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Biomedical subjects

J M Shugar

Publications and source records attributed to J M Shugar.

At least 19 recordsLinked to original sources
PubMed1999

Recurrence of a deep neck infection: a clinical indication of an underlying congenital lesion.

OBJECTIVE: To discuss the computed tomographic (CT) and clinical findings of those entities that may present as recurrent deep neck infections. PATIENTS AND METHODS: Twelve patients with recurrent deep neck infections and CT scans were retrospectively identified since 1990. Their CT scans and medical histories were reviewed. The diagnosis was pathologically confirmed in all cases. RESULTS: The CT scans revealed an abscess or a localized infected cyst in the deep soft tissues of the neck, with varying degrees of associated inflammatory change in the adjacent soft tissues. The diagnoses in these cases included 1 first branchial cleft cyst, 3 second branchial cleft cysts, 1 third branchial cleft cyst, 2 fourth branchial cleft cysts, 2 infected lymphangiomas, 2 thyroglossal duct cysts, and 1 cervical thymic cyst. CONCLUSIONS: Most deep neck infections are the result of suppurative adenitis. The location of the primary focus is usually from the mucosa of the upper aerodigestive tract or from an odontogenic source. Less common causes are perforations due to a foreign body, thrombophlebitis of the internal jugular vein, or osteomyelitis of the spine. Recurrences in these situations are unusual. Less commonly, congenital lesions can present as deep neck infections, and recurrences are common. Our cases suggest that the recurrence of a deep neck infection should alert the physician to the possibility of an underlying congenital lesion and that CT is helpful in the early recognition of these lesions.

Adolescent↗
PubMed1998

CT of pilomatrixoma in the cheek.

Pilomatrixoma is an uncommon benign tumor arising from hair follicles. They occur most commonly in the head and neck region, and are usually found in girls during the first two decades of life. These tumors may contain calcification, which, when present, is helpful in suggesting the diagnosis. We present a classic case of pilomatrixoma in the cheek of a young woman. The tumor was documented on CT studies, which showed a subcutaneous, noninvasive mass with calcifications.

Adult↗
PubMed1997

Subcutaneous fat necrosis of the newborn: CT findings of head and neck involvement.

We present the CT findings in two newborns with subcutaneous fat necrosis. This is an uncommon disease that occurs in neonates who have had difficult deliveries. The CT findings varied from discrete subcutaneous nodules to a diffuse subcutaneous fullness. Although the subcutaneous disease tends to spontaneously resolve within weeks to months, an associated hypercalcemia may have a fatal outcome.

Cheek↗
PubMed1989

Lingual osteoma.

The 29th patient with a lingual osteoma is presented. This is the first case, to our knowledge, with preoperative radiographic and computed tomographic documentation. This rare, benign tumor almost always occurs as a pedunculated solitary mass that arises from the posterior tongue near the foramen cecum. The patients are usually young women who complain wf dysphagia or fullness in the base of the tongue. The imaging findings and theories of the origin of this tumor are described.

Adult↗
PubMed1988

The use of magnetic resonance and computed tomography in the management of a patient with intrasinus hemorrhage.

The judicious use of computed tomography and magnetic resonance imaging in a critically ill patient with leukemia is discussed to demonstrate how a rapid and accurate diagnosis of intrasinus hemorrhage was established, thereby avoiding an unnecessary invasive procedure in this high-risk patient. In this clinical setting, a brief T1-weighted study distinguished between blood and infection.

Adult↗
PubMed1988

Multicentric parotid cysts and cervical adenopathy in AIDS patients. A newly recognized entity: CT and MR manifestations.

Patients with AIDS or ARC may present with parotid gland enlargement either initially or during the course of their disease. Of nine such patients, eight had unilateral gland enlargement, and one had bilateral disease. CT and MR scanning revealed that all patients except one had bilateral multiple intraparotid cysts. In addition, four of the nine patients clinically had cervical adenopathy, while all patients had adenopathy on scanning. We believe that the association of parotid cysts and cervical adenopathy is another manifestation of AIDS or ARC and, when found on scanning, should alert the clinician to the probable underlying condition.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Persistent cervical adenitis and nasopharyngeal carcinoma in children.

The high prevalence of inflammatory disease in pediatric patients makes the occurrence of prominent adenoidal tissue and cervical adenopathy a common finding. Unfortunately, rare nasopharyngeal cancer shares these physical findings in common with benign inflammatory disease of the pharynx. Computed tomography permits evaluation of nodal necrosis or wall nodularity, allowing clinically silent submucosal tumor extension to be well defined. In patients with suspected nasopharyngeal inflammatory disease who do not respond to conservative therapy, computed tomography can be used to aid directed biopsies.

