Computed Tomogram Research Articles

Radiological study of the adipose tissue at the para-cavernous region of middle cranial fossa

Introduction: The cavernous sinus (CS) lesions are difficult to identify on computed tomogram (CT) film, and the subtle changes may help in the diagnosis. The objective of the present study was to examine the para-cavernous adipose tissue in the CT scan in the Indian population. Material and Methods: The study included 100 patients of all age groups, who were examined using a 16 slice multidetector CT. The axial images were analyzed for the presence of adipose tissue on either side of the CS. The intracranial pathology and atrophic changes, if any, were noted. Results: The present study observed that 17% of the patients had intracranial pathologies. Among the 83% of patients with no pathology, paracavernous adipose tissue was observed in 85.5% and 89.2% over the right and left sides, respectively. It was observed that the paracavernous fat was visualized in higher frequency in elderly adults. It was visualized in all the patients (100%) of over 60 years. In some patients, with mass effect, the paracavernous fat was obliterated over the ipsilateral side, but it was visualized on the contralateral side. Discussion and Conclusion: The present study suggests that the CS lesions are difficult to identify on the CT scan, and the subtle signs may help in making a diagnosis. The para-CS adipose deposit is one among these subtle changes; if there is the presence of adipose tissue on one side and its absence on the other side, then pathology should be suspected.

Unidentical Double Trouble- A Rare Case Report

Collision tumours are relatively rare entities and are thus, not well recognised. Collision tumour can be defined as two coexisting but histologically different malignancies involving the same organ or adjacent organ with an equivocal intermediate transitional zone between them. Collision tumours of the lung and oesophagus are very rare. Such cases are diagnosed by Computerised Tomogram (CT) Scan or Chest X-Ray for complaint of dysphagia. Definitive diagnosis is made by tissue biopsy. Here, a 66-year-old male is admitted for evaluation of an anterior mediastinal mass. Radiology revealed an anterior mediastinal mass extending in to the left hilar region and upper lobe of right lung anteriorly and in to the lower end of oesophagus posteriorly. Biopsy was performed. Microscopically, transbronchial biopsy revealed a cellular lesion, composed of round-to-oval cells with streaming nucleus, positive for Immunohistochemistry (IHC) markers, CD-56 and Synaptophysin pertaining to a diagnosis of small cell carcinoma. Biopsy of the oesophageal growth shows nest of dysplastic squamous epithelium which infiltrates into underlying muscularis propria showing features of a squamous cell carcinoma. Multiple fragments of squamous epithelium are also seen with necrotic tissue in vicinity and acute inflammatory exudate. Few cells show multinucleation, molding and margination of chromatin, showing the characteristic morphological features of Herpes oesophagitis. The patient was administered platinum-based Chemotherpy.

Investigation of the relationship between fractal and hydraulic properties of porous structures of the upper respiratory tract of some Arctic animals

The respiratory ducts of animals and humans are presented by curved tubes with complex geometries. The open areas in such structures are filled with moving air governed by a pressure drop between the inlet and outlet of the duct. The complex structures formed by thin walls and warmed by constant blood flow at the body temperatures T=36-39 C serve for fast and efficient warming of the inhaled air to the body temperature and its moistening up to 100% humidity. The Arctic animals possess the most efficient nasal ducts allowing the heating of the inhaled air from T=-30-60C to T=38-39 C during the duct with the length L=8-15 only. The detailed geometry of the nasal ducts of some Arctic animal has been studied on the computed tomograms (CT) scans of the heads of the animals found in the open databases and published in literature. The highly porous structures on some slices are formed by fractal-like divisions of the walls protruded into the nasal lumen. Since the fractal structures are characterized by their fractal dimensions D, the relationships between the hydrodynamic properties and fractal dimensions of the porous structures of the upper respiratory tract of some Arctic animals has been studied. The dimensions D of the cross sections of the tract have been calculated by the counting box method. The porosities of the samples, the tortuosity of the pores, and the equivalent hydraulic diameter Dh of the channel have been calculated. Sierpinski fractals of various types have been used as models of porous structures, for which the above listed parameters, as well as hydraulic resistance to a stationary flow, have also been computed. A number of statistical dependencies between the calculated parameters were revealed, but the absence of their correlations with D was shown. It was obtained, the structures with different porosities and hydraulic resistance Dh can have the same values ​​of D. Therefore, the choice of an adequate model based on only D value introduces significant errors in the calculations of air heating along the upper respiratory tract. The statistical dependences inherent in the natural samples studied can be obtained only on the basis of multifractal models in which the number and shape of the channels, as well as the scale of their decrease, change in a certain way at each generation.

