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Serindere G, Bilgili E, Yesil C, Ozveren N. Evaluation of maxillary sinusitis from panoramic radiographs and cone-beam computed tomographic images using a convolutional neural network. Imaging Sci Dent 2022; 52:187-195. [PMID: 35799961 PMCID: PMC9226235 DOI: 10.5624/isd.20210263] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/14/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- Gozde Serindere
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Ersen Bilgili
- Department of Dentomaxillofacial Radiology, Izmir Education Dental Hospital, Izmir, Turkey
| | - Cagri Yesil
- Department of Computer Engineering, Faculty of Engineering, Yeditepe University, İstanbul, Turkey
| | - Neslihan Ozveren
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University, Edirne, Turkey
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Zhang H, Han N, Lin Y, Huang J, Svanberg S, Svanberg K. Gas Monitoring in Human Frontal Sinuses-Stability Considerations and Gas Exchange Studies. SENSORS 2021; 21:s21134413. [PMID: 34203142 PMCID: PMC8271500 DOI: 10.3390/s21134413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/14/2021] [Accepted: 06/23/2021] [Indexed: 11/16/2022]
Abstract
Acute rhinosinusitis is a common infectious disease, which, in more than 90% of cases, is caused by viruses rather than by bacteria. Even so, antibiotics are often unnecessarily prescribed, and in the long run this contributes to the alarming level of antibiotics resistance. The reason is that there are no good guiding tools for defining the background reason of the infection. One main factor for the clearance of the infection is if there is non-obstructed ventilation from the sinus to the nasal cavity. Gas in Scattering Media Absorption Spectroscopy (GASMAS) has potential for diagnosing this. We have performed a study of frontal sinuses of volunteers with a focus on signal stability and reproducibility over time, accurate oxygen concentration determination, and assessment of gas transport through passages, naturally and after decongestant spray administration. Different from earlier studies on frontal sinuses, water vapor, serving the purpose of oxygen signal normalization, was measured at 818 nm rather than earlier at 937 nm, now closer to the 760 nm oxygen absorption band and thus resulting in more reliable results. In addition, the action of decongestants was objectively demonstrated for the first time. Evaluated oxygen concentration values for left- and right-hand side sinus cavities were found to agree within 0.3%, and a left-right geometrical asymmetry parameter related to anatomical differences was stable within 10%.
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Affiliation(s)
- Han Zhang
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou 510006, China; (H.Z.); (N.H.); (Y.L.); (J.H.)
- Guangdong Provincial Key Laboratory of Optical Information Materials and Technology, Center for Optical and Electromagnetic Research, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - Ning Han
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou 510006, China; (H.Z.); (N.H.); (Y.L.); (J.H.)
- Guangdong Provincial Key Laboratory of Optical Information Materials and Technology, Center for Optical and Electromagnetic Research, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - Yueyu Lin
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou 510006, China; (H.Z.); (N.H.); (Y.L.); (J.H.)
- Guangdong Provincial Key Laboratory of Optical Information Materials and Technology, Center for Optical and Electromagnetic Research, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - Jiawen Huang
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou 510006, China; (H.Z.); (N.H.); (Y.L.); (J.H.)
- Guangdong Provincial Key Laboratory of Optical Information Materials and Technology, Center for Optical and Electromagnetic Research, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - Sune Svanberg
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou 510006, China; (H.Z.); (N.H.); (Y.L.); (J.H.)
- Guangdong Provincial Key Laboratory of Optical Information Materials and Technology, Center for Optical and Electromagnetic Research, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
- Lund Laser Centre, Lund University, SE-221 00 Lund, Sweden
- Correspondence: (S.S.); (K.S.)
| | - Katarina Svanberg
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou 510006, China; (H.Z.); (N.H.); (Y.L.); (J.H.)
- Guangdong Provincial Key Laboratory of Optical Information Materials and Technology, Center for Optical and Electromagnetic Research, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
- Lund Laser Centre, Lund University, SE-221 00 Lund, Sweden
- Correspondence: (S.S.); (K.S.)
