Clinical Study on the Reliable Temporal Bone Fracture Classification Scheme / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Until now, the temporal bone fracture patient has been classified mostly according to the classic definition of transverse or longitudinal one, but it is often obscure and has problems of discrepancy in correlation with otologic symptoms. So we investigated the practicality of other noticeable reporting schemes for reasonable adoption. SUBJECTS AND METHOD: We thoroughly reviewed the medical records of the temporal bone fracture patients in past two years. And high resolution CT images were also re-evaluated by the senior radiologist using traditional and newer (otic capsule sparing vs. otic capsule violating, petrous vs. nonpetrous) classification schemes. RESULTS: A total of 61 cases were identified as temporal bone fracture. Among various symptoms, only sensorineural hearing loss was significantly higher in the transverse type of traditional scheme and in otic capsule violating fracture. Symptoms such as subjective and verified hearing loss including conductive hearing loss and ear fullness were higher in nonpetrous fracture (p<0.05). CONCLUSION: Traditional and otic capsule scheme correlated poorly with clinical presentation, whereas the petrous classification was better matched with main symptoms. Therefore, the petrous scheme was suggested as the more discriminative classification plan of temporal bone fracture to predict its sequela.

The Significance of a Hypoplastic Bony Canal for the Cochlear Nerve in Patients with Sensorineural Hearing Loss: CT and MRI Findings

PURPOSE: The purpose of this study is to evaluate the significance of the hypoplastic canal for the cochlear nerve in patients with sensorineural hearing loss (SNHL) and the relationship between the hypoplastic bony canal and aplasia or hypoplasia of the cochlear nerve. MATERIALS AND METHODS: A retrospective review of high resolution temporal CT(HRCT) and MRI findings was conducted. The narrow bony canal of the cochlear nerve and the relative size of the internal auditory canal were correlated with the cochlear nerve deficiency on MRI. The comparative size of the component nerves (facial, cochlear, superior vestibular, inferior vestibular nerve), and the relative size of the internal auditory canal and the bony canal of the cochlear nerve were measured. The clinical history and the results of the clinical examination were reviewed for each patient. RESULTS: High resolution MRI showed aplasia of the common vestibulocochlear nerve in one patient and a deficiency of the cochlear nerve in 9 patients. These abnormalities occurred in association with a prominent narrowing of the canal for the cochlear nerve and a stenosis of the internal auditory canal, which was observed on temporal bone CT in 9 patients with congenital SNHL. Three patients had normal IAC, despite the presence of a hypoplastic cochlear nerve on the side on which they had SNHL. In one patient, the narrowing of the canal for the cochlear nerve and internal auditory canal were not found to be associated with acquired SNHL. CONCLUSION: The hypoplastic bony canal for the cochlear nerve might be more highly indicative of congenital cochlear nerve deficiency than that of the narrow internal auditory canal, and the position of the crista falciformis should also be carefully.

A Case of Medullomyoblastoma of Cerebellopontine Angle Mimicking Acoustic Neuroma

Medulloblastoma is a common malignant central nervous system neoplasm found mainly in children. One the contrary, medulloblastoma of the cerebellopontine angle, the location of the tumor is very unusual. This is the the first case of the medullomyoblastoma, a rare form of medulloblastoma, occurring in the cerebellopontine angle. A 15-year-old boy experienced a sudden hearing loss in the left ear. Conservative medical treatment failed, and temporal MR imaging revealed a heterogeneously enhancing mass at the left cerebellopontine angle cistern and in the internal auditory canal; therefore, the lesion was regarded as a typical acoustic neuroma. Few days before surgery, an ipsilateral facial palsy developed, and a follow-up MR imaging showed a rapid growth of the previous lesion. The extended translabyrinthine approach permitted surgical removal. And under pathological diagnosis of malignancy, radiation therapy and series of chemotherapy was performed.

A Case of Cavernous Lymphangioma of the Mediastinum in Adult / 결핵

Lymphangiomas in the mediastinum are rare beningn tumors, characterized by proliferating lymphatic vessels. They are usually found in children and young adults, but rarely in older adults. Most are located in the neck, with less than 1 percent found in the mediastinum, with mediastinal lymphangiomas comprising 0.7-4.5 percent of all tumors in this location. They are often classified pathologically according to the size of the cystic spaces within them, as simple or capillary, cavernous and cystic, or just cystic, hygromas, Of the 3 types above, the cavernous type of mediastinal lymphangioma is very rare.We report a case of a mediastinal lymphangioma of the cavernous type that was confirmed from pathological findings, a CT and MRI scan.