Determination of parameters of occlusal spheres on computer tomograms of the head of patients with different structures of the gnatic part of the facial skeleton of the skull

In the literature, various methods for constructing prosthetic structures in the complete absence of teeth are known, including spherical surfaces. However, these methods do not consider characteristics of patients with dolichognathic, mesognathic and brachygnathic structure of the face. The aim — to expand the understanding of sagittal and transversal movements of the lower jaw as a result of determining the parameters of occlusal spheres on computer tomograms of the head of patients with different types of structure of the gnatic part of the facial part of the skull. This article is devoted to the problem of determining the size of the radius of individual spheres in persons with dolichognathic, mesognathic and brachygnathic jaw structure. Materials and methods. The authors studied computed tomograms in lateral and axial projection. A study of the radius of the occlusal sphere was carried out. The features of the location of the projection of the center of the circle in patients with different types of structure were determined. Results. Largest values of the radius correspond to the dolichognathic type of structure, the average values of the radius were noted in persons with the mesognathic type, the brachygnathic type is characterized by the smallest radius of the sphere. The features of the location of the projection of the center of the circle in patients with different types of structure were determined. Conclusions. The fact that the coordinated forces of the masticatory muscles are directed parallel to the axes of the teeth in the sagittal and transversal directions obliges to take into account the choice of the radius of the spherical surface when setting artificial teeth during the manufacture of prosthetic structures for patients with complete absence of teeth. Since articulatory movements of the lower jaw directly depend on the severity of the compensatory sagittal and transversal curves in patients with different types of structure of the gnatic part of the facial skull, in the clinic of orthodontic dentistry, it is necessary to take into account these structural features when working with the straight arch technique.

3D analysis of the temporomandibular joint and occlusal relationships based on computer virtual simulation

To develop a method for automated analysis of TMJ elements based on computed tomography and a method for analyzing the features of the ratio of TMJ elements when changing the position of the mandible without repeated CT examination. To complete method required a computer tomogram of the temporomandibular joint in habitual occlusion recorded on spiral or cone-beam imaging; and 3D scans of the dentition obtained with intraoral and laboratory scanners; computer software - 3D graphics editor that can handle volumetric CT data and 3D mesh objects. Analysis of the joint space of the temporomandibular joint in the entire volume, not a single slice represents a more complete and reliable information about the condition of the joint. The presented method of predicting the position of TMJ heads on the basis of obtaining bite registers eliminates the probable errors of the doctor and the need for repeated CT scans, which reduces the radiation load on the patient. Virtual simulation of movements of the mandible from the position of habitual occlusion in the position of Central correlation, protrusion, right and left literaturesee with the visualization of movements of the articular heads helps to better understand the biomechanics of the TMJ, diagnostics and to obtain valuable data about the individual characteristics of the masticatory apparatus of the patient. The developed virtual articulator (patent No. 2567604) is another useful step in the development of digital technologies in dentistry.

