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Fulltext Necrotizing fasciitis of the upper back presenting with left shoulder pain

Mohamad Isa MZ, Mohamed-Yassin MS, Abdul Kadir RF

Clin Pract, 2020 Mar 31;10(1):1218.
PMID: 32373307 DOI: 10.4081/cp.2020.1218

Necrotizing fasciitis is a severe and progressive infection of deep soft tissues which results in destruction of the fascia and overlying subcutaneous fat. We report a case of a 45-year-old diabetic gentleman who initially presented with left shoulder pain, which was treated symptomatically. Upon representation, he had fever and the pain extended to his left upper back. There was a warm, firm and mildly tender purplish swelling on his mid to the left upper back. Blood tests revealed significantly elevated white cell counts and C-reactive protein. A CT thorax showed extensive soft tissue gas within the deep and superficial fascial layers of his left upper back. Necrotizing fasciitis was confirmed intraoperatively. The diagnosis of this condition is often difficult as early symptoms can be mild and nonspecific. A high Laboratory Risk Indicator for NECrotizing fasciitis (LRINEC) score may be helpful to rule in this diagnosis and guide further management.

Matched MeSH terms: Tomography, X-Ray Computed
Correlation analysis of CT-based rectal planning dosimetric parameters with in vivo dosimetry of MOSkin and PTW 9112 detectors in Co-60 source HDR intracavitary cervix brachytherapy

Jamalludin Z, Malik RA, Ung NM

Phys Eng Sci Med, 2021 Sep;44(3):773-783.
PMID: 34191272 DOI: 10.1007/s13246-021-01026-x

Intracavitary cervical brachytherapy delivers high doses of radiation to the target tissue and a portion of these doses will also hit the rectal organs due to their close proximity. Rectal dose can be evaluated from dosimetric parameters in the treatment planning system (TPS) and in vivo (IV) dose measurement. This study analyzed the correlation between IV rectal dose with selected volume and point dose parameters from TPS. A total of 48 insertions were performed and IV dose was measured using the commercial PTW 9112 semiconductor diode probe. In 18 of 48 insertions, a single MOSkin detector was attached on the probe surface at 50 mm from the tip. Four rectal dosimetric parameters were retrospectively collected from TPS; (a) PTW 9112 diode maximum reported dose (RPmax) and MOSkin detector, (b) minimum dose to 2 cc (D2cc), (c) ICRU reference point (ICRUr), and (d) maximum dose from additional points (Rmax). The IV doses from both detectors were analyzed for correlation with these dosimetric parameters. This study found a significantly high correlation between IV measured dose from RPmax (r = 0.916) and MOSkin (r = 0.959) with TPS planned dose. The correlation between measured RPmax with both D2cc and Rmax revealed high correlation of r > 0.7, whereas moderate correlation (r = 0.525) was observed with ICRUr. There was no significant correlation between MOSkin IV measured dose with D2cc, ICRUr and Rmax. The non-significant correlation between parameters was ascribable to differences in both detector position within patients, and dosimetric volume and point location determined on TPS, rather than detector uncertainties.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext 3D-Printed Coronary Plaques to Simulate High Calcification in the Coronary Arteries for Investigation of Blooming Artifacts