Emphysematous Cystic Pulmonary Metastasis of Angiosarcoma

Pulmonary metastatic angiosarcoma usually reveals multiple nodular lesions associated with parenchymal hemorrhage. It is presented, in rare cases, as multiple emphysematous cystic lesions, complicated by pneumothorax. We experienced a case of pulmonary metastastasis from angiosarcoma of the scalp in a 58-year-old male showing multiple thin-walled emphysematous cystic lesions. The tumor cells spread along the subpleural and interlobular septa, focally surrounding the cystic lesions. This case suggests that a rare metastatic pattern seen in angiosarcoma of the scalp should be considered as a differential diagnosis of bullous emphysematous lesion.

Sinonasal Tuberculosis: Report of Two Cases Demonstrated with CT

Tuberculous infections of the nasal cavity and paranasal sinuses are rare, as are descriptions of their radiologic findings, including those of CT. The authors recently encountered two cases of tuberculosis which developed in the paranasal sinus and the nasal cavity. Both were diagnosed by means of tissue biopsies taken from the mucosa of the maxillary sinus during endoscopic sinus surgery and Caldwell-Luc 's operation, respectively. In one case biopsy revealed caseous epitheloid granuloma, shown on histopathological examination to be consistent with tuberculosis. The other case involved a patient with pulmonary tuberculosis, in which nasal biopsy showed the presence of chronic granulomatous inflammation. In both cases CT scanning revealed a heterogeneous enhanced soft tissue mass in the paranasal sinus and nasal cavity, and associated findings consisting of surrounding bony thickening of the maxillary sinus and focal bony erosion or destruction were noted. CT findings of the latter showed prominent mass extension to the skull base, which was difficult to differentiate from the tumorous condition of the sinonasal cavity. After taking antituberculous medication for about two months, both patients showed substantial improvement.

Radiographic Features of Tuberculous Osteitis in Greater Trochanter and Ischium

PURPOSE: To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. MATERIALS AND METHODS: We retrospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involvingthe greater trochanter and ischium. In each case, the following were analyzed : morphology of bone destruction, including cortical erosion; periosteal reaction ; presence or abscence of calcific shadows in adjacent softtissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. RESULTS: Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. Inaddition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. CONCLUSION: Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that the selesions result from an extrinsic pathophysiologic cause such as adjacent bursitis.

MR Findings of Laryneal Cancer: Pathologic Correlation

PURPOSE: MRI is known to display the anatomy of the larynx in excellent detail with its remarkable soft tissue delineation and multiplanar imaging capability. We evaluate the accuracy of MRI in diagnosis and staging of laryngeal cancer MATERIALS AND METHODS: Sixteen cases with pathologically proved squamous cell carcinoma of the larynx were reviewed, retrospectively. The examination was performed with a 0.5 T superconductive MR system and C1 surface coil. Axial, sagittal and coronal plane with T1WI(TR/TE 450/20) and T2WI(TR/TE 18OO/80) were done. RESULTS: Eleven cases with glottic cancer(5 Tla, 3 Tlb, 1 T3 and 2 T4) and 5 cases with supraglottic cancer (1 T1, 1 T3 and 1 T4) were included. Cancer tissue showed intermediate signal intensity on TIWI and high signal intensity on T2Wl. Among 16 cases, 13 cases were correctly staged and 3 cases were overstaged due to edema caused by previous biopsy, partial volume averaging effect of abutted lesion, or surrounding inflammation. CONCLUSION: MRI is an useful modality for diagnosis of laryngeal cancer, especially in evaluation of paraglottic extention on coronal image and cartilage invasion.

67Gallium scan findings in miliary tuberculosis / 대한핵의학회잡지

No abstract available.

Radiological evaluation of G-I tract diverticulum in Korean

We reviewed 887 cases of esohagogram, 8863 cases of UGI series, 174 cases of small bowel series and 1926 casesof double contrast barium enema performed at the department of Radiology, Wonju College of Medicine from Jan. 1982 to Dec. 1984 to analyzed diverticula disease pattern of the GI tract in Korean. The results were as follows: 1.Esophageal diverticula The incidence was 3.27% and the sex ratio of male to female was 2.22:1 Age distribution wasrelatively even and most common in 5th decade. Most of them showed single in number, above 6mm sized and common inmiddle one third of both lateral side of esophagus. 2. Stomach diverticula The incidence was 0.07% and the sexratio of male to female was equal. Multiplicity was single in all cases. Most of them were above 11mm sized andcommon in gastric fundic area of greater curvature site of stomach. 3. Duodenal diverticula The incidence was1.51% and relatively even distribution in sex and age and common in after 5th decade. Most of them showed singlein number, 11-30mm sized and common in medial margin of 2nd portion of duodenum. 4. Colonic diverticula Theincidence was 2.34% and predominant in male and common in 5th. and 6th. decade. Most of them showed single innumber, below 5mm sized and common in right sided colon.