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Setiawan A, Huang C, Mitrayana M. Development of non-contact foreign body imaging base on photoacoustic signal intensity measurement. J Appl Clin Med Phys 2024; 25:e14230. [PMID: 38014732 PMCID: PMC11087178 DOI: 10.1002/acm2.14230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/25/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND It is challenging to visually identify tiny and concealed foreign objects within the body due to their small size and subcutaneous location while they can cause infections. METHODS A non-contact photoacoustic system based on Rosencwaig-Gersho photoacoustic theory and dual modulator method is developed for detecting foreign objects in meat. RESULT The experiments conducted validate the successful development of this measurement technique with 10 μm spatial resolution and its corresponding mathematical model, demonstrating an 11% Mean Absolute Percentage Error (MAPE) in comparison to the experimental results. Dual modulator successfully regulates laser energy at MPE limit. CONCLUSION The utilization of non-contact photoacoustic signal intensity measurements enables the identification of foreign objects within the body. Further, the application of mathematical modelling can validate the measurement outcomes. These findings serve as a foundation for creating an affordable and straightforward foreign body detector.
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Affiliation(s)
- Andreas Setiawan
- Department of PhysicsUniversitas Kristen Satya WacanaSalatigaIndonesia
| | - Chia‐Yi Huang
- Department of Applied PhysicsTunghai UniversityTaichungTaiwan R.O.C
| | - Mitrayana Mitrayana
- Department of PhysicsFaculty of Mathematics and Natural Sciences Universitas Gadjah MadaSekip Utara BulaksumurYogyakartaIndonesia
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2
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Zhang Z, Yang M, Zhang R. Radiographic grid for locating foreign bodies in maxillofacial emergency trauma. BMC Oral Health 2024; 24:46. [PMID: 38191426 PMCID: PMC10775646 DOI: 10.1186/s12903-023-03807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES The accurate localization of the foreign bodies (FBs) is essential. This work presents a new noninvasive technique for subcutaneous metallic FBs under a radiographic grid, a system that simplifies the localization of facial FBs removal using a grid with embedded reference points. METHODS This work designed a retrospective study to evaluate the effect of a radiographic grid on FBs removal surgery. All patients who met the inclusion criteria and attended the Hospital of Stomatology of China Medical University from January 2022 to June 2023 were enrolled and randomly divided into grid and non-grid groups. The assessment of facial swelling, the primary indicator, was conducted on days 2 and 7 post-surgery. The variables were analyzed using the Student t test and a repeated-measures general linear model. RESULTS The study sample consisted of 20 patients, with 14 males (70%) and 6 females (30%), who had an average age of 30.30 ± 5.38. The average time of operation was 1.85 ± 0.66 h (range 0.7 to 3.2). In the present cases in this report, of the 20 patients' FBs, 14 were metal, 5 were glass, and 1 was residual root. And the FBs were surgically removed with no postoperative complications. Through comparison, it was found that the degree of swelling on day 2 postoperatively was significantly different between the grid group and the non-grid group (P < 0.05). CONCLUSIONS This study demonstrates that a radiographic grid with mark points is a more efficient approach compared with traditional methods for FBs removal, and this surgical method is more accurate, fast and noninvasive.
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Affiliation(s)
- Ziqi Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Mingliang Yang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Ran Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China.
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3
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Huopainen P, Virkkunen S, Snäll J, Tezvergil-Mutluay A, Hagström J, Apajalahti S. Periapical foreign body findings - histological and radiological comparison. Acta Odontol Scand 2023; 81:622-626. [PMID: 37470399 DOI: 10.1080/00016357.2023.2236213] [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: 03/07/2023] [Revised: 06/20/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE This study aimed to clarify the perceptibility of periapical foreign materials in imaging compared with histopathology. We hypothesized that dentoalveolar imaging is sufficient to detect periapical foreign bodies. MATERIAL AND METHODS Radiological and histopathological records of patients diagnosed with periapical granuloma or radicular cyst from 2000 to 2013 were evaluated retrospectively. Patients with histologically verified foreign bodies were included in the study and their pathological samples and radiological images were reviewed. The outcome variable was radiologically detectable foreign material. The predictor variables were histopathological diagnosis, type of inflammation, type and number of foreign bodies, imaging modality, and site of foreign material. RESULTS Compared to the histopathological diagnosis of foreign bodies as the gold standard, the level of radiologic detectability was mild. Histologically verified foreign material could be detected by imaging in 32/59 (53.5%) patients. Histological diagnosis, type of inflammation, type or number of foreign bodies, imaging modality or site of foreign material had no association with radiological detectability (p > 0.05). CONCLUSIONS According to our results, histopathology is a more accurate diagnostic tool than radiology in periapical foreign bodies or foreign body reactions. Clinicians should keep in mind the limitations of imaging when setting the diagnosis and planning treatment.
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Affiliation(s)
- Piia Huopainen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sirke Virkkunen
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Arzu Tezvergil-Mutluay
- Department of Restorative Dentistry and Cariology, Adhesive Dentistry Research Group, Institute of Dentistry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jaana Hagström
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Oral Pathology and Radiology, University of Turku, Turku, Finland
| | - Satu Apajalahti
- HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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4
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Kufel J, Bargieł-Łączek K, Koźlik M, Czogalik Ł, Dudek P, Magiera M, Bartnikowska W, Lis A, Paszkiewicz I, Kocot S, Cebula M, Gruszczyńska K, Nawrat Z. Chest X-ray Foreign Objects Detection Using Artificial Intelligence. J Clin Med 2023; 12:5841. [PMID: 37762783 PMCID: PMC10531506 DOI: 10.3390/jcm12185841] [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: 08/13/2023] [Revised: 09/02/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Diagnostic imaging has become an integral part of the healthcare system. In recent years, scientists around the world have been working on artificial intelligence-based tools that help in achieving better and faster diagnoses. Their accuracy is crucial for successful treatment, especially for imaging diagnostics. This study used a deep convolutional neural network to detect four categories of objects on digital chest X-ray images. The data were obtained from the publicly available National Institutes of Health (NIH) Chest X-ray (CXR) Dataset. In total, 112,120 CXRs from 30,805 patients were manually checked for foreign objects: vascular port, shoulder endoprosthesis, necklace, and implantable cardioverter-defibrillator (ICD). Then, they were annotated with the use of a computer program, and the necessary image preprocessing was performed, such as resizing, normalization, and cropping. The object detection model was trained using the You Only Look Once v8 architecture and the Ultralytics framework. The results showed not only that the obtained average precision of foreign object detection on the CXR was 0.815 but also that the model can be useful in detecting foreign objects on the CXR images. Models of this type may be used as a tool for specialists, in particular, with the growing popularity of radiology comes an increasing workload. We are optimistic that it could accelerate and facilitate the work to provide a faster diagnosis.
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Affiliation(s)
- Jakub Kufel
- Department of Biophysics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19, 41-808 Zabrze, Poland;
| | - Katarzyna Bargieł-Łączek
- Paediatric Radiology Students’ Scientific Association at the Division of Diagnostic Imaging, 40-752 Katowice, Poland; (K.B.-Ł.); (W.B.)
- Department of Radiology and Nuclear Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Maciej Koźlik
- Division of Cardiology and Structural Heart Disease, Medical University of Silesia, 40-635 Katowice, Poland;
| | - Łukasz Czogalik
- Professor Zbigniew Religa Student Scientific Association at the Department of Biophysic, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19, 41-808 Zabrze, Poland; (Ł.C.); (P.D.); (M.M.); (I.P.)
| | - Piotr Dudek
- Professor Zbigniew Religa Student Scientific Association at the Department of Biophysic, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19, 41-808 Zabrze, Poland; (Ł.C.); (P.D.); (M.M.); (I.P.)
| | - Mikołaj Magiera
- Professor Zbigniew Religa Student Scientific Association at the Department of Biophysic, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19, 41-808 Zabrze, Poland; (Ł.C.); (P.D.); (M.M.); (I.P.)
| | - Wiktoria Bartnikowska
- Paediatric Radiology Students’ Scientific Association at the Division of Diagnostic Imaging, 40-752 Katowice, Poland; (K.B.-Ł.); (W.B.)
| | - Anna Lis
- Cardiology Students’ Scientific Association at the III Department of Cardiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-635 Katowice, Poland;
| | - Iga Paszkiewicz
- Professor Zbigniew Religa Student Scientific Association at the Department of Biophysic, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19, 41-808 Zabrze, Poland; (Ł.C.); (P.D.); (M.M.); (I.P.)
