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Rozas Pozo M, Fiori-Chíncaro GA, Llaguno-Rubio JM. [Narrative review of imaging studies of calcifications of the submandibular gland]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e143. [PMID: 38303738 PMCID: PMC10832393 DOI: 10.21142/2523-2754-1101-2023-143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/05/2023] [Indexed: 02/03/2024] Open
Abstract
Sialolithiasis is one of the most common pathologies of the major salivary glands and occurs more frequently in the submandibular glands. Between 80 and 95% of sialoliths develop in the submandibular glands, between 5 and 20% in the parotid gland, and only 1% in the sublingual gland. Sialoliths form within the parenchyma and associated duct systems. In Wharton's duct (80-90%) and only 15% in the gland. Sialolithiasis is the cause of pain and inflammation of the salivary gland by obstructing the duct and preventing salivary secretion, before, during and after food.The objective of this article was to review the different diagnostic imaging methods used for the study of calcifications of the submandibular gland, based on different studies reported in contemporary scientific literature, in order to establish the correct diagnosis. A search of the literature was carried out in the main information sources including Medline (via PubMed), SEVIER, SCIELO, and LILACS, using the search terms with a date limitation of the last 5 years on average. The selected articles included information regarding the calcifications of the salivary glands. Imaging studies of salivary gland calcifications can be obtained with conventional radiographs, Sialography, Ultrasonography (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MR).
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Affiliation(s)
- Marco Rozas Pozo
- Division de Radiologia Bucal y Maxilofacial, Instituto Latinoamericano de Altos Estudios en Estomatologia. Lima, Peru. , , Division de Radiologia Bucal y Maxilofacial Instituto Latinoamericano de Altos Estudios en Estomatologia Lima Peru
| | - Gustavo Adolfo Fiori-Chíncaro
- Division de Radiologia Bucal y Maxilofacial, Instituto Latinoamericano de Altos Estudios en Estomatologia. Lima, Peru. , , Division de Radiologia Bucal y Maxilofacial Instituto Latinoamericano de Altos Estudios en Estomatologia Lima Peru
| | - Jhoana Mercedes Llaguno-Rubio
- Division de Radiologia Bucal y Maxilofacial, Instituto Latinoamericano de Altos Estudios en Estomatologia. Lima, Peru. , , Division de Radiologia Bucal y Maxilofacial Instituto Latinoamericano de Altos Estudios en Estomatologia Lima Peru
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Koch M, Schapher ML, Mantsopoulos K, Goncalves M, Iro H. Simultaneous Application of Ultrasound and Sialendoscopy and its Value in the Management of Sialolithiasis. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2022; 43:289-297. [PMID: 33063297 DOI: 10.1055/a-1270-7174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Ultrasound (US) and sialendoscopy (SE) are routinely used in patients presenting with sialolithiasis in the submandibular (SMG) and parotid gland (PG). The objective was to assess the value of the simultaneous application of US and SE in the management of sialolithiasis. STUDY DESIGN Retrospective study. SETTING Tertiary referral center for salivary gland diseases. PARTICIPANTS Patients in whom US and SE as single investigation tools were neither conclusive nor useful in the management of sialolithiasis were investigated using both methods simultaneously (simUS + SE). MAIN OUTCOME MEASURES Establishment of the final diagnosis and/or contribution to the planning/performing of treatment in sialolithiasis. RESULTS 74 patients were examined by simUS + SE (58.1 % SMG and 41.9 % PG). In all patients (unclear) hyperechoic reflexes were assessed and/or localized by SE-controlled US navigation. 68.9 % of the patients were investigated for diagnostic or differential-diagnostic reasons including distinguishing extraductal from intraductal calcifications and/or to exclude residual stones after therapy. In 52.7 % simUS + SE was used to plan and/or perform further treatment, in 20.3 % to enable performing a combined approach (all PG) and in 29.7 % to evaluate and plan the most adequate therapy (mainly intraductal vs. extracorporeal shock wave lithotripsy, 68.2 % of these SMG). In two cases SE-controlled and US-guided stone extraction was performed. CONCLUSION SimUS + SE is an innovative approach which proved to be very useful in managing sialolithiasis. It added valuable information regarding the establishment of a diagnosis or differential diagnosis, planning and performing the most adequate treatment, intraoperative control of therapy and postoperative follow-up.