Sun Z, Ng CKC, Wong YH, Yeong CH

Biomolecules, 2021 09 03;11(9).
PMID: 34572520 DOI: 10.3390/biom11091307

The diagnostic value of coronary computed tomography angiography (CCTA) is significantly affected by high calcification in the coronary arteries owing to blooming artifacts limiting its accuracy in assessing the calcified plaques. This study aimed to simulate highly calcified plaques in 3D-printed coronary models. A combination of silicone + 32.8% calcium carbonate was found to produce 800 HU, representing extensive calcification. Six patient-specific coronary artery models were printed using the photosensitive polyurethane resin and a total of 22 calcified plaques with diameters ranging from 1 to 4 mm were inserted into different segments of these 3D-printed coronary models. The coronary models were scanned on a 192-slice CT scanner with 70 kV, pitch of 1.4, and slice thickness of 1 mm. Plaque attenuation was measured between 1100 and 1400 HU. Both maximum-intensity projection (MIP) and volume rendering (VR) images (wide and narrow window widths) were generated for measuring the diameters of these calcified plaques. An overestimation of plaque diameters was noticed on both MIP and VR images, with measurements on the MIP images close to those of the actual plaque sizes (<10% deviation), and a large measurement discrepancy observed on the VR images (up to 50% overestimation). This study proves the feasibility of simulating extensive calcification in coronary arteries using a 3D printing technique to develop calcified plaques and generate 3D-printed coronary models.

Matched MeSH terms: Tomography, X-Ray Computed
Perforated gastric ulcer in severe dengue infection: A case report

Ng CY, Lee SL, Foo SL

Med J Malaysia, 2017 08;72(4):244-245.
PMID: 28889137 MyJurnal

Abdominal pain is one of the common presentations in severe dengue infection. We report a rare case of perforated gastric ulcer in a young man diagnosed with severe dengue infection and the challenges we faced in managing this patient. Perforated gastric ulcer need to be considered if there are signs of peritonitis and persistent abdominal pain that does not conform to the natural history of dengue. Proper imaging and early surgical intervention in perforated gastric ulcer is vital in preventing further complication and reducing the risk of mortality.

Matched MeSH terms: Tomography, X-Ray Computed
Dengue shock syndrome with retroperitoneal haematoma requiring repeated artery angioembolization

Teh YH, Tan YP, Zain MM

Med J Malaysia, 2017 08;72(4):254-256.
PMID: 28889142 MyJurnal

Eyelid reconstruction is complex and challenging since it is not only for structural and functional restoration, but also for an acceptable aesthetic result. In full thickness eyelid injuries, it will involve both anterior and posterior lamella. Therefore, when reconstructing the defect, it requires at least two layers; one will be a flap with blood supply, and the other can be a free graft. In this case, a rotational advancement cheek flap and composite graft were used to reconstruct the lower eyelid.

Matched MeSH terms: Tomography, X-Ray Computed
Electro-navigational bronchoscopy for bilateral peripheral lung lesions: A case report

Faisal AH, Sopian AW, Tidi H

Med J Malaysia, 2017 08;72(4):241-243.
PMID: 28889136 MyJurnal

Electromagnetic navigational bronchoscopy (ENB), one of the methods of navigational bronchoscopy is an advanced diagnostic tool allowing tissue sampling at the lung peripheries which were previously accessible only by computed tomography (CT) guidance or video-assisted thoracoscopic surgery (VATS). We report a 53-year-old man who presented with a cough and dyspnea with constitutional symptoms for one month. CT thorax revealed multiple bilateral peripheral lung nodules and there were no endobronchial lesions on flexible bronchoscopy. ENB was performed using a loan machine from Veran navigational technology. Biopsy successfully revealed small cell carcinoma of the lung thus preventing him from undergoing a more invasive diagnostic procedure. This case highlights the utility of ENB in the evaluation of peripheral lung nodules that were inaccessible by conventional bronchoscopy. This is one of the first few successful applications of Veran ENB in Asia.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext Imaging modalities for an uncommon inguinal scrotal pathology: A case report and literature review

