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Biomedical subjects

W N Hanafee

Publications and source records attributed to W N Hanafee.

At least 55 records · Page 3Linked to original sources
PubMed1983

Differential diagnosis of nasopharyngeal tumors by computed tomography scanning.

While direct visual or even fiberoptic endoscopic examination of the nasopharynx may at times be diagnostic, some limitations are frequently encountered as follows: (1) determination of the extent of submucosal spread, (2) identification of intracranial extensions, (3) in some instances, the differentiation of benign from malignant processes, and (4) the delineation of aggressive inflammatory processes such as Wegener's granulomatosis or mucormycosis. Seventy patients were reviewed to determine what help could be anticipated from computed tomography scanning. Low-density fascial planes are readily identified in the paranasopharyngeal space that provide important clues to the spread and diagnosis of malignant disease or aggressive inflammatory processes. The use of intravenous contrast material for enhancement of intracranial spread of tumors or for identification of the margins of hypervascular lesions can be quite helpful.

Diagnosis, Differential↗
PubMed1983

Work in progress: NMR anatomy of the larynx and tongue base.

The normal anatomy of the larynx and base of the tongue as seen on nuclear magnetic resonance (NMR) images was studied. Scans of normal volunteers were obtained using a 3.5 kilogauss (0.35 T) superconductive magnet and a 3.0 kilogauss (0.3 T) permanent magnet. The NMR images were compared with images obtained by CT and with anatomical sections of these regions. Although resolution is not comparable to that seen on scans obtained with modern CT equipment, there are some advantages to NMR imaging. These include availability of multiple projections, ease of identifying blood vessels and differentiating them from lymph nodes, and the possibility of improved tissue specificity.

Adipose Tissue↗
PubMed1983

Elusive head and neck carcinomas beneath intact mucosa.

This study presents 19 patients who had mucosally inapparent carcinomas of the upper aerodigestive tract demonstrated by computed tomography (CT). This group contains subpopulations that were identified both retrospectively and prospectively. During the same period 40 nasopharyngeal, 20 oropharyngeal-tongue base, and over 100 laryngeal and hypopharyngeal carcinomas were studied; all had clinically obvious mucosal components. Nine of our 19 patients had strictly submucosal tumors and a variety of clinical presentations; 5 patients had strictly submucosal recurrence of treated carcinomas and 5 had mucosal lesions which were not identified on examinations by more than one practicing head and neck surgeon. Sixteen of the 19 tumors were confirmed histologically; in 3 others confirmation was by a combination of CT and clinical course. CT can demonstrate the deep extent of aerodigestive tract carcinomas more accurately than physical examination and it can show mucosally inapparent disease. CT should be part of the staging work-up in nearly all upper aerodigestive tract carcinomas and in patients suspected of harboring an unknown primary within this region.

Aged↗
PubMed1982

Pseudomass lesions due to occult trauma of the larynx.

Fracture of the laryngeal skeleton is best diagnosed by computed tomography. Deformity of the laryngeal cartilage may cause signs and symptoms that suggest neoplastic submucosal mass. Symptoms may not develop until years after the original injury. A series is described in which the patients demonstrate the characteristic signs, symptoms, and computed tomographic appearance of old, often forgotten, fractures of the thyroid cartilage. The diagnosis is best made by computed axial tomography of the neck.

Adult↗
PubMed1981

Parotid CT sialography.

Computed tomographic (CT) scanning of the parotid gland during the injection of water-soluble contrast medium allows precise mapping of the gland's parenchyma and of any filling defects or extrinsic masses. Thirty-six patients were examined in this way. The most valuable information that was gained was the differentiation of extrinsic and intrinsic tumors and an accurate appraisal of the location of the facial nerve with respect to intrinsic parotid lesions. In the majority of patients the diagnosis of benign or malignant tumor is suggested by the patterns of tumor growth. Inflammatory disease shows diminution in the amount of parotid parenchyma in relationship to interstitial tissues, but the appearance is not sufficiently characteristic for definitive diagnosis.

Chronic Disease↗
PubMed1980

Computerized tomography with simultaneous sialography in evaluating parotid tumors.