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Affiliation(s)
- Michael Koch
- Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mirco Lothar Schapher
- Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
| | - Miguel Goncalves
- Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Head and Neck Surgery, FA University of Erlangen-Nuremberg, Erlangen, Germany
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France K, AlMuzaini AAAY, Mupparapu M. Radiographic Interpretation in Oral Medicine and Hospital Dental Practice. Dent Clin North Am 2021; 65:509-528. [PMID: 34051928 DOI: 10.1016/j.cden.2021.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Oral medicine practice includes the diagnosis and nonsurgical treatment of oral and orofacial diseases and oral manifestations of systemic conditions. Oral medicine specialists in medical and dental settings often require imaging in assessment and treatment of these conditions. This article reviews imaging that may be used in practice, particularly as relevant for facial pain, bone conditions, and salivary gland disease. It reviews imaging that may be considered in a hospital setting for assessment of admitted patients, patient evaluation before surgical procedures, and provision of dentistry in a hospital setting for patients who cannot submit to treatment in an outpatient setting.
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Affiliation(s)
- Katherine France
- University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | | | - Mel Mupparapu
- University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
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Cone-Beam Computed Tomography: A User-Friendly, Practical Roadmap to the Planning and Execution of Every Rhinoplasty-A 5-Year Review. Plast Reconstr Surg 2021; 147:749e-762e. [PMID: 33835107 DOI: 10.1097/prs.0000000000007900] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cone-beam computed tomography has recently rapidly developed worldwide as a versatile and convenient alternative to traditional computed tomography for imaging of the maxillofacial region. However, most surgeons performing rhinoplasty are surprisingly unfamiliar with it, in both the plastic surgery and ear, nose, and throat communities. METHODS The broad clinical experience of a single center over the past 5 years is reviewed. The many applications of cone-beam computed tomography to primary and secondary rhinoplasty are analyzed regarding septum, turbinates, nasal bones, skin thickness, and other issues. The importance of a paradigm shift from a two-dimensional to a three-dimensional approach in image reconstruction is demonstrated, together with the value of surface contour enhancement. RESULTS Cone-beam computed tomography has a multitude of practical applications highly relevant to rhinoplasty. The surface image will strengthen aesthetic analysis, and the detailed preview of bony and functional anatomy will facilitate surgical planning. Cone-beam computed tomography serves as a roadmap to plan and execute rhinoplasties more predictably and efficiently. The availability of spatial views and accurate detail, together with the possibility of easy, accurate measuring, offers a plenitude of potential applications. CONCLUSIONS Cone-beam computed tomography is a user-friendly, quick technique with abundant advantages in planning any rhinoplasty. It causes the patient no inconvenience and has very few, if any, drawbacks, with these being limited to radiation exposure and limited cost.
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Schapher M, Goncalves M, Mantsopoulos K, Iro H, Koch M. Transoral Ultrasound in the Diagnosis of Obstructive Salivary Gland Pathologies. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2338-2348. [PMID: 31227261 DOI: 10.1016/j.ultrasmedbio.2019.05.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/04/2019] [Accepted: 05/16/2019] [Indexed: 06/09/2023]
Abstract
Transcutaneous ultrasound (TCUS) is an accepted diagnostic method in salivary gland diseases. However, sparse data are available on the use of transoral ultrasound (TOUS) in sialadenopathies. One hundred five patients presenting with various obstructive sialadenopathies were examined using TOUS and TCUS. Ultrasound findings were validated by direct visualization in subsequent sialendoscopy examinations. By TOUS, but not by TCUS, all patients with sialolithiasis (70/105) could be identified and virtually all concrements, even very small ones, were detected and distinguished from artifacts. Ductal stenoses (16/105) could be correctly differentiated from sialoliths, and exceptional insights into the delicate anatomy of parotid duct stenoses were gained. TOUS provided detailed information on other space-occupying lesions (14/105) and circumvented the method-related diagnostic weaknesses of TCUS. As a valuable tool in the diagnosis of obstructive sialadenopathies, TOUS seems superior to TCUS in pathologies involving the distal parotid duct, the submandibular duct system and the floor of the mouth.
