soft tissue attenuating opacity with calcified spots in the bilateral nasal cavities and frontal sinuses. Loss of nasal turbinate pattern and nasal septum was found. And destruction of the insicor bone, nasal bone, maxilla, hard palate, perpendicular palatine bone, and cribriform plate were identified. Nasal malignant melanoma was confirmed by nasal biopsy.

• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.232-238
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• 2021

Background: Galeal or temporalis muscle flaps have been traditionally used to reconstruct skull base defects after tumor removal. Unfortunately, these flaps do not provide sufficient vascularized tissue for a dural seal in extensive defects. This study describes the successful coverage of large skull base defects using anterolateral thigh (ALT) free flaps. Methods: This retrospective study included five patients who underwent skull base surgery between June 2018 and June 2021. Reconstruction was performed using an ALT free flap to cover defects that included the intracranial space and extended to the frontal sinus and cribriform plate. Results: There were no major complications, such as ascending infections or cerebrospinal leakage. Postoperative magnetic resonance imaging showed that the flaps were well-maintained in all patients. Conclusion: Successful reconstruction was performed using ALT free flaps for large anterior skull base defects. In conclusion, the ALT free flap is an effective option for preventing communication between the nasal cavity and the intracranial space.

• Journal of Veterinary Clinics
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• v.23 no.3
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• pp.361-365
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• 2006

A spayed female, 5-year-old, weighing 2.7 kg, domestic short hair cat was referred to Veterinary Medical Teaching Hospital, Seoul National University. The clinical signs of this patient were weight loss, sneezing, respiratory distress, nasal discharge, epistaxis, ocular discharge, left exophthalmos, and left facial edema and deformity. The laboratory tests represented mild leukocytosis. On the skull radiographs, soft tissue density filled nasal cavity with loss of turbinate detail was found. Destructive and lytic changes of the left nasal bone with soft tissue swelling were identified. On the thorax radiographs, there were a tracheobronchial lymph node swelling and a soft tissue round mass in the left caudal lung field. On computed tomographic scan images, asymmetrical destruction of turbinate and nasal septum and increased soft tissue opacity in the nasal cavity were identified. Destruction of the lateral maxillary bone, invasion to the left retrobulbar region, and craniodorsal deviation of the left eye were seen. Also, there was lysis of hard palate and cribriform plate. Invasion to the brain was found. The patient was diagnosed as nasal lymphoma by cytology and histopathology.

• Journal of Veterinary Clinics
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• v.23 no.3
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• pp.355-360
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• 2006

Four dogs with similar respiratory signs were referred to Veterinary Medical Teaching Hospital, Seoul National University. The clinical signs observed in these cases were anorexia, nasal discharge, sneezing, epistaxis, ocular discharge, and exophthalmoses. The routine laboratory tests revealed leukocytosis in two cases. On the skull radiographs, soft tissue density filled nasal cavity with loss of turbinate detail and increased density in frontal sinuses were found in all cases. Lysis of nasal bone was seen in two cases. Lysis of zygomatic arch was seen in one case. On computed tomography scan images, asymmetrical destruction of turbinate and nasal septum, and the superimposition of a soft tissue mass over the turbinate with peripheral contrast enhanced effect were identified in all cases. Destruction of ipsilateral orbital bone and invasion to retrobulbar region were visualized in all cases. In addition, all cases had lysis of cribriform plate. Lysis of nasal bone and destruction of hard palate were seen in two cases. Swelling of submandibular lymph node and salivary gland was seen in a case. Invasion to brain was identified in a case. All cases were diagnosed as nasal adenocarcinoma by cytology with fine needle aspiration and curettage.

• Journal of Veterinary Clinics
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• v.33 no.3
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• pp.168-171
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• 2016

Signalment: An 8-month-old female Alaskan malamute was presented for progressive cluster seizure disorder. Results: There were no abnormalities on neurological examination, survey radiographs, or blood analysis. Magnetic resonance (MR) imaging and computed tomography revealed extension of the olfactory bulb and frontal lobe into the nasal cavity. They also confirmed abnormal anatomy of the nasal turbinates within the rostral part of the nasal cavity and the absence of a cribriform plate. On T2-weighted and fluid-attenuated inversion recovery images, the herniated brain showed heterogeneous and hyperintense signals consistent with intraparenchymal edema. Transverse MR images showed brain herniation into the right frontal cavity and an asymmetrical lateral ventricle because of a left midline shift. On contrast-enhanced MR images, the protruding brain parenchyma was mildly enhanced. Ethmoidal encephalocele was suspected as the final diagnosis. Despite symptomatic treatment, the dog continued to exhibit seizures and was euthanized. Clinical relevance: Ethmoidal encephalocele is a rare disease in dogs. However, it could be considered as a cause of seizure in young dogs.