Ultrasound Is Superior to Palpation in Identifying the Cricothyroid Membrane in Subjects with Poorly Defined Neck Landmarks

2018 ◽  
Vol 129 (6) ◽  
pp. 1132-1139 ◽  
Author(s):  
Naveed Siddiqui ◽  
Eugene Yu ◽  
Sherif Boulis ◽  
Kong Eric You-Ten
Keyword(s):  
Computed Tomography ◽  
Adverse Events ◽  
Primary Outcome ◽  
Cricothyroid Membrane ◽  
Computed Tomography Scan ◽  
Accurate Identification ◽  
Neck Anatomy ◽  
The Mean ◽  
Tomography Scan ◽  
Group Allocation

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Success of a cricothyrotomy is dependent on accurate identification of the cricothyroid membrane. The objective of this study was to compare the accuracy of ultrasonography versus external palpation in localizing the cricothyroid membrane. Methods In total, 223 subjects with abnormal neck anatomy who were scheduled for neck computed-tomography scan at University Health Network hospitals in Toronto, Canada, were randomized into two groups: external palpation and ultrasound. The localization points of the cricothyroid membrane determined by ultrasonography or external palpation were compared to the reference midpoint (computed-tomography point) of the cricothyroid membrane by a radiologist who was blinded to group allocation. Primary outcome was the accuracy in identification of the cricothyroid membrane, which was measured by digital ruler in millimeters from the computed-tomography point to the ultrasound point or external-palpation point. Success was defined as the proportion of accurate attempts within a 5-mm distance from the computed-tomography point to the ultrasound point or external-palpation point. Results The percentage of accurate attempts was 10-fold greater in the ultrasound than external-palpation group (81% vs. 8%; 95% CI, 63.6 to 81.3%; P < 0.0001). The mean (SD) distance measured from the external-palpation to computed-tomography point was five-fold greater than the ultrasound to the computed-tomography point (16.6 ± 7.5 vs. 3.4 ± 3.3 mm; 95% CI, 11.67 to 14.70; P < 0.0001). Analysis demonstrated that the risk ratio of inaccurate localization of the cricothyroid membrane was 9.14-fold greater with the external palpation than with the ultrasound (P < 0.0001). There were no adverse events observed. Conclusions In subjects with poorly defined neck landmarks, ultrasonography is more accurate than external palpation in localizing the cricothyroid membrane.

scholarly journals Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature

2016 ◽  
Vol 9 (1) ◽  
pp. 13-17
Author(s):  
Priyanko Chakraborty ◽  
Rajiv K Jain ◽  
Purnima Joshi ◽  
Rakhi Kumari ◽  
Sidharth Pradhan
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Chronic Rhinosinusitis ◽  
Sinus Surgery ◽  
Anatomic Variations ◽  
Review Of Literature ◽  
Computed Tomography Scan ◽  
Diagnostic Endoscopy ◽  
The Mean ◽  
Tomography Scan

ABSTRACT Background Chronic rhinosinusitis (CRS) refers to a group of disorders characterized by inflammation of the mucosa of the paranasal sinuses. Nasal endoscopy and computed tomography (CT) scans are successfully used as diagnostic modalities of nose and paranasal sinus diseases. There have been many studies regarding the anatomic variations leading to pathogenesis of paranasal sinus diseases. Considerable progress has been made in the medical and surgical control of these conditions; however, a large number of questions relating to the diagnosis, evaluation, and treatment of the diseases remain unanswered. Materials and methods The study included 82 clinically diagnosed cases of CRS who underwent CT scan and were advised to undergo diagnostic endoscopy. The anatomical findings of the nose were compared to see correlation between nasal endoscopy and CT scan. Results The mean age (±standard error of the mean) of presentation was 34.11 (±1.42) years, while most patients were from the age group of 18 to 30 years. Males were predominating the study group with 62.2%, while 37.8% were females. The most common anatomic variation was deviated nasal septum with 92.68% CT reported patients. This was followed by inferior turbinate hypertrophy, septal spur, concha bullosa, and agger nasi cells. Conclusion Computed tomography scan is considered the gold standard for sinonasal imaging. Diagnostic endoscopy and CT scan are a must prior to any functional endoscopic sinus surgery. They help in assessing the extent of sinus disease and to know the variations and vital relations of the paranasal sinuses. Computed tomography scan assists the surgeon as a “road map” during endoscopic sinus surgery. How to cite this article Chakraborty P, Jain RK, Joshi P, Kumari R, Pradhan S. Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature. Clin Rhinol An Int J 2016;9(1):13-17.

scholarly journals Prevalence, Location, and Size of Maxillary Sinus Septa: Computed Tomography Scan Analysis