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Affiliation(s)
- Mirco Schapher
- Department of Otorhinolaryngology, Head and Neck Surgery, FAU Medical School, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Miguel Goncalves
- Department of Otorhinolaryngology, Head and Neck Surgery, FAU Medical School, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, FAU Medical School, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, FAU Medical School, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, FAU Medical School, University of Erlangen-Nuremberg, Erlangen, Germany
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Costan VV, Ciocan-Pendefunda CC, Sulea D, Popescu E, Boisteanu O. Use of Cone-Beam Computed Tomography in Performing Submandibular Sialolithotomy. J Oral Maxillofac Surg 2019; 77:1656.e1-1656.e8. [DOI: 10.1016/j.joms.2019.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 11/27/2022]
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Goncalves M, Mantsopoulos K, Schapher M, Iro H, Koch M. Ultrasound Supplemented by Sialendoscopy: Diagnostic Value in Sialolithiasis. Otolaryngol Head Neck Surg 2018; 159:449-455. [DOI: 10.1177/0194599818775946] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To assess the value of ultrasound, if indicated, supplemented by sialendoscopy, in the diagnosis of sialolithiasis. Study Design Retrospective study. Setting Referring center for salivary gland diseases. Subjects and Methods All patients who presented with a suspected diagnosis of obstructive sialopathy between January 2011 and April 2017 and had not undergone any treatment were retrospectively evaluated. A total of 2052 patients and 2277 glands were included in the study. Ultrasound examinations were carried out initially and followed by sialendoscopy in all cases. Direct demonstration of sialothiasis by sialendoscopy, transoral ductal surgery, and discharge of concrements/observation of fragments during sialendoscopy after extracorporeal shock-wave lithotripsy were regarded as definitive evidence of sialolithiasis. Results Ultrasound had an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 94.77%, 94.91%, 94.57%, 96.14%, and 92.89%, respectively, for the diagnosis of sialolithiasis. All false-positive findings were correctly diagnosed, and in all false-negative findings, stones/fragments were visualized by sialendoscopy. Over 95% of the false-negative findings in major salivary glands (64/67) had visible ductal dilation in sonography, and in 73.1%, the stones not detected on ultrasound were located in the distal part of the duct, which is easily accessible with the sialendoscope. Conclusion This study shows that sialolithiasis can be diagnosed using ultrasonography with a high degree of certainty. If supplemented by sialendoscopy, the correct diagnosis could be established in virtually all cases of sialolithiasis. Ultrasound supplemented by sialendoscopy has the potential to serve as an alternative diagnostic standard in the future.
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Affiliation(s)
- Miguel Goncalves
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, Germany
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Missias EM, Nascimento E, Pontual M, Pontual AA, Freitas DQ, Perez D, Ramos-Perez F. Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT. Oral Dis 2018; 24:628-637. [PMID: 29224195 DOI: 10.1111/odi.12815] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/28/2017] [Accepted: 12/03/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine the prevalence of soft tissue calcifications in cone beam computed tomography (CBCT) scans with different fields of view (FOV) and to assess its relation with the clinical relevance of the CBCT findings. MATERIAL AND METHODS One thousand CBCT scans were grouped according to FOV's size and region scanned (MX-FOV, maxilla; MD-FOV, mandible; and MM-FOV, maxilla/mandible) and evaluated for the presence of soft tissue calcifications. Laterality and length of the elongated styloid processes (ESP) were also assessed. RESULTS Eight hundred and eighty-two soft tissue calcifications were detected in 626 (62.6%) patients. MM-FOV presented the highest prevalence (76.8%), followed by MD-FOV (60.6%) and MX-FOV (57.2%). ESP and tonsillolith were the most frequent calcifications. Calcifications requiring treatment or not and those in need of follow-up accounted for 6.9%, 92.7%, and 0.3% of cases, respectively. There was no association between calcifications and subjects' gender or age (p > .05). Most cases of ESP occurred bilaterally and were longer in males (p < .05). CONCLUSIONS There is a high prevalence of soft tissue calcifications in CBCT, and ESP and tonsilloliths are the most common types in all evaluated FOVs. While most cases do not require treatment, we emphasize the importance of detailed CBCT assessment for its diagnosis.