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Abstract
BACKGROUND Despite extensive literature on the classification and management of nasal septal deviation (NSD) for preoperative planning, standardized objective measures to evaluate the NSD severity remains challenging. In this study, we quantitatively analyzed NSD to determine the most predictive two-dimensional (2D) computed tomography (CT)-landmark for overall three-dimensional (3D) septal morphology derived from nasal airway segmentation. METHODS A retrospective study was conducted at a large academic center. One hundred four patients who underwent CT scans of the face were selected from a computer imaging database. Demographic variables were screened to ensure an equal number of men and women in different age groups. Digital Imaging and Communications in Medicine files were imported for 3D nasal cavity segmentation using 3D Slicer software. A volumetric analysis was performed to determine 3D NSD ratios. These values were compared to previously reported methods of obtaining objective 2D NSD measures using OsiriX and MATLAB software. Maximum deviation values were calculated using OsiriX, while the root mean square values were retrieved using MATLAB. Deviation area and curve to line ratios were both quantified using OsiriX and MATLAB. RESULTS The data set consisted of 52 men and 52 women patients aged 20 to 100 years (mean = 58 years, standard deviation = 23 years). There was a strong correlation between 3D NSD ratio and maximum deviation (r = 0.789, P < 0.001) and deviation area (r = 0.775, P < 0.001). Deviation area (r = 0.563, P < 0.001), root mean square (r = 0.594, P < 0.001), and curve to line ratio (r = 0.470, P < 0.001) had a positive correlation of moderate strength. The curve to line ratio was not significant (r = 0.019, P = 0.85). CONCLUSIONS The 2D CT-based NSD landmarks maximum deviation and deviation area were the most predictive of the severity of NSD from 3D nasal cavity segmentation. We present a robust open-source method that may be useful in predicting the severity of NSD in CT images.
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Çolak M. An Evaluation of Bone Mineral Density Using Cone Beam Computed Tomography in Patients with Ectodermal Dysplasia: A Retrospective Study at a Single Center in Turkey. Med Sci Monit 2019; 25:3503-3509. [PMID: 31079139 PMCID: PMC6528545 DOI: 10.12659/msm.914405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this retrospective study was to compare the measurements of bone mineral density (BMD) combined with volumetric dental tomography measurements taken from three main regions selected on the lower mandible, the right mandibular, medial mandibular, and left mandibular regions, in patients with ectodermal dysplasia and age-matched and gender-matched controls. Measurement of BMD in Hounsfield units (HUs) were evaluated using three-dimensional (3D) cone beam computed tomography (CBCT) imaging. MATERIAL AND METHODS Mandibular bone tomography images were evaluated from 9 women and 5 men diagnosed with ectodermal dysplasia and a control group of 9 women and 5 men. The HU values obtained according to age and gender of the total 28 study participants were measured. Statistical analysis of the data used Student's t-test. RESULTS BMD in the ectodermal dysplasia group was significantly lower compared with the BMD in the control group. Comparison of the left and right mandibular angulus regions showed that the BMD of patients with ectodermal dysplasia was significantly lower when compared with the control group in both regions, but no significant difference was found between the two groups in the BMD of the central mandibular region. CBCT was found to be an effective method for the measurement of BMD. CONCLUSIONS In patients with ectodermal dysplasia, reduced BMD should be taken into consideration when planning surgical interventions involving bone tissue and when planning implant surgery. The results of this study may be of value in dentistry and other fields of medicine.
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Affiliation(s)
- Mehmet Çolak
- Department of Dentomaxillofacial Radiology, Dicle University, Faculty of Dentistry, Diyarbakir, Turkey
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Cho BH, Jung YH, Hwang JJ. Maxillary antroliths detected by cone-beam computed tomography in an adult dental population. Imaging Sci Dent 2019; 49:59-63. [PMID: 30941289 PMCID: PMC6444011 DOI: 10.5624/isd.2019.49.1.59] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 12/21/2018] [Accepted: 12/30/2018] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study evaluated the prevalence and characteristics of maxillary antroliths using cone-beam computed tomography (CBCT) scans performed for maxillofacial diagnostic purposes. MATERIALS AND METHODS CBCT scans of 13,946 patients over the age of 20 were reviewed for maxillary antroliths, and prevalence according to sex, age, and the side of the jaw was calculated. The relationships of single or multiple antroliths with sex, side, and the degree of sinus inflammation were evaluated. The shape and dimension of antroliths were also assessed. The data were analyzed using descriptive statistics, the chi-square or Fisher exact tests, and Kendall's tau-b. RESULTS A total of 138 (0.99%) of the 13,946 patients showed an antrolith in at least 1 sinus. Only 18 patients presented a bilateral manifestation, which brought the total number of sinuses containing an antrolith to 156 (0.56%). Multiple antroliths were observed in 36 sinuses, and the total number of antroliths was 207: 110 punctate, 65 linear, and 32 amorphous. The antrolith dimensions varied from 1 mm2 to 91 mm2 (average, 10.2±15.5 mm2). No statistically significant differences were found according to sex, side, and age group (P>0.05). However, there was a statistically significant difference between the multiplicity of antrolith and the degree of sinus inflammation (P<0.05). CONCLUSION Cone-beam computed tomography is an effective modality for the detection of incidental antroliths. Maxillary antroliths were found to be very rare and were usually asymptomatic. Dentists should have a comprehensive understanding of their diagnosis and treatment in light of possible associated dental problems.