Chun KH, Inn FX, Hing EY, Hong GE

Urol Ann, 2017 11 10;9(4):387-389.
PMID: 29118545 DOI: 10.4103/UA.UA_69_17

Inguinal scrotal swelling is a common presentation to surgical clinic with various differential diagnoses. In most circumstances, a good clinical assessment is sufficient to identify the diagnosis. Imaging is necessary when diagnostic difficulty was encountered. The choice of imaging study could affect the management and outcome. A 60-year-old male presented with an enlarging right inguinal scrotal swelling for 5 years. Clinical examination showed a swelling extended from the right inguinal region down to the right scrotum, firm, not reducible, and not separable from the right testis. Differential diagnoses range from the malignant testicular tumor, irreducible inguinal hernia to the soft-tissue tumor. Ultrasonography and computed tomography scan were unable to conclude the origin of the tumor and involvement of the right testis. Inguinal exploration with potential radical orchiectomy was planned and caused much distress to the patient, resulted in delay in surgery. Intraoperatively, the mass was separated from the testis and spermatic cord, and thus, excision biopsy was performed sparing the testis and spermatic cord. Histopathological examination showed cellular angiofibroma. The right choice of imaging modality is important to provide a precise diagnosis and better treatment plan. This could avoid the unnecessary distress to the patient for potential organ lost. A review through the literature showed the ability of magnetic resonance imaging to better delineate the anatomy of inguinal scrotal soft-tissue mass and thus should have been the imaging modality of choice.

Matched MeSH terms: Tomography, X-Ray Computed
A comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of tracheobronchomalacia in children

Su SC, Masters IB, Buntain H, Frawley K, Sarikwal A, Watson D, et al.

Pediatr Pulmonol, 2017 04;52(4):480-486.
PMID: 27641078 DOI: 10.1002/ppul.23606

INTRODUCTION: Flexible bronchoscopy (FB) is the current gold standard for diagnosing tracheobronchomalacia. However, it is not always feasible and virtual bronchoscopy (VB), acquired from chest multi-detector CT (MDCT) scan is an alternative diagnostic tool. We determined the sensitivity, specificity, and positive and negative predictive values of VB compared to FB in diagnosing tracheobronchomalacia.
METHODS: Children aged <18-years scheduled for FB and MDCT were recruited. FB and MDCT were undertaken within 30-min to 7-days of each other. Tracheobronchomalacia (mild, moderate, severe, very severe) diagnosed on FB were independently scored by two pediatric pulmonologists; VB was independently scored by two pairs (each pair = pediatric pulmonologist and radiologist), in a blinded manner.
RESULTS: In 53 children (median age = 2.5 years, range 0.8-14.3) evaluated for airway abnormalities, tracheomalacia was detected in 37 (70%) children at FB. Of these, VB detected tracheomalacia in 20 children, with a sensitivity of 54.1% (95%CI 37.1-70.2), specificity = 87.5% (95%CI 60.4-97.8), and positive predictive value = 90.9% (95%CI 69.4-98.4). The agreement between pediatric pulmonologists for diagnosing tracheomalacia by FB was excellent, weighted κ = 0.8 (95%CI 0.64-0.97); but only fair between the pairs of pediatric pulmonologists/radiologists for VB, weighted κ = 0.47 (95%CI 0.23-0.71). There were 42 cases of bronchomalacia detected on FB. VB had a sensitivity = 45.2% (95%CI 30.2-61.2), specificity = 95.5% (95%CI 94.2-96.5), and positive predictive value = 23.2 (95%CI 14.9-34.0) compared to FB in detecting bronchomalacia.
CONCLUSION: VB cannot replace FB as the gold standard for detecting tracheobronchomalacia in children. However, VB could be considered as an alternative diagnostic modality in children with symptoms suggestive of tracheobronchomalacia where FB is unavailable. Pediatr Pulmonol. 2017;52:480-486. © 2016 Wiley Periodicals, Inc.

Matched MeSH terms: Tomography, X-Ray Computed
Permeability study of cancellous bone and its idealised structures

Syahrom A, Abdul Kadir MR, Harun MN, Öchsner A

Med Eng Phys, 2015 Jan;37(1):77-86.
PMID: 25523865 DOI: 10.1016/j.medengphy.2014.11.001

