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J Drutman

Publications and source records attributed to J Drutman.

4 recordsLinked to original sources
PubMed1994

Sinonasal polyposis: investigation by direct coronal CT.

To demonstrate the typical clinical and CT features of sinonasal polyposis, we reviewed the clinical records and preoperative direct coronal CT scans of 35 patients with surgically proven disease. Symptoms included progressive nasal stuffiness (100%), rhinorrhea (69%), facial pain (60%), headache (43%) and anosmia (17%). We found associations with rhinitis (46%), asthma (29%) and aspirin sensitivity (9%). Coronal CT features included polypoid masses in the nasal cavity (91%), partial or complete pansinus opacification (90%), enlargement of infundibula (89%), bony attenuation of the ethmoid trabeculae (63%) and nasal septum (37%), opacified ethmoid sinuses with convex lateral walls (51%) and air-fluid levels (43%). The latter feature correlated with symptoms and signs of acute sinusitis in only 40% of patients. Recognition of sinonasal polyposis is important to the endoscopic surgeon since it can be the most troubling sinonasal inflammatory disease to manage due to its aggressive nature and tendency to recur despite appropriate treatment.

Diagnosis, Differential↗
PubMed1994

Evaluation of subclavian steal with two-dimensional phase-contrast and two-dimensional time-of-flight MR angiography.

We describe two MR angiographic methods of diagnosing subclavian steal in each of three patients. By using phase-directional information from a single two-dimensional phase-contrast sequence, we were able to show that the direction of flow in the affected vertebral artery was reversed. The same vertebral artery showed no signal on a 2-D time-of-flight sequence with a concatenated presaturation pulse applied above each section.

Aged↗
PubMed1991

Sinonasal polyposis.

The SSCT findings of the SNP pattern are nearly diagnostic for this entity. SNP is characterized by the major findings of nasal polypoid masses and infundibular enlargement. Patients may also show individual sinus involvement with polypoid masses and/or opacification of the paranasal sinuses without visualization of polypoid masses. The presence of polypoid masses within the sinuses also can be inferred if the major findings are present, especially if there are the minor findings of nasal septal and sinus trabeculae attenuation and bulging of the lateral ethmoid sinus walls. Air/fluid levels are frequent in SNP but do not always indicate acute sinusitis. Patients typically present with nasal stuffiness and rhinorrhea. They often have facial pain and less often headaches. Common associations exist between SNP and atopy (either allergic or nonallergic), asthma, infection, cystic fibrosis, and aspirin intolerance. Therapy may be either medical or surgical, with steroids being the mainstay of the medical treatment. FESS provides a relatively atraumatic means of removing polyps and creating better sinus drainage. Regardless of the type of therapy, recurrences are common, requiring repeated bursts of systemic steroids, nasal steroid maintenance, and frequent additional surgical procedures. Identification of the SNP pattern on SSCT helps the otolaryngologist to institute an appropriate therapy aimed at alleviating symptoms. The SSCT is adequate for evaluation of SNP in the vast majority of cases and serves as a detailed road map for the treating endoscopic surgeon.

Acute Disease↗