In an effort to improve on the amount of preoperative information obtainable, computerized tomography was combined with contrast sialography in the evaluation of parotid masses. Experience to date is limited to 17 patients, but this combination of techniques seems to demonstrate clearly the margins of the tumor, whether or not there is extraparotid extension, whether the mass is medial or lateral to the facial nerve, and whether or not the mass will hamper access to the main trunk of the facial nerve.

Adult↗
PubMed1980

Fibrous dysplasia: findings in a pre-Columbian skull.

An ancient Peruvian specimen (600 to 800 years old) with fibrous dysplasia involving the left frontoethmoidal region is discussed. The skull is that of a woman aged 20 to 30 years exhibiting marked deformity of the left frontal bone, ethmoids, orbit, and nasal wall. Plane radiographs and tomographic views demonstrate a heavily calcified, expanding process in the frontal region and replacement of the ethmoids by less dense osseous tissue. This specimen represents the second reported instance of fibrous dysplasia occurring in the Americas, further documenting the antiquity of the disease on this continent. The lesion is probably monostotic and has characteristics similar to the process as it is known today.

Adult↗
PubMed1980

Cerebrospinal fluid rhinorrhea: the significance of an air-fluid level in the sphenoid sinus.

The radiographs of 13 patients with proved cerebrospinal fluid (CSF) fistulas were reviewed, with special attention paid to the presence or absence of an air-fluid level in the sphenoid sinus. The findings on plain radiographs and tomograms were compared to carefully documented sources of CSF leak. Seven patients demonstrated air-fluid levels in the sphenoid sinus even though the leak was through more anteriorly placed dural defects. The anatomical arrangement of the ostium of the sphenoid sinus is such that fluid will enter the sinus from the superior nasal recess, thus rendering air-fluid levels in the sphenoid sinus is such that fluid will enter the sinus from the superior nasal recess, thus rendering air-fluid levels in the sphenoid sinus a nonlocalizing finding in CSF fistulas.

Adult↗
PubMed1980

Edge enhancement computed tomography scanning in inflammatory lesions of the middle ear.

The high resolution modification of an EMI 5005 scanner was utilized with an edge enhancement technique to study inflammatory lesions of the temporal bone. Bone erosions caused by cholesteatomas can be accurately delineated because of the circumscribed nature of expansion. The soft tissue masses cannot be appreciated by present CT techniques. Erosions of the horizontal semicircular canal and involvement of the sinus tympani are readily visualized by CT scanning. Computed tomography is limited in demonstrating the stapes superstructure and horizontal portion of the facial canal due to the inability to obtain good coronal scans. The remaining ossicles can be demonstrated with equal clarity with pluridirectional tomography.

Bone Resorption↗
PubMed1980

Combined gas cisternography and edge-enhanced computed tomography of the internal auditory canal.

Gas cisternography was combined with edge-enhanced computed tomography (CT) in 6 patients and demonstrated the seventh and eighth cranial nerves thorugh both the cerebellopontine angle cistern and the internal auditory canal in the normal patients. The normal nerve outline was lost when a tumor was contained within the canal. This technique is a more reliable means of identifying small tumors than relying on non-filling of the canal by positive contrast media or gas.

Humans↗
PubMed1980

Pitfalls in the radiographic diagnosis of stenosis of the internal auditory canal.

The syndrome of stenosis of the internal auditory canal is radiographically suggested by narrowing of the canal on temporal bone tomography or nonfilling on Pantopaque cysternography. The internal auditory canal ends medially at the porous acousticus. In the literature, the radiographs employed to demonstrate this stenosis show the narrowing to be medial to the porous acousticus and therefore extracanalicular. The presumed narrowing is actually in a neurovascular groove on the posterior aspect of the temporal bone. Temporal bone specimens were photographed and tomographed to demonstrate this point. These data suggest that present radiographic criteria for diagnosis of this syndrome are invalid.

Constriction, Pathologic↗
PubMed1980

CT of the fixed vocal cord.

