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Biomedical subjects

T Karhuketo

Publications and source records attributed to T Karhuketo.

5 recordsLinked to original sources

Reliability of acoustic rhinometry.

In recent years increasing evidence has been provided on frequent simultaneous coexistence of inflammatory diseases and allergies in upper and lower airways. To achieve a good standard of measurement of upper airways, an objective method should be used. A total of 48 nasal cavities with nasal stuffiness associated with chronic sinusitis were measured with acoustic rhinometry (AR) and High-resolution computer tomography volumetry (HRCTV). Comparison of volumes and minimum cross-sectional areas measured with these methods was performed. The volumes measured from the nostril with both methods were the anterior (0-10 mm), middle (11-40 mm) and posterior (41-70 mm) volumes. The AR cross-sectional area curve was analysed based on two minimal notches corresponding to local minimal areas. A series of 1-mm coronal CT images without intervening gaps were made and analysed based on two minimal voxel values, which were later converted to cross-sectional areas corresponding to local, minimum cross-sectional areas (MCA). Furthermore, the distances of these 2 MCAs from the nostril were also measured. Strong statistically significant (P < 0.05) correlations were found between AR and computer tomography volumetry (CTV) volumes in the anterior (r = 0.83) and middle (r = 0.77) parts of the nasal cavity. In the posterior part of the nasal cavity a statistically significant (P < 0.05) correlation was also found (r = 0.62). Good agreements between the AR and CTV volumes in the anterior and middle parts of the nasal cavities were confirmed with Bland-Altman plots. Correlations among the MCAs were weaker (r = 0.59 and r = 0.55). Our results suggest that the reliability of AR appears sufficient for clinical and scientific use in the nasal cavities. Reliability is very good in the anterior and middle parts of the nasal cavities, while strong conclusions based on evaluation of the posterior part should be avoided due to decreasing accuracy.

Adult↗

Axial HRCT, two-dimensional and maximum intensity projection reconstructions in temporal bone lesions.

Axial and coronal high resolution computer tomography (HRCT) of the temporal bone is an important imaging technique to evaluate hearing loss. However the acquisition of the coronal imaging proves uncomfortable to the patient and is not always technically possible in old and ill patients. Clinical diagnoses of chronic otitis media, mastoiditis, cholesteatoma and cochlear otosclerosis in 10 patients were studied on a third generation CT scanner. Axial 1 mm HRCT slices were acquired and the images were transferred to an Advantage Windows workstation where two-dimensional (2D) multiplanar and sagittal maximum intensity projection (MIP) reformations were performed. Our aim was to study the ability of this technique to identify several small structures of the temporal bone in various diseases. In all cases the finer structures of the temporal bone were identified in axial HRCT images. The tegmen tympani, atticus and the cochlea were best seen in the 2D coronal reconstructions. The aditus ad antrum, facial canal, vestibule and the semicircular canals were best seen on 2D sagittal reconstructions. The joints between the bony ossicles of the middle ear was best seen in the sagittal MIP reconstructions. Our results suggest that axial HRCT, 2D multiplanar and MIP reconstructions of the temporal bone produce images with sufficient diagnostic quality in patients with hearing loss.

Adolescent↗

Pharyngeal patency caused by stimulation of the hypoglossal nerve in anaesthesia-relaxed patients.

Impaired function of the genioglossal muscle is the most frequent reason for upper airway obstruction during sleep. Functional electrical stimulation (FES) of the hypoglossal nerve may be used to push the tongue forward to release the obstruction. Anaesthesia-induced upper airway obstruction resembles the situation during obstructive sleep apnea (OSA) syndrome. In order to develop an implantable FES system for treatment of OSA, we stimulated the exposed hypoglossal nerve in 6 patients undergoing radical cancer surgery of the head and neck region. Tongue movements during stimulation were video filmed and the amount of unobstructed airway achieved with stimulation was estimated using the adjacent intubation tube as reference. In every case, stimulation created an unobstructed airway, larger than the intubation tube.

Anesthesia, General↗

Radical surgery for lingual cancer.

The survival rates of 58 patients treated for squamous carcinoma of the tongue between 1972 and 1985 were evaluated. The overall 5-year survival rate was 41.6%; for stage I it was 61.8%; stage II 59.5%; and stage III, 27.7%. No patient survived for more than 2 years when their tumour was stage IV on presentation. A composite pull-through resection with radical neck dissection gave a 5-year survival rate of 50.7%, which was significantly (P less than 0.01) higher than the 13.8% achieved by other treatments, mainly local tumour excision combined with radiation therapy. The same trend in favour of radical surgery was also seen stage by stage. In 45% of the patients regional neck metastases (palpable in 35% and occult in 10%) were present and predicted a poor prognosis. Among T1-T2 cases the 5-year survival of 58.5% in the N0 group was significantly (P less than 0.01) higher than the 15.1% among those with nodal involvement. The location of the primary tumour did not affect the survival rates.

Adult↗