Showing papers by "Hee-Won Jung published in 1999"

Neurenteric cyst: its various presentations.

Abstract: Neurenteric (NE) cyst is an uncommon developmental lesion lined with epithelium of endodermal origin. To investigate the clinical manifestation and response to surgery, we retrospectively analyzed eight cases of NE cyst that has been confirmed by surgery. Four were in children. The duration of follow-up ranged from 2 to 105 (mean 38) months. One cyst was in the ventral portion of the posterior cranial fossa and the other seven were on the spinal cord. The chief complaints were motor weakness (5), pain (2), and voiding difficulty (1). In one child and three adults, the duration of symptoms was more than 3 years. Children tended to show rapid progression and excellent recovery after surgery. Although total removal of cyst was possible only in two cases, there was no recurrence. The presentation of an NE cyst may be insidious. Clinical suspicion is important for an early diagnosis and better outcome. Because of the benign course after subtotal excision, too-aggressive removal of the lesion should be avoided.

Jugular Foramen Schwannomas: Surgical Approaches and Outcome of Treatment

Abstract: Twelve cases of schwannomas of the jugular foramen that involved surgery in our department between 1983 and 1997 are described. Eight were women and 4 were men (mean age, 40 years), and the duration of their symptoms, the most predominant of which were hearing loss and tinnitus, ranged from 1 month to 20 years (median, 8.5 months). Depending on their radiological and surgical features, tumors were classified as type A, a tumor primarily at the cerebellopontine angle with minimal enlargement of the jugular foramen (n = 5); type B, a tumor primarily at the jugular foramen with or without intracranial extension (n = 4); type C, a primarily extracranial tumor with extension into the jugular foramen (n = 0); or type D, a dumbbell tumor with both intracranial and extracranial components (n = 3). A retrosigmoid suboccipital craniectomy (RSSOC) was performed for type A tumors; for types B and D, the RSSOC or staged infratemporal fossa approach (ITFA)/RSSOC was used. Total removal was achieved in 6 cases, near total removal in 3, and subtotal removal in 3. The most common complication was lower cranial nerve dysfunction (n = 5). The follow-up period ranged from 6 to 173 (mean, 48) months, and there was no recurrence. Two patients showed regrowth of the tumor after subtotal resection, however. In 1 of these, the residual tumor had progressed within 12 months of initial surgery, it was again resected and linac radiosurgery was successful. In the other, the residual mass had progressed within 8 months of initial surgery, and the pathological report indicated malignant peripheral nerve sheath tumor. Conclusively, type A tumors could be totally resected with the retrosigmoid approach alone. For type B and D tumors, however, combined ITFA and retrosigmoid approach showed the better results. In spite of our limited data, cases showing adhesion to critical structures can be managed by subtotal or near total resection followed by radiosurgery to reduce postoperative complications.