The presence or absence of mobility of the vocal cords is one of the major clinical criteria used in staging laryngeal cancer. Decisions regarding radical laryngectomy may be made on the basis of vocal cord mobility rather than an appraisal of the actual tumor extension. Seventy-one patients in whom the status of vocal cord mobility was clinically proven was studied by computed tomographic (CT) scanning. CT showed two cancers to be more advanced than estimated by normal vocal cord motion due to involvement of the preepiglottic or subglottic space. In three patients with suspected laryngeal tumor presenting with neck pain and hoarseness, CT showed that the sequelae of "occult" trauma had limited vocal cord mobility and had given a false clinical impression of possible tumor. CT correctly predicted vocal cord fixation in 16 of 19 patients with tumor and in eight of nine patients after trauma. In both groups, most patients had multiple findings which could explain fixation. In the tumor group, cricoarytenoid involvement (12 instances) and paralaryngeal space spread (10 instances) were the most frequent. In the trauma group, injuries to the laryngeal skeleton (nine instances) and a variety of soft tissue changes (seven instances) were the most frequent findings, related to fixation.

Adult↗
PubMed1979

A comparative evaluation of computed tomography and laryngography.

A prospective study of 66 patients was conducted to evaluate the relative merits of computed tomography (CT) and laryngography in the assessment of laryngeal disorders. CT complemented direct laryngoscopy and biopsy for treatment planning and was superior to both modalities for showing deep infiltration, invasion of cartilage, and extension to the soft tissues of the neck. The subglottic space can be studied adequately by CT, which could also be useful in diagnosis of lymph node metastases. Distortion of the thyroid cartilage can be shown by CT. CT was equal to or better than laryngography in approximately 90% of cases.

False Negative Reactions↗
PubMed1979

Computed tomography of the injured larynx.

Computed tomography (CT) permitted a much more detailed appraisal of laryngeal dysfunction in patients with blunt laryngeal trauma (8 cases) and iatrogenic injury caused by radiation therapy (7 cases), surgery (2 cases), or intubation (1 case). In thyroid cartilage fractures, the fragments may be widely displaced. The cricoid ring breaks in two places, frequently involving the signet. CT facilitates diagnosis of the mechanism of injury based on the site and extent of fractures. The patterns of distortion and fibrosis of the laryngeal cartilage following radiation therapy may be manifested as encroachment on the airway, easily mistaken for recurrent tumor or localized edema. Minor distortion probably escapes detection on clinical examination. The authors consider CT the examination of choice in laryngeal injury.

Adolescent↗
PubMed1978

Extensions of paranasal sinus tumors and inflammatory disease as evaluated by CT and pluridirectional tomography.

CT and pluridirectinal tomography are compared in their ability to show the extent of paranasal sinus tumors or benign aggressive processes. Thirty-one cases are reviewed; CT was superior to pluridirectional tomography in showing spreads of tumor to all clinically important areas, including the infratemporal fossa, nasopharynx, orbit, and intracranial compartment. CT not only consistently allowed less equivocal interpretation, but also enabled us to qualify orbital involvement as intra- or extraconal, and to quantitate better both brain and infratemporal fossa involvement. We feel that CT scanning is the better way to determine the extent of such pathology.

Adult↗
PubMed1978

Dilatation of the nasolacrimal duct under radiographic control.

Obstruction of the nasolacrimal duct is a major cause of epiphora, or tearing. The authors describe a method of dilating obstructions to re-establish drainage of the lacrimal sac which utilizes fluoroscopic control to stay within the natural lumen of the nasolacrimal duct. The procedure is simple to perform under local anesthesia. An unsuccessful dilatation does not interfere with subsequent dacrocystorhinostomy.

Catheterization↗
PubMed1978

Incudostapedial joint in health and disease.

The incudostapedial joint was studied in tomograms of 370 normal and 80 diseased middle ears. The Guillen view was found to be superior to the anteroposterior view in demonstrating this joint in normal middle ears (85% and 62% visualization, respectively). In the presence of disease, visualization was markedly reduced to 19%; this lack of visualization is a nonspecific finding since early cholesteatomas, chronic otitis media, and retraction pockets could not be differentiated radiologically. Nonvisualization of the incudostapedial joint in the Guillen view is a more objective indicator of middle ear disease than such terms as "indistinct of hazy" middle ear cavities.

Ear Diseases↗