2017 ◽  
Vol 18 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Ferial Taleghani ◽  
Maryam Tehranchi ◽  
Shahryar Shahab ◽  
Zahra Zohri
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Maxillary Sinus ◽  
Cone Beam ◽  
Sinus Lift ◽  
Computed Tomography Scan ◽  
Maxillary Sinus Septa ◽  
The Mean ◽  
Tomography Scan ◽  
Maxillary Sinuses

ABSTRACT Introduction The present study was undertaken to evaluate the anatomy of the maxillary sinus in relation to its position and the height of its septa, using cone beam computed tomography (CBCT). Materials and methods In this descriptive retrospective study, 300 CBCT images of maxillary sinuses of patients with posterior maxillary edentulism were evaluated. The maxillary sinus septa were evaluated in relation to their prevalence, height, and position; t-test and Mann–Whitney tests were used for the analysis of data. Results Sinus septa were detected in 44% of the subjects, with equal frequencies in the anterior, middle, and posterior positions. The mean height of the septa was 3.6 ± 1.56 mm. Conclusion In a population of Iranian subjects, in half of the cases, the sinus septa might be present in the anterior, middle, and posterior positions. Clinical significance In order to avoid intraoperative problems during sinus lift procedures, it is necessary to accurately evaluate the sinus, preferably with the use of CBCT. How to cite this article Taleghani F, Tehranchi M, Shahab S, Zohri Z. Prevalence, Location, and Size of Maxillary Sinus Septa: Computed Tomography Scan Analysis. J Contemp Dent Pract 2017;18(1):11-15.

scholarly journals Case Series of Antrovestibular Polyp: An Unusual Growth of Antral Polyp Toward the Nasal Vestibule Through the Anterior Fontanelle

2020 ◽  
Vol 27 (1) ◽  
pp. 50-53
Author(s):  
Goun Choe ◽  
January E. Gelera ◽  
Jeong-Whun Kim
Keyword(s):  
Computed Tomography ◽  
Demographic Data ◽  
Case Series ◽  
Uncinate Process ◽  
Anterior Fontanelle ◽  
Computed Tomography Scan ◽  
Nasal Vestibule ◽  
The Mean ◽  
Tomography Scan ◽  
Antral Polyp

Background and Objectives: This case series is aimed to introduce a new term, antrovestibular polyp (AVP), for an antral polyp herniating anteriorly toward the nasal vestibule and to describe an antral polyp direction of growth through the anterior and posterior fontanelles.Materials and Method: This is a retrospective study involving review of patients who underwent surgery due to maxillary sinus polyp herniating anteriorly toward the nasal vestibular area or posteriorly toward the choana at a tertiary training hospital from January 2007 through July 2016. Their demographic data, computed tomography scan findings, and endoscopic evaluations were analyzed.Results: This study included 49 subjects; 8 (16.33%, 6 males) with AVP and 41 (83.67%, 24 males) with antrochoanal polyps (ACP). The mean ages of AVP and ACP patients were 9 and 14.4 years, respectively (p=0.006). The subjects were identified as AVP when computed tomography scan showed an antral polyp directed anteriorly toward the nasal vestibular area, while polyps growing toward the choana were identified as ACP. Endoscopic review showed that AVP grew out through an accessory ostium located anterior to the uncinate process at the area of the anterior fontanelle, while ACP started from an accessory ostium of the posterior fontanelle or a widened maxillary natural ostium.

Radio-Pathological Correlations in Patients with Liver Metastases for Colorectal Cancer

2020 ◽  
Vol 37 (5) ◽  
pp. 383-389
Author(s):  
Alejandro Serrablo ◽  
Panagiotis Paliogiannis ◽  
Carlos Paradisi ◽  
Carlos Hörndler ◽  
Luis Sarría ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Liver Metastases ◽  
Pathological Features ◽  
Computed Tomography Scan ◽  
Histopathological Response ◽  
Curative Intent ◽  
Peripheral Ring ◽  
The Mean ◽  
Tomography Scan

Background:Colorectal cancer (CRC) is the most frequent gastrointestinal cancer. The liver is the organ most commonly affected by CRC metastases. Synchronous CRC liver metastases (CRCLM) are present in 15–25% at diagnosis, and metastases are confined to the liver in 70–80% of these cases. The aim of the present study was to investigate the existence of significant correlations between the pathological features and computed tomography scan morpho-densitometric findings. Summary:A retrospective study of prospectively collected data has been performed; all patients underwent curative-intent hepatic resection from January 2004 to December 2012 and had histologically confirmed CRCLM. Key Messages: Thirty-four (57%) patients were males; the mean age was 64.4 (±10.2) years. Statistically significant differences have been found with the percentages of intra-tumoral fibrosis (p = 0.038) and necrosis (p = 0.007); the values of fibrosis are higher in the absence of a peri-lesional ring, while those of necrosis are higher in the presence of a peri-lesional ring.There was a correlation between the histopathological response to treatments and the global attenuation levels observed in the computed tomography scan of CRCLM. Furthermore, the presence of a radiologically evidenced peripheral ring was associated with the amount of viable tumor cells in the periphery of the tumor, and with responses predominated by necrosis. More studies are needed to clarify the radiological and histological correlation and to be able to better select patients who are going to undergo surgery.

