Does CISS MRI Reliably Depict the Endolymphatic Duct in Children with and without Vestibular Aqueduct Enlargement?

Background And Purpose: High-resolution CT is the mainstay for diagnosing an enlarged vestibular aqueduct (EVA), but MR imaging may be an appealing alternative, given its lack of ionizing radiation exposure. The purpose of this study was to determine how reliably MR imaging demonstrates the endolymphatic duct and endolymphatic duct enlargement in hearing-impaired children.

Materials And Methods: We performed a retrospective review of temporal bone high-resolution CT and MR imaging of hearing-impaired children evaluated between 2017 and 2020.

Osseointegration and Bone Resorption of Scapula Tip Free Flaps in Mandibular Reconstruction.

Objectives: Bone resorption of more conventional vascularized bone grafts have been well described showing minimal resorption over time. Few studies have evaluated osseous union and bone resorption in scapula tip free flaps (STFF) in the reconstruction of mandibulectomy defects. We aimed to describe our series on STFF with respect to osseous union and bone resorption over time.

Anatomy of the Larynx and Cervical Trachea.

The larynx serves as the gateway between the upper and lower respiratory tracts and is involved in the tasks of phonation, deglutition, and airway protection. Familiarity with the complex anatomy of the larynx is critical for detecting and characterizing disease in the region, especially in cancer staging. In this article, we review the anatomy of the larynx and cervical trachea, including an overview of their cartilages, supporting tissues, muscles, mucosal spaces, neurovascular supply, and lymphatics, followed by correlation to the clinically relevant anatomic sites of the larynx.

Update on MR Imaging of Soft Tissue Tumors of Head and Neck.

This article reviews soft tissue tumors of the head and neck following the 2020 revision of WHO Classification of Soft Tissue and Bone Tumours. Common soft tissue tumors in the head and neck and tumors are discussed, along with newly added entities to the classification system. Salient clinical and imaging features that may allow for improved diagnostic accuracy or to narrow the imaging differential diagnosis are covered.

MRI surveillance following concurrent cochlear implantation in cases of vestibular schwannoma resection.

Objective: Cochlear nerve preserving translabyrinthine vestibular schwannoma (VS) resection enables concurrent cochlear implantation. Implantation in patients with VS raises important concerns including the ability to undergo postoperative magnetic resonance imaging (MRI) monitoring of residual tumor growth or tumor recurrence, specifically with a retained magnet. We aim to assess the feasibility of MRI monitoring and the impact on image quality with retained cochlear implant (CI) magnets.

Delineation of Human Carotid Plaque Features In Vivo by Exploiting Displacement Variance.

While in vivo acoustic radiation force impulse (ARFI)-induced peak displacement (PD) has been demonstrated to have high sensitivity and specificity for differentiating soft from stiff plaque components in patients with carotid plaque, the parameter exhibits poorer performance for distinguishing between plaque features with similar stiffness. To improve discrimination of carotid plaque features relative to PD, we hypothesize that signal correlation and signal-to-noise ratio (SNR) can be combined, outright or via displacement variance. Plaque feature detection by displacement variance, evaluated as the decadic logarithm of the variance of acceleration and termed "log(VoA)," was compared to that achieved by exploiting SNR, cross correlation coefficient, and ARFI-induced PD outcome metrics.

Long-term Efficacy of Single-agent Vemurafenib for Pleomorphic Xanthoastrocytoma.

Pleomorphic xanthoastrocytoma is a malignant brain tumor that has a good prognosis with complete resection but does not respond well to chemotherapy if there is residual tumor. BRAF V600E mutations are common in pleomorphic xanthoastrocytomas and provide an additional means for treatment when excision is not possible. Monotherapy with the BRAF V600E inhibitor vemurafenib has only been reported in a small number of cases and mostly in adults.

Image quality and dose reduction in sinus computed tomography using iterative reconstruction: a cadaver study.

Background: Concerns about radiation dose in computed tomography (CT) imaging have renewed interest in iterative reconstruction (IR), a technique which has the potential to produce images with less noise at lower radiation doses than traditional filtered back projection (FBP). This study aimed to assess whether application of IR could provide comparable quality sinus CT images to FBP at lower kilovolt (kV) and milliamp (mA) settings, and to establish optimal scan settings for sinus imaging.