Assessment of Diagnostic Reference Dose Associated with Computed Tomography Examination

The current study is aimed to estimate the diagnostic reference dose levels (DRLs), the volume computer tomogram dose index (CTDIvol), the CT air kerma-length product (PKL,CT) and the effective dose (E) for head, chest and chest-abdomen-pelvic CT examinations performed on adults in King Abdullah Medical City (KAMC), Saudi Arabia. Demographic parameters (such as age, gender, weight, height) for a sample of 535 computed tomography (CT) patients and physical scan parameters (such as patient tube voltage (kV), reference and effective mill ampere-second (mAs), scan length, number of slices, and pitch factor) were collected from a picture archiving and communication system (PACS). CTDIvol and PKL,CT were studied for different patients weights (40 -60 kg, 60-80 kg, 80-100 kg and 100-120 kg). Mean CTDIvol, PKL,CT and effective dose for a standard weight (70 kg ±10%) was evaluated according to the three CT protocols considered and the results were, as follows: for head examinations – 61.8 mGy, 1212 mGy.cm and 2.55 mSv, respectively; for chest examinations- 13.1 mGy, 657.5 mGy.cm and 9.21 mSv, respectively; for chest-abdomen-pelvic examinations - 13.9 mGy, 782.5 mGy.cm and 11.73 mSv, respectively. The effective dose for the chest examinations was lower than the corresponding value communicated by the European study group under European Commission. The effective dose for head examinations, was slightly higher than the one communicated by the European Commission study due to differences in the scan length. It needs optimizing the radiation dose delivered to patients via periodical review of scan parameters for a protocol under study.

External ear canal parameters and endoscopic otosurgery in children

Main difficulties of endoscopic ear surgery in children could be connected with width of external ear canal (EEC) and endoscope diameter discrepancy. To investigate EEC parameters in children, to determine cross section and to develop the recommendations whenever possible of endootosurgery performance in children. Research included two stages. First - average values determination of narrowest site EEC in children according to computer tomograms. Second - determination of age of the patient and the amount of acoustical pass at which there are specifications for performance of interventions endoscopic. EEC square: 1-3 years - 12.6±1.91 mm2, diameter is 4.01±0.59 mm; 4-7 years - 16.8±1.34 mm2, diameter is 5.34±0.43 mm; 8-11 years - 21.7±1.38 mm2, diameter is 6.9±0.45 mm; 12-18 years - 31.3±4.27 mm2, diameter is 9.96±1.4 mm. The difference between parameters at each of age groups was statistically reliable. Comfortable work endoscopically is possible with EEC square 20.4±3.19 mm2 and more. This corresponds to average value of EEC in 8-18 years. Endoscopic ear surgery is inexpedient in children up to 4 years. It is necessary to expect that intervention will be exigeant and transition to the microscopic equipment is required in case of 4-7 years old patients. Endoscopic ear surgery can be used with success to performance of various manipulations and surgical interventions on a middle ear in patients 8-18 years old.

Intra-articular Osteoid Osteoma of Hip – A Lesson Learnt From “Half-moon Sign” in Early Diagnosis

We emphasize the importance of “half-moon sign” which was seen on magnetic resonance imaging (MRI) done at an early stage of osteoid osteoma in a young patient with hip pain. The hip radiograph and computed tomogram (CT) obtained during his initial presentation were unremarkable. MRI showed a half-moon shaped marrow edema within the femoral neck which was misinterpreted as osteomyelitis. After a prolonged morbidity, the patient again underwent a CT study which picked the lesion as it was evident by that stage. The recent literature has shown the half-moon sign to be a highly specific sign for osteoid osteoma, a knowledge of which, if were known to us at the time of patient’s initial presentation would have significantly reduced his period of pain and disability. Confirming the patient is a not an athlete and does not have a recent history of physical overactivity is crucial, as the sign can also be seen due to stress reaction.

Gender abdominal features, determining depth of incisional wound in abdominal surgeries

Aim. To determine the mean values of the anterior abdominal wall thickness and abdominal cavity depth for men and women with different types of constitution and reveal the mechanisms, allowing the surgeon to predict these parameters in the preoperative period.
 Materials and methods. One hundred twenty male and female computer tomograms of the abdominal cavity were studied.
 Results. The anterior abdominal wall thickness and abdominal cavity depth values for men and women with different types of constitution at different levels of measurement were determined. The depth of laparotomy wound was found to be dependent on the distance between the anterior upper iliac spines.
 Conclusions. The gender features of the anterior abdominal wall thickness and abdominal cavity depth were revealed. There were determined the coefficients, permitting to predict the depth of laparotomy wound in the preoperative period.