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Affiliation(s)
- Bong-Hae Cho
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Yun-Hoa Jung
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jae-Joon Hwang
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
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Kirsch CF, Bykowski J, Aulino JM, Berger KL, Choudhri AF, Conley DB, Luttrull MD, Nunez D, Shah LM, Sharma A, Shetty VS, Subramaniam RM, Symko SC, Cornelius RS. ACR Appropriateness Criteria ® Sinonasal Disease. J Am Coll Radiol 2017; 14:S550-S559. [DOI: 10.1016/j.jacr.2017.08.041] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 08/14/2017] [Indexed: 01/09/2023]
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Kilickesmez O, Onerci Celebi O, Yalcinkaya M, Gokduman AR, Karagoz Y, Yigit O. Correlation of quantitative MR imaging findings with symptoms in patients with incidentally detected inflammatory sinonasal disease. Diagn Interv Imaging 2017; 99:65-72. [PMID: 28729182 DOI: 10.1016/j.diii.2017.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 05/16/2017] [Accepted: 05/23/2017] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the relationships between mucosal thickness, T1-weighted, T2-weighted signals and restricted diffusion on magnetic resonance imaging (MRI) with the degree of symptoms in patients with incidentally detected inflammatory sinonasal disease. MATERIALS AND METHODS Conventional and diffusion-weighted MRI of 100 patients with incidental sinonasal mucosal thickening were prospectively evaluated. There were 53 men and 47 women, with a mean age of 44.6 years±15.17 (SD) (range: 18-81 years). Correlations between quantitative values (T1-signal, T2-signal and apparent diffusion coefficient [ADC]) and three different quality of life questionnaires (chronic sinusitis survey, sinonasal outcomes test-22 and nasal obstruction and septoplasty effectiveness scale [NOSE]) were searched using the Spearman correlation test. RESULTS The mean SNOT-22 score was 35.81±20.36 (SD) (range: 0-83), CSS score was 4.64±3.42 (SD) (range: 0-14), and NOSE score was 5.91±4.84 (range: 0-18). All patients (100%) had maxillary sinus involvement. Ethmoidal sinus involvement was present in 57% of patients, frontal sinus involvement in 33% and sphenoidal sinus involvement in 27%. Morphologically, 40 patients (40%) had septal deviation, 41 (41%) had maxillary sinus retention cyst and 78 (78%) had hypertrophy of the conchae. No correlations were found between morphological abnormalities, quantitative values and patient scores in none of the questionnaires. CONCLUSION Incidental morphological abnormalities or restricted diffusion of the paranasal sinuses on MRI do not correlate with the degree of symptoms in patients with incidentally detected inflammatory sinonasal disease.
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Affiliation(s)
- O Kilickesmez
- Department of Radiology, Istanbul Training and Research Hospital, Samatya-Istanbul, Turkey.
| | - O Onerci Celebi
- Department of Otorhinolaryngology, Istanbul Training and Research Hospital, Samatya-Istanbul, Turkey.
| | - M Yalcinkaya
- Department of Radiology, Istanbul Training and Research Hospital, Samatya-Istanbul, Turkey.
| | - A R Gokduman
- Department of Otorhinolaryngology, Istanbul Training and Research Hospital, Samatya-Istanbul, Turkey.
| | - Y Karagoz
- Department of Radiology, Istanbul Training and Research Hospital, Samatya-Istanbul, Turkey.
| | - O Yigit
- Department of Otorhinolaryngology, Istanbul Training and Research Hospital, Samatya-Istanbul, Turkey.
