Computed tomography in rhinology.
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Female↗
Biomedical subjects
G Grevers
Publications and source records attributed to G Grevers.
[The predictive value of so-called secondary reconstruction in fractures of the frontal skull base].
While MRI offers excellent possibilities to visualize different planes of a structure of interest, CT is limited to the axial and coronal plane. In most cases, CT examination can be carried out in the traumatised patient in the axial plane only. Therefore, in the present study the authors tried to investigate the value of multiplanar reconstruction of CT scans in anterior skull base traumatology, 18 patients (6 female, 12 male) aged between 18 and 57 years with bony lesions of the anterior skull base caused by different traumatic events were examined under a CT scanner of the fourth generation. A high-resolution mode was used in 14 out of 18 patients. The axial scans were reformated in coronal and sagittal planes. The clinical value of the reconstructed images, however, was poor. They would not supply additional information compared to the original scans; the quality of the reconstructed scans was even worse. Artifacts could not be distinguished from bony lesions. The results indicate that multiplanar reconstructions of CT scans are not sufficient in the evaluation of bony lesions of the anterior skull base.
Adolescent↗
[Diagnostic approach in diseases of the parapharyngeal space].
Diseases of the parapharyngeal space (p.s.) are quite rare. Nevertheless, the clinical and therapeutic approach to this anatomical site is not easy in many cases. Possibly some of the patients suffering from lesions in the p.s. could be cured, if the disease were detected in an earlier stage. In the present paper the authors introduce the diagnostic evaluation of this region. Clinical and radiological procedures are demonstrated in selected patients with characteristic lesions of the p.s. in order to find out about reasonable and sufficient diagnostic approaches to this hidden area. While the clinical examination is limited mainly to inspection and palpation, diagnostic imaging--and particularly modern techniques like CT, MRI and 3-D-reconstruction--enables us to receive a better approach to the p.s.. Advantages and disadvantages of the different methods are discussed according to their diagnostic value for the various kinds of lesions in the p.s.
Adult↗
[Proton spin tomography in HIV 1-induced diseases in head and neck region].
Most HIV-infected patients present with associated diseases (inflammations, hyperplastic disorders of the lymphatic tissue and malignancies) in the head and neck region. Speculum, endoscopy, ultrasound and computed tomography are important tools in the diagnostic management of HIV presentations. Moreover, MR is known to be an excellent technique especially in the evaluation of soft tissue disorders. -A prospective study of 23 out of 161 HIV-seropositive patients was performed to determine the efficiency of magnetic resonance imaging in HIV-related disorders. T1- and T2-sequences, as well as the contrast medium uptake (Gd-DTPA), presentation in three planes and the morphology of the tissue were useful parameters to distinguish the different HIV-related diseases (lymphatic hyperplasia, inflammation, Kaposi's sarcoma, Hodgkin's und Non-Hodgkin lymphoma, lymphoepithelial cysts and carcinoma) in most cases even prior to histological examination. -MR proved to be a significant non-invasive diagnostic tool especially in HIV-associated soft tissue disorders in the head and neck.
Adult↗
[Coincidental appearance of laryngocele and laryngeal carcinoma].
The authors present a case of a 54-year-old male patient suffering from a laryngocele with concomitant laryngeal cancer. The patient had a three-month history of hoarseness. The clinical examination as well as the endoscopic evaluation did not reveal any signs of malignancy inside the larynx. MR imaging, however, showed an endolaryngeal cystic process surrounded by a soft tissue mass. Resection of the lesion revealed the concomitant occurrence of both laryngocele and laryngeal carcinoma. Etiology, symptoms, diagnostic management and differential diagnosis are presented and discussed according to the relevant literature.
Carcinoma, Squamous Cell↗
[Current diagnosis and therapy of cysts of the mouth floor].