| | - Szymon Kocot
- Bright Coders’ Factory, Technologiczna 2, 45-839 Opole, Poland;
| | - Maciej Cebula
- Individual Specialist Medical Practice, 40-754 Katowice, Poland;
| | - Katarzyna Gruszczyńska
- Department of Radiology and Nuclear Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Zbigniew Nawrat
- Department of Biophysics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19, 41-808 Zabrze, Poland;
- Foundation of Cardiac Surgery Development, 41-800 Zabrze, Poland
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Manzoni S, Santos M, Leveugle A, Dekerle B, Garnier P, Maurice E, Decambron A, Mortier J, Manassero M, Viateau V. Preoperative computed tomography, surgical treatment and long-term outcomes of dogs with abscesses on migrating vegetal foreign bodies and oropharyngeal stick injuries: 39 cases (2010-2021). J Small Anim Pract 2023; 64:581-589. [PMID: 37382056 DOI: 10.1111/jsap.13624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 04/02/2023] [Accepted: 04/21/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES This study evaluated success rates of surgical treatment of head and neck abscesses and draining tracts for suspected migrating vegetal foreign body and oropharyngeal penetrating injuries, and compared the outcomes according to whether a vegetal foreign body was identified in preoperative computed tomography (CT) examination. MATERIALS AND METHODS This retrospective study involved 39 dogs that underwent CT and subsequent surgical exploration of abscesses and/or draining tracts in the head and neck, in a single institution between 2010 and 2021. Recorded data included signalment, history, physical examination, CT and surgical findings. The postoperative follow-up period was at least 8 months. Cases were classified according to whether a foreign body was identified on CT or was only suspected because of the presence of cavities and/or draining tracts on CT. RESULTS A vegetal foreign body was identified on CT in 11 of 39 cases and later confirmed at surgery in 10 cases. In 28 of 39 cases, a vegetal foreign body was not identified on CT, but in seven of these 28 cases it was found at surgery. Resolution of clinical signs was achieved in 11 of 11 cases when a vegetal foreign body was identified on CT and in 26 of 28 cases without a foreign body identified on CT. Two cases of recurrence were observed in animals in which no foreign body was detected. CLINICAL SIGNIFICANCE In this population of dogs undergoing surgery after preoperative CT scan, we observed resolution of clinical signs after a single surgical procedure in 95% of the cases. All animals in which a foreign body was identified were cured.
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Affiliation(s)
- S Manzoni
- Department of Small Animal Surgery, Paris-Est University, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - M Santos
- Department of Small Animal Surgery, Paris-Est University, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - A Leveugle
- Department of Small Animal Surgery, Paris-Est University, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - B Dekerle
- Department of Small Animal Surgery, Paris-Est University, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - P Garnier
- Department of Small Animal Surgery, Paris-Est University, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - E Maurice
- Department of Small Animal Surgery, Paris-Est University, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - A Decambron
- Department of Small Animal Surgery, Paris-Est University, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - J Mortier
- Department of Diagnostic Imaging, Paris-Est University, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - M Manassero
- Department of Small Animal Surgery, Paris-Est University, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - V Viateau
- Department of Small Animal Surgery, Paris-Est University, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
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Rodriguez Betancourt A, Samal A, Chan HL, Kripfgans OD. Overview of Ultrasound in Dentistry for Advancing Research Methodology and Patient Care Quality with Emphasis on Periodontal/Peri-implant Applications. Z Med Phys 2023; 33:336-386. [PMID: 36922293 PMCID: PMC10517409 DOI: 10.1016/j.zemedi.2023.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Ultrasound is a non-invasive, cross-sectional imaging technique emerging in dentistry. It is an adjunct tool for diagnosing pathologies in the oral cavity that overcomes some limitations of current methodologies, including direct clinical examination, 2D radiographs, and cone beam computerized tomography. Increasing demand for soft tissue imaging has led to continuous improvements on transducer miniaturization and spatial resolution. The aims of this study are (1) to create a comprehensive overview of the current literature of ultrasonic imaging relating to dentistry, and (2) to provide a view onto investigations with immediate, intermediate, and long-term impact in periodontology and implantology. METHODS A rapid literature review was performed using two broad searches conducted in the PubMed database, yielding 576 and 757 citations, respectively. A rating was established within a citation software (EndNote) using a 5-star classification. The broad search with 757 citations allowed for high sensitivity whereas the subsequent rating added specificity. RESULTS A critical review of the clinical applications of ultrasound in dentistry was provided with a focus on applications in periodontology and implantology. The role of ultrasound as a developing dental diagnostic tool was reviewed. Specific uses such as soft and hard tissue imaging, longitudinal monitoring, as well as anatomic and physiological evaluation were discussed. CONCLUSIONS Future efforts should be directed towards the transition of ultrasonography from a research tool to a clinical tool. Moreover, a dedicated effort is needed to introduce ultrasonic imaging to dental education and the dental community to ultimately improve the quality of patient care.
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Affiliation(s)
| | - Ankita Samal
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontology and Oral Medicine, Dental School, University of Michigan, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
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Koyama M, Matai K, Kinoshita A, Ishizaki S, Okazaki K, Inoue M, Kodera K, Hiramoto Y, Arima T, Saito N, Kobayashi M, Yamazaki S, Eto K. A case of traumatic intrapleural foreign body with progressive supranuclear palsy removed by thoracoscopic surgery. Trauma Case Rep 2023; 43:100761. [PMID: 36660402 PMCID: PMC9842933 DOI: 10.1016/j.tcr.2023.100761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2023] [Indexed: 01/11/2023] Open
Abstract
Traumatic intrathoracic foreign bodies are said to occur in many cases when the patient himself/herself is aware of the trauma. However, at the time of injury, the patient may sometimes be accompanied by loss of consciousness. We report a case of traumatic intrathoracic foreign body that was difficult to diagnose due to loss of consciousness at the time of injury. A 51-year-old female was brought to our emergency department with a fall trauma due to loss of consciousness while bathing. The head computed tomography and electrocardiogram showed no abnormalities, and the laceration of approximately 3 cm in length was found on the left side thorax, and it was sutured and the patient was sent home. Four days later, she returned to our hospital with a complaint of left anterior chest pain, and chest X-ray showed a left degree pneumothorax and mediastinal emphysema. She underwent semi-emergency thoracoscopic removal of the foreign body, and was discharged from the hospital on the fourth postoperative day. She had progressive supranuclear palsy, and her memory at the time of injury was not clear due to loss of consciousness caused by central autonomic neuropathy, and she also had dementia, making it difficult to interview her. She had no thoracic symptoms, and the glass fragment that had strayed into the thoracic cavity was not exposed outside the body, making the diagnosis difficult at the time of initial examination. When a patient with loss of consciousness is difficult to interview at the time of injury, it is advisable to perform an imaging examination appropriate for the site of injury, taking into consideration the presence of foreign bodies.
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Affiliation(s)
- Muneyuki Koyama
- Department of Surgery, Kumagaya Geka Hospital, 3811-1, Sayada, Kumagaya city, Saitama 360-0023, Japan,Department of Gastrointestinal Surgery, The Jikei University School of Medicine, 3-19-18, Nishishinbashi, Minato-ku, Tokyo 105-8471, Japan,Corresponding author at: Department of Gastrointestinal Surgery, The Jikei University School of Medicine, 3-19-18, Nishishinbashi, Minato-ku, Tokyo 105-8471, Japan.
| | - Kazuo Matai
- Department of Surgery, Kumagaya Geka Hospital, 3811-1, Sayada, Kumagaya city, Saitama 360-0023, Japan
| | - Akiyoshi Kinoshita
- Department of Gastroenterology & Hepatology, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae City, Tokyo 201-8601, Japan
| | - Shunta Ishizaki
- Department of Gastrointestinal Surgery, The Jikei University School of Medicine, 3-19-18, Nishishinbashi, Minato-ku, Tokyo 105-8471, Japan
| | - Kouhei Okazaki
- Department of Surgery, Kumagaya Geka Hospital, 3811-1, Sayada, Kumagaya city, Saitama 360-0023, Japan
| | - Masaya Inoue
- Department of Surgery, Kumagaya Geka Hospital, 3811-1, Sayada, Kumagaya city, Saitama 360-0023, Japan
| | - Keita Kodera
- Department of Surgery, Kumagaya Geka Hospital, 3811-1, Sayada, Kumagaya city, Saitama 360-0023, Japan
| | - Yuki Hiramoto
- Department of Surgery, Kumagaya Geka Hospital, 3811-1, Sayada, Kumagaya city, Saitama 360-0023, Japan
| | - Toshihiko Arima
- Sato Orthopedic Clinic, 1-7-3, Misuji, Daito-ku, Tokyo 111-0055, Japan
| | - Nobuhiro Saito
- Department of Surgery, Kumagaya Geka Hospital, 3811-1, Sayada, Kumagaya city, Saitama 360-0023, Japan
| | - Miki Kobayashi
- Department of Surgery, Kumagaya Geka Hospital, 3811-1, Sayada, Kumagaya city, Saitama 360-0023, Japan
| | - Satoshi Yamazaki
- Department of Surgery, Kumagaya Geka Hospital, 3811-1, Sayada, Kumagaya city, Saitama 360-0023, Japan
| | - Ken Eto
- Department of Gastrointestinal Surgery, The Jikei University School of Medicine, 3-19-18, Nishishinbashi, Minato-ku, Tokyo 105-8471, Japan
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8
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Jiang ZH, Xv R, Xia L. Foreign body granuloma in the tongue differentiated from tongue cancer: A case report. World J Clin Cases 2022; 10:6247-6253. [PMID: 35949813 PMCID: PMC9254197 DOI: 10.12998/wjcc.v10.i18.6247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/12/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Embedded foreign bodies in the tongue are rarely seen in clinical settings. An untreated foreign body can cause a granuloma which often presents as an enlarged tongue mass. However, if foreign body ingestion status is unknown, physical examination and magnetic resonance imaging (MRI) tend to lead to suspicion of tongue cancer, especially in older patients. Thus, differential diagnosis of an enlarged tongue mass is important, especially because it is closely related to the choice of treatment method.
