Lateral Skull Research Articles

Potential role of the sella turcica X-ray imaging aspects for sex estimation in the field of forensic anthropology: a systematic review and meta-analysis.

Studies from different geographic regions evaluated the morphology of ST according to sex and showed this anatomical structure as an important indicator of dimorphism.Meta-analysis showed shorter ST length and diameter in women.Subgroup analysis found lower ST width in women based on lateral skull radiographs.Subgroup analysis found smaller lengths and diameters in women based on CT scans.

Craniotomy hematoma was removed from the bone flap and multiple holes were drilled on the bone flap: A case report.

Chronic subdural hematoma (CSDH) is a common disease in neurosurgery department. Burr-hole drainage is the main surgical treatment. And the recurrence rate is as high as 25%. In this case, a male patient with CSDH in the left frontotemporal parietal region underwent 2 drilling and drainage operations in the local hospital, but the hematoma recurred after operations. Being unable to bearing the repeated and progressive aggravation of headache, he came to our hospital for treatment. After considering the comprehensive situation, we use a new surgical method, removal of hematoma by drilling multiple holes in the lateral skull, to cure the patient. We get inspirations from the treatment of moyamoya disease surgery, through the bone holes the scalp forms many "meat column" like structures which have powerful capability in absorption, so the scalp could deep into the hematoma, then the CSDH could be cured. Provide a new surgical method for the treatment of refractory CSDH.

Postoperative Complications after Surgical Management of Mandibular Angle Fracture

Introductions: Mandibular angle fractures represent a high percentage and an important clinical challenge because of their treatment pattern and the highest postsurgical complication rate among all mandibular fractures. Materials and methods: The objectives of this cross-sectional observational study were to observe the postoperative complications after surgical management of a mandibular angle fracture and to facilitate early detection of complications and reduction of patients’ morbidity. This study was carried out among forty patients with mandibular angle fractures who were managed by open reduction and internal fixation by miniplate osteosynthesis. All the study patients were evaluated clinically pre- and postoperatively for various parameters at the 1st week, 2nd week, 1st month, and 4th month. Radiographs (OPG, PA skull, lateral skull, and CT scan of the oral and maxillofacial region) were taken pre- and postoperatively to assess complications. The infection was detected by culture and a sensitivity test. Nerve injury was evaluated by the “tactile test”, the brush directional stroke test by using a ’00’ camel hair brush, and the pinprick test performed by using a sterile 27-gauge syringe needle. Occlusion and chewing were evaluated postoperatively according to the Treatment Scoring System developed by V. Uglesic in 1993. The data was analyzed using the SPSS version 20 statistical software. Results: In this study, most of the patients (85%) were male and the mean age was 24.5 years. In the fracture line third molar was present in 55% cases. The most common complication of this study shows postoperative nerve injury 30% cases. Infection in 10% cases, malocclusion in 7.5% cases. Slight restricted mouth opening in 5% cases. Other complications such as malunion,, delayed union, and non-union were absent. Conclusion: The most common complication after surgery is nerve injury along with infection and malocclusion. A careful preoperative assessment, early surgical intervention, meticulous surgical technique, postoperative care and appropriate rehabilitation are the main concern to prevent neurological and other complications. Update Dent. Coll. j: 2023; 13(1): 9-13

Maturation of the internal auditory canal and posterior petrous bone with relevance to lateral and posterolateral skull base approaches

Anatomic knowledge of the internal auditory canal (IAC) and surrounding structures is a prerequisite for performing skull base approaches to the IAC. We herein perform a morphometric analysis of the IAC and surgically relevant aspects of the posterior petrous bone during pediatric maturation, a region well-studied in adults but not children. Measurements of IAC length (IAC-L), porus (IAC-D) and midpoint (IAC-DM) diameter, and distance from the porus to the common crus (CC; P-CC) and posterior petrosal surface (PPS) to the posterior semicircular canal (PSC; PPS-PSC) were made on thin-cut axial CT scans from 60 patients (grouped by ages 0–3, 4–7, 8–11 12–15, 16–18, and > 18 years). IAC-L increased 27.5% from 8.7 ± 1.1 at age 0–3 to 11.1 ± 1.1 mm at adulthood (p = 0.001), with the majority of growth occurring by ages 8–11. IAC-D (p = 0.52) and IAC-DM (p = 0.167) did not significantly change from ages 0–3 to adult. P-CC increased 31.1% from 7.7 ± 1.5 at age 0–3 to 10.1 ± 1.5 mm at adulthood (p = 0.019). PPS-PSC increased 160% from 1.5 ± 0.7 at age 0–3 to 3.9 ± 1.2 mm at adulthood (p < 0.001). The majority of growth in P-CC and PPS-PSC occurred by ages 12–15. Knowledge of these patterns may facilitate safe exposure of the IAC in children.