Cystic tumors of the floor of the mouth are relatively rare. Until today the exact localisation of the cysts in relationship to the muscles of the floor of the mouth is established mainly during operation. Therefore the preoperative decision for the optimal surgical approach can be difficult, at least in large space occupying lesions. In the present study the case of a 24-year-old female patient with an extensive dermoid cyst of the floor of the mouth is demonstrated. The preoperative use of magnetic resonance imaging enabled us to determine the exact localisation of the cyst in relationship to the muscular structures of the floor of the mouth. The differential diagnosis of dermoids of the floor of the mouth as well as the adequate therapeutic approach is discussed according to the relevant literature.
Adult↗
[Magnetic resonance tomography of the oropharynx and oral cavity with Gd-DTPA. An optimized study technic and its diagnostic value].
In the evaluation of space-occupying lesions of the oropharynx it is necessary to perform modern imaging methods, such as magnetic resonance imaging additionally to clinical and endoscopical methods. 126 patients were examined using T1-weighted (TR = 500 ms, TE = 25 ms) and T2-weighted (TR = 3000 ms, TE = 25/90 ms) spin-echo-sequences before and after i.v. application of Gd-DTPA. Superficially growing lesions of stage T1 could not be delineated from isointense mucosa. The preoperative staging of T2-T4 lesions can be markedly improved by using T1- and T2-weighted sequences in combination with Gd-DTPA. MR imaging with Gd-DTPA is recommended as the primary diagnostic tool for diagnosing lesions in the region of the oropharynx.
Adenoma↗
Magnetic resonance imaging of the parotid gland in patients with Sjögren's syndrome.
To detect structure and size abnormalities, magnetic resonance imaging (MRI) of the parotid gland was performed on 36 patients with sicca complaints. Twenty-four patients had primary Sjögren's syndrome (SS) without rheumatoid arthritis (RA) or connective tissue disease; 6 had secondary SS associated with RA, whereas in another 6 cases the related disease could not be classified. Characteristic gland size and structural abnormalities were identified in patients with SS and various stages could be established, compared to patients with other parotid gland disorders, as well as healthy persons. MRI provides an accurate noninvasive technique for assessment of xerostomia in patients with SS.
Arthritis, Rheumatoid↗
Alterations in Na+, K+ and Ca2+ transport in erythrocytes of patients with carcinomas of the head and neck: possible role of mild anaemia and cell age.
1. Rates of erythrocyte Ca2+ inward transport, activities of erythrocyte Ca2(+)-adenosine triphosphatase, Na+, K+ pump, Na(+)-K+ co-transport and Na(+)-Li+ exchange, and erythrocyte Ca2+, K+ and Na+ contents have been determined in patients with carcinomas of the head and neck. 2. Decreases in Ca2+ inward transport and Na(+)-K+ co-transport activity, and increases in erythrocyte Ca2+ and K+ contents, were observed. 3. The more pronounced changes found in advanced carcinoma stages proved to be related to a 50% incidence of a mild anaemia of chronic disease in patients with carcinoma stages T3 and T4. 4. 'Young' (light) erythrocytes from healthy donors obtained by density centrifugation showed modifications in Na+ transport and K+ content similar to those seen in the patients. 5. It is concluded that the decrease in Na(+)-K+ co-transport activity, as well as the elevated K+ content and the lowered mean corpuscular haemoglobin content, but not the disturbances in Ca2+ homoeostasis, in erythrocytes of patients with carcinomas of the head and neck are most probably due to the occurrence of a mild anaemia of chronic disease in advanced carcinoma stages, associated with a reduction in mean erythrocyte age.
Adult↗
[Traumatically-induced foreign bodies of the paranasal sinuses].
Foreign bodies of the nose and its related sinuses are a common feature in otorhinolaryngology. Particularly in small children, one will find unilateral rhinorrhea as an initial symptom. In the adult, foreign bodies of the nose or paranasal sinuses are mainly caused by traumatic events. In the present paper the authors report two cases of foreign bodies of the paranasal sinuses. In one case the patient had been suffering from unilateral cephalgia for more than 40 years. The other patient had a short history prior to the extraction of the foreign body from the sphenoid sinuses. Diagnostic and therapeutic procedures are discussed and compared with the relevant literature.