CASE SUMMARY A 61-year-old woman was admitted to the hospital with pain and noticeable swelling in the tongue that had persisted for over 1 mo. She had no previous medical history. MRI revealed abnormal signal intensities that were indicative of a neoplasm. Thus, the oral surgeon and radiologist arrived at a primary diagnosis of tongue cancer. The patient visited the Ear Nose and Throat Department for further consultation and underwent an ultrasound examination of the tongue. The ultrasonography was consistent with a linear hyperechoic foreign body which was indicative of an embedded foreign body (bone) in the tongue, even though the patient denied any history of foreign body ingestion. Complete surgical enucleation of the lesion was conducted. The mass which included a fish bone was completely removed. The post-operative pathological examination confirmed that the mass was a granuloma containing collagen fibers, macrophages and chronic inflammatory cells. The patient recovered without complications over a 2 mo follow-up period.
CONCLUSION We report a rare case of foreign body granuloma in the tongue that was primarily diagnosed as tongue cancer. The MRI and ultrasound examinations revealed a piece of bone in the left lateral aspect of the tongue. The granuloma, which contained a fish bone, was completely removed via surgery and confirmed via biopsy. Differential diagnosis of the enlarged tongue mass was critical to the selection of treatment method.
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Affiliation(s)
- Zhen-Hua Jiang
- Department of Otolaryngology - Head and Neck Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
| | - Ran Xv
- Department of Otolaryngology - Head and Neck Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
| | - Li Xia
- Department of Otolaryngology - Head and Neck Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
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9
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Alfuraih AM, Almutairi FN, Alotaibi SB, Alshmrani AA. Semi-quantitative scoring of imaging modalities in detecting soft tissue foreign bodies: an in vitro study. Acta Radiol 2022; 63:474-480. [PMID: 33673754 DOI: 10.1177/0284185121999654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Accurate identification of foreign bodies (FB) using medical imaging is essential for diagnosis and determining the suitable retrieval technique. PURPOSE To compare the sensitivity of different imaging modalities for detecting various FB materials in soft tissue and assess the reproducibility of a scoring system for grading the conspicuity of FBs. MATERIAL AND METHODS Five FB materials (plastic, wood, glass, aluminum, and copper) were embedded in a tissue-mimicking phantom. Computed radiography (CR), ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) were compared using a semi-quantitative 5-point Likert scale scoring system. The intra- and inter-reader reproducibility of four independent readers was analyzed using Kendall's coefficient of concordance (W). RESULTS Glass was visible on all imaging modalities. Plastic was only visible in excellent detail using ultrasound. Wood was detected in excellent resolution using ultrasound and CT using the default window while plain X-ray failed to detect it. Ultrasound was the only modality that showed aluminum in excellent quality while CT showed it with good demarcation from the surroundings. Copper was detectable in excellent detail using CR, ultrasound, and CT. MRI performance was suboptimal, especially with the plastic FB. The scoring system showed excellent intra-reader (W = 0.91, P = 0.001) and inter-reader (W = 0.88, P < 0.001) reproducibility. CONCLUSION Ultrasound can be used as the first line of investigation for wood, plastic, glass, and metallic FBs impacted at superficial depths in soft tissue. The semi-quantitative FB scoring system showed excellent within- and between-reader reliability, which can be used to score and compare the detection performance of new imaging techniques.
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Affiliation(s)
- Abdulrahman M Alfuraih
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kharj, Saudi Arabia
| | - Faisal N Almutairi
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kharj, Saudi Arabia
| | - Sultan B Alotaibi
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kharj, Saudi Arabia
| | - Abdullah A Alshmrani
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kharj, Saudi Arabia
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10
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David J, Eldred J, Raper D. Unintentional Epinephrine Auto-Injector Maxillofacial Injury in a Pediatric Patient. Clin Pract Cases Emerg Med 2022; 6:93-95. [PMID: 35226862 PMCID: PMC8885230 DOI: 10.5811/cpcem.2021.11.54464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/10/2021] [Indexed: 12/04/2022] Open
Abstract
Case Presentation A four-year-old female patient presented to the emergency department with an
epinephrine auto-injector that had unintentionally discharged into her
mandible. There was difficulty removing the auto-injector at bedside. Images
we acquired noted needle curvature not present in an off-the-shelf model.
She was sedated, and the auto-injector was removed by retracing the angle of
discharge, with care taken not to inject epinephrine into the patient. Discussion Epinephrine auto-injector accidental discharges are an unusual injury
pattern, but the incidence of such events is increasing in the United
States. The emergency clinician should be cognizant of complicating factors
with discharges, such as bent needles. Here we discuss a case of discharge
into the maxillofacial region (lower jaw), with approaches to treatment.
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Affiliation(s)
- Jason David
- Nellis Air Force Base, Mike O’Callaghan Military Medical Center, Department of Emergency Medicine, Las Vegas, Nevada
| | - Jerad Eldred
- University of Nevada, Las Vegas, University Medical Center of Southern Nevada, Department of Emergency Medicine, Las Vegas, Nevada
| | - David Raper
- Nellis Air Force Base, Mike O’Callaghan Military Medical Center, Department of Emergency Medicine, Las Vegas, Nevada
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11
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Geduk G, Geduk SE, Seker C. Simulating submandibular area with everyday-use materials in dental education: A didactic US study. Niger J Clin Pract 2022; 25:849-854. [DOI: 10.4103/njcp.njcp_1831_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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12
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Ota K, Yokoyama H, Takasu A. Removal of a Pencil Embedded in a Child’s Foot: A Case Report. Cureus 2021; 13:e20033. [PMID: 34987918 PMCID: PMC8716160 DOI: 10.7759/cureus.20033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 11/21/2022] Open
Abstract
The foot is the most common anatomic site for foreign body embedment in both children and adults. An 11-year-old boy boy with a history of autism spectrum disorder (ASD), learning disorder, and attention-deficit hyperactivity disorder (ADHD) was brought to our ED with a pencil deeply embedded in his right foot. The broken portion of the pencil was completely embedded in his right foot, with mild bleeding and it could not be extracted easily. The pencil was eventually mobilized via gentle back-and-forth twisting motion, which allowed successful removal of a significant portion of the embedded pencil. To establish the presence of a foreign body, as in each X-ray, the affected body part should be imaged in at least two directions. Based on the density of the embedded foreign body, ultrasound imaging should be considered.
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13
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Ayalon A, Fanadka F, Levov D, Saabni R, Moisseiev E. Detection of Intraorbital Foreign Bodies Using Magnetic Resonance Imaging and Computed Tomography. Curr Eye Res 2021; 46:1917-1922. [PMID: 34325598 DOI: 10.1080/02713683.2021.1945108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE We analyze the detectability of intraorbital foreign bodies (OrbFBs) of various types and sizes using computed tomography (CT) and magnetic resonance imaging using a three-Tesla machine (MRI 3 T). METHODS An ex vivo model of sheep eyes with preserved extraocular muscles and orbital fat tissue placed in the orbital cavity of the human skull was created for this study. Foreign bodies made of four different materials - plastic, bottle glass, stone and wood - each in three different sizes (large, intermediate and small) were inserted into the soft tissue of the orbit in the extraocular space. Each orbit was scanned by CT and MRI. Images were analyzed by a senior radiologist and underwent masked review by three oculoplastic surgeons. RESULTS Analysis of MRI and CT scans identified distinguishing characteristics for each of the four materials. This information was further integrated into a clinical algorithm. CT allowed easier identification of most of the embedded materials compared to MRI. Smaller OrbFB size was associated with lower detectability. Review of CT yielded 94.4% agreement between oculoplastic specialists in detecting OrbFbs using CT scans and allowed detection of most OrbFBs. In contrast, the overall agreement with MRI was lower: 66.7% with T1 MPRAGE, 50% with T1TSE, 88.9% with T2 TSE and 72.2% with T2 TSE FS. Plastic was the most difficult material to detect in all size categories. CONCLUSIONS CT offers a clear advantage over MRI for detecting and localizing nonmetallic OrbFBs of all sizes, except for plastic. Plastic OrbFBs can be detected with CT depending on size but are more visible in MRI scans.