Artificial bone is a suitable alternative to autografts and allografts, however their use is still limited. Though there were numerous reports on their structural properties, permeability studies of artificial bones were comparably scarce. This study focused on the development of idealised, structured models of artificial cancellous bone and compared their permeability values with bone surface area and porosity. Cancellous bones from fresh bovine femur were extracted and cleaned following an established protocol. The samples were scanned using micro-computed tomography (μCT) and three-dimensional models of the cancellous bones were reconstructed for morphology study. Seven idealised and structured cancellous bone models were then developed and fabricated via rapid prototyping technique. A test-rig was developed and permeability tests were performed on the artificial and real cancellous bones. The results showed a linear correlation between the permeability and the porosity as well as the bone surface area. The plate-like idealised structure showed a similar value of permeability to the real cancellous bones.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext Malignant rhabdoid tumour of the brain

Abdullah JM, Rahman ZA, Ariff AR, Jaafar H, Phang KS

Singapore Med J, 2004 Jun;45(6):286-8.
PMID: 15181525

Rhabdoid tumour is a rare childhood tumour with poor prognosis. We report a 13-month-old Malay girl suffering from this tumour that was located at the left fronto-temporo-parietal region of the brain. Computed tomography showed a large irregular enhancing mass that caused obstructive hydrocephalus. The tumour did not reduce in size after three operations and finally the patient succumbed to the disease four months after diagnosis.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext Hyperplasia of thymic gland

Lee YM, Koh MT, Omar A, Majid A

Singapore Med J, 1996 Jun;37(3):288-90.
PMID: 8942232

Hyperplasia of the thymus is the most common anterior mediastinal mass in infants. It is however exceedingly difficult to evaluate by the weight of the gland as it continues to grow after birth until puberty and thereafter undergoes progressive atrophy. It normally maintains most of the radiographic characteristics of the normal thymus. Massive thymic hyperplasia, a rare variant of true thymic hyperplasia is extremely rare during the first two decades of life and clinically can cause mediastinal compression or acute and recurrent pulmonary infection. Two such cases are reported and the clinico-pathology is briefly described and discussed.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext Delayed intracranial haemorrhage in head injury

Zahari M, Mohd Ali AK, Chandrasekharan S

Singapore Med J, 1996 Jun;37(3):285-7.
PMID: 8942231

To determine the incidence of delayed intracranial haemorrhage and the indication for repeat computed tomography (CT), a one and a half year retrospective study was made. A total of 289 patients had CT scan for head injury of which 78 (26.9%) had multiple scans. Out of these, 5 patients developed delayed haemorrhages (one extradural, one subdural, and three intracerebral haematoma). The incidence of delayed intracranial haemorrhage in our series is small when compared with others. The main predisposing factors are decompressive surgery, hyperventilation and cerebral dehydration therapy. It is important to know when to repeat the CT scan. A review of the literature regarding this aspect is presented and compared with our protocol. Intracranial pressure monitoring plays an increasingly important role in the management of head injury and should be used to decide the patient requiring repeat CT. Follow-up CT without other indication is not necessary.

Matched MeSH terms: Tomography, X-Ray Computed
Endoscopic Intervention of Aberrant Carotid Artery in the Middle Ear

Hashim ND, Jang SH, Moon IS

Otol Neurotol, 2021 Jan;42(1):e82-e85.
PMID: 33156236 DOI: 10.1097/MAO.0000000000002865

OBJECTIVE: To describe surgical management for transcanal endoscopic ear surgery (TEES) in two patients with aberrant internal carotid artery (ICA) in the middle ear.
PATIENTS: A young girl who complained of pulsatile tinnitus and an elderly man who presented with ear bleeding. Otoendoscopy examination revealed a pulsatile reddish mass protruding through the tympanic membrane in both patients.
INTERVENTIONS: A combination of clinical assessments and imaging supported the diagnosis of aberrant ICA in the middle ear. Transcanal endoscopic reinforcement of the artery was performed; tragal cartilage was used as a shield to strengthen the carotid canal defect.
RESULTS: Assisted by fine endoscopic instruments, the protruding arteries were separated without damage to the surrounding structures and reinforced using tragal cartilage. Both patients' symptoms improved postoperatively; they reported tinnitus relief and hearing improvement.
CONCLUSION: To prevent catastrophic events, diagnosis of aberrant ICA is important before any surgical intervention. With appropriate management, surgical intervention using transcanal endoscopic ear surgery offers a clear view of the surgical field and is an excellent choice for management of aberrant ICA.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext MRFGRO: a hybrid meta-heuristic feature selection method for screening COVID-19 using deep features

Dey A, Chattopadhyay S, Singh PK, Ahmadian A, Ferrara M, Senu N, et al.