Adult↗
[A new method of 3-dimensional reconstruction of the head and neck].
In the past decades the development of MRI has significantly increased the importance of diagnostic imaging of head and neck lesions. The standard imaging method is based on two-dimensional slices. The present study was performed to evaluate the diagnostic value of 3D MRI-reconstructions for head and neck lesions. The 3D reconstruction method and the results of the 3D-reconstructed images are presented. Important aspects of the interesting structures can be evaluated much more easily with reconstructed images than by mentally reconstructing two-dimensional slices. In the light of the present results, 3D reconstruction promises to be an accurate method for the diagnosis of head and neck lesions and might be of clinical importance in the future.
Computer Simulation↗
[The value of 3D proton spin tomography reconstruction as exemplified by an extensive parotid adenoma].
In the past few years, 3 D reconstruction has been established as a new imaging method in various medical fields, such as orthopedic surgery and neurosurgery. In a former article, the authors introduced a new 3 D imaging method for the head and neck. The present study reports the case of a 37-year-old woman with a huge adenoma of the parotid gland. The tumor grew along the skull base, protruding onto the left tonsil. The diagnostic value of the authors' reconstruction method for lesions in the head and neck is discussed. The results indicate that this technique might be of significant clinical importance for special questions arising in the head and neck region as well as for preoperative planning in the case of certain tumors.
Adenoma↗
[Incidence of epithelial neoplasms in the head and neck area in non-Hodgkin's lymphomas].
There is an increased risk of malignancy in patients with genetically determined or acquired immunosuppression. The authors report a case of a 70-year-old patient with a lymphoplasmocytic immunocytoma who developed 19 squamous-cell carcinomas (SCC) and nine basal-cell carcinomas (BCC) over a three-year period. This was the reason to review 100 cases of malignant lymphomas for evidence of additional malignancies. Of these patients, 15% had one or more SCC or BCC in the head and neck area. The age range was 59 to 79 years (mean, 71.7 years) and the male:female ratio 11:4. One or more SCC arose in 93% of these patients, 36% developed an additional one or more BCC, and BCC alone occurred in 7%. The usual ratio of BCC:SCC is 10:1; in the authors' patients, by contrast, this ratio was 6:14. In 12 cases, SCC and BCC were located on the skin. The remaining cases of SCC developed in the oral mucosa, the tonsils and the hypopharynx. In 13 cases, low-grade malignant lymphomas were found and in two cases high-grade malignant lymphomas were found. The SCC were clinically aggressive. Thirty-six percent of the patients had recurrent lesions, 43% multiple neoplasms, and 50% metastases. Histologically, the SCC showed moderate to poor differentiation, a high degree of cell polymorphism and mitotic activity, and deep tissue infiltration. There are several explanations for the increased incidence of neoplasms in patients with immunodeficiency disorders. The surveillance function of the immune system may be impaired due to the disease itself or due to the treatment for immunosuppression. Immunosuppressive and cytotoxic agents are potential carcinogens.(ABSTRACT TRUNCATED AT 250 WORDS)
Basal Cell Carcinoma↗
[Modern imaging of the larynx].
Many diseases of the larynx can be diagnosed by clinical examination. In many cases, however, further diagnostic procedures are necessary to receive adequate information on the localisation and extent of the lesion. In the present paper the authors report on the different possibilities of diagnostic imaging of the larynx. The value of each technique is discussed to set adequate indications as well as to recommend an appropriate imaging for laryngeal lesions.
Contrast Media↗
[Supraorbital tumor as manifestation of Jaffe-Lichtenstein fibrous dysplasia].
