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N Bely

Publications and source records attributed to N Bely.

16 recordsLinked to original sources
PubMed2001

[Articulatory compensation after supracricoid partial laryngectomy with cricohyoidoepiglottopexy].

OBJECTIVES: The consequences of the modification of the glottis and the shortening of the vocal tract after supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) were investigated prospectively on ten patients. An acoustic analysis of the transfer function of the vocal tract was performed by measuring the formant frequencies of the [a] and [i] vowels. The articulation compensatory mechanisms of the vocal tract were observed with cinefluoroscopy in order to evaluate the phonation and articulation constraints. PATIENTS AND METHODS: Ten male patients were recorded before surgery and at six, 12 and 18 months after surgery. The results were compared with those of 10 male normal speakers having the same range of age. For the acoustic measures, we tracked the three first formant frequencies of the cardinal vowels [a] and [i], before and after surgery. Articulation investigation was performed with cinefluoroscopy for the vowels [a] and [i] uttered by two of the 10 patients. RESULTS: For the [a] vowel, the acoustic analysis showed higher values for all three formants, related to the shortening of the vocal tract after surgery. For the [i] vowel, the lowering of the second formant frequencies after surgery was related to an articulatory compensation. Cinefluoroscopy confirmed the shortening of the vocal tract, the tongue-root retraction for voicing and the anterior position of the tip of the tongue for the [i] vowel. CONCLUSIONS: The consequences of the shortening of the vocal tract after SCPL with CHEP can be evaluated, non invasively, by means of acoustic analysis. The understanding of the articulation compensatory mechanisms resulting from voicing constraints should help voice rehabilitation and improve oral communication in such patients.

Adult↗
PubMed1999

[Cystic lymphangioma of the neck and mediastinum: are there acquired forms? Report of 37 cases].

BACKGROUND: In 9 out of 10 cases, lymphangiomas are observed during the first years of life, generally located in the neck. Rare lymphangiomas have been reported in adults, usually in an intrathoracic localization, raising the hypothesis of an acquired origin. PATIENTS AND METHODS: A retrospective analysis of patients undergoing surgery for lymphanioma of the neck or mediastinum was conducted. Pathology reports, clinical data and medical imaging (CT) were reviewed and operative and post-operative findings were analyzed in order to determine whether the cases could be divided into congenital and non-congenital forms. RESULTS: Data were obtained on 37 patients (23 men and 14 women, mean age 45 years, range 8-77). Four lesions (11%) were located in the neck: 3 in children and one in an elderly subject (77 yrs). Thirty-three tumors (89%) were located in the mediastinum. In 5 cases, the tumor was located in the phrenic nodes of the anterior mediastinum. These lymphangiomas occurred in young adults, had a CT density less than liquid with enhancement after contrast injection, and had a malformative vascular component proven anatomically and histologically (hemolymphangioma). These elements favored a congenital orgin. In 28 cases (76.6%) the tumor involved nodes in the posterior or middle mediastinum. They occurred in older adults and were purely liquid with no vascular component. These lymphangiomas were undoubtedly acquired. CONCLUSION: In children, adolescents and young adults, lymphagiomas are found in the neck or anterior mediastinum and have a tissular component. These tumors should be considered as congenital lymphangiomas. In older adults, lymphangiomas are found in the posterior or middle mediastinum and are purely liquid cysts suggesting an acquired origin.

Adolescent↗
PubMed1998

Intraductal papillary and mucinous tumors of the pancreas: accuracy of preoperative computed tomography, endoscopic retrograde pancreatography and endoscopic ultrasonography, and long-term outcome in a large surgical series.

