Characterizing mandibular growth using three-dimensional imaging techniques and anatomic landmarks.

Objective: To provide quantitative data on the multi-planar growth of the mandible, this study derived accurate linear and angular mandible measurements using landmarks on three dimensional (3D) mandible models. This novel method was used to quantify 3D mandibular growth and characterize the emergence of sexual dimorphism.

Design: Cross-sectional and longitudinal imaging data were obtained from a retrospective computed tomography (CT) database for 51 typically developing individuals between the ages of one and nineteen years.

Aspergillus Mycetoma Causing Epiphora and Ipsilateral Facial Pain.

Tearing is a frequently encountered chief complaint in an ophthalmologist's office. Certain associated atypical symptoms may warrant further workup. The authors present a case of a patient presenting with painful tearing which elicited further evaluation with CT imaging.

The Many Faces of Granulomatosis With Polyangiitis: A Review of the Head and Neck Imaging Manifestations.

Objective: Wegener granulomatosis has recently been renamed as granulomatosis with polyangiitis (GPA). In this review, we examine the clinical criteria and pathologic and pathophysiologic mechanisms of GPA, with an emphasis on findings encountered in the realm of head and neck imaging. Particular attention is paid to generating an appropriate differential diagnosis, because many of the imaging features of GPA overlap with those of other diseases, most notably lymphoma and sarcoidosis.

Pterygoid Plate Fractures: Not Limited to Le Fort Fractures.

Pterygoid plate fractures are often described in the setting of Le Fort fractures. The goal of this study was to define other craniofacial fracture patterns causing injury to the pterygoid plates. A retrospective review of computed tomography (CT) scans obtained on craniofacial trauma patients over a 5-year period revealed 209 patients with pterygoid plate fractures.

Validation of Clinical Criteria for Obtaining Maxillofacial Computed Tomography in Patients With Trauma.

Background: More than 180,000 patients present annually with facial trauma to emergency rooms in the United States. Maxillofacial computed tomography is the gold standard in identifying facial fractures. Providers must evaluate patients quickly; therefore, they use decision instruments to determine which patients need imaging.

Nasolacrimal System Fractures: A Description of Radiologic Findings and Associated Outcomes.

Background: Fractures of the bony nasolacrimal system (NLS), including the lacrimal sac fossa and nasolacrimal canal, have not been comprehensively described in patients with facial trauma. Characterization of these injuries may help facial trauma surgeons better predict which patients will develop lacrimal outflow obstruction symptoms including epiphora and dacryocystitis and who may eventually need lacrimal surgery.

Methods: CT images for all patients seen at the University of Wisconsin Hospital and Clinics for craniofacial trauma were reviewed from January 2001 to December 2005.

Hyoid Bone Development: An Assessment Of Optimal CT Scanner Parameters and Three-Dimensional Volume Rendering Techniques.

The hyoid bone anchors and supports the vocal tract. Its complex shape is best studied in three dimensions, but it is difficult to capture on computed tomography (CT) images and three-dimensional volume renderings. The goal of this study was to determine the optimal CT scanning and rendering parameters to accurately measure the growth and developmental anatomy of the hyoid and to determine whether it is feasible and necessary to use these parameters in the measurement of hyoids from in vivo CT scans.

A novel classification of frontal bone fractures: The prognostic significance of vertical fracture trajectory and skull base extension.

Purpose: The broad spectrum of frontal bone fractures, including those with orbital and skull base extension, is poorly understood. We propose a novel classification scheme for frontal bone fractures.

Methods: Maxillofacial CT scans of trauma patients were reviewed over a five year period, and frontal bone fractures were classified: Type 1: Frontal sinus fracture without vertical extension.

Phase 1 trial of bevacizumab with concurrent chemoradiation therapy for squamous cell carcinoma of the head and neck with exploratory functional imaging of tumor hypoxia, proliferation, and perfusion.

Purpose: A phase 1 trial was completed to examine the safety and feasibility of combining bevacizumab with radiation and cisplatin in patients with locoregionally advanced squamous cell carcinoma of the head and neck (HNSCC) treated with curative intent. Additionally, we assessed the capacity of bevacizumab to induce an early tumor response as measured by a series of biological imaging studies.

Methods And Materials: All patients received a single induction dose of bevacizumab (15 mg/kg) delivered 3 weeks (±3 days) before the initiation of chemoradiation therapy.

Imaging of head and neck emergencies.

The anatomy of the head and neck contains very few structures that could be considered expendable and, consequently, is exceptionally intolerant to infection, inflammation, and injury. Acute pathologic processes in this body region, therefore, tend to result in significant suffering, functional impairment, or life endangerment if the diagnosis is missed or treatment is delayed. Many emergent processes within the cervical region also need to be considered for their possible impact on structures within the head and chest, into which there are many routes for potential communication.

Cerebrovascular trauma.

Significant progress has been made recently in the recognition, screening, diagnosis, and treatment of blunt cerebrovascular vascular injury (BCVI). Although controversy still exists as to optimal screening algorithms and best diagnostic modality, the vital and growing role of noninvasive imaging in identifying patients at high risk for BCVI and in characterizing the injury itself has been clearly established. There has been promising early work in stratifying BCVI patients into risk categories by initially evaluating them with high-resolution head, maxillofacial, and cervical computed tomographic examinations with the ultimate goal of maximizing diagnostic yield and enabling prompt initiation of therapy.

Imaging of temporal bone trauma.

Temporal bone trauma is commonly seen in patients with craniofacial injury and can be detected using multidetector computed tomography. A thorough understanding of the different types of temporal bone fracture patterns is needed to accurately describe the trajectory of injury as well as anticipated complications. Fractures should be described based on direction, segment of temporal bone involved, as well as involvement of the otic capsule.