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Hochhegger B, Alves GRT, Irion KL, Watte G, Scheeren B, Rottenfuser R, Marchiori E. Computed tomographic pulmonary changes in patients with chronic rhinosinusitis. Br J Radiol 2015; 88:20150273. [PMID: 26246280 DOI: 10.1259/bjr.20150273] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To investigate whether patients with a diagnosis of chronic rhinosinusitis (CRS) show characteristic pulmonary changes on chest CT compared with a control group without sinusopathy. METHODS This retrospective, observational study included patients with and without a diagnosis of CRS who underwent CT examination of the lungs between 2012 and 2014. Two radiologists, who were blinded for the presence of CRS, reviewed the scans for the presence of any abnormalities consensually. The χ(2) test was used for correlative analysis, with a significance level of 0.05. RESULTS A total of 123 CT series (51.2% from male patients, mean age 41 ± 16 years) were reviewed, including those from 59 (48%) patients with a diagnosis of CRS. Patients with CRS were more likely than the control group to exhibit atelectasis, bronchiolectasis, centrilobular nodules and ground-glass opacities (all p < 0.05), with a significant predilection for middle lobe and lingular involvement observed (p < 0.001). Other abnormalities, such as bronchial wall thickening and air trapping, did not differ between groups. CONCLUSION Atelectatic changes, ground-glass opacities, bronchiolectasis and centrilobular nodules are the most frequent abnormalities associated with CRS, with peculiar middle lobe and lingular involvement observed on chest CT examinations. ADVANCES IN KNOWLEDGE CRS is a frequent disorder that displays typical pulmonary changes at CT. The recognition of such findings can prevent patients with this condition from undergoing unnecessary investigations that might be based on the presence of the aforementioned radiological features.
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Affiliation(s)
- Bruno Hochhegger
- 1 Post-graduation Program in Medicine (Radiology), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Giordano R T Alves
- 1 Post-graduation Program in Medicine (Radiology), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Klaus L Irion
- 2 Radiology Department, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Guilherme Watte
- 3 Medical Imaging Research Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Betina Scheeren
- 3 Medical Imaging Research Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Robson Rottenfuser
- 4 Division of Radiology, Hospital da Cidade de Passo Fundo, Passo Fundo, Brazil
| | - Edson Marchiori
- 1 Post-graduation Program in Medicine (Radiology), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Raghav M, Karjodkar FR, Sontakke S, Sansare K. Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images. Contemp Clin Dent 2014; 5:361-5. [PMID: 25191074 PMCID: PMC4147814 DOI: 10.4103/0976-237x.137949] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aim of the present study was to infer and to record the prevalence of incidental maxillary sinus pathologies in patients presenting with dental problems using the cone-beam computed tomography (CBCT) scans performed for maxillofacial diagnostic purposes. MATERIALS AND METHODS This retrospective study has evaluated 201 patients (402 maxillary sinuses consecutive CBCT) for various incidental maxillary sinus pathologies by two observers. Pathologic findings were categorized as mucosal thickening (MT), opacification (OPA), polypoidal-mucosal thickening (PT), others (antrolith and discontinuity of the sinus floor) and no pathologic findings. Correlations for pathologic findings and the factors of age and gender were calculated. RESULTS The prevalence for total incidental findings is 59.7%. The present study showed MT (35.1%) as most prevalent finding followed by OPA in (16.6%), PT in 7.2% and others in 0.7%. There was no statistically significant difference between gender and between the age groups. There was no statistically significant difference between different indications groups for CBCT scans. CONCLUSIONS The incidental maxillary sinus abnormalities are highly prevalent in the asymptomatic dental patients; hence oral radiologists should be aware of these incidental findings and comprehensively evaluate the entire captured CBCT volume, which can help in early diagnosis, treatment and follow-up of the patient.
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Affiliation(s)
- Mamta Raghav
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Freny R Karjodkar
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Subodh Sontakke
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Kaustubh Sansare
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
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Cornelius RS, Martin J, Wippold FJ, Aiken AH, Angtuaco EJ, Berger KL, Brown DC, Davis PC, McConnell CT, Mechtler LL, Nussenbaum B, Roth CJ, Seidenwurm DJ. ACR Appropriateness Criteria Sinonasal Disease. J Am Coll Radiol 2013; 10:241-6. [DOI: 10.1016/j.jacr.2013.01.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 01/02/2013] [Indexed: 10/27/2022]
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Buric N, Jovanovic G, Tijanic M. Usefulness of cone-beam CT for presurgical assessment of keratoma (cholesteatoma) of the maxillary sinus. Head Neck 2012; 35:E221-5. [PMID: 22714837 DOI: 10.1002/hed.23031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2012] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Evaluating the presurgical usefulness of cone-beam CT (CBCT) in the diagnosis and subsequent surgery of keratoma (cholesteatoma) of the maxillary sinus. METHODS CBCT scans were obtained by using 3-dimensional CT (3DCT) apparatus. The exposure factors had a field of view of 16 × 12 cm, 120 kVp, 7 mA, and an exposure time of 20 seconds. The acquired image data consisted of a 14-bit sensor that delivers 16,384 shades of gray with a standard isotropic cubic voxel size of 0.3 mm. RESULTS The CBCT scans clearly demonstrated a 22- × 16.82- × 17.62-mm expansile lesion in the left maxillary sinus area, with thin cortical plates, and a focal perforation of the medial cortical plate at the level of the apices. CONCLUSION All CBCT visual data provide impressive, full 3D images of maxillary sinus keratoma, and help us to perform successful surgery.