Adolescent↗
PubMed1987

Intramuscular head and neck myxoma: report of a case and review of the literature.

Intramuscular myxoma of the head and neck is a rare lesion with only six cases documented in the literature. The tumor demonstrates a benign clinical course without a tendency to recur and is occasionally associated with fibrous dysplasia. It thus deserves to be considered in a separate class from other soft tissue myxomas. The seventh case of a head and neck intramuscular myxoma is presented and the clinical, pathological, and CT characteristics of this tumor are reviewed.

Aged↗
PubMed1983

Unrecognized aspiration of an oropharyngeal airway.

A case of unsuspected aspiration of an oropharyngeal airway causing dysphagia is described. Visualization of this airway on plain film would be facilitated if radio-opaque material were included at manufacture.

Adolescent↗
PubMed1983

Computed tomography of glomus tympanicum tumors.

Previously it has been very difficult or impossible for radiologists to delineate accurately the size and extent of glomus tympanicum tumors. By utilizing axial transverse and coronal computed tomography detailed enlargement techniques we have been able to accurately demonstrate four such lesions. We believe that this mode of investigation is now the method of choice for glomus tympanicum tumors.

Adult↗
PubMed1983

Auricular reconstruction with postauricular myocutaneous flap.

In the past reconstruction of large auricular defects more than 2 cm have been repaired with the use of local skin flaps from various sites in multiple stages. This entails longer hospitalization and a poorer aesthetic result. We developed a postauricular myocutaneous flap that has been used successfully in five patients. The cosmetic results are superior to previously described reconstructive techniques. This flap, which can be used in immediate one-stage reconstruction, is based on the auricular branch of the posterior auricular artery. This vessel supplies the auricularis posterior muscle, the skin over the mastoid, and the cranial surface of the auricle. This vessel was dissected and found to be anatomically consistent in five cadavers.

Aged↗
PubMed1982

Maxillary sinusitis as a cause of cheek swelling. A rare occurrence.

Inflammatory swelling of the cheek is an extremely rare complication of antral sinusitis. When such swelling occurs, diagnostic search for a specific coexisting condition must be made. The differential diagnosis includes a postsurgical or posttraumatic defect in the anterior antral wall; an unusual fungal, granulomatous, or neoplastic disease of the maxillary sinus; dental infection; or dacryocystitis.

Adult↗
PubMed1982

The early detection of antral malignancy in the postmaxillectomy patient.

A protocol was developed for the radiographic evaluation of the postmaxillectomy patient that called for a six- to eight-week postoperative, baseline computed tomography (CT) scan, followed by CT scans at four- to six-month intervals for at least three years. This protocol allowed for an early, more complete assessment of clinically discovered recurrences and the detection of clinically occult recurrences in three out of 18 patients who followed the protocol. The CT appearance of the normal partial and total maxillectomy is discussed, as well as the focal nodular soft-tissue findings suggestive of recurrent disease.

Follow-Up Studies↗
PubMed1981

A new technique for wide-field exposure of the base of the skull.

Surgical exposure of the extracranial surface of the floor of the middle and posterior cranial fossa is difficult using the available techniques of skull base surgery. Considering this problem, cadaver dissections were performed and a new approach to the skull base developed. The parapharyngeal space is entered through a transcervical incision combined with a median labiomandibulotomy. This allows control of the major neurovascular structures up to their entrance at the skull base. The Eustachian tube is divided between the base of the skull and Rosenmüller's fossa. This allows the pharynx to be detached from the skull base and retracted to the contralateral side, exposing both the clivus and upper cervical vertebrae. Exposure of the posterior nasal cavity and body of the sphenoid is obtained by a transpalatal approach. The sphenoid sinus can be entered and, if necessary, the dissection extended to the pterygomaxillary space and anterior skull base. Herein, this technique is described in detail, as are the various disease states in which it may be indicated and its application in a representative clinical case.

Cadaver↗
PubMed1981

Benign chondroma of the petrous apex.

The roentgen findings of a rare benign chondroma of the petrous apex are presented. This patient's clinical history made it imperative that we rule out a metastatic breast lesion. A transcochlear approach verified the benign nature of this lesion.

Chondroma↗
PubMed1981

The nonspecificity of the antral bowing sign in maxillary sinus pathology.

Although bowing of the posterior antral wall occurs most commonly with juvenile angiofibroma, it can occur with any slow growing noninvasive lesion involving the retromaxillary region. Cases of schwannomas, a lymphoepithelioma, and a fibrous histiocytoma are presented as examples of the nonspecificity of the antral bowing sign.

Adult↗