Sci Rep, 2021 Dec 15;11(1):24065.
PMID: 34911977 DOI: 10.1038/s41598-021-02731-z

COVID-19 is a respiratory disease that causes infection in both lungs and the upper respiratory tract. The World Health Organization (WHO) has declared it a global pandemic because of its rapid spread across the globe. The most common way for COVID-19 diagnosis is real-time reverse transcription-polymerase chain reaction (RT-PCR) which takes a significant amount of time to get the result. Computer based medical image analysis is more beneficial for the diagnosis of such disease as it can give better results in less time. Computed Tomography (CT) scans are used to monitor lung diseases including COVID-19. In this work, a hybrid model for COVID-19 detection has developed which has two key stages. In the first stage, we have fine-tuned the parameters of the pre-trained convolutional neural networks (CNNs) to extract some features from the COVID-19 affected lungs. As pre-trained CNNs, we have used two standard CNNs namely, GoogleNet and ResNet18. Then, we have proposed a hybrid meta-heuristic feature selection (FS) algorithm, named as Manta Ray Foraging based Golden Ratio Optimizer (MRFGRO) to select the most significant feature subset. The proposed model is implemented over three publicly available datasets, namely, COVID-CT dataset, SARS-COV-2 dataset, and MOSMED dataset, and attains state-of-the-art classification accuracies of 99.15%, 99.42% and 95.57% respectively. Obtained results confirm that the proposed approach is quite efficient when compared to the local texture descriptors used for COVID-19 detection from chest CT-scan images.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext Clinical Characteristics and Diagnostic Challenges of COVID-19: An Update From the Global Perspective

Israfil SMH, Sarker MMR, Rashid PT, Talukder AA, Kawsar KA, Khan F, et al.

Front Public Health, 2020;8:567395.
PMID: 33505949 DOI: 10.3389/fpubh.2020.567395

Clinical characteristics are essential for the correct diagnosis of diseases. The current review aimed to summarize the global clinical characteristics of the COVID-19 patients systematically and identify their diagnostic challenges to help the medical practitioners properly diagnose and for better management of COVID-19 patients. We conducted a systematic search in PubMed, Web of Science, Scopus, Science Direct, and Google Scholar databases for original articles containing clinical information of COVID-19 published up to 7th May 2020. Two researchers independently searched the databases to extract eligible articles. A total of 34 studies from 8 different countries with 10889 case-patients were included for clinical characteristics. The most common clinical symptoms were cough 59.6, fever 46.9, fatigue 27.8, and dyspnea 20.23%. The prominent laboratory findings were lymphocytopenia 55.9, elevated levels of CRP 61.9, aspartate aminotransferase 53.3, LDH 40.8, ESR 72.99, serum ferritin 63, IL-6 52, and prothrombin time 35.47%, and decreased levels of platelets 17.26, eosinophils 59.0, hemoglobin 29, and albumin 38.4%. CT scan of the chest showed an abnormality in 93.50% cases with bilateral lungs 71.1%, ground-glass opacity 48%, lesion in lungs 78.3%, and enlargement of lymph node 50.7%. Common comorbidities were hypertension, diabetes, obesity, and cardiovascular diseases. The estimated median incubation period was 5.36 days, and the overall case fatality rate was 16.9% (Global case fatality outside China was 22.24%: USA 21.24%, Italy 25.61%, and others 0%; whereas the case fatality inside the Hubei Province of China was found to be 11.71%). Global features on the clinical characteristics of COVID-19 obtained from laboratory tests and CT scan results will provide useful information to the physicians to diagnose the disease and for better management of the patients as well as to address the diagnostic challenges to control the infection.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext Malignant Peripheral Nerve Sheath Tumor: Treat or Not Treat?

