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RISS 인기검색어
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- 저자 : 김주평(Joo Pyung Kim) (검색결과 2 건)
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김주평(Joo Pyung Kim),박봉진(Bong Jin Park),임영진(Young Jin Lim) 대한두개저학회 2008 대한두개저학회지 Vol.3 No.2
Instruction : The most important factors for treatment of tuberculum sellae meningioma is complete resection of the tumor without provoking symptoms such as decreased visual acuity and visual field defect. We retrospectively analyzed patients with tuberculum sellae meningioma with regard to postoperative tumor control and visual outcomes. Material and Method : From 1994 to 2008, 17 patients with tuberculum sellae meningioma underwent surgical treatment. Mean age was 49.8 years, mean symptom duration was 12.5 months. The mean follow up period was 67.2 months. 13 patients underwent surgery through extradural anterior clinoidectomy with optic nerve decompression. Subfrontal approach was performed in 2 patients and orbitozygomatic approach in 2 patients. Result : Twelve patients presented with symptoms of optic nerve compression, and hypopituitarism symptoms in 1 patient. Four patients were found incidentally as tuberculum sellae meningioma. Ten patients who presented with visual acuity disturbance before operation, 6 with visual field defect and optic nerve atropy in 5 patient. Gross total resection was achieved in 13 patients. Simpson grade I in 1 case, grade II in 8 cases, grade III in 4 cases and subtotal resectionl in 4 cases. Of the 12 patients with preoperative optic nerve compression symptoms pre-operatively, 8 patients(66.7%) were improved and 4 were unchanged(33.3%). There were no further visual deteriorations for the patients with no visual disturbances before operations. Conclusion : We obtained good outcome via the extradural anterior clinoidectomy with optic nerve decompression. We think that this approach was suitable access to patients with visual deterioration and reduces the risk of intraoperative optic nerve injury.
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홍제범(Je Beom Hong),김한규(Han Kyu Kim),김주평(Joo Pyung Kim),장종희(Jong Hee Chang),문인석(In Seok Moon) 대한두개저학회 2017 대한두개저학회지 Vol.12 No.2
Background: The infratemporal fossa approach type A (ITFA-A) is a good approach for small jugular foramen tumors with a small extraforaminal cervical extension. On the other hand, the posterolateral approach to jugular foramen has been adopted to see the posterior aspect of the jugular foramen. For large tumors, we combined posterolateral approach with various otologic operations including ITFA-A, transcochlear approach and fallopian bridge technique. The purpose of this study is to evaluate the surgical adequacy of our approaches including postoperative complications and outcomes. Methods: From January 2014 to January 2017, we operated total 14 cases of jugular foramen tumors. We chose the surgical approach to these tumors based on their location and extent. And the facial nerve manipulation was added in combined approach in which facial nerve was dissected and transpositioned (3 cases) or remained in fallopian canal (fallopian bridge technique, 3 cases). Results: Grossly total resection was achieved in 12 patients (85.7%). Immediate postoperative lower cranial nerve deficit occurred in 10 patients (71.4%). Postoperative facial nerve paralysis and hearing impairment occurred in 4 patients (28.6%) and 6 patients (42.9%) respectively. Two-thirds of the jugular foramen could be exposed in the combined approach which enabled the complete removal of tumors regardless of the size at this area. Conclusion: Using skull base technique with thorough understanding of surrounding anatomic structures followed in wider exposure, gross total removal can be achieved by multidirectional approach under relative safety.
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