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Affiliation(s)
- E M Missias
- Department of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Ehl Nascimento
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Mla Pontual
- Department of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - A A Pontual
- Department of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - D Q Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Dec Perez
- Department of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Fmm Ramos-Perez
- Department of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
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The value of cone beam computed tomography in the detection of salivary stones prior to sialendoscopy. Int J Oral Maxillofac Surg 2018; 47:223-227. [DOI: 10.1016/j.ijom.2017.07.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/19/2017] [Accepted: 07/27/2017] [Indexed: 11/19/2022]
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Gardon MA, Foletti JM, Avignon S, Graillon N, Chossegros C. CT scan assessment in salivary gland lithiasis diagnosis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 119:110-112. [PMID: 29175510 DOI: 10.1016/j.jormas.2017.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 09/22/2017] [Accepted: 11/16/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The aim of the study was to assess computed tomography (CT) scan efficiency for the diagnosis of salivary lithiasis. METHODS Patients who were included were all the patients who consulted in our department for main salivary gland (submandibular and parotid) obstruction symptoms between June 2014 and December 2016. A CT scan without injection was prescribed for all of them. The 163 patients were divided into two groups after the CT scan: patients with and without lithiasis. During surgery, we confirmed the presence or absence of the lithiasis previously diagnosed on the CT scan. The patients were divided in two groups: case and control groups. For statistical analysis, the sensitivity, specificity, and the negative and positive predictive values of the preoperative CT scan were calculated. RESULTS A total of 163 patients with a salivary obstructive syndrome were included. On the CT scans, we found lithiases (hyperdense images) in 157 glands ("CT scan⊕" group), and we found no lithiasis in 6 glands ("CT scan" group). In the "CT scan⊕" group, 203 lithiases were present. During surgery, we found and removed lithiases in 155 patients (case group), and 8 patients had no lithiases (control group). The overall sensitivity, specificity, positive predictive value, and negative predictive values of the CT scan for the detection of lithiasis were 100%, 75%, 99%, and 100%, respectively. The specificity of CT scans for the lithiasis located in the anterior and middle third of the duct was 100%. DISCUSSION According to our study, the CT scan is very efficient in diagnosing salivary main gland lithiases in patients with an obstructive syndrome.
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Affiliation(s)
- M A Gardon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France.
| | - J M Foletti
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial & plastic surg department, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - S Avignon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France
| | - N Graillon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France
| | - C Chossegros
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France; Laboratoire parole et langage, 5, rue Pasteur, 13100 Aix-en-Provence, France
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Goncalves M, Schapher M, Iro H, Wuest W, Mantsopoulos K, Koch M. Value of Sonography in the Diagnosis of Sialolithiasis: Comparison With the Reference Standard of Direct Stone Identification. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:2227-2235. [PMID: 28556090 DOI: 10.1002/jum.14255] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 02/02/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The aim of this study was to assess the effectiveness of sonography for diagnosing sialolithiasis in comparison with the existing reference standard of direct identification of a stone. METHODS A total of 659 glands with signs of obstructive sialadenopathy were evaluated retrospectively. Sonographic examinations of the large head salivary glands had been performed initially in all cases. Direct depiction of a stone during sialoendoscopy or transoral ductal surgery or observation of stone fragmentation with discharge of concrements after extracorporeal shock wave lithotripsy, was regarded as definitive evidence and as the reference standard for the presence of sialolithiasis. The sonographic results were compared with those for direct identification of stones. RESULTS The sensitivity of sonography was 94.7%, with specificity of 97.4%, a positive predictive value of 99.4%, and a negative predictive value of 79.6%. Stones that were not diagnosed correctly on sonography were most often located in the distal area of the duct. CONCLUSIONS These results show that sialolithiasis can be diagnosed by sonography with a high degree of certainty. Sonography thus appears to be highly appropriate as the examination method of choice.