Bin Samsuddin MF, Bin Omar MA

Asian J Neurosurg, 2019 4 3;14(1):283-285.
PMID: 30937055 DOI: 10.4103/ajns.AJNS_332_17

Malignant peripheral nerve sheath tumors (MPNSTs) are uncommon, biologically aggressive soft tissue sarcomas of neural origin that poses tremendous challenges to effective therapy. MPNSTs are among the most challenging mesenchymal malignancies to treat with poor prognosis. They usually affect young and middle-aged adults, tend toward early metastasis, and often demonstrate resistance to chemotherapy. We present a case of a 23-year-old female who initially presented with the right temporal swelling for 1 month associated with constitutional symptom which progressively worsening. The right craniotomy and excision biopsy were done with histopathological examination results suggestive of MPNST. Thorax-abdominal-pelvic computed tomography and magnetic resonance imaging further revealed multiple metastatic lesions involving spine, retroperitoneal, pelvic, chest wall, and lungs. This case illustrates the typical presentation of MPNST with its known poorly outcome.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext Tuberculosis of the skull mimicking a bony tumor

Rosli FJ, Haron R

Asian J Neurosurg, 2016 2 19;11(1):68.
PMID: 26889285 DOI: 10.4103/1793-5482.172594

We present a rare case of calvarial tuberculosis mimicking a solitary bone tumor, which was surgically removed. A 52-year-old female presented with a right forehead swelling, which gradually enlarged over the course of 2 years, with no symptoms or raised intracranial pressure or neurological deficits. Plain and contrast-enhanced brain computed tomography scans were done, revealing a punched-out lesion of the right frontal bone, with a nonenhancing lytic mass. With an initial diagnosis of an intraosseous meningioma, and later on intraoperatively thought to be a metastatic tumor, the mass was excised along with a rim of bone. Histopathological examination results came back as caseous necrosis, highly suggestive of tuberculosis. The patient was then treated with a 1 year regimen of anti-tuberculous medications. Tuberculosis of the cranium is a rare entity, and can mimic tumors or multiple myeloma. A high index of suspicion and knowledge is required for an early diagnosis. A combined surgical and medical therapy is curative.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext Recent Update on Radiation Dose Assessment for the State-of-the-Art Coronary Computed Tomography Angiography Protocols

Tan SK, Yeong CH, Ng KH, Abdul Aziz YF, Sun Z

PLoS One, 2016;11(8):e0161543.
PMID: 27552224 DOI: 10.1371/journal.pone.0161543

OBJECTIVES: This study aimed to measure the absorbed doses in selected organs for prospectively ECG-triggered coronary computed tomography angiography (CCTA) using five different generations CT scanners in a female adult anthropomorphic phantom and to estimate the effective dose (HE).
MATERIALS AND METHODS: Prospectively ECG-triggered CCTA was performed using five commercially available CT scanners: 64-detector-row single source CT (SSCT), 2 × 32-detector-row-dual source CT (DSCT), 2 × 64-detector-row DSCT and 320-detector-row SSCT scanners. Absorbed doses were measured in 34 organs using pre-calibrated optically stimulated luminescence dosimeters (OSLDs) placed inside a standard female adult anthropomorphic phantom. HE was calculated from the measured organ doses and compared to the HE derived from the air kerma-length product (PKL) using the conversion coefficient of 0.014 mSv∙mGy-1∙cm-1 for the chest region.
RESULTS: Both breasts and lungs received the highest radiation dose during CCTA examination. The highest HE was received from 2 × 32-detector-row DSCT scanner (6.06 ± 0.72 mSv), followed by 64-detector-row SSCT (5.60 ± 0.68 and 5.02 ± 0.73 mSv), 2 × 64-detector-row DSCT (1.88 ± 0.25 mSv) and 320-detector-row SSCT (1.34 ± 0.48 mSv) scanners. HE calculated from the measured organ doses were about 38 to 53% higher than the HE derived from the PKL-to-HE conversion factor.
CONCLUSION: The radiation doses received from a prospectively ECG-triggered CCTA are relatively small and are depending on the scanner technology and imaging protocols. HE as low as 1.34 and 1.88 mSv can be achieved in prospectively ECG-triggered CCTA using 320-detector-row SSCT and 2 × 64-detector-row DSCT scanners.