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Affiliation(s)
- Anfisa Ayalon
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Feda Fanadka
- Department of Radiology, Meir Medical Center, Kfar Saba, Israel, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dimitry Levov
- Department of Radiology, Meir Medical Center, Kfar Saba, Israel, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ramei Saabni
- Department of Animal Health and Epidemiology, Veterinary Service and Animal Health, Rishon Le-Zion, Israel
| | - Elad Moisseiev
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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14
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Isman O, Isman E. Identification of various orthodontic materials as foreign bodies via panoramic radiography, cone beam computed tomography, magnetic resonance imaging, and ultrasonography: an in vitro study. Oral Radiol 2021; 37:524-530. [PMID: 34037939 DOI: 10.1007/s11282-021-00537-3] [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: 02/27/2021] [Accepted: 05/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We evaluated the in vitro detection sensitivity of orthodontic materials (serving as foreign bodies) using panoramic radiography, cone beam computed tomography (CBCT), magnetic resonance imaging (MRI), and ultrasonography. METHODS Five different orthodontic materials served as foreign bodies: titanium-molybdenum alloy wire (TMA; ORMCO, Orange, CA, USA; 0.017 × 0.025 in in cross-sectional dimensions and 1 cm long); stainless steel bracket tooth #34 (American Orthodontics, Sheboygan, WI, USA); a monocrystalline, sapphire ceramic bracket tooth #34 (Skyortho Dental Supplies Medical, China); a polycrystalline alumina clear bracket, Damon clear bracket tooth #34 (ORMCO); and a 1 × 1 × 0.1 cm polyurethane-based thermoplastic material, Invisalign clear aligner (Align Technology, San Jose, CA, USA). Panoramic radiography, CBCT, MRI, and ultrasonography were used, and four observers scored all findings independently. RESULTS The TMA and stainless steel bracket were visualised in all fields by panoramic radiography and CBCT. The sapphire and Damon brackets were very clear on CBCT. The Invisalign in air was evident only on CBCT. MRI was unable to identify any material in muscle. Ultrasonography detected the TMA, sapphire bracket, and the Invisalign in muscle but only the TMA on bone. CONCLUSIONS Panoramic radiography does not reveal nonmetallic orthodontic equipment in air and reveals them only poorly in muscle. CBCT was the optimal imaging modality for all materials in all fields except for the Invisalign in muscle and bone. CBCT was the only method that revealed the Invisalign in air. MRI and ultrasonography should be used to detect orthodontic materials in muscle.
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Affiliation(s)
- Ozlem Isman
- Vocational High School of Health Service, Gaziantep University, Gaziantep, 27310, Şehitkamil/Gaziantep, Turkey.
| | - Eren Isman
- Private Practice, Gaziantep, 27310, Turkey
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15
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Öztürk AM, Aljasim O, Şanlıdağ G, Taşbakan M. Retrospective evaluation of 377 patients with penetrating foreign body injuries: a university hospital experience (a present case of missed sponge foreign body injury). Turk J Med Sci 2021; 51:570-582. [PMID: 32967414 PMCID: PMC8203142 DOI: 10.3906/sag-2006-34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/24/2020] [Indexed: 12/18/2022] Open
Abstract
Background/aim This study aimed to retrospectively analyse patients with foreign body (FB) injuries in our hospital and to present a patient with missed penetrating sponge FB injury. Materials and methods This study lasted 12 years (2008–2020) and reviewed all patients with FB injuries who were admitted to the emergency department (ED) of our hospital. Along with our overall results, we present a case with missed penetrating sponge FB injury in detail. Results Approximately 377 patients were included in the study (age: 28.3 ± 18.3 years, m/f: 229/148). The foot (n = 148, 39.3%) and the hand (n = 143, 37.9%) were the most frequently injured body parts. Regarding FB types, sewing needles (n = 140, 37.1%), metal pieces (n = 91, 24.1%), and glass (n = 80, 21.2%) were the most frequently observed objects. Most of the patients were injured at home, often by needles or glass. The injury-admission mean time was 7.38 ± 2.5 days. FBs were frequently removed in the ED (n = 176, 46.7%). Plain radiography is the first line in identifying FBs. Soft tissue infection was the most common complication. MRIs were much useful than USGs in detecting the missed penetrating sponge injury of the single patient in the study. Conclusion For diagnosis of FBs, besides recording the patient’s history, obtaining a two-sided radiogram is of great importance. For nonradiolucent or deeply located FBs, further clinical or radiological investigation must be considered to avoid complications. Although most of the FBs can be removed in the ED, patients may require hospitalisation and operation for FB removal, depending upon FB location and age.
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Affiliation(s)
- Anıl Murat Öztürk
- Department of Orthopedics, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Omar Aljasim
- Department of Orthopedics, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Gamze Şanlıdağ
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Meltem Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey
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16
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Singh A, Roy S, Srikanth G, Gunashekhar S, Smriti K. Temporalis space infection secondary to an undiagnosed intra-oral foreign object - a case report. Med Pharm Rep 2021; 94:260-266. [PMID: 34013200 PMCID: PMC8118217 DOI: 10.15386/mpr-1594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 06/23/2020] [Accepted: 07/10/2020] [Indexed: 11/23/2022] Open
Abstract
The penetration of foreign objects is one of the leading causes of maxillofacial infection following trauma. Failure to detect such objects at initial stages can lead to complications like abscess formation, cellulitis, or space infections. Detection is even more complicated if the patient presents to the maxillofacial center after a delay of days or weeks following trauma. Sole reliance on radiographs or CT can be inconclusive as most of these objects are radiolucent and can be difficult to detect even by the experienced radiologists. We report the case of a patient who had an unwitnessed trauma and presented to our center 7 days after the incident, with signs of buccal space infection. Failure to detect the embedded intra-oral wooden object at an earlier stage led to the propagation of infection to superficial temporal space. The management strategy and pitfalls associated with conventional imaging in detecting wooden object are discussed.
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Affiliation(s)
- Anupam Singh
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Sreea Roy
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - G Srikanth
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Shruti Gunashekhar
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Komal Smriti
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
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17
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George AM, Azad AK, Mayya A, Mayya A. Displacement of a composite restoration fragment into the gingiva: an unusual complication of surgical removal of teeth. BMJ Case Rep 2021; 14:14/4/e240294. [PMID: 33888476 PMCID: PMC8070858 DOI: 10.1136/bcr-2020-240294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Ann Mary George
- Oral and Maxillofacial Surgery, Melaka Manipal Medical College, Melaka, Malaysia
| | - Abdul Kalam Azad
- Oral and Maxillofacial Surgery, Melaka Manipal Medical College, Melaka, Malaysia
| | - Anoop Mayya
- Prosthodontics, Melaka Manipal Medical College, Melaka, Malaysia
| | - Arun Mayya
- Conservative Dentistry and Endodontics, Srinivas Institute of Dental Sciences, Mangalore, India
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18
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Voss JO, Maier C, Wüster J, Beck-Broichsitter B, Ebker T, Vater J, Dommerich S, Raguse JD, Böning G, Thieme N. Imaging foreign bodies in head and neck trauma: a pictorial review. Insights Imaging 2021; 12:20. [PMID: 33587198 PMCID: PMC7884531 DOI: 10.1186/s13244-021-00969-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/15/2021] [Indexed: 12/26/2022] Open
Abstract
Open injuries bear the risk of foreign body contamination. Commonly encountered materials include gravel debris, glass fragments, wooden splinters or metal particles. While foreign body incorporation is obvious in some injury patterns, other injuries may not display hints of being contaminated with foreign body materials. Foreign objects that have not been detected and removed bear the risk of leading to severe wound infections and chronic wound healing disorders. Besides these severe health issues, medicolegal consequences should be considered. While an accurate clinical examination is the first step for the detection of foreign body materials, choosing the appropriate radiological imaging is decisive for the detection or non-detection of the foreign material. Especially in cases of impaired wound healing over time, the existence of an undetected foreign object needs to be considered. Here, we would like to give a practical radiological guide for the assessment of foreign objects in head and neck injuries by a special selection of patients with different injury patterns and various foreign body materials with regard to the present literature.