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Affiliation(s)
- Miguel Goncalves
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Wolfgang Wuest
- Institute of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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"Is Cone Beam Computed Tomography (CBCT) a Potential Imaging Tool in ENT Practice?: A Cross-Sectional Survey Among ENT Surgeons in the State of Odisha, India. Indian J Otolaryngol Head Neck Surg 2017; 70:130-136. [PMID: 29456957 DOI: 10.1007/s12070-017-1168-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 07/17/2017] [Indexed: 01/18/2023] Open
Abstract
This questioner survey aimed about awareness of the Cone Beam Computed Tomography (CBCT) machine and its various clinical applications in ENT, among the ENT surgeons in the state of Odisha. 150 questioner forms on CBCT were distributed to the all the participating ENT surgeons at a state level ENT conference, out of which the response rate was 110. The participants were asked to answer 30 multiple choice questions, which were divided into 3 parts; general information on CBCT, general approach to CBCT and practice related to CBCT. The statistical analysis of the data collected was carried out by a Chi square test to compare the means at a significance level of P < 0.05. The response rate for this study was 73%. The mean age of the participant ENT surgeons was 47.9 (±19.2). Of the study population, 71.2% (89) did not ever advice CBCT in their practice. Only 33.9% (38) of the population believed that CBCT is more beneficial in the field of ENT. Only 25% (28) knew that CBCT requires lower radiation dose than conventional CT. 28.1% (31) of population believed that the spatial orientation is better in CBCT than CT. 62.5% (69) of the population did not knew that CBCT can be used in imaging sinusitis of dental origins. 75% (83) of the population did not knew that CBCT can be used in diagnosis of obstructive sleep apnoea and visualizing airway space. Only 18.8% (21) of the study population agreed that the CBCT has the potential to replace conventional CT in ENT imaging in future. In the conclusion, this study clearly showed that the number of ENT surgeons advising CBCT imaging in their practice is very less. The knowledge about various advantages and clinical applications of CBCT had been very limited. However, through continuing medical education and conducting various seminars and workshops on CBCT, imparting chapters on CBCT, in the undergraduate and post graduate curriculum will definitely help increase the awareness on CBCT among ENT fraternity.
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Thomas WW, Douglas JE, Rassekh CH. Accuracy of Ultrasonography and Computed Tomography in the Evaluation of Patients Undergoing Sialendoscopy for Sialolithiasis. Otolaryngol Head Neck Surg 2017; 156:834-839. [DOI: 10.1177/0194599817696308] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To determine the accuracy of the 2 most utilized imaging modalities in obstructive sialadenitis secondary to sialolithiasis—computed tomography (CT) and ultrasonography (US)—using sialendoscopic findings as a comparison standard. To review the impact of CT and US on the management of sialolithiasis managed with sialendoscopy alone and through combined approaches. Study Design Retrospective cohort study. Setting Quaternary academic referral center. Subjects and Methods All cases of patients undergoing sialendoscopy by a single surgeon for suspected parotid and submandibular gland pathology between the October 2013 and April 2016 were reviewed. Results Sixty-eight patients were in this cohort, of whom 44 underwent US, CT, and sialendoscopy; 20 underwent CT and sialendoscopy only; and 4 underwent US and sialendoscopy only. The sensitivity and specificity were 65% and 80% for US and 98% and 88% for CT, respectively. These 68 patients had 84 total stones addressed, with 79 being removed and 5 remaining in situ. The methods of stone removal were sialendoscopy alone (34 stones), open transoral approaches (36 stones), and an external approach: transcervical for submandibular and transfacial for parotid (11 stones). Conclusion US had a lower sensitivity (65%) than what has been reported in the literature (70%-94%), and the majority of missed stones were anterior Wharton’s duct stones. These sialoliths were likely missed due to an incomplete examination. US and CT were complementary in this study, and the findings suggest that both modalities can be utilized to optimize the outcome of sialendoscopy and combined approaches.
