PubMed · 9627635
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I F Wessels, J Bowers. 1998. Avoiding Tenon's capsule.. https://doi.org/10.1016/s0161-6420(98)96038-9
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Infestation in soft tissue by Echinococcus granulosus is not a common disease, and its diagnosis is based on clinical, laboratory data and radiological findings. The aim of our retrospective study is to give an overview of the different signs and patterns shown by MRI that can be useful in characterizing soft tissue hydatid disease. The MRI images obtained in seven patients with soft tissue and subcutaneous hydatidosis were reviewed. Typical signs of hydatidosis were multivesicular lesions with or without hypointense peripheral ring ("rim sign"). Related to the presence and absence, respectively,of viable scolices in the microscopic exam, daughter cysts were presented either as high signal intensity or low signal intensity on T2-weighted images. Low-intensity detached layers within the cyst and peripheral enhancement with gadolinium-DTPA were also presented. Atypical signs were presented in an infected muscular cyst, a subcutaneous unilocular cyst and several unilocular cysts. Knowledge of the different patterns in MRI of soft tissue hydatid disease can be useful in diagnosing this entity. We observed that the "rim sign" is not as common as in other locations, and in addition, MRI seems to be of assistance when evaluating the vitality of the cysts.
The most recent comprehensive review of the literature on repair of nasoseptal perforations dates back to 1985, since then there have been developments in the repair of very large perforations, previously thought to have been untreatable by surgical methods. The purpose of this article is to review the various methods which have been used to repair perforations, and their reported efficacies, with particular reference to the problem of large perforations. The article reviews the methods in use for providing mucosal cover for perforations; the options for a supporting layer; and the more recent solutions to mending perforations greater than 4 cm diameter. In conclusion, nasoseptal perforations of up to 4 cm diameter have been reported to be closed reliably with bilateral mucoperichondrial flaps and a connective tissue autograft. However, for larger perforations the only methods successfully used have been a three stage, composite graft and intranasal tissue expanders.
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