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Affiliation(s)
- Jan Oliver Voss
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany. .,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178, Berlin, Germany.
| | - Christoph Maier
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Jonas Wüster
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Benedicta Beck-Broichsitter
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Tobias Ebker
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Jana Vater
- Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin, 13353, Germany
| | - Steffen Dommerich
- Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin, 13353, Germany
| | - Jan D Raguse
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany.,Department of Oral and Maxillofacial Surgery, Fachklinik Hornheide, Dorbaumstraße 300, 48147, Münster, Germany
| | - Georg Böning
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Nadine Thieme
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin, 13353, Germany
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19
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Abolvardi M, Akhlaghian M, Hamidi Shishvan H, Dastan F. Detection of different foreign bodies in the maxillofacial region with spiral computed tomography and cone-beam computed tomography: An in vitro study. Imaging Sci Dent 2021; 50:291-298. [PMID: 33409137 PMCID: PMC7758271 DOI: 10.5624/isd.2020.50.4.291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/05/2020] [Accepted: 08/18/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose The detection and exact localization of penetrating foreign bodies are crucial for the appropriate management of patients with dentoalveolar trauma. This study compared the efficacy of cone-beam computed tomography (CBCT) and spiral computed tomography (CT) scans for the detection of different foreign bodies composed of 5 frequently encountered materials in 2 sizes. The effect of the location of the foreign bodies on their visibility was also analyzed. Materials and Methods In this in vitro study, metal, tooth, stone, glass, and plastic particles measuring 1×1×1 mm and 2×2×2 mm were prepared. They were implanted in a sheep's head in the tongue muscle, nasal cavity, and at the interface of the mandibular cortex and soft tissue. CBCT and spiral CT scans were taken and the visibility of foreign bodies was scored by 4 skilled maxillofacial radiologists who were blinded to the location and number of foreign bodies. Results CT and CBCT were equally accurate in visualizing metal, stone, and tooth particles of both sizes. However, CBCT was better for detecting glass particles in the periosteum. Although both imaging modalities visualized plastic particles poorly, CT was slightly better for detecting plastic particles, especially the smaller ones. Conclusion Considering the lower patient radiation dose and cost, CBCT can be used with almost equal accuracy as CT for detecting foreign bodies of different compositions and sizes in multiple maxillofacial regions. However, CT performed better for detecting plastic particles.
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Affiliation(s)
- Masoud Abolvardi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, AJA University of Medical Sciences, Tehran, Iran
| | - Marzieh Akhlaghian
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Hamidi Shishvan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, AJA University of Medical Sciences, Tehran, Iran
| | - Farivar Dastan
- Department of Orthodontics, School of Dentistry, Shahed University, Tehran, Iran
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20
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Voss JO, Doll C, Raguse JD, Beck-Broichsitter B, Walter-Rittel T, Kahn J, Böning G, Maier C, Thieme N. Detectability of foreign body materials using X-ray, computed tomography and magnetic resonance imaging: A phantom study. Eur J Radiol 2020; 135:109505. [PMID: 33421828 DOI: 10.1016/j.ejrad.2020.109505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the effectiveness of plain radiography (X-ray. XR), computed tomography (CT) and magnetic resonance imaging (MR) in visualising commonly seen foreign bodies. A special focus was put on objects relevant to head and neck surgery. METHOD Thirty-four commonly encountered objects of different compositions including wood, plastic, and glass were embedded in a gelatin gel phantom and imaged using XR, CT and MR. The success rates of radiologists in detecting and correctly identifying the foreign objects were evaluated. Subjective visibility was rated on a 4-point Likert scale. Objective visibility was analysed using region of interest-based contrast for CT. RESULTS Sensitivity in foreign bodies detection was highest in MR (97.1 %) followed by CT (86.0 %) and x-ray (61.8 %). Success rates for the correct identification of the objects and material types were highest in MR (33.3 % and 39.2 %, respectively) followed by CT (25.5 % for both) and XR (16.7 % and 15.7 %). Overall, subjective visibility was rated higher in CT and MR imaging ("good visibility"), as compared to XR ("poor visibility"). Interreader agreement was high across modalities (Kendall's W = 0.935, 0.834 and 0.794 for XR, MR and CT, respectively). CONCLUSIONS Detection and identification of non-ferromagnetic objects was most successful in MR followed by CT imaging in this experimental setup.
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Affiliation(s)
- Jan Oliver Voss
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany.
| | - Christian Doll
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Jan D Raguse
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; Fachklinik Hornheide, Department of Oral and Maxillofacial Surgery, Dorbaumstraße 300, 48147 Münster, Germany.
| | - Benedicta Beck-Broichsitter
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Thula Walter-Rittel
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Diagnostic and Interventional Radiology and Nuclear Medicine, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Johannes Kahn
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Diagnostic and Interventional Radiology and Nuclear Medicine, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Georg Böning
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Diagnostic and Interventional Radiology and Nuclear Medicine, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Christoph Maier
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Diagnostic and Interventional Radiology and Nuclear Medicine, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Nadine Thieme
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Diagnostic and Interventional Radiology and Nuclear Medicine, Augustenburger Platz 1, 13353 Berlin, Germany.
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21
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Ogden NKE, Milner PI, Stack JD, Talbot AM. CT more accurately detects foreign bodies within the equine foot than MRI or digital radiography. Vet Radiol Ultrasound 2020; 62:225-235. [PMID: 33325609 DOI: 10.1111/vru.12944] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/25/2020] [Accepted: 11/01/2020] [Indexed: 11/27/2022] Open
Abstract
Identification and characterization of foreign bodies in the distal limb of horses poses a diagnostic challenge. The aims of this prospective experimental cadaver study were to describe the appearance of five foreign body materials within the equine hoof using CT, MRI, and digital radiography (DR) and to compare interrater agreement among three reviewers. Fifty foreign bodies consisting of five materials were implanted at a solar location or a coronary location in 25 equine cadaver feet. The images were reviewed by three equine veterinarians experienced in advanced imaging interpretation, who were blinded to the material of the foreign body. Foreign bodies were graded on visibility and appearance. Sensitivity and specificity were calculated for accurate identification of the different materials. Interrater agreement was assessed using Fleiss' kappa. Computed tomography had higher visibility score, sensitivity/specificity, and interrater agreement for detection of all materials; particularly slate, glass, and dry wood, compared to the other imaging modalities. Soaked wood and plastic had lower sensitivity (31-33%) on CT with a similar attenuation of the two materials. Foreign bodies were often visible on MRI, although with similar appearance and unclear details. On DR, only slate and glass were visible. The interrater agreement for identifying the correct material was almost perfect for slate, glass, and dry wood (κ = 0.92-1.00) and poor for plastic and soaked wood (κ < 0.20) on CT. Interrater agreement was poor for all materials on MRI and DR (κ < 0.20), with the except for fair (κ = 0.28) for slate on DR and moderate (κ = 0.28) for soaked wood on MRI.
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Affiliation(s)
- Nadine K E Ogden
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, UK
| | - Peter I Milner
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, UK
| | - John D Stack
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, UK
| | - Alison M Talbot
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, UK
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22
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Saxena RC, Friedman S, Bly RA, Otjen J, Alessio AM, Li Y, Hannaford B, Whipple M, Moe KS. Comparison of Micro-Computed Tomography and Clinical Computed Tomography Protocols for Visualization of Nasal Cartilage Before Surgical Planning for Rhinoplasty. JAMA FACIAL PLAST SU 2020; 21:237-243. [PMID: 30730533 DOI: 10.1001/jamafacial.2018.1931] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Importance There is no imaging standard to model nasal cartilage for the planning of rhinoplasty procedures. Preoperative visualization of cartilage may improve objective evaluation of nasal deformities, surgical planning, and surgical reconstruction. Objectives To evaluate the feasibility of visualizing nasal cartilage using high resolution micro-computed tomography (CT) compared with the criterion standard of pathologic findings in a cadaveric specimen and to evaluate its accuracy compared with various clinical CT protocols. Design, Setting, and Participants Anatomic study at the University of Washington using single human cadaveric nasal specimens performed from July 10, 2017, to March 30, 2018. Interventions A micro-CT acquisition with 60-micron resolution was obtained of a nasal specimen. The specimen was then scanned with 5 different clinical CT protocols to span both clinical care and machine limits. The specimen was then sectioned in 5-mm axial slices for pathologic analysis. Main Outcomes and Measures Micro-CT images were registered to pathologic specimen cross-sections using a graphite fiducial system. Cartilage substructures were manually segmented and analyzed. A library of matched images across the micro-CT and various clinical CT protocols was then developed. Region of interest analysis was performed for each of the cartilage structures and their boundaries on clinical CT protocols and micro-CT, with the outcome of mean (SD) density using Hounsfield units. Results A single human cadaveric nasal specimen was used to obtain the following results. Lower lateral cartilage, upper lateral cartilage, and septal cartilage were accurately delineated on the micro-CT images compared with pathologic findings. The mean absolute deviation from pathologic findings was 0.30 mm for septal cartilage thickness, 0.98 mm for maximal upper lateral cartilage length, and 1.40 mm for maximal lower lateral cartilage length. On clinical CT protocols, only septal cartilage was well discriminated from boundary. Higher radiation dose resulted in more accurate density measurements of cartilage, but it did not ultimately improve ability to discriminate cartilage. Conclusions and Relevance The results of this anatomic study may represent a notable step toward advancing knowledge of the capabilities and pitfalls of nasal cartilage visualization on CT. Nasal cartilage visualization was feasible on the micro-CT compared with pathologic findings. Future research may further examine the barriers to accurately visualizing upper lateral cartilage and lower lateral cartilage, a prerequisite for clinical application. Level of Evidence NA.
