Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Aug 2003
ReviewMalignant tumors of the oral cavity and oropharynx: clinical, pathologic, and radiologic evaluation.
Carcinomas of the oral cavity and oropharynx constitute approximately 2% to 5% of head and neck cancers. Alcohol abuse and tobacco chewing, including chewing Shamma, predispose individuals to the development of cancer in the oral cavity. CT and MR imaging are best suited in the evaluation of cancer of the oral cavity and oropharynx. ⋯ Some malignant lesions may mimic a benign tumor, such as the adenoid cystic or mucoepidermoid carcinoma. Histopathologic diagnosis is therefore necessary for the final diagnosis before treatment by surgery or radiotherapy. PET scanning is indicated in the following instances: in search of an unknown primary tumor in patients who have a neck mass secondary to carcinoma, if a recurrent carcinoma may be present, when there are metastatic N0 lymph nodes in the neck, or where CT is inconclusive for metastatic lymph nodes in the neck.
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Neuroimaging Clin. N. Am. · Aug 2003
ReviewThe temporomandibular joint: clinical and surgical aspects.
Advances in imaging techniques have greatly enhanced the ability to visualize the internal anatomy of the temporomandibular joint and have increased understanding of the etiology of many temporomandibular disorders. When used together with careful history and physical examination, this knowledge can contribute to better treatment outcomes.
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Neuroimaging Clin. N. Am. · Aug 2003
ReviewLesions of the maxilla: crossroads of the head and neck.
The maxilla may be involved by a wide range of pathologic conditions. Lesions originating in the maxilla may involve the adjacent orbit, oral cavity, or retroantral spaces. Recognition of this relationship plays an important role in diagnosis, prognosis, and presurgical planning.
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Vascular interventions are important and helpful for treatment of various pathologies of the head and neck. Interventional neuroradiology of the head and neck includes image-guided biopsies, vessel occlusion, and local chemotherapy. Knowledge of anatomy, functional relationships between intra- and extracranial vessels, and pathology are the basis for therapeutic success. ⋯ Avoiding complications, handling unavoidable problems, and dealing with complications is a skill founded on knowledge and experience. Continuing education is a firm basis to push the limits of interventions and expand benefits without increasing risk for the patient. Nevertheless, state-of-the-art external carotid intervention should, in skilled hands, have a permanent morbidity far below 1% and no mortality.
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Before application of any cross-sectional imaging modality, the orthopanoramic view is indispensable in assessing the status of dentition, in recognizing direct radiographic signs of osteomyelitis, or in determining the presence of predisposing conditions such as a fracture or systemic bone disease. The orthopanoramic view is the procedure of choice in follow-up examinations in patients who have osteomyelitis. In acute osteomyelitis, the higher sensitivity of MR imaging for detection of intramedullary inflammation advocates this imaging modality for confirmation of the clinical diagnosis. ⋯ In chronic osteomyelitis, the higher sensitivity of MR imaging to detect periosteal inflammation and soft tissue involvement advocates this modality to reveal the presence, location, and extent of chronic inflammation. The assessment of persistence or recurrence of chronic inflammation after surgical treatment is by high-resolution CT for the first 6 months following surgery. Finally, scintigraphy is recommended when multi-focal systemic disease is suspected, such as in CRMO and SAPHO syndrome.