Methodology/principal: 30 sinus CT scans were performed on 5 cadaver heads at two kV setting and three mA settings.

Radiographic muscle invasion not a recurrence predictor in HPV-associated oropharyngeal squamous cell carcinoma.

Objective: To determine whether muscle invasion evident on pretreatment imaging in p16 + oropharyngeal squamous cell carcinoma (OPSCC) correlates with recurrence.

Study Design: Retrospective review.

Methods: Two-hundred and seventy-six patients with p16 + OPSCC treated at a tertiary referral center from 2003 to 2015 were analyzed.

Performance of acoustic radiation force impulse ultrasound imaging for carotid plaque characterization with histologic validation.

Objective: Stroke is commonly caused by thromboembolic events originating from ruptured carotid plaque with vulnerable composition. This study assessed the performance of acoustic radiation force impulse (ARFI) imaging, a noninvasive ultrasound elasticity imaging method, for delineating the composition of human carotid plaque in vivo with histologic validation.

Methods: Carotid ARFI images were captured before surgery in 25 patients undergoing clinically indicated carotid endarterectomy.

Evaluation of PET/MRI for Tumor Volume Delineation for Head and Neck Cancer.

Introduction: Computed tomography (CT), combined positron emitted tomography and CT (PET/CT), and magnetic resonance imaging (MRI) are commonly used in head and neck radiation planning. Hybrid PET/MRI has garnered attention for potential added value in cancer staging and treatment planning. Herein, we compare PET/MRI vs.

Does residual wall size or technique matter in the treatment of Zenker's diverticulum?

Objectives/hypothesis: We aimed to compare three surgical techniques (open approach for diverticulectomy with cricopharyngeal myotomy [OA], endoscopic laser-assisted diverticulotomy [ELD], and endoscopic stapler-assisted diverticulotomy [ESD]) for treatment of Zenker's diverticulum with regard to validated swallowing outcomes, radiographic outcomes, complications, and revision rates. We statistically analyzed whether the size of residual postoperative party wall or the specific surgical technique correlates with swallowing outcomes.

Study Design: Retrospective chart review and radiographic study analysis.

Imaging in Endoscopic Cranial Skull Base and Pituitary Surgery.

Endoscopic endonasal approaches have widely accepted techniques for managing benign and malignant processes along the entire ventral skull base with similar or better results compared with open procedures, but with lower rates of complication. Managing pathology affecting the skull base can be challenging because of complex anatomy and the proximity of critical neurovascular structures. Postoperative imaging can be challenging, because of surgical alterations of normal anatomy and the now common use of complex reconstruction techniques.

Current Trends in Sinonasal Imaging.

As endoscopic sinus surgery (ESS) has evolved since its introduction to the United States, so has technology for imaging the sinonasal cavities. Although imaging is most frequently performed for evaluating chronic sinusitis refractory to medical therapy, its uses have expanded beyond inflammatory sinus disease. Multidetector Computed Tomography is the current workhorse for both diagnosis and preoperative planning in prospective ESS patients, while MR imaging remains a complementary tool for evaluating suspected tumors or intracranial and orbital complications of rhinosinusitis.

Endoscopic sinonasal meningoencephalocele repair: a 13-year experience with stratification by defect and reconstruction type.

Objective: Sinonasal meningoencephalocele is a rare defect, with varying etiologies and treatment strategies. Here we present the largest published series from a single institution of patients with endoscopic repair. The primary goal is to examine rates of success with consideration to accompanying patient demographic data.

Connexin-related (DFNB1) hearing loss: is routine computed tomography imaging necessary?

Objectives: Determine if routine computed tomography (CT) imaging is necessary in the workup for children with connexin-related (DFNB1) sensorineural hearing loss (SNHL).

Study Design: Case-control retrospective chart and imaging review.

Setting: Tertiary care otolaryngology practice.

Obstructive sleep apnea in patients undergoing endoscopic surgical repair of cerebrospinal fluid rhinorrhea.

Objectives/hypothesis: To examine the relationship between cerebrospinal fluid (CSF) rhinorrhea and obstructive sleep apnea (OSA).