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Affiliation(s)
- Rajeev C Saxena
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle.,Department of Anesthesiology and Pain Medicine, University of Washington, Seattle
| | - Seth Friedman
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington
| | - Randall A Bly
- Department of Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington
| | - Jeffrey Otjen
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington
| | - Adam M Alessio
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington
| | - Yangming Li
- Department of Electrical Engineering, University of Washington, Seattle
| | - Blake Hannaford
- Department of Electrical Engineering, University of Washington, Seattle
| | - Mark Whipple
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle
| | - Kris S Moe
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle
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Altmayer S, Verma N, Dicks EA, Oliveira A. Imaging musculoskeletal soft tissue infections. Semin Ultrasound CT MR 2020; 41:85-98. [PMID: 31964497 DOI: 10.1053/j.sult.2019.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Musculoskeletal soft tissue infections are not uncommonly encountered in both the clinic and Emergency Department setting. The clinical diagnosis is not always evident as these infections can have variable presentations depending on the duration and depth of disease extension through the soft-tissue layers. Imaging often plays an important role in diagnosing the infection, defining the extent of involvement, directing tissue sampling, and in monitoring treatment response. After initial radiographs, ultrasound (US) is often the next modality utilized to evaluate patients with suspected soft tissue infections given its low cost, availability, portability, and potential for real-time guidance of fluid aspiration. The widespread use of cross-sectional imaging with magnetic resonance imaging (MRI) and computed tomography (CT) has greatly increased the radiological diagnosis in conditions where US may be limited. In addition, CT and MRI allow a thorough evaluation of disease extension, including assessment of joint spaces, tendons, and osseous changes indicative of bone involvement. This review will focus on the radiological findings of soft tissue infections on US, CT, and MRI.
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Affiliation(s)
- Stephan Altmayer
- Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Elizabeth A Dicks
- Department of Radiology, Imperial College Healthcare Trust, London, England
| | - Amy Oliveira
- University of Massachusetts Medical School-Baystate, Springfield, MA.
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Captanian N, Palma D. Limitation of Computed Tomography in Identifying Intranasal Porcupine Quills in a Dog ( Canis lupus familiaris). J Am Anim Hosp Assoc 2019; 55:e55404. [PMID: 31099605 DOI: 10.5326/jaaha-ms-6697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 6 yr old, spayed female, Rhodesian ridgeback was presented for a 6-8 wk history of serous nasal discharge after being quilled by a porcupine. Physical exam revealed mid dorsal maxilla sensitivity. Computed tomography showed a normal nasal cavity. Rhinoscopy revealed three porcupine quills which were removed from the nasal cavities. The patient's clinical signs had improved dramatically at 1 wk follow-up. This case demonstrates the limitations of computed tomography for diagnosing intranasal porcupine quills and the importance of pursuing rhinoscopy in patients with clinical signs of nasal disease.
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Hwang JH, Lee DG, Kim KS, Lee SY. Proximal migration of retained pencil lead along a flexor tendon in the hand: A case report. Medicine (Baltimore) 2019; 98:e13876. [PMID: 30608408 PMCID: PMC6344185 DOI: 10.1097/md.0000000000013876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE The hand is the most common site for foreign body injuries. Pencil lead penetration mainly occurs in school-age children.We report a case of proximal migration of a retained pencil lead in the hand, emphasizing the importance of adequate imaging and prompt removal of the foreign body. PATIENT CONCERNS We report the case of an 8-year-old boy who visited our outpatient clinic for a retained foreign body in the right palm. Removal was planned under general anesthesia. Black staining from the pencil lead was observed around the tendon sheath in the operative field, but the foreign body itself was not apparent. DIAGNOSIS Intraoperative radiography located the foreign body at the wrist, 5 cm away from the original site. Proximal migration of the retained foreign body was suspected. INTERVENTION Incision was extended toward the wrist and the foreign body was discovered in the flexor sheath at the wrist. CONCLUSION Foreign bodies may migrate to adjacent tissues, but rarely wander far. Computed tomography is the most useful tool in diagnosing a pencil lead foreign body. LESSONS Adequate imaging and prompt removal of the foreign body is important. When a retained foreign body is removed after a delay, the physician must always consider the possibility of foreign body migration.
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Younis R, Berkowitz E, Shreter R, Kesler A, Braverman I. Traumatic Optic Neuropathy and Monocular Blindness following Transnasal Penetrating Optic Canal Injury by a Wooden Foreign Body. Case Rep Ophthalmol 2018; 9:341-347. [PMID: 30057545 PMCID: PMC6062664 DOI: 10.1159/000490758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 06/10/2018] [Indexed: 12/28/2022] Open
Abstract
Purpose To report a case of right eye blindness due to a penetrating injury in the contralateral nostril. Methods This is a case report of a 67-year-old patient who presented to the emergency room complaining of transient blurred vision in his right eye after falling on a small branch with no apparent injury besides minor lacerations. The following day, the patient experienced blindness in the right eye. Physical examination revealed small lacerations on his left forehead and optic neuropathy on the right side with no other obvious discerning physical or imaging abnormalities. Results After elevated suspicion and reassessment of the neuroimaging findings, a radiolucent track was observed in the nasal cavity, continuing up from the left nostril to the right optic nerve. Transnasal endoscopic surgery was performed and a long wooden branch was removed from the nasal cavity. Conclusion A nasally penetrating wooden foreign body can cause traumatic optic neuropathy and vision loss on the unaffected side and can be very difficult to locate and image without any clear external evidence as to its presence. This case highlights the importance of maintaining a high level of suspicion in these types of cases.
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Affiliation(s)
- Reem Younis
- Department of Otolaryngology, Head and Neck Surgery Unit, Hillel Yaffe Medical Center, Hadera, Israel
| | - Eran Berkowitz
- Department of Ophthalmology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Roni Shreter
- Radiology Unit, Department of Diagnostic Radiology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Anat Kesler
- Department of Ophthalmology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Itzhak Braverman
- Department of Otolaryngology, Head and Neck Surgery Unit, Hillel Yaffe Medical Center, Hadera, Israel
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Britt CJ, Hyman D, Hartig GK. Use of sialendoscopy as an aid to identify a large retained foreign body. EAR, NOSE & THROAT JOURNAL 2018; 96:E18-E19. [PMID: 28846794 DOI: 10.1177/014556131709600805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We describe the novel use of sialendoscopy in a 51-year-old man to identify a large and long-standing foreign body (wood) within the facial soft tissues that had eluded detection on previous imaging and surgical exploration. The identification of this foreign body was elusive on both computed tomography and magnetic resonance imaging, illustrating the limitations of imaging in identifying vegetable matter within soft tissues.
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Affiliation(s)
- Christopher J Britt
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Voss JO, Thieme N, Doll C, Hartwig S, Adolphs N, Heiland M, Raguse JD. Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge. Craniomaxillofac Trauma Reconstr 2018; 11:172-182. [PMID: 30087746 DOI: 10.1055/s-0038-1642035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/29/2017] [Indexed: 10/17/2022] Open
Abstract
Penetrating foreign bodies of different origins in the head and neck are rare and potentially dangerous injuries, which might pose problems for their detection, primary care, and final treatment. Depending on the severity of the underlying trauma, some injuries present a higher risk for the presence of foreign bodies. Minor wounds, including common lacerations, are likely to be contaminated with loose gravel debris or dental fragments, and need to be distinguished from severe wounds caused by impalement, shootings, stabbings, and explosions. Blast injuries resulting from terror attacks are challenging recent therapeutic concepts. Even though these injury patterns are uncommon, they carry the risk of impacted objects with dramatic consequences. Despite improving medical imaging techniques, detection remains a challenge as it is dependent on the material of the foreign body, the affected anatomical site, and the injury severity. Therefore, a detailed history of the circumstances leading to trauma is essential when foreign objects are not visible during clinical examination. Precise detection of the foreign body, its anatomical position, and the affected surrounding structures are vital, especially for impalement injuries of the head and neck area. Therefore, an interdisciplinary planning approach is essential prior to removal of the foreign object. Finally, tension-free anatomical adaptation of the corresponding structures is crucial for maintaining and restoring aesthetic and function. Here, we give an overview of the diagnosis and treatment of cases of foreign body injuries encountered in our department.
