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Biomedical subjects

J L Weissman

Publications and source records attributed to J L Weissman.

At least 73 records · Page 4Linked to original sources
PubMed1994

Computer-assisted frontal sinusotomy.

An osteoplastic frontal sinus flap with flat obliteration is the "gold" standard for the management of chronic frontal sinus inflammatory disease caused by obstruction of the nasofrontal duct. Frontal sinusotomy, with an osteoplastic technique, call for osteotomies, guided by a template obtained from a Caldwell radiographic view taken at a distance of 6 feet. The reliability of the template depends on the position of the patient, distance at which the radiograph is taken, penetration of the x-rays, and other technical aspects. Therefore the template is a potential source of error. We present the use of a computer-assisted frontal sinusotomy as a method to corroborate the shape and margins of the frontal sinus in six patients undergoing obliterative frontal sinus surgery. In our hands, this technique has proved more reliable than the radiographic template to corroborate the positioning of the osteotomies.

Ethmoid Sinus↗
PubMed1994

Congenital perilymphatic fistula: computed tomography appearance of middle ear and inner ear anomalies.

Congenital perilymphatic fistula is an abnormal communication between the inner ear and middle ear. Inner ear anomalies have been described on computed tomography scans. Middle ear anomalies have been found at surgery; the most frequent are anomalies of the stapes and round window. This retrospective study describes the appearance of the inner and middle ear on computed tomography scans, and of the middle ear at surgery, in 10 patients (15 ears) in whom perilymphatic fistula was found at surgery. Twelve of 15 stapes were abnormal at surgery; 4 of these 12 (33%) could be seen on computed tomography scans. Two stapes normal at surgery were normal on computed tomography. Three round windows were abnormal at surgery; none of these was seen on computed tomography scans. There were also four dysplastic cochleas, four dysplastic vestibules, and three dilated vestibular aqueducts. Computed tomography scans identified an abnormal inner ear, middle ear, or both in 8 (53%) of the 15 ears with perilymphatic fistula. An inner ear or middle ear anomaly on computed tomography may heighten clinical suspicion of congenital perilymphatic fistula.

Adolescent↗
PubMed1994

Double mucocele of the paranasal sinuses.

We have observed two contiguous mucoceles in one patient. Based on the mucoceles' signal intensities on MR imaging, as well as their anatomic location as delineated by CT and MR, we hypothesize that the "downstream" mucocele obstructed the "upstream" sinus, leading to formation of a secondary mucocele.

Adult↗
PubMed1994

Fast spin-echo imaging of the neck: comparison with conventional spin-echo, utility of fat suppression, and evaluation of tissue contrast characteristics.

PURPOSE: To determine whether fast spin-echo sequences could replace conventional spin-echo methods in the evaluation of head and neck neoplasms and associated adenopathy and to evaluate differences in tissue contrast characteristics between conventional spin-echo and fast spin-echo examinations of head and neck disease. METHODS: Twenty-seven patients with squamous cell carcinoma were imaged on a 1.5-T imager with both conventional spin-echo and fast spin-echo sequences with identical section thickness and position. Twenty-one of the 27 fast spin-echo studies were performed with frequency-selective fat suppression. Three radiologists independently evaluated the images using a five-point scale to compare primary lesion margin definition and conspicuity, lymph node margin definition and conspicuity, gross motion artifact, and flow artifact. Quantitative percent contrast and contrast-to-noise ratios were calculated and compared in 7 cases with fat-suppressed fast spin-echo. RESULTS: Fast spin-echo was preferred by all three readers for lesion margin conspicuity and lymph node conspicuity. Gross motion and flow artifact demonstrated trends toward reader preference for fast spin-echo. Quantitative contrast values for fast spin-echo were significantly greater than those for conventional spin-echo. CONCLUSIONS: Fast spin-echo with fat suppression can replace conventional spin-echo at a time savings of more than 50% and improves tissue contrast and the conspicuity and definition of margins for primary lesions and lymph nodes. Fat-suppression heterogeneity remains the major limitation of this technique. Thus, careful attention to fat-suppression failure and unwanted water saturation is essential.

Adipose Tissue↗
PubMed1992

Magnetic resonance imaging of the large vestibular aqueduct.

The large vestibular aqueduct syndrome describes an abnormally large endolymphatic duct and sac with associated sensorineural hearing loss. This entity was originally reported in 1978 and has since been identified as a finding in children with progressive hearing loss. The original description of the large vestibular aqueduct employed hypocycloidal polytomography of temporal bone. Subsequent reports studied patients identified with this syndrome using computed tomographic scans. We report magnetic resonance imaging of two patients diagnosed with the large vestibular aqueduct syndrome. The magnetic resonance imaging and computed tomographic scans are compared and the significant findings on magnetic resonance imaging are reviewed. This should assist the otolaryngologist and radiologist with establishing the appropriate diagnosis.

Adult↗
PubMed1991

Sphenochoanal polyps: evaluation with CT and MR imaging.

A sphenochoanal polyp is a solitary mass of low attenuation on computed tomographic (CT) scans that arises from the sphenoid sinus and extends through the sphenoid ostium, across the sphenoethmoid recess, and into the choana (the boundary between the nasal cavity and nasopharynx). More often, however, a choanal polyp is an antrochoanal polyp, which arises from the maxillary antrum, protrudes through the middle meatus, extends into the nasal cavity, and continues back to the choana. Contiguous axial or coronal magnetic resonance and CT images help clearly differentiate the rare sphenochoanal polyp from the more common antrochoanal polyp. The sinus of origin is important to identify, as the surgical approach depends on the target sinus.

Adult↗
PubMed1991

Dehiscent temporomandibular joint.

The appearance of an acute effusion in a well-pneumatized temporal bone directs attention to the nasopharynx and skull base. Two patients are described in whom dehiscence of the temporomandibular joint allowed herniation of the contents of the joint posteromedically, where they obstructed the middle ear entrance of the eustachian tube, the protympanum. This is, to the authors' knowledge, a previously unreported cause of an acute middle ear and mastoid effusion.

Adolescent↗
PubMed1991

Computerized tomography and magnetic resonance imaging following cranial base surgery.

The computed tomography scans and magnetic resonance imaging films of 57 patients who underwent anterior or anterolateral cranial base surgery from January 1987 to August 1989 were retrospectively reviewed to ascertain the significance of early and late postoperative intracranial imaging changes. Extra-axial changes (air, blood, cerebrospinal fluid collection) were found in 96% of patients; axial changes (brain edema, contusion) were seen in 30% of patients in the first postoperative period (72 hours). Subsequently, extra-axial changes began to resolve but axial changes became more prevalent. After 6 months, only axial changes persisted (encephalomalacia). It was encouraging to find a low correlation of imaging abnormalities with clinically significant findings.

Encephalomalacia↗
PubMed1990

Magnetic resonance imaging of the paranasal sinuses.

MRI has been very helpful in evaluating tumors in the paranasal sinuses. MRI can differentiate retained secretions from tumors. The multiplanar capabilities of MRI are also very helpful in identifying tumor margins. Although a specific diagnosis can be suggested in most cases, demonstration of the extent of the disease and specifically the relationship to key surgical landmarks is more important. Structures of thin cortical bone are better seen with CT than MRI. For several reasons, CT is still the examination of choice for evaluation of the osteomeatal complex and inflammatory disease of the sinuses.

Carcinoma, Squamous Cell↗