scholarly journals Multiple Tracheal Diverticula in a COVID-19 Positive Patient

2021 ◽  
pp. 014556132110346
Author(s):  
Konstantinos Garefis ◽  
Konstantinos Tarazis ◽  
Konstantinos Gkiouzelis ◽  
Anastasia Kipriotou ◽  
Iordanis Konstantinidis ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Incidental Finding ◽  
Positive Patient ◽  
Computed Tomography Scan ◽  
Tracheal Diverticulum ◽  
Tomography Scan ◽  
Paratracheal Air Cyst

A tracheal diverticulum is a type of paratracheal air cyst and is usually an incidental finding after a computed tomography scan of the neck and thorax. With an incidence between 1% and 4% in adults, tracheal diverticula are rare entities that can be symptomatic in certain cases. We present a case of a COVID-19 positive patient who presented to our hospital and was diagnosed with multiple tracheal diverticula during his hospitalization.

scholarly journals Pulmonary coinfection of Mycobacterium tuberculosis and Tropheryma whipplei: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Binghua Zhu ◽  
Jing Tang ◽  
Rong Fang ◽  
Xuejie Fei ◽  
Qing Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Mycobacterium Tuberculosis ◽  
Next Generation Sequencing ◽  
Tropheryma Whipplei ◽  
Diagnostic Methods ◽  
Next Generation ◽  
Computed Tomography Scan ◽  
Chest Computed Tomography ◽  
Tomography Scan ◽  
Generation Sequencing

Abstract Background We diagnosed a clinical case of pulmonary infection involving Mycobacterium tuberculosis and Tropheryma whipplei in a patient with acute respiratory distress syndrome. The diagnosis was assisted by metagenomic next-generation sequencing of bronchoalveolar lavage fluid. Case presentation A 44-year-old Han Chinese inmate was transferred to the emergency department because of dry cough, chest tightness, and shortness of breath. The patient’s body temperature rose to 39.3 °C following empirical cephalosporin treatment for 1 week. The blood CD4+/CD8+ ratio was 0.7, suggesting immunodeficiency. Routine microbiological tests were performed, and tuberculosis interferon gamma release assays were positive. Mycobacterium tuberculosis polymerase chain reaction was also positive. Chest computed tomography scan revealed miliary nodules and ground-glass opacifications, which were in accordance with tuberculosis. To fully examine the etiology, we performed routine laboratory tests and metagenomic sequencing, the results of which indicated the presence of Mycobacterium tuberculosis and Tropheryma whipplei. We administered anti-tuberculosis regimen in combination with trimethoprim/sulfamethoxazole. The patient recovered, with chest computed tomography scan showing absorption of lesions. Conclusions Compared with traditional diagnostic methods such as culture and serology, metagenomic next-generation sequencing has the advantage of detecting a wide array of microorganisms in a single test and therefore can be used for clinical diagnosis of rare pathogens and microbial coinfections. It is particularly useful for immunocompromised patients as they are more prone to infection by opportunistic microorganisms.

Numerical assessment of natural respiration and particles deposition in the computed tomography scan airway with a glomus tumour

2021 ◽  
pp. 095440892110240
Author(s):  
Digamber Singh
Keyword(s):  
Computed Tomography ◽  
Respiratory Tract ◽  
Particle Deposition ◽  
Flow Characteristics ◽  
Glomus Tumour ◽  
Computed Tomography Scan ◽  
Human Respiratory Tract ◽  
Airflow Pattern ◽  
Human Airways ◽  
Tomography Scan

The human respiratory tract has a complex airflow pattern. If any obstruction is present in the airways, it will change the airflow pattern and deposit particles inside the airways. This is the concern of breath quality (inspired air), and it is decreasing due to the unplanned production of material goods. This is a primary cause of respiratory illness (asthma, cancer, etc.). Therefore, it is important to identify the flow characteristics in the human airways and airways with a glomus tumour with particle deposition. A numerical diagnosis is presented with an asymmetric unsteady-state light breathing condition (10 l/min). An in vitro human respiratory tract model has been reconstructed using computed tomography scan techniques and an artificial glomus tumour developed 2 cm above a carina on the posterior wall of the trachea. The transient flow characteristics are numerically simulated with a realizable (low Reynolds number) k–ɛ turbulence model. The flow disturbance is captured around the tumour, which influenced the upstream and downstream of the flow. The flow velocity pattern, wall shear stress and probable area of inflammation (hotspot) due to suspended particle deposition are determined, which may assist doctors more effectively in aerosol therapy and prosthetics of human airways illness.

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