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Affiliation(s)
- Jan Oliver Voss
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Nadine Thieme
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universitaät zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Christian Doll
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Stefan Hartwig
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Nicolai Adolphs
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Jan-Dirk Raguse
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
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Abdinian M, Aminian M, Seyyedkhamesi S. Comparison of accuracy between panoramic radiography, cone-beam computed tomography, and ultrasonography in detection of foreign bodies in the maxillofacial region: an in vitro study. J Korean Assoc Oral Maxillofac Surg 2018. [PMID: 29535965 PMCID: PMC5845963 DOI: 10.5125/jkaoms.2018.44.1.18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Objectives Foreign bodies (FBs) account for 3.8% of all pathologies of the head and neck region, and approximately one third of them are missed on initial examination. Thus, FBs represent diagnostic challenges to maxillofacial surgeons, rendering it necessary to employ an appropriate imaging modality in suspected cases. Materials and Methods In this cross-sectional study, five different materials, including wood, metal, glass, tooth and stone, were prepared in three sizes (0.5, 1, and 2 mm) and placed in three locations (soft tissue, air-filled space and bone surface) within a sheep's head (one day after death) and scanned by panoramic radiography, cone-beam computed tomography (CBCT), and ultrasonography (US) devices. The images were reviewed, and accuracy of the detection modalities was recorded. The data were analyzed statistically using the Kruskal-Wallis, Mann-Whitney U-test, Friedman, Wilcoxon signed-rank and kappa tests (P<0.05). Results CBCT was more accurate in detection of FBs than panoramic radiography and US (P<0.001). Metal was the most visible FB in all of modalities. US was the most accurate technique for detecting wooden materials, and CBCT was the best modality for detecting all other materials, regardless of size or location (P<0.05). The detection accuracy of US was greater in soft tissue, while both CBCT and panoramic radiography had minimal accuracy in detection of FBs in soft tissue. Conclusion CBCT was the most accurate detection modality for all the sizes, locations and compositions of FBs, except for the wooden materials. Therefore, we recommend CBCT as the gold standard of imaging for detecting FBs in the maxillofacial region.
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Affiliation(s)
- Mehrdad Abdinian
- Dental Implants Research Center, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran.,Department of Radiology, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran
| | - Maedeh Aminian
- Department of Radiology, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran
| | - Samad Seyyedkhamesi
- Department of Oral and Maxillo-Facial Surgery, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
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Usefulness of Computed Tomography Image Processing by OsiriX Software in Detecting Wooden and Bamboo Foreign Bodies. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3104018. [PMID: 29119104 PMCID: PMC5651097 DOI: 10.1155/2017/3104018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 08/29/2017] [Indexed: 01/09/2023]
Abstract
Objective The aim of this study was to evaluate the usefulness of reconstructed computed tomography (CT) images using OsiriX software in detecting wooden and bamboo foreign bodies. Methods Four sizes of wet and dry wooden and bamboo foreign bodies were selected to be analyzed. Those in the air and in the head of edible swine were scanned with a multidetector row CT scanner. The images were evaluated with OsiriX software in the bone and the abdomen window setting as unprocessed images. Three-dimensional rendered images assigned colors and opacity by a 16-bit color look-up table (CLUT) editor in OsiriX software were evaluated as processed images. Results In the unprocessed images, dry and wet foreign bodies in the air were not detected except a part of wet wooden foreign bodies, and all the dry and wet foreign bodies in the swine's head mimicked air with linear shapes. In the processed images, all the dry and wet foreign bodies in the air were detected clearly, and all the wooden and some of the bamboo foreign bodies in the swine's head were detected clearly. Conclusions CT images processed using OsiriX software, especially with a CLUT editor, were useful in detecting wooden and bamboo foreign bodies.
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Abstract
BACKGROUND Traumatic lacerations to the skin represent a fairly common reason for seeking emergency department care. Although the incidence of lacerations has decreased over the past decades, traumatic cutaneous lacerations remain a common reason for patients to seek emergency department care. OBJECTIVE Innovations in laceration management have the potential to improve patient experience with this common presentation. DISCUSSION Studies have confirmed that delays in wound closure rarely confer increased rates of infection, although comorbidities such as diabetes, chronic renal failure, obesity, human immunodeficiency virus, smoking, and cancer should be considered. Antibiotics should be reserved for high-risk wounds, such as those with comorbidities, gross contamination, involvement of deeper structures, stellate wounds, and selected bite wounds. Topical anesthetics, which are painless to apply, have a role in select populations. In most studies, absorbable sutures perform similarly to nonabsorbable sutures and do not require revisit for removal. Novel atraumatic closure devices and expanded use of tissue adhesives for wounds under tension further erode the primacy of regular sutures in wound closure. Maintaining a moist wound environment with occlusive dressings is more important than previously thought. Most topical wound agents are of limited benefit. CONCLUSIONS Recent innovations in wound closure are allowing emergency physicians to shift toward painless, atraumatic, and rapid closure of lacerations.
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Javadrashid R, Golamian M, Shahrzad M, Hajalioghli P, Shahmorady Z, Fouladi DF, Sadrarhami S, Akhoundzadeh L. Visibility of Different Intraorbital Foreign Bodies Using Plain Radiography, Computed Tomography, Magnetic Resonance Imaging, and Cone-Beam Computed Tomography: An in Vitro Study. Can Assoc Radiol J 2017; 68:194-201. [DOI: 10.1016/j.carj.2015.09.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 09/21/2015] [Accepted: 09/22/2015] [Indexed: 11/25/2022] Open
Abstract
Purpose The study sought to compare the usefulness of 4 imaging modalities in visualizing various intraorbital foreign bodies (IOFBs) in different sizes. Methods Six different materials including metal, wood, plastic, stone, glass. and graphite were cut in cylindrical shapes in 4 sizes (dimensions: 0.5, 1, 2, and 3 mm) and placed intraorbitally in the extraocular space of fresh sheep's head. Four skilled radiologists rated the visibility of the objects individually using plain radiography, spiral computed tomography (CT), magnetic resonance imaging (MRI), and cone-beam computed tomography (CBCT) in accordance with a previously described grading system. Results Excluding wood, all embedded foreign bodies were best visualized in CT and CBCT images with almost equal accuracies. Wood could only be detected using MRI, and then only when fragments were more than 2 mm in size. There were 3 false-positive MRI reports, suggesting air bubbles as wood IOFBs. Conclusions Because of lower cost and using less radiation in comparison with conventional CT, CBCT can be used as the initial imaging technique in cases with suspected IOFBs. Optimal imaging technique for wood IOFBs is yet to be defined.
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Affiliation(s)
- Reza Javadrashid
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Golamian
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Parisa Hajalioghli
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Shahmorady
- Department of Oral Radiology, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Daniel F. Fouladi
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shohreh Sadrarhami
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Akhoundzadeh
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Shokri A, Jamalpour M, Jafariyeh B, Poorolajal J, Sabet NK. Comparison of Ultrasonography, Magnetic Resonance Imaging and Cone Beam Computed Tomography for Detection of Foreign Bodies in Maxillofacial Region. J Clin Diagn Res 2017; 11:TC15-TC19. [PMID: 28571230 DOI: 10.7860/jcdr/2017/24523.9736] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/03/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Foreign Bodies (FBs) entrapped in the maxillofacial region have a high prevalence due to trauma and accidents. Accurate localization of FBs and verifying their type and size are critical to assist the surgeon in their fast retrieval with minimal tissue damage. AIM To assess and compare the imaging modalities including MRI, ultrasonography and Cone Beam Computed Tomography (CBCT) for detection of different types of FBs. MATERIALS AND METHODS In this study, four types of FBs including pieces of normal glass, barium glass, wood and pebbles with equal sizes were placed randomly in two sheep heads in different locations such as upper lip, maxillary sinus and body of mandible as FBs and subjected to MRI, ultrasound and CBCT. The images were interpreted by expert observers and the data was analysed using the stata 11 software, kappa test and chi-square test. RESULTS Sensitivity of CBCT, MRI and ultrasound for detecting foreign bodies was 79.19%, 20.83% and 33.33%, respectively. None of the imaging modalities could clearly visualize wooden FBs. Among different FBs, pebbles and barium glass were detected more accurately by radiographic imaging technique. The sensitivity of CBCT, ultrasound and MRI for pebbles was 100%, 33.33% and 16.67%, respectively. The sensitivity of CBCT, ultrasound and MRI for barium glass was 100%, 33.33% and 41.69%, respectively. The sensitivity of CBCT, ultrasound and MRI for wood was 33.33%, 33.33% and 16.67%, respectively. Specificity of all three imaging modalities was 100%. Diagnostic accuracy of all three imaging modalities was higher for detection of FBs in the upper lip than those in the body of mandible, and FBs in the latter location had higher detection accuracy than those in the maxillary sinus. CONCLUSION Among the three imaging modalities, CBCT had the highest diagnostic sensitivity for the examined FBs. The highest diagnostic sensitivity was noted for pebbles and barium glass.