Matched MeSH terms: Tomography Scanners, X-Ray Computed
Fulltext Pneumatization of Mastoid Air Cells, Temporal Bone, Ethmoid and Sphenoid Sinuses. Any Correlation?

Hindi K, Alazzawi S, Raman R, Prepageran N, Rahmat K

Indian J Otolaryngol Head Neck Surg, 2014 Dec;66(4):429-36.
PMID: 26396957 DOI: 10.1007/s12070-014-0745-z

The aim of this study is to assess the pneumatization of the paranasal sinuses (PNS) and other parts of temporal bone such as mastoid air cells and to investigate if there was any association between the aeration of these structures among the three major ethnic groups in Malaysia (Malay, Chinese, Indian) as this would be representative of Asia. A retrospective review of 150 computed tomography (CT) scans of PNS and temporal bones was done and analysed. The pneumatization of each area was obtained and compared using statistical analysis. Patients with a history of previous medical or surgical problems in the intended areas were excluded from the study. The pneumatization of the mastoid air cells and other temporal bone parts were noted to be symmetrical in more than 75 %. There was a positive correlation between the pneumatization of mastoid air cells and that of the sphenoid sinus. The prevalence of Agger nasi, Haller's and Onodi cells was observed to be significantly higher in the Chinese group. Preoperative assessment of the temporal bone and PNS with CT scan may be helpful in the evaluation of their anatomical landmark and decrease the possibility of surgical complications related to 3D structures.

Matched MeSH terms: Tomography, X-Ray Computed
Fulltext The Correlation Between Pre and Postoperative Hearing Level with High Resolution Computed Tomography (HRCT) Findings in Congenital Canal Atresia (CAA) Patients

Asma A, Abdul Fatah AW, Hamzaini AH, Mazita A

Indian J Otolaryngol Head Neck Surg, 2013 Dec;65(Suppl 3):526-31.
PMID: 24427708 DOI: 10.1007/s12070-011-0438-9

In managing patient with congenital congenital aural atresia (CAA), preoperative high resolution computed tomography (HRCT) scan and hearing assessment are important. A grading system based on HRCT findings was first introduced by Jahrsdoefer in order to select appropriate candidates for operation and to predict the postoperative hearing outcome in CAA patients. The score of eight and more was considered as a good prognostic factor for hearing reconstruction surgery. However previously in our center this score was not used as the criteria for surgical procedure. This study was conducted at Center A to evaluate the correlation between pre and postoperative hearing level with HRCT based on a Jahrsdoefer grading system in patients with CAA. All records and HRCT films with CAA from January 1997 until December 2007 at Center A were evaluated. The demographic data, operative records, pre and post operative hearing levels and HRCT findings were analyzed. Hearing level in this study was based on a pure tone average of air-bone gap at 500 Hz, 1 kHz and 2 kHz or hearing level obtained from auditory brainstem response eudiometry. This study was approved by Research Ethics Committee (code number, FF-197-2008). Thirty-two ears were retrospectively evaluated. The postoperative hearing level of 30 dB and less was considered as successful hearing result postoperatively. Of the six ears which underwent canalplasty, three had achieved successful hearing result. However, there was no significant correlation between preoperative hearing level (HL) with HRCT score and postoperative HL with HRCT score at 0.05 significant levels (correlation coefficient = -0.292, P = 0.105 and correlation coefficient = -0.127, P = 0.810) respectively. Hearing evaluation and HRCT temporal bone are two independent evaluations for the patients with CAA before going for hearing reconstructive surgery.

Matched MeSH terms: Tomography

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