BACKGROUND: Few data are available on the accuracy of preoperative imaging or on long-term outcome after surgery for intraductal papillary and mucinous tumors of the pancreas. The aims of this study were to assess the following: (1) the accuracy of preoperative computed tomography, endoscopic retrograde pancreatography, and endoscopic ultrasonography for determination of tumor invasion and pancreatic extension as compared with surgical findings; (2) the long-term outcome after surgery. METHODS: Forty-seven patients who underwent surgery between 1980 and 1995 for pathologically diagnosed intraductal papillary and mucinous tumors were included in this study. The findings of available computed tomography (n = 25), endoscopic retrograde pancreatography (n = 29), and endoscopic ultrasonography (n = 21) were reviewed by experienced clinicians blinded to pathologic diagnosis to assess tumor invasion and pancreatic extension. Pathologic specimens were reviewed by experienced pathologists. Postoperative follow-up data were analyzed. RESULTS: Histologic features of invasive carcinoma were found in 43% of patients, severe dysplasia in 21%, and mild or moderate dysplasia in 36%. The overall accuracy of computed tomography, endoscopic retrograde pancreatography, and endoscopic ultrasonography in distinguishing between invasive and noninvasive tumors were, respectively, 76%, 79%, and 76%. The overall 3-year disease-free survival rate was 63%, but it was 21% among patients with invasive carcinoma at surgery (p < 0.001). CONCLUSIONS: This study emphasizes the need for early surgical resection in patients with suspected intraductal papillary and mucinous tumors of the pancreas because of the high frequency of invasive carcinoma and the inadequacy of preoperative imaging for assessing malignancy.

Adenocarcinoma, Mucinous↗
PubMed1997

[Radiological surveillance of operated ethmoidal cancers. Practical points].

Radiological follow-up of ethmoidal neoplasms is not clearly established in terms of imaging modalities (CT, MRI) or periodicity. This paper, based on 4 typical cases, tries to describe the main imaging features of this radiological follow-up. Initial CT 3 to 6 months after surgery is essential, being the reference examination. It can show postoperative bone changes. During follow-up, a CT scanner every 6 months seems sufficient. For the image interpretation, a comparison with the two previous CT is mandatory. Any bone destruction must be considered as suspicious, even if very small. MRI should be performed in case of sphenoidal opacity, in order to differentiate between tumor recurrence and retentional fluid. MRI is also necessary and useful when the tumor presents an intradural or intracranial extension.

Adenocarcinoma↗
PubMed1997

[False radiologic pneumoperitoneum. The value of emergency abdominal computed tomography].

We report 2 cases of false pneumoperitoneum. The diagnosis was suspected on an upright chest or abdominal plain films. The absence of clinical signs and symptoms of peritoneal irritation suggested a wrong radiological diagnosis. Emergency CT scan definitely eliminated a pneumoperitoneum and suggested the right diagnosis in both cases. This exam may play the decisive role in preventing needless emergency laparotomy.

Aged↗
PubMed1993

Internal architecture of the parotid gland at MR imaging: facial nerve or ductal system?

A radiologic-anatomic study was performed to determine the nature of the low-signal-intensity curvilinear structures currently seen in the normal parotid gland on axial T1-weighted magnetic resonance (MR) images. These structures are considered by some to represent the intraparotid facial nerve. After cannulation of the Stensen duct, the authors imaged the parotid gland of two cadavers in situ before and after intraductal injection of gadolinium tetrazacyclododecanetetraacetic acid. Retrograde filling was obtained in one gland. The same sections were used throughout a subsequent anatomic study, allowing correlation of the MR findings with the macroscopic and histologic appearance of the gland. Comparison of MR images and gross and histologic sections established that two intraparotid facial nerve segments, although identified from the histologic study, were not visible on corresponding MR images. Many areas of low signal intensity seen within the gland were found to represent the main duct and some afferent ductal branches.

Cadaver↗
PubMed1993

Intraabdominal serous fluid collections after appendectomy: a normal sonographic finding.

OBJECTIVE: The significance of sonographic findings 1 week or less after appendectomy is difficult to evaluate without knowing the inconsequential abnormalities that may occur in these patients. Accordingly, we performed postoperative sonography on patients who had a normal course after appendectomy to determine the findings that can be considered normal within 1 week after surgery. SUBJECTS AND METHODS: Forty-four patients who had an appendectomy for acute appendicitis and who had normal findings at clinical follow-up 5 days and 6 months later were included in the study. In all patients, sonograms were obtained on the fifth postoperative day and interpreted by a radiologist who did not know the surgical findings. RESULTS: Ten fluid collections (23%) were found in the pericecal area, ranging in size from 10 x 10 mm to 40 x 20 mm. The collections were hypoechoic or anechoic, crescent-shaped, and immobile. Fluid collections were more common in cases of suppurative appendixes (6/20, 30%) than in cases of inflamed appendixes (4/19, 21%) and in retrocecal appendixes (3/9, 33%) than in normally located appendixes (7/34, 21%). However, the differences were not statistically significant (p > .05). CONCLUSION: Inconsequential fluid collections are detected with considerable frequency on postoperative sonograms 5 days after an appendectomy. Consequently, not every fluid collection should be considered an abscess.