We report on the case of a 16 year old white female who presented at our outpatient clinic with a swelling of the left supraorbital region. Histologically a fibrous dysplasia Jaffe-Lichtenstein was found. Diagnostic procedures, possible complications, adequate therapy and prognosis of this disease are discussed and compared with the relevant literature.
Adolescent↗
[Immuno-diagnostic findings in "secondary" Sjögren syndrome in chronic polyarthritis].
In order to characterize typical findings in patients (pts.) with secondary Sjögren's Syndrome (SS) associated with rheumatoid arthritis (RA), 173 patients with RA were studied. Pathological screening-test results (Schirmer- and Saxon-test) were followed by ENT- and ophthalmological investigations and examinations in the field of internal medicine. Secondary SS associated with RA was diagnosed in 34 pts. (20%). Immuno-serological SS-A and/or SS-B-antibodies were found in 11 (32%) of 34 patients. 9 pts. (27%) had antinuclear antibodies. Abnormal titers of circulating immune complexes were present in the sera of 24 pts. (71%), salivary gland-antibodies in 3 pts. (9%). In 16 of 34 pts. (47%) minor salivary gland biopsy was performed. Lympho-plasma cell sialadenitis could be verified in all pts. Immuno-histological reactions to anti-IgG and/or anti-IgM and/or anti-IgA were detected in 10 (62%) of 16 pts. We could not find a single criterion to ascertain the diagnosis SS which still has to be made by considering all clinical and serological findings. Immunological findings may provide helpful and interesting diagnostic aspects which by long term observation may even gain importance; however, no differential therapeutic consequences can be seen at the moment.
Antibodies, Antinuclear↗
[The clinical manifestations of histologically classified malignant lymphomas in the ENT area].
For an optimum therapy of malignant lymphomas in the ENT region an extensive analysis of the interrelations of exact histological classification, clinical manifestation and prognosis is desirable. We therefore classified, according to various criteria, 57 patients (34 male, 23 female) aged between 17 and 88, in whom the first diagnosis of a malignant lymphoma was established at our department between 1970 and April 1989. Histologically, in 52 cases (91%) this concerned a non-Hodgkin lymphoma (NHL), in the other 5 cases Hodgkin's disease (HL). According to the "Kiel classification", 60% of the NHL displayed a high degree of malignancy, 36% a low one, while 4% could not be exactly classified histologically. Clinically (Ann Arbor classification), 27 patients with NHL were at stage I (with 21 at stage IE), 16 patients at stage II (with 14 at stage II E), and 9 patients at stage IV. The first manifestation was often extranodular (9 patients tonsil, 8 parotid gland, 8 base of tongue, 7 nasopharynx). A cervical lymph node enlargement was the first sign in 12 patients only. Four patients with NHL additionally developed a second malignancy (squamous cell carcinoma) of another localization. The 5-year survival rate was 81% at stage I, but there were no meaningful differences between stage II (51%) and stage IV (40%). Our study demonstrated that malignant lymphomas of the head and neck are primarily NHL which frequently affect an extranodular organ as a first manifestation. Moreover, malignant lymphomas in the ENT region seem to have a relatively good survival prognosis even in an advanced stage.
Adolescent↗
[The further development of the 3D-MRI reconstruction technic for the head-neck area].
Twenty-one healthy volunteers and seventeen patients with head and neck lesions were examined with 3D MR imaging since the end of 1988. A new kind of reconstruction mode was used, which shows the structures of the region of interest by overlaying a predetermined window within the three-dimensional reconstruction of the head. Using this mode, the morphology of the lesion could be evaluated more precisely than by using individual two-dimensional slices. With regard to preoperative surgery planning, the previous results were insufficient. With the new development and increased capacity of the MRI-technique and improvement of the reconstruction mode it is now possible to "cut" several slices in different orientations into the head achieving higher resolution of the images. The innovation of the method and its actual clinical value is discussed in the example of a meningioma of the sphenoid which has been examined by both reconstruction modes.
Head↗