Study Design: Retrospective chart review of patients who underwent surgical repair of encephaloceles and/or CSF rhinorrhea at a tertiary medical center over a 12-year period.

Methods: Pertinent demographic, clinical, and surgical data including age, sex, and medical and surgical history were obtained.

Clinical significance of indeterminate pulmonary nodules in patients with locally advanced head and neck squamous cell carcinoma.

Background: The purpose of this study was to determine whether indeterminate pulmonary nodules (IPNs) at staging are predictive of lung metastasis, primary lung carcinoma, or survival in patients with advanced head and neck squamous cell carcinoma (HNSCC).

Methods: One hundred ten patients with IPN at staging who had follow-up imaging and 100 patients without IPN were identified from an HNSCC database. The primary endpoints were lung progression-free survival (PFS) and overall survival (OS).

Larynx: anatomic imaging for diagnosis and management.

Imaging with CT, MRI, or fluorodeoxyglucose F 18-positron emission tomography is often an important complement to laryngoscopy for diagnosis and management of laryngeal pathology. At most centers, CT is the most popular modality for general laryngeal imaging given its widespread availability, ease of acquisition, and familiarity to clinicians, whereas MRI and positron emission tomography are used as problem-solving tools. Frequent indications for laryngeal imaging include cancer staging, suspected submucosal abnormalities, vocal cord paralysis, laryngeal trauma, and laryngotracheal stenosis.

Lesions of the petrous apex: classification and findings at CT and MR imaging.

The petrous apex is a complex region of the central skull base that is surrounded by a number of important vascular and neural structures and can be home to a wide range of disease processes. Lesions arising in or spreading to the petrous apex cause varied and occasionally severe clinical sequelae, which typically result from mass effect or direct invasion of the cranial nerves, brainstem, or internal carotid artery. Because the petrous apex is not amenable to direct examination, cross-sectional imaging with computed tomography and magnetic resonance (MR) imaging plays an important role in diagnosis and characterization of lesions occurring there.

Soft tissue tumors of the head and neck: imaging-based review of the WHO classification.

The World Health Organization (WHO) system for defining and classifying soft tissue tumors is usually applied to lesions that occur in the trunk and extremities, but it also provides an excellent framework for characterizing nonepithelial extraskeletal tumors of the head and neck. Although nonepithelial extraskeletal tumors are in the minority among head and neck lesions, they are by no means rare. The WHO classification system recognizes nine major types based on histologic differentiation: adipocytic, fibroblastic or myofibroblastic, fibrohistiocytic, smooth muscle, skeletal muscle, vascular, pericytic, and chondro-osseous tumors, as well as soft tissue tumors of uncertain differentiation.

Sensorineural hearing loss in a pediatric population: association of congenital cytomegalovirus infection with intracranial abnormalities.

Objectives: To examine the incidence of congenital cytomegalovirus (CMV) infection relative to common genetic etiologies of hearing loss in a pediatric population with sensorineural hearing loss (SNHL), and to characterize intracranial radiological abnormalities in patients with CMV-associated hearing loss.

Design: Retrospective study.

Setting: Academic tertiary care center.

Imaging characteristics of children with auditory neuropathy spectrum disorder.

Objective: To identify and define the imaging characteristics of children with auditory neuropathy spectrum disorder (ANSD).

Design: Retrospective medical records review and analysis of both temporal bone computed tomographic (CT) and magnetic resonance images (MRI) in children with a diagnosis of ANSD.

Setting: Tertiary referral center.

Endoscopic pedicled nasoseptal flap reconstruction for pediatric skull base defects.

Objectives/hypothesis: A prospective study of endoscopic expanded endonasal approaches (EEA) with nasoseptal flap reconstructions revealed anecdotal evidence of less available relative septal length in pediatric patients. Our goal is to use radioanatomic analysis of computed tomography (CT) scans to determine limitations of the nasoseptal flap in pediatric skull base reconstruction and to describe clinical outcomes after using the nasoseptal flap in six pediatric patients.

Study Design: Six pediatric patients who underwent EEA with nasoseptal flap reconstruction were prospectively analyzed for flap coverage and postoperative cerebrospinal fluid (CSF) leak.