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Affiliation(s)
- W. Walsh Thomas
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer E. Douglas
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christopher H. Rassekh
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Chan HHL, Siewerdsen JH, Vescan A, Daly MJ, Prisman E, Irish JC. 3D Rapid Prototyping for Otolaryngology-Head and Neck Surgery: Applications in Image-Guidance, Surgical Simulation and Patient-Specific Modeling. PLoS One 2015; 10:e0136370. [PMID: 26331717 PMCID: PMC4557980 DOI: 10.1371/journal.pone.0136370] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 08/03/2015] [Indexed: 01/06/2023] Open
Abstract
The aim of this study was to demonstrate the role of advanced fabrication technology across a broad spectrum of head and neck surgical procedures, including applications in endoscopic sinus surgery, skull base surgery, and maxillofacial reconstruction. The initial case studies demonstrated three applications of rapid prototyping technology are in head and neck surgery: i) a mono-material paranasal sinus phantom for endoscopy training ii) a multi-material skull base simulator and iii) 3D patient-specific mandible templates. Digital processing of these phantoms is based on real patient or cadaveric 3D images such as CT or MRI data. Three endoscopic sinus surgeons examined the realism of the endoscopist training phantom. One experienced endoscopic skull base surgeon conducted advanced sinus procedures on the high-fidelity multi-material skull base simulator. Ten patients participated in a prospective clinical study examining patient-specific modeling for mandibular reconstructive surgery. Qualitative feedback to assess the realism of the endoscopy training phantom and high-fidelity multi-material phantom was acquired. Conformance comparisons using assessments from the blinded reconstructive surgeons measured the geometric performance between intra-operative and pre-operative reconstruction mandible plates. Both the endoscopy training phantom and the high-fidelity multi-material phantom received positive feedback on the realistic structure of the phantom models. Results suggested further improvement on the soft tissue structure of the phantom models is necessary. In the patient-specific mandible template study, the pre-operative plates were judged by two blinded surgeons as providing optimal conformance in 7 out of 10 cases. No statistical differences were found in plate fabrication time and conformance, with pre-operative plating providing the advantage of reducing time spent in the operation room. The applicability of common model design and fabrication techniques across a variety of otolaryngological sub-specialties suggests an emerging role for rapid prototyping technology in surgical education, procedure simulation, and clinical practice.
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Affiliation(s)
- Harley H. L. Chan
- TECHNA Institute, University Health Network, Toronto, Ontario, Canada
| | - Jeffrey H. Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Allan Vescan
- Department of Otolaryngology–Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Michael J. Daly
- TECHNA Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Eitan Prisman
- Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia
| | - Jonathan C. Irish
- TECHNA Institute, University Health Network, Toronto, Ontario, Canada
- Department of Surgical Oncology, University Health Network, Toronto, Ontario, Canada
- Department of Otolaryngology–Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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Affiliation(s)
- A Lacout
- Centre d'imagerie médicale, radiologie, 47, boulevard du Pont-Rouge, 15000 Aurillac, France.
| | - M El Hajjam
- Pôle d'imagerie médicale, clinique Saint-Dominique, 61100 Flers, France
| | - P-Y Marcy
- Service imagerie médicale, polyclinique Les Fleurs, 332, avenue Frédéric-Mistral, 83190 Ollioules, France
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Sialendoscopy-assisted transfacial surgical removal of parotid stones. J Craniomaxillofac Surg 2014; 42:1964-9. [DOI: 10.1016/j.jcms.2014.08.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 08/22/2014] [Accepted: 08/27/2014] [Indexed: 11/23/2022] Open
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Schwarz D, Kabbasch C, Scheer M, Mikolajczak S, Beutner D, Luers JC. Comparative analysis of sialendoscopy, sonography, and CBCT in the detection of sialolithiasis. Laryngoscope 2014; 125:1098-101. [DOI: 10.1002/lary.24966] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/12/2014] [Accepted: 09/17/2014] [Indexed: 11/11/2022]
Affiliation(s)
- David Schwarz
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
| | | | - Martin Scheer
- Department of Oral and Maxillofacial Surgery; Johannes Wesling Hospital; Minden Germany
| | - Stefanie Mikolajczak
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
| | - Jan C. Luers
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