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Affiliation(s)
- Nikola Buric
- Department of Oral Surgery, University of Niš School of Medicine and Stomatology, Niš, Serbia.
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The role of CT and MRI in the diagnosis of chronic rhinosinusitis. Curr Allergy Asthma Rep 2010; 10:171-4. [PMID: 20425010 DOI: 10.1007/s11882-010-0103-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Chronic rhinosinusitis (CRS) is one of the most common chronic disease conditions in the United States. Currently, diagnosis is based initially on clinical symptomatology and signs, but the final diagnosis of CRS should be confirmed by objective measures. CT of the paranasal sinuses is the most commonly obtained test to confirm or exclude a diagnosis of CRS. CT has been shown to be reliable, accurate, and effective in diagnosing CRS, but it also imparts radiation exposure. More recently, MRI of the paranasal sinuses has been explored as a diagnostic modality in CRS. Initial data suggest it may be a viable alternative to CT in the diagnosis of CRS. As clinicians are likely to begin to use MRI as a diagnostic modality in CRS, further studies are warranted with respect to its particular diagnostic validation.
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Campbell PD, Zinreich SJ, Aygun N. Imaging of the paranasal sinuses and in-office CT. Otolaryngol Clin North Am 2010; 42:753-64, vii. [PMID: 19909856 DOI: 10.1016/j.otc.2009.08.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Since the introduction of functional endoscopic sinus surgery (FESS) in the United States in 1985, the information gained from imaging has proved imperative in understanding regional morphology and guidance of surgical procedures. More than 20 years later, the importance of imaging continues to be the anatomic detail afforded by this technology, the roadmap it provides in planning the surgery, and the morphologic detail it provides in recurrent disease. The latest development in CT technology, cone beam CT instrumentation, may change the way imaging of the nasal cavity and paranasal sinuses is performed in the future. These topics are discussed in this article.
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Affiliation(s)
- Paul D Campbell
- The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Medical Institutions, 600 North Wolfe Street/Phipps B-112, Baltimore, MD 21287, USA
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Abstract
Imaging the head and neck presents a unique challenge because of the dense concentration of complex anatomy and the importance of lesion localization in formulating the differential diagnosis and prognosis. Critical imaging features such as the ability to define fascial borders of soft tissue neck compartments, the demonstration of intricate anatomy such as the temporal bones and paranasal sinuses, and the noninvasive assessment of vascular integrity have improved greatly in recent years in parallel with the rapid technologic advances in multidetector CT and MRI. After comparing the available imaging techniques, this article explores the imaging findings by anatomic region.
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Affiliation(s)
- Michael C Hurley
- Division of Neuroradiology, Vancouver General Hospital, 899 West 12th Avenue, Vancouver, BC, Canada V5Z 1M9
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Abstract
Imaging technology has played a significant role in the diagnosis and management of sinonasal disorders. Plain sinus films are almost exclusively replaced by CT in the work-up for inflammatory sinus disease. MRI provides complementary information to CT in cases of sinonasal and skull-base neoplasms. The evolution of endoscopic surgical techniques for the paranasal sinuses and skull base is made possible by the parallel advancement of imaging technologies. Recent advances that are currently in clinical use have included multidetector row CT scanners and computer image-guidance systems for surgery. Three-dimensional CT angiography, image-guided CT-MR fusion, and intraoperative image-guidance are new techniques that are currently being evaluated. As imaging technology continues to advance, so does the capability to treat diseases beyond the sinuses and skull base with minimally invasive, endoscopic approaches.
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Affiliation(s)
- Francis T K Ling
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, USA
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Abstract
Radiologic imaging is an essential part of the presurgical evaluation of patients with sinusitis and of the monitoring of difficult-to-treat,recurrent, and postsurgical disease. In patients with noninflammatory sinus pathology and those who "baffle" clinical diagnosis, ima-ging is extremely helpful in differentiating the various pathological entities and determining the extent of disease. Computerized tomography (CT), when deemed clinically necessary, is the current modality of choice to evaluate sinusitis. CT's ability to display bone,mucosa, and air makes it a perfect tool for imaging of the paranasal sinuses. The fine bony architecture of the nasal cavity and the para-nasal sinus drainage pathways are depicted accurately with CT examination.
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Affiliation(s)
- Nafi Aygun
- Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Medical Institution, 600 N. Wolfe Street/Phipps B-126-A, Baltimore, MD 21287, USA.
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