Comparative characteristics of the morphometric parameters of the abdominal part of aorta and its unpaired branches in the age and sex aspects

Computer tomograms of the abdominal part of the aorta and its unpaired branches of adults belonging to three age groups are analyzed: the first, the second mature, and the elderly. It has been established that individual morphometric parameters of the abdominal part of the aorta and its unpaired branches in men and women significantly change with age. It is proved that the diameter of the aorta at different levels significantly increases with age from the first mature age to the elderly by an average of 5 mm. In addition, in men, the length of the abdominal aorta, celiac trunk and main trunk of the superior mesenteric artery do not change with age. In women, the length of the celiac trunk increases with age by 5,9 mm, the length of the main trunk of the superior mesenteric artery - by 17 mm. It can be assumed that this fact is due to the structural features of the connective tissue structures of the arterial wall in women, and, in particular, the elastic framework. The angle of discharge of the celiac trunk in men changes unevenly with age - in the second period of mature age, there is a statistically significant decrease on average of 12,3°, then in old age an increase of 15°. Moreover, in women, the values of this indicator vary more evenly. The angles of discharge of other vessels did not show a clear age dependence, since this parameter is largely due to the constitutional features. The aorto-mesenteric distance changes with age only in women. In old age, it is on average 4,4 mm larger than in the first period of mature age. In general, a number of morphometric parameters of the abdominal part of the aorta and its unpaired branches significantly changes with age. The findings are important for endovascular interventions.

Changing Modalities in the Management of Bronchiectasis after the Invention of Computer Tomogram

Changing Modalities in the Management of Bronchiectasis after the Invention of Computer Tomogram

Right ventricular strain in patients with pulmonary embolism and syncope.

Patients with acute pulmonary embolism (PE) can present with various clinical manifestations including syncope. The mechanism of syncope in PE is not fully elucidated and data of right ventricular (RV) function in patients has been limited. We retrospectively identified 477 consecutive patients hospitalized with acute PE diagnosed with a computed tomogram (CT) who also had a transthoracic echocardiogram (TTE) 24h prior to or 48h after diagnosis. Parameters of RV strain on CT, TTE, electrocardiogram (ECG), and clinical characteristics and adverse outcomes were collected. Patients with all three studies available for assessment were included (n = 369) and those with syncope (n = 34) were compared to patients without syncope (n = 335). Patients with syncope were more likely to demonstrate RV strain on all three modes of assessment compared to those without syncope [17 (50%) vs. 67 (20%); p = 0.001], and those patients were more likely to receive advanced therapies [9 (53%) vs. 15 (22%); p = 0.02]. PE-related mortality was highest among those presenting with high-risk PE and syncope (36%, OR 20.1, 95% CI 5.3-81.1; p < 0.001) and was low in patients with syncope without criteria for high-risk PE (3%, OR 1.2, 95% CI 0.2-10.0; p < 0.001). In conclusion, acute PE patients with syncope are more likely to demonstrate multimodality evidence of RV strain and to receive advanced therapies. Syncope was only associated with increased PE-related mortality in patients presenting with a high-risk PE. Syncope alone without evidence of RV strain is associated with low short-term adverse events and is similar to those without syncope.

Use of an acrylic jig to aid orbital reconstruction after resection of a sphenoid intraosseous meningioma: a technical note.

A 48-year-old woman presented to neurosurgery with proptosis of the left globe and worsening pain and swelling in the left temporal region. Her visual acuity was unaffected. A computed tomogram (CT) of her head showed a large expansile lesion that involved the left frontal, parietal, temporal, and sphenoid bones (Fig. 1 and Supplemental Fig. S1). It impinged on the orbit, causing proptosis and crowding of the orbital contents. A diagnosis of intraosseous meningioma was suspected.