Radiographic features of superior semicircular canal dehiscence in the setting of chronic ear disease.

Objective: To determine if radiologic chronic otitis media (COM), both with and without cholesteatoma, is associated with superior semicircular canal dehiscence (SSCD).

Study Design: Retrospective review of consecutive high-resolution computed tomography (HRCT) scans of the temporal bone.

Setting: Tertiary care medical center.

The effect of computed tomographic scanner parameters and 3-dimensional volume rendering techniques on the accuracy of linear, angular, and volumetric measurements of the mandible.

Objectives: This study investigates the effect of scanning parameters on the accuracy of measurements from three-dimensional (3D), multi-detector computed tomography (MDCT) mandible renderings. A broader range of acceptable parameters can increase the availability of computed tomographic (CT) studies for retrospective analysis.

Study Design: Three human mandibles and a phantom object were scanned using 18 combinations of slice thickness, field of view (FOV), and reconstruction algorithm and 3 different threshold-based segmentations.

When is fluid in the mastoid cells a worrisome finding?

Mastoiditis is a common clinical entity that is technically present in all cases of otitis media; only a minority of cases actually represents the otolaryngologic emergency of acute coalescent mastoiditis. When reviewing an image with a radiologic diagnosis of mastoiditis, looking for key signs such as destruction of bony septa and considering patient presentation can help distinguish mild mastoiditis from acute coalescent mastoiditis.

Aggressive inflammatory and neoplastic processes of the paranasal sinuses.

Although uncommon, sinonasal malignancies and aggressive inflammatory processes are entities every radiologist will encounter during the evaluation of routine sinus imaging studies. A high index of suspicion is necessary for prompt diagnosis. It is important to consider aggressive inflammatory disease in all patients having routine sinus computed tomography because any delay in diagnosis can adversely affect the patients' care.

Clinical usefulness of orbital and facial Time-Resolved Imaging of Contrast KineticS (TRICKS) magnetic resonance angiography.

Purpose: The clinical usefulness of orbital and facial Time-Resolved Imaging of Contrast KineticS (TRICKS) MRI was assessed quantitatively and qualitatively.

Methods: A retrospective chart review of the years 2001 to 2011 was conducted at the University of Wisconsin, Madison. Patients were selected based on tumor location (extracranial head and neck) and evaluation with TRICKS imaging at any stage of the clinical course.

Orbital fibrous histiocytoma mimicking cavernous hemangioma on dynamic contrast-enhanced MRA imaging.

Orbital lesions include a broad spectrum of tumors, vascular abnormalities, and inflammatory conditions. High-resolution imaging has become an invaluable tool toward formulating an accurate diagnosis, and facilitates proper counseling regarding appropriate interventions. Imaging may guide whether partial excision to minimize damage to orbital structures, or en bloc removal to prevent potential recurrence, as seen in mesenchymal tumors, is indicated.

New insights into mechanism of Eustachian tube ventilation based on cine computed tomography images.

There is debate concerning the mechanism of Eustachian tube (ET) ventilation. While a mechanism of complete opening has been advocated previously, sequential contraction of the levator veli palatini and medial pterygoid muscles followed by the tensor veli palatini and lateral pterygoid muscles may produce a transient sequential opening mechanism, allowing an air bolus to traverse the ET. This may explain confusion surrounding sonotubometry reports that not every swallow leads to sound passage in normal subjects.

Presurgical localization of parathyroid adenomas with magnetic resonance imaging at 3.0 T: an adjunct method to supplement traditional imaging.

Purpose: To investigate the use of a chemical shift-based water-fat separation magnetic resonance imaging (MRI) method, and time-resolved contrast-enhanced MRI at 3 T for improved presurgical localization of parathyroid adenomas.

Methods: Twenty-five patients with primary hyperparathyroidism were prospectively enrolled. Patients underwent MRI, which was reviewed by two experienced neuroradiologists who were blinded to Tc-99m sestamibi imaging and operative results.

Clinical criteria for obtaining maxillofacial computed tomographic scans in trauma patients.

Background: Over 150,000 patients present with maxillofacial trauma annually to emergency rooms in the United States. Although maxillofacial computed tomography is a sensitive screening tool for identifying facial fractures, indiscriminate use leads to unnecessary radiation exposure and substantial costs. A decision instrument is needed to ensure computed tomographic evaluation of patients at high risk for facial fracture and limit computed tomography use in low-risk patients.

Developmental sexual dimorphism of the oral and pharyngeal portions of the vocal tract: an imaging study.

Purpose: The anatomic origin for prepubertal vowel acoustic differences between male and female subjects remains unknown. The purpose of this study is to examine developmental sex differences in vocal tract (VT) length and its oral and pharyngeal portions.

Method: Nine VT variables were measured from 605 imaging studies (magnetic resonance imaging and computed tomography) of subjects between birth and age 19 years.

A case of congenitally absent left internal carotid artery: vascular malformations in 22q11.2 deletion syndrome.

Our report is on a Hispanic boy for whom, shortly after birth, clinical suspicion of 22q11.2 deletion syndrome (22q11.2DS) was raised as a result of his characteristic features, including facial dysmorphisms and hypotonia.

Developmental craniofacial anthropometry: Assessment of race effects.

Differences in craniofacial anatomy among racial groups have been documented in a variety of structures, but the oral and maxillofacial regions have been shown to be a particularly defining region of variability between different racial/ethnic groups. Such comparisons are informative, but they neither address developmental changes of the craniofacial anatomy nor do they assess or take into account the natural variability within individual races that may account for similar reported, across-group variations. The purpose of this report was to compare-using medical imaging studies-the growth trend of select race-sensitive craniofacial variables in the oral and pharyngeal regions when all races [White, Asian, Black, and Hispanic (AR)] are included versus only a single race category [White (WR)].