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Effective dose and risk assessment from computed tomography of the maxillofacial complex.

The effective dose from computed tomography of the maxillofacial complex has been estimated and used for an assessment of risk. For each scan sequence 64 TLDs were placed in 27 selected sites in the upper portion of a tissue-equivalent human phantom to record the equivalent dose in radiosensitive organs/tissues. Equivalent doses ranged from 0.11 mSv (bone marrow, maxillary scan) to 20 mSv (salivary glands, mandibular scan). By the use of a calculation that included the salivary glands as part of the remainder, two contiguous 1 cm axial slices of the maxilla were found to result in an effective dose of 0.1 mSv, and four contiguous 1 cm axial slices of the mandible in an effective dose of 0.76 mSv. Effective doses of this magnitude represent a probability of stochastic effects of the order of 8 X 10(-6) and 56 X 10(-6) respectively.

Absorption↗

Salivary otorrhoea: a case report and a review of the literature.

This report presents an unusual case of spontaneous salivary otorrhoea in which advanced imaging was used to identify a developmental defect in the anterior wall of the bony external auditory meatus. This defect, the so-called foramen of Huschke, was subsequently found to be the source of the fistula. A review of the literature highlights the diagnostic dilemmas that such cases pose for the clinician.

Ear Canal↗

Adenocarcinoma of the parotid gland with calcification.

A 78-year-old Korean woman was referred to Chonbuk National University Dental Hospital complaining of facial palsy and palpable mass in the right parotid gland area for 4 years. Clinical examination showed an asymmetrical facial appearance due to a 4 cmx5 cm hard, fixed, non-tender mass in the right parotid gland area, incomplete eye closure and a slight tremor at the corner of the mouth. A panoramic radiograph showed an amorphous calcified mass on the posterior mandibular ramus with thinning of the cortical plate adjacent to the mass. A sialogram showed constriction of the main duct and no further filling of striated, intercalated ducts and parenchymal areas. CT indicated an expansile mass with slight contrast enhancement involving the right parotid gland. The large mass showed necrotic areas and calcifications. A bone scan showed marked accumulation of (99)Tc(m)-methylene diphosphonate on the right posterior maxilla. Microscopic findings revealed minimal morphological alterations and rare mitotic figures within tumour cells, and the lesion was diagnosed as adenocarcinoma not otherwise specified (NOS, grade II).

Adenocarcinoma↗

The controversy of Warthin's tumor.

Warthin's tumor is controversial. This controversy is multifaceted and relates to all aspects of the tumor from its historical beginnings to its pathogenesis, investigations, and treatments. In this paper, an in depth study of Warthin's tumor has been made to help clarify these controversies.

Adenolymphoma↗

Multiple Stafne bone cavities: a diagnostic dilemma.

Salivary gland inclusions in the mandible are relatively uncommon. If defects occur they are generally unilateral, although bilateral cases have been reported. This article describes an unusual case in which the dental panoramic tomogram revealed three radiolucent areas in the mandible. The diagnosis of the two posterior radiolucencies was confirmed as Stafne's bone cavities but a definite diagnosis for the parasymphyseal lesion remained elusive, even after surgery. However, Stafne's bone cavities are known to occur in this region and this diagnosis remains the most probable.

Diagnosis, Differential↗

Alcoholic parotid sialadenosis.

Alcoholism is a primary cause of sialadenosis, which is an asymptomatic, bilateral enlargement of the parotid glands. The authors outline the pathogenesis, symptoms and testing involved in diagnosing sialadenosis. Recognizing sialadenosis is important because it may point to the unsuspected presence of underlying systemic disease. Therefore, dental practitioners need to be able to differentiate sialadenosis from an inflammatory or neoplastic process to prevent unnecessary treatment.

Alcoholism↗