AN UNUSUAL CASE OF DESQUAMATIVE INTERSTITIAL PNEUMONIA RECURRENCE AFTER LUNG TRANSPLANT

SESSION TITLE: Tuesday Fellows Case Report Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM INTRODUCTION: Desquamative interstitial pneumonia (DIP) is a form of interstitial lung disease that is characterized by diffuse interstitial infiltrates on chest X-ray, restrictive pulmonary function tests and intra-alveolar accumulation of macrophages. We report a rare case of DIP recurrence after lung transplantation complicated by Aspergillus and Cytomegalovirus (CMV) infection. CASE PRESENTATION: The patient is a 59 year-old male former smoker with a history of Hepatitis C treated in 2006 with Ribavirin and Interferon. He was evaluated for progressive hypoxic respiratory failure requiring bilateral lung transplantation in December 2017. Explanted lung pathology was consistent with end-stage DIP. Post-surgical course was complicated with antibody-mediated rejection requiring intravenous immunoglobulin therapy and plasmapheresis, Aspergillus pneumonia and Cytomegalovirus (CMV) viremia. 14 months later, he presented to hospital with dyspnea and cough. He was hypoxic requiring 2L/min at rest. Computed tomogram (CT) of the chest showed diffuse ground glass opacities bilaterally and a new patchy left basilar airspace opacity. His bronchoscopy and transbronchial biopsy showed a DIP-like injury pattern, focal interstitial fibrosis and chronic bronchiolitis. Respiratory cultures grew Pseudomonas putida for which IV Piperacillin and Tazobactam was given. Laboratory studies showed speckled pattern ANA with a titre of 1:160 and negative anti Ds-DNA, RF, anti-CCP, anti ScL-70, ANCA, SSA/SSB and CPK. HCV RNA was undetected with normal cryoglobulin levels. While he responded to Medrol 32 mg daily and was discharged home without oxygen supplementation, the mechanism for the DIP-like pattern is not well understood. His immunosuppressive regimen post lung transplantation was tacrolimus and mycophenolate. DISCUSSION: In our patient, DIP recurrence post lung transplantation suggests presence of a systemic disease. Though the patient did not show any evidence of connective tissue disease, further workup is pending. The reported association between history of Hepatitis C and DIP in previous case reports may explain this patient’s presentation, however undetected HCV RNA with normal liver function would not support this theory. It is also possible that Aspergillus and CMV infection may have triggered a DIP-like pattern as described in another case post lung and renal transplantation. To our knowledge, this is the second reported case of DIP recurrence after lung transplant. Early recognition and treatment of DIP is essential as it has the most favorable prognosis of all Idiopathic Interstitial Pneumonia subtypes. In cases where DIP occurs in lung transplant patients, opportunistic pathogens might be suspected as causative agents. CONCLUSIONS: It is important to diagnose and treat the underlying etiology that causes DIP so that recurrence after lung transplantation can be prevented. Reference #1: King, M. B., et al. (1997). "Recurrence of desquamative interstitial pneumonia after lung transplantation.” Am J Respir Crit Care Med 156(6): 2003-2005. DISCLOSURES: No relevant relationships by alaa abu-sayf, source=Web Response No relevant relationships by Bathmapriya Balakrishnan, source=Web Response No relevant relationships by Aditya Kotecha, source=Web Response no disclosure on file for Lisa Stagner; No relevant relationships by Krishna Thavarajah, source=Web Response