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Affiliation(s)
- Abbas Shokri
- Assistant Professor, Dental Research Center, Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammadreza Jamalpour
- Associate Professor, Dental Research Center, Department of Oral and Maxillofacial Surgery, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Jalal Poorolajal
- Associate Professor, Modeling of Noncommunicable Diseases Research Center, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Negar Kanouni Sabet
- Postgraduate Student, Department of Periodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
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Yamamoto K, Nakayama Y, Yamamoto I, Matsusue Y, Shimotsuji H, Kirita T. A Ferromagnetic Foreign Body at the Lateral Aspect of the Mandibular Ramus in a Medically Compromised Patient. Open Dent J 2016; 10:390-4. [PMID: 27583049 PMCID: PMC4988091 DOI: 10.2174/1874210616021001390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 06/06/2016] [Accepted: 06/24/2016] [Indexed: 11/22/2022] Open
Abstract
A case of a ferromagnetic foreign body in a medically compromised patient was reported. The patient was a 45-year-old male who consulted our department complaining of a foreign body accidentally impacted in the right cheek. X-ray examination revealed a foreign body at the lateral aspect of the right mandibular ramus. The removal of the foreign body was scheduled, but the patient did not return for the procedure. After 8 years he revisited our department for the removal of the foreign body, because it had been found to be ferromagnetic and a barrier to MRI examination. X-ray examination confirmed the foreign body was located at the same site as 8 years prior. Although the patient was suffering from liver cirrhosis with thrombocytopenia and leukopenia, the foreign body was successfully removed under general anesthesia. The foreign body was 12 × 5 × 1 mm, weighed 0.48 g, and was ferromagnetic. The patient’s postoperative course was uneventful. X-ray examination confirmed the removal of the foreign body. Since the surgery, the patient has been in generally stable condition with no complications. This case was a rare example of a foreign body that needed to be removed for medical examination.
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Affiliation(s)
- K Yamamoto
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Y Nakayama
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - I Yamamoto
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Y Matsusue
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - H Shimotsuji
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - T Kirita
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
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Haghnegahdar A, Shakibafard A, Khosravifard N. Comparison between Computed Tomography and Ultrasonography in Detecting Foreign Bodies Regarding Their Composition and Depth: An In Vitro Study. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2016; 17:177-84. [PMID: 27602392 PMCID: PMC5006826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
STATEMENT OF THE PROBLEM Impaction of foreign bodies in the soft tissues is a sequela of traumatic and penetrating injuries. Such foreign bodies should be removed due to the complications they cause. Patient's history, clinical evaluation and imaging examinations aid in the proper detection and localization of the foreign bodies. PURPOSE The aim of the present study was to compare the sensitivity of computed tomography (CT) and ultrasonography for detecting foreign bodies in in-vitro models simulating facial soft tissues. MATERIALS AND METHOD Fifty foreign particles with five different compositions including wood, glass, metal, plastic, and stone were embedded in five calf tongues at 1, 2, 3, 4 and 5 cm depths. CT and ultrasonography were compared regarding their capability of detecting and localizing the foreign bodies. RESULTS Wood and plastic foreign bodies were demonstrated more clearly on ultrasonography images. High density materials such as metal, stone, and glass were detected with almost the same accuracy on CT and ultrasonography examinations. Visibility of the foreign bodies deteriorated on ultrasonography images as their depth increased; however, CT appearances of the foreign particles were not influenced by their depths. CONCLUSION Ultrasonography is an appropriate technique for detection of foreign bodies especially the ones with low density. Therefore, it seems logical to perform ultrasonography in combination with CT in cases with the suspicion of foreign body impaction.
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Affiliation(s)
- Abdolaziz Haghnegahdar
- Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Alireza Shakibafard
- Specialist in Radiology and Sonography, TABA Medical Imaging Center, Shiraz, Iran.
| | - Negar Khosravifard
- Postgraduate Student in Oral and Maxillofacial Radiology, Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
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Blade of Grass as an Unusual Cause of Recurrent Facial Cutaneous Sinus Tract: A Clinical Case. Case Rep Dent 2016; 2016:4639693. [PMID: 27340573 PMCID: PMC4908261 DOI: 10.1155/2016/4639693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 04/28/2016] [Accepted: 05/10/2016] [Indexed: 11/17/2022] Open
Abstract
The presence of an embedded foreign body in the oral and maxillofacial region is not unusual, but the impaction of a foreign body with vegetative nature is rare. Prompt diagnosis and surgical removal of these foreign bodies will minimize their associated complications. This case report presents a patient with recurrent submandibular abscess and persistent facial cutaneous sinus tract caused by a retained blade of grass inside the facial soft tissue. The fact that the plain radiograph misdiagnosed the presence of a foreign body meant that the pathology persisted for about three months, and the patient underwent hospitalization, surgical procedures, and antibiotic regimens; however all of these failed until the foreign body was detected and removed. Conclusion. To avoid misdiagnosis of foreign body presence in the orofacial region, notably suspected foreign bodies with low radiopacity, the clinician must perform careful clinical examination and use the ultrasonography. Also, in the uncertain cases where the pathology persists, despite having undertaken surgical procedures and antibiotic regimens, the clinician should pay more attention to the patient's history which may suggest the presence of the foreign body.
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Johari M, Ghavimi MA, Mahmoudian H, Javadrashid R, Mirakhor Samani S, Fouladi DF. A comparable study of the diagnostic performance of orbital ultrasonography and CBCT in patients with suspected orbital floor fractures. Dentomaxillofac Radiol 2016; 45:20150311. [PMID: 27074346 DOI: 10.1259/dmfr.20150311] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES: To compare the diagnostic performance of ultrasonography and CBCT against CT in detecting orbital floor fractures. METHODS: A total of 120 orbits with clinical suspicion of isolated orbital floor fractures underwent multislice CT scanning with coronal reconstruction; orbital ultrasonography using a standard machine equipped with a 7- to 10-MHz linear transducer; and CBCT. Patients with severe head and face injuries were not included. The diagnostic performance of ultrasonography and CBCT was reported assuming conventional CT as the imaging method of choice. RESULTS: According to CT findings, fractures of the floor were present in 39 orbits. The sensitivity, specificity, positive-predictive value and negative-predictive value of ultrasonography in detecting orbital floor fractures were 87.2%, 100%, 100% and 94.2%, respectively. The corresponding values for CBCT were 97.4%, 97.5%, 95.0%, and 98.8%, respectively. Areas under the receiver operator characteristics curves of orbital floor fracture detection were 0.94 for ultrasonography and 0.98 for CBCT. CONCLUSIONS: When conventional CT cannot be performed in patients with clinically suspected orbital floor fracture and no severe or complex head and face injuries, CBCT could be used in detecting fractures as a reliable surrogate. Because of a lower sensitivity of ultrasonography, however, its use is limited in this regard.
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Affiliation(s)
- Masoumeh Johari
- 1 Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Mohammad Ali Ghavimi
- 2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Hediyeh Mahmoudian
- 1 Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Reza Javadrashid
- 3 Department of Radiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Simin Mirakhor Samani
- 4 Department of Pathology, Qazvin University of Medical Sciences, Qazvin, Islamic Republic of Iran
| | - Daniel F Fouladi
- 5 Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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Tarzamni MK, Derakhshan B, Meshkini A, Merat H, Fouladi DF, Mostafazadeh S, Rezakhah A. The diagnostic performance of ultrasonographic optic nerve sheath diameter and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure. Clin Neurol Neurosurg 2015; 141:82-8. [PMID: 26771156 DOI: 10.1016/j.clineuro.2015.12.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 12/02/2015] [Accepted: 12/10/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To assess the diagnostic accuracy of ultrasonographic optic nerve sheath diameter (ONSD) measurement and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure (ICP). PATIENTS AND METHODS A total 60 patients with (cases, n=30) and without (controls, n=30) acute clinical and computed tomographic findings of elevated ICP due to intracranial mass/hemorrhage were recruited from a teaching hospital. The mean binocular and maximum ultrasonographic ONSDs, as well as the mean binocular Doppler ultrasound waveform indices of the ophthalmic arteries including pulsatility index (PI), resistive index (RI), end-systolic velocity (ESV), peak systolic velocity (PSV) and end-diastolic velocity (EDV) were compared between the two groups. RESULTS Compared to controls, the case group had significantly higher mean binocular ONSD (5.48 ± 0.52 mm vs. 4.09 ± 0.22 mm, p<0.001), maximum ONSD (5.63 ± 0.55 mm vs. 4.16 ± 0.23 mm, p<0.001), mean PI (1.53 ± 0.16 vs. 1.45 ± 0.20, p=0.01), and mean RI (0.76 ± 0.07 vs. 0.73 ± 0.04, p=0.01). The mean EDV, in contrast, was significantly higher in controls (8.55 ± 3.09 m/s vs. 7.17 ± 2.61 m/s, p=0.01). The two groups were comparable for the mean PSV (30.73 ± 7.93 m/s in cases vs. 32.27 ± 10.39 m/s in controls, p=0.36). Among the mentioned variables, the mean binocular ONSD was the most accurate parameter in detecting elevated ICP (sensitivity and specificity of 100%, cut-off point=4.53 mm). The Doppler indices were only moderately accurate (sensitivity: 56.7-60%, specificity: 63.3-76.7%). CONCLUSION While the ultrasonographic mean binocular ONSD (>4.53 mm) was completely accurate in detecting elevated ICP, color Doppler indices of the ophthalmic arteries were of limited value.
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Affiliation(s)
- Mohammad Kazem Tarzamni
- Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Derakhshan
- Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Meshkini
- Department of Neurosurgery, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Merat
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Samira Mostafazadeh
- Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Rezakhah
- Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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