Abdomen↗
PubMed1992

[Is facial nerve visible on magnetic resonance imaging?].

The internal architecture of the parotid gland was studied by nuclear magnetic resonance (NMR) imaging, particular attention being paid to the intra-parotid portion of the facial nerve. Currently available apparatuses provide high resolution images of previously poorly elucidated anatomic details. Certain authors consider that images in the axial plane in T1 allow direct visualization of the facial nerve and its branches in the form of low frequency linear signals within the gland. The present study, based on radio-anatomic correlations and date determined in a healthy volunteer, demonstrated that these structures correspond in fact to segments of the excretory canal tree, the facial nerve and its branches being invisible on NMR imaging. It is not possible, therefore, to determine the location of a parotid tumor in relation to these nerve elements using this imaging technique.

Facial Nerve↗
PubMed1991

[The normal cranial nerves in MRI. Description and visualization frequency].

In order to assess the value of MR in the depiction of intracranial nerves, we retrospectively reviewed 60 patients investigated over a period of 2 years. The aim of this study was: 1) to assess the score of MR in the detection of cranial nerves III to XII; 2) to determine accurate landmarks allowing for easy detection of those cranial nerves. Cranial nerves III, V, VII, VIII are well seen (70 to 100%), very often in both axial, sagittal and coronal sections. Nerves IX to XII are correctly studied only on axial planes [81 and 83%), but it is difficult to distinguish between the vagal nerve and the glossopharyngeal and spinal nerves. Due to their oblique direction and small size, fourth and sixth nerves are rarely visualized. The more important landmarks are the chiasma, the colliculi, the Meckel's cave, the internal auditory canal, the jugular foramen, the hypoglossal canal and the different brainstem structures. We suggest the following scanning protocol: short spin echo sequences (TR = 600 ms, TE = 20 msec), 3 to 5 continuous sections, 16 to 20 cm field of vue with respectively 4 or 2 excitations, 256 x 256 matrix, with at least one acquisition plane (axial), but preferably two or three planes. Thus MR is sensitive exam in the recognition of cranial nerves, and it must be the first step exam in patients presenting with cranial nerve disease.

Adult↗
PubMed1990

Visibility of cranial nerves at MRI.

In order to assess the value of MRI in the depiction of intracranial nerves, we retrospectively reviewed 60 patients investigated over a 2-year period. The purposes of this study were: 1) to determine the score of MRI in detecting cranial nerves III to XII, and 2) to establish accurate landmarks for easy detection of these nerves. Cranial nerves III, V, VII and VIII are well seen (70 to 100%), very often on axial, sagittal and coronal sections. Nerves IX to XII are correctly studied only on axial planes (81 and 83%), but it is difficult to distinguish between the vagus nerve and the glossopharyngeal and spinal nerves. Due to their oblique direction and small size, nerves IV and VI are seldom visualized. The most important landmarks are the chiasma, the colliculi, Meckel's cavity, the internal auditory canal, the jugular foramen, the hypoglossal canal and the brainstem structures. We suggest the following scanning technique: short spin-echo sequences (TR 600 ms, TE 20 ms), 3 to 5 mm thick contiguous sections, 16 to 20 cm field of view with 4 or 2 excitations respectively, 256 x 256 matrix, and at least one acquisition plane (axial plane), but preferably two or three planes. MRI is a sensitive examination in the recognition of cranial nerves. It should be the first-step exploratory procedure in patients with cranial nerve pathology.

Adolescent↗
PubMedDate not supplied

The aryepiglottic fold as a rare location of adenoid cystic carcinoma.

We report one case of a mass in the aryepiglottic fold seen on CT, which proved to be an adenoid cystic carcinoma. There was nothing specific about the imaging characteristics that would allow it to be confidentially differentiated from squamous cell carcinoma.

Carcinoma, Adenoid Cystic↗