FEATURES OF THE TOPOGRAPHY OF THE ABDOMINAL AORTA AND ITS UNPAIRED BRANCHES IN SEXUAL AND AGE ASPECTS

In the last few decades there has been a steady growth of vessels diseases, including diseases of the abdominal aorta and its unpaired branches. The aim of this study was to study the topography of the abdominal aorta and its unpaired branches in men and women belonging to different age groups. It was analyzed 266 computer tomograms of the abdominal aorta and its unpaired branches of adult men and women divided into three age groups (first and second periods of mature age and old age). It was found that for men is typical the more distal location of the studied anatomical objects relatively to the vertebral column in comparison with women. It was proved that in women of the first mature age period, as well as in men, most often the beginning of the abdominal aorta is observed at the middle of the Th12 body (35.8%), in the second period of mature age - at the middle of the Th12 body (33.3%); in the elderly - at the level of the lower edge of the body of this vertebra. The level of the aorta bifurcation in men in the first period of mature age are most often located at the level of the lower edge of the L4 body, in other age groups at mid-body L4. While in women the age-related changes of the level of the bifurcation of the aorta is not significant. It was shown that in women in all age groups the outfall of the celiac trunk is localized higher than that in men. Dynamics of age changes of the position of the outfalls of the upper and a lower mesenteric artery, in men and women varies considerably. The obtained information about sex and age characteristics of the position of the abdominal aorta and its bifurcation, the outfalls of the celiac trunk, upper and lower mesenteric arteries have not only anatomical interest but also have clinical importance in surgical interventions on the organs of gastro-splenic-pancreaticoduodenal zone.

THE COMPARATIVE CHARACTERISTICS OF AGE, SEXUAL AND TYPOLOGICAL MORPHOMETRIC PARAMETERS OF UNPAIRED BRANCHES OF THE ABDOMINAL AORTA OF ADULTS ACCORDING COMPUTED TOMOGRAPHY

The rapid development of transplantation, endovascular and minimally invasive surgery necessitates a detailed study of the structural features of the vessels of the abdominal cavity. The purpose of the study is the characteristics of the morphometric parameters of the abdominal aorta and its unpaired branches in men and women at different ages and depending on the body type. The analysis of 266 computer tomograms of the abdominal part of aorta and its unpaired branches was carried out in adult men women divided into three age groups (first and second periods of mature age and elderly age), as well as into three groups according to the Pinier index (asthenic, normosthenic and hypersthenic body types). It was established that individual morphometric parameters of the abdominal part of aorta and its unpaired branches in men and women significantly change with age. It is proved that the diameter of the aorta at various levels significantly increases with age from the first mature to the elderly age by an average of 5 mm. However, in men, the length of the abdominal aorta, celiac trunk and main trunk of the superior mesenteric artery does not change with age. In women, the length of the celiac trunk increases with age at 5.9 mm, the length of the main trunk of the superior mesenteric artery - at 17 mm. The angle of discharge of the celiac trunk in men changes unevenly with age - in the second period of mature age, there is a statistically significant decrease by an average to 12.3°, then in old age an increase to 15°. Moreover, in women, the values of this indicator vary more evenly. The angles of discharge of other vessels did not show a clear age dependence, since this parameter is largely due to the constitutional features. The aorto-mesenteric distance changes with age only in women. In elderly age, it is on average 4.4 mm larger than in the first period of mature age. It was also found that there are significant differences between constitutional types identified using the Pinier index in the overwhelming majority of the morphometric parameters studied. The obtained information has a significant clinical importance, since it will allow objectifying the diagnostic criteria of various vascular syndromes and minimizing the risk of endovascular interventions.

Radiographic Parameters in Non-Contrast Computed Tomography Predict the Success of Percutaneous Nephrolithotomy

Aim: To evaluate whether non-contrast Computed Tomogram (CT) parameters (stone density, localization, size &amp; degree of pelvicalceal system dilatation) predict the outcome of percutaneous Nephrolithotomy (PCNL). Method: This study included 68 patients (43 male &amp; 25 female) with renal calculi scheduled for PCNL. They were examined by non-contrast CT to determine calculus size, calculus density, calculus location &amp; degree of pelvicalceal system dilatation.&nbsp; Ultrasound at scheduled PCNL follow-up one and two months later and undertaken by 2 radiologist at the same unit (HD11XE Philips 2010 unit) checked for residual stones. Stones equal or more than 4 mm in largest diameter was regarded as significant. Result&nbsp; : CT parameters that were associated with more residual stones ( P value &lt;0.001) included density less than 700 HU, upper calyx location, presence of preoperative hydronephrosis and large stone size. Conclusion: pre-operative CT can predict the outcome of PCNL. Stone parameters that predict the oucome of PCNL included stone density, less than 700 HU, upper calyceal stone, large size stone &amp; the presence of pre-operative hydronephrosis.

