Ademar José de Oliveira Paes Junior

Alongamento do processo estilóide (síndrome de Eagle): relato de dois casos

Elongated styloid process or Eagles syndrome is a multifactorial disease with unspecific characteristics on clinical and imaging examinations. The use of imaging methods in combination with the signs and symptoms are valuable in the confirmation of the diagnosis since they show the extension of the styloid complex, the muscles and ligaments, and adjacent structures. The diagnosis can be established when there is an association of clinical information and imaging findings. The authors report two cases of elongated styloid process including the imaging findings, mainly obtained using computed tomography.

Ameloblastoma da mandíbula: relato de dois casos

Ameloblastomas are benign odontogenic neoplasms of epithelial origin, nonmineralized, relatively uncommon which present an aggressive local behavior. They affect predominantly the mandible and they can reach varied proportions depending on the evolution time. Radiographically they appear as unilocular or multilocular cystic lesions. The clinical and radiological findings assist to the differential diagnosis, although the histologic evaluation is necessary in characterization of the lesions.

Carcinoma de seio maxilar: análise de dez casos

OBJECTIVE: To evaluate the role, especially of computed tomography, in the staging of maxillary sinus carcinomas. MATERIALS AND METHODS: Ten cases of carcinoma treated in Hospital Heliopolis Department of Diagnostic Imaging and Head and Neck Surgery, Sao Paulo, SP, Brazil, in the period between 1988 and 2002, were evaluated. RESULTS: Nine patients presented with tumor extension to the cheek, eight to the masticator space, seven to the mouth floor and hard palate, five to the pterygoid fossa, five to the orbit, three to the ethmoid bone, and one to the skull base. Three of the patients were staged T3, and seven T4. Two patients had lymph nodes metastases at their initial presentation, and were staged T4. All of the cases were histopathologically confirmed. CONCLUSION: The accurate analysis of the tumor local extent and dissemination by means of computed tomography and magnetic resonance imaging plays a relevant role in the surgical planning, besides influencing the therapeutic conduct and prognosis.

Complexo nasossinusal: anatomia radiológica

Este estudo propoe-se a avaliar o complexo nasossinusal, a fim de identificar os principais achados e determinar as doencas desta area. A analise precisa da extensao local e disseminacao tumoral, dada pela tomografia computadorizada e ressonância magnetica, desempenha papel importante no planejamento terapeutico, influenciando tambem o prognostico.

Value of computed tomography for evaluating the subglottis in laryngeal and hypopharyngeal squamous cell carcinoma

CONTEXT AND OBJECTIVE Subglottic involvement in squamous cell carcinoma is a determining factor for contraindicating conservative partial surgery. The subglottis is easily identified by axial computed tomography sections. The present study aimed to evaluate the occurrence of false-negative and false-positive results, and the overall accuracy of staging by computed tomography, in order to detect the involvement of the subglottic laryngeal compartment, in cases of laryngeal and hypopharyngeal squamous cell carcinoma. DESIGN AND SETTING Retrospective, non-randomized study of patients treated at Hospital Heliópolis, São Paulo, Brazil. METHODS Computed tomography scans were performed on third-generation equipment with 5-mm slice thickness. Afterwards, all patients underwent surgical and anatomopathological examinations as the gold standard procedures. RESULTS Among 60 patients, 14 were diagnosed with subglottic extension by surgical and histopathological examination. There were three false-negative and no false-positive results from computed tomography scans. The sensitivity and negative predictive value were 100.0%. Accuracy was 95.0%, specificity was 93.5% and positive predictive value was 82.4%. CONCLUSIONS Computed tomography could serve as a powerful auxiliary method for staging laryngeal and hypopharyngeal cancer. However, precautions should be taken in analyzing computed tomography scan data, because vegetating lesions may also be projected into the subglottic compartment, without real involvement of the subglottis, which may cause a false-positive result.

Doença de Madelung (lipomatose cervical benigna simétrica): relato de dois casos

The authors report two cases of patients with Madelungs disease, a symmetric fat deposit in the neck and superior mediastinum that involves nerves and vessels. Computed tomography can reveal the fat contents of these masses and guide preoperative staging and post-surgical follow-up.

O espaço sublingual

The sublingual space is a semilunar shaped space of the floor of the mouth that extends from the internal surface of the alveolar edge to the base of the tongue. The sublingual space is located medially to the mylohyoid muscle, which separates the sublingual space from the submandibular space, anteriorly to the hyoglossus-styloglossus complex, and is medially bounded by the genioglossus muscle. It contains the sublingual gland, the deep portion of the submandibular gland, the submandibular duct, the lingual artery and vein, the lingual nerve and the cranial nerves IX and XII. The relationships of the sublingual space are very important since lesions originating from the oropharynx and oral cavity can extend into this area whereas lesions arising from the sublingual space readily spread to involve the adjacent submandibular space. The authors present an anatomical and functional description of the structures within the sublingual space and discuss the diseases occurring in this region. Imaging methods are useful in the assessment and understanding of the lesions in the sublingual space and may help in the clinical and surgical management of the patients.

Diagnóstico por imagem da cavidade oral

Magnetic resonance imaging and computed tomography are important additional methods for the diagnosis of oral cavity diseases. The technical aspects of both methods are discussed including their advantages and limitations. The anatomy of the oral cavity is reviewed as well as some characteristics of squamous cell carcinoma, which is the most frequent neoplasia in this region.