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Are All Soft Tissue Calcifications Detected by Cone-Beam Computed Tomography in the Submandibular Region Sialoliths? J Oral Maxillofac Surg 2014; 72:1531.e1-6. [DOI: 10.1016/j.joms.2014.04.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/02/2014] [Accepted: 04/06/2014] [Indexed: 12/20/2022]
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Kiringoda R, Eisele DW, Chang JL. A comparison of parotid imaging characteristics and sialendoscopic findings in obstructive salivary disorders. Laryngoscope 2014; 124:2696-701. [DOI: 10.1002/lary.24787] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 04/28/2014] [Accepted: 05/22/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Ruwan Kiringoda
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco School of Medicine; San Francisco California U.S.A
| | - David W. Eisele
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University School of Medicine; Baltimore Maryland U.S.A
| | - Jolie L. Chang
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco School of Medicine; San Francisco California U.S.A
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Jadu FM, Lam EWN. A comparative study of the diagnostic capabilities of 2D plain radiograph and 3D cone beam CT sialography. Dentomaxillofac Radiol 2013; 42:20110319. [PMID: 23253564 DOI: 10.1259/dmfr.20110319] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the diagnostic capabilities of two-dimensional sialography with a novel three-dimensional technique using cone beam CT (CBCT). METHODS 47 subjects underwent parotid or submandibular gland sialography over a 2 year period using both plain imaging and CBCT. Both image sets were anonymized and independently reviewed by three certified oral and maxillofacial radiologists blinded to the clinical data. McNemar's χ(2) test was used to determine differences between the two modalities for feature visualization and interpretation. RESULTS CBCT outperformed plain imaging with respect to visualization of the gland parenchyma (p < 0.001) and identification of sialoliths (p = 0.02). Plain imaging outperformed CBCT for the identification of strictures (p = 0.04); however, the negative per cent agreement ("specificity") between the two imaging modalities was 100%. Although both imaging modalities performed equally in identifying normal and abnormal sialographic examinations, CBCT demonstrated a high negative per cent agreement for normal glands and a high positive per cent agreement ("sensitivity") for abnormal glands with inflammatory changes. CONCLUSION CBCT sialography allowed better visualization of gland parenchyma and identification of sialoliths. The high negative per cent agreement for strictures suggests that, if strictures are identified on CBCT images, then obstruction can be ruled in. Relative to plain images, the high negative per cent agreement for normal glands suggests that, if an abnormal finding is detected on CBCT images, then disease can be ruled in, and the high positive per cent agreement for glands with inflammatory changes suggests that inflammation can be ruled out if these changes are not seen on CBCT images.
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Affiliation(s)
- F M Jadu
- Faculty of Dentistry, the University of Toronto, Toronto, ON, Canada.
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Ahmad M, Jenny J, Downie M. Application of cone beam computed tomography in oral and maxillofacial surgery. Aust Dent J 2012; 57 Suppl 1:82-94. [PMID: 22376100 DOI: 10.1111/j.1834-7819.2011.01661.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In the past decade, the utility of cone beam computed tomography (CBCT) images in oral and maxillofacial surgery has seen continuous increase. However, CBCT images are not always able to replace other imaging modalities. Based on the current published knowledge, this paper discusses advantages and limitations of CBCT images in the diagnosis and surgical planning of dentoalveolar procedures, odontogenic cysts, benign and malignant tumours, inflammatory changes, orthognathic surgery, maxillofacial trauma, sinus disorders, and systemic and osseous conditions that manifest in the maxillofacial area. This paper also suggests alternative imaging modalities when CBCT images are not adequate for surgical planning.
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Affiliation(s)
- Mansur Ahmad
- Division of Oral and Maxillofacial Radiology, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA.
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Dreiseidler T, Alarabi N, Ritter L, Rothamel D, Scheer M, Zöller JE, Mischkowski RA. A comparison of multislice computerized tomography, cone-beam computerized tomography, and single photon emission computerized tomography for the assessment of bone invasion by oral malignancies. ACTA ACUST UNITED AC 2011; 112:367-74. [DOI: 10.1016/j.tripleo.2011.04.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 03/28/2011] [Accepted: 04/05/2011] [Indexed: 11/16/2022]
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