Radiological Analysis of Frontal Cells and its Association with Frontal Sinus Mucosal Disease: A Tertiary Care Hospital Based Study

Introduction&#x0D; The frontal sinus and frontal recess both have complex anatomy causing difficulty during endoscopic sinus surgeries. The term frontal cells is currently used to describe a group of anterior ethmoidal cells classified by Kuhn et al into 4 types. Though there are precise descriptions, the frequency of frontal sinus cells (FSCs) varies widely in the literature. The presence of FSCs is responsible for a narrowing of the frontal sinus outflow tract which subsequently causes a partial obstruction of drainage and aeration of the frontal sinus. Our main aim is to the see the distribution of different frontal cells in Nepali population and relation with frontal sinus mucosal disease.&#x0D; &#x0D; Materials and Methods&#x0D; This prospective, longitudinal study performed in 110 consecutive patients who underwent CT scan of nose and paranasal sinuses. The frontal cells and agger nasi cells were identified and association between the frontal cells and agger nasi cells with frontal sinus mucosal disease was analyzed with chi square test.&#x0D; &#x0D; Results&#x0D; The agger nasi was present in 83.63% CT scans whereas frontal cells were distributed in 61.82% CT (computed tomogram) scans. There was not statistical significance and any association between the frontal cells and agger nasi cells with frontal sinus mucosal disease.&#x0D; &#x0D; Conclusion&#x0D; The frontal cells and agger nasi cells distribution in Nepalese population, even though in small sample size, is similar with other studies in the literature. There is also non association of either frontal cells or agger nasi cells with frontal sinus mucosal disease.

ENHANCEMENT OF RESEARCH METHOD FOR SPATIAL LOCATION OFTEMPOROMANDIBULAR ELEMENTS AND MAXILLARY AND MANDIBULAR MEDIALINCI

This work reveals the analysis outcomes for craniometric and morphometric parameters of the temporomandibular joints and incisal dentofacial segments obtained through studying 157 computer tomograms and lateral skull teleradiographies from people with physiological occlusion of permanent teeth in the first mature age period. Detailed investigation of the spatial arrangement of the craniofacial structures allowed developing, substantiating and testing a method of computer tomograms combination of the mandibular joint and dentofacial segments of the mandibular and maxillary medial incisors with head teleradiographies in the lateral projection. This algorithm allowed increasing the measurements reliability (linear, angular) in the sagittal plane, identifying the degree of complexity and justifying the choice of tactics for the planned treatment, describing the facial skull growth type (horizontal, vertical and neutral), as well as evaluating the effectiveness of orthodontic treatment at all stages.

Detectability and surgical outcomes in parathyroid surgery – a single-centre experience

The incidence of primary hyperparathyroidismand referrals for the removal of parathyroid adenomas are increasing. Factors that improve the detectability, and ultimately the surgical outcome, are the focus of this retrospective study. We included 117 patients who had parathyroid operations with intraoperative monitoring of parathyroid hormone (PTH). Sestamibi, ultrasound and, in selected cases, fusion with computed tomograms (CT), were done to locate the lesion preoperatively. Concentrations of calcium and PTH before and after operation, specimen weight, and preoperative vitamin D concentrations, were assessed. The sensitivity of sestamibi and ultrasound for the preoperative location of adenomas was 92% and 80%, respectively. Sestamibi located them more accurately in patients with low preoperative concentrations of vitamin D (p = 0.037) and with heavier adenomas (p < 0.001). We found no significant association between the preoperative concentrations of PTH and detectability on preoperative scans (p = 0.058). Postoperative follow up showed that 97% of the 117 patients were biochemically cured. Accurate location helps to lower morbidity as it facilitates a targeted approach. Further studies are needed to explore the role of vitamin D in the location of parathyroid adenomas before parathyroidectomy.