Evaluation and Multidisciplinary Treatment of a Patient with Temporomandibular Disorder

Demonstrate that patients with signs and symptoms of the temporomandibular joint, prior to orthodontic treatment, should be treated multidisciplinary A 31-year-old female, a student at the Mexican Center for Stomatology, with a personal and family health history and orthodontic treatment who came to the clinic for presenting symptoms of pain in the face over the region of the bilateral temporomandibular joint, with alterations of the function, which radiated to the neck and back of several months of evolution. The clinical findings presented by the patient were: wear on the upper anterior teeth. The pain map diagnostic index was used, photographs of the face, whole body from the front and sides, panoramic radiography, lateral skull, anteroposterior and spine, articulated models in semi-adjustable articulator, this facilitated us to diagnose joint disorders. The proposed treatment was multidisciplinary treatment: Neuro-muscular rehabilitation and the use of physical agents, massage therapy, Kinesiology and manual therapy. The multidisciplinary treatment of occlusal guard by stomatology and the combination of physical agents, Kinesiology and manual therapy by physiotherapy, demonstrated excellent results with the disappearance of the symptoms in the patient, improved her expectations. Giving you a better quality of life.

Biodosimetry in interventional radiology: cutaneous-based immunoassay for anticipating risks of dermatitis.

Interventional radiology procedures expose individuals to ionizing radiation. However, existing dosimetry methods do not provide the dose effectively absorbed to the skin, and do not consider the patient's individual response to irradiation. To resolve this lack of dosimetry data, we developed a new external irradiation biodosimetry device, DosiKit, based on the dose-dependent relationship between irradiation dose and radiation-induced H2AX protein phosphorylation in hair follicles. This new biological method was tested in Clermont-Ferrand University Hospital to evaluate the assay performances in the medical field and to estimate DosiKit sensitivity threshold. DosiKit was tested over 95 patients treated with neuroradiological interventions. For each intervention, lithium fluoride thermoluminescent dosimeters (TLD) were used to measure total dose received at each hair collection point (lateral and occipital skull areas), and conventional indirect dosimetry parameters were collected with a Dosimetry Archiving and Communication System (DACS). Quantitative measurement of radiation-induced H2AX protein phosphorylation was performed on 174 hair samples before and after the radiation exposure and 105 samples showed a notable induction of gammaH2AX protein after the radiological procedure. According to a statistical analysis, the threshold sensitivity of the DosiKit immunoassay was estimated around 700 mGy. With this study, we showed that DosiKit provides a useful way for mapping the actually absorbed doses, allowing to identify patients overexposed in interventional radiology procedures, and thus for anticipating risk of developing dermatitis. • DosiKit is a new external irradiation biodosimetry device, based on the dose-dependent relationship between irradiation dose and radiation-induced H2AX protein phosphorylation in hair follicles. • DosiKit was tested over 95 patients treated with neuroradiological interventions. • The threshold sensitivity of the DosiKit immunoassay was estimated around 700 mGy and DosiKit provides a useful way for mapping the actually absorbed doses.

Evaluation of vertical facial height reduction and severity of temporomandibular joint disorders using Shimbashi number and cephalometric analysis

ABSTRACT Objective: This study was designed to evaluate the correlation between vertical dimension at occlusion (VDO) and various grades of temporomandibular disorders (TMDs) versus controls. Methods: Clinically measured Shimbashi number and radiographic cemento-enamel junction (CEJ-CEJ) measurements on 120 TMD patients and 40 controls were evaluated. Radiographic lateral cephalometric skull images of the patients were subjected to cephalometric analysis. The relationship between Shimbashi number, the cephalometric values, and its correlation with the degree of TMD were evaluated and statistically analyzed. Results: Shimbashi number and radiographic CEJ-CEJ values in the TMD patients were significantly lower than those in the controls. TMD severity appeared to increase with the increase in interincisal angle and the decrease in both Shimbashi number and radiographic CEJ-CEJ value. Conclusion: These findings indicate that radiographic evaluation of cephalograms is a reliable indicator of presence and degree of TMD, and the severity of TMD increases with the degree of reduction in VDO.

Orbital multilobular osteochondrosarcoma in a dog

Retrobulbar tumors may arise from any orbital tissue. Some are primary and others may extend from adjacent structures or derived from metastases. Multilobular osteochondrosarcomas are regarded as slowly growing and potentially malignant neoplasms in dogs. This tumor is of rare occurrence on retrobulbar region. This paper aims to report a rare case of female dog, Shih Tzu, spayed, five-year-old, that was referred to the Hospital of Veterinary Medicine, Federal University of Bahia, Brazil, with an increased volume in the orbital space, after enucleation for exophthalmia of unknown etiology. This animal was evaluated clinic and the diagnosis image (radiography and computed tomography) demonstrated a large formation of bone predominantly in the region of the right orbit and zygomatic arch, with invasion and destruction of adjacent bones. Due to her poor quality of life, the dog was submitted to euthanasia and after necropsy. On gross examination, an encapsulated nodular mass with an irregular surface, measuring 5.6 x 4.6 x 3.9 cm, was located in the right lateral skull, occupying the orbit with displacement of the zygomatic arch. The tumor was identified by histopathology as a malignant mesenchymal neoplasm, multilobular osteochondrosarcoma. Thus, differential diagnoses for exophthalmos should include cancers, including the multilobular osteocondrossarcoma.

TH-AB-201-03: Estimating Pediatric Entrance Skin Dose From Digital Radiography Examination Using DICOM Metadata: A Quality Assurance Tool

Purpose: To develop an automated pediatric dose reporting quality assurance (QA) tool for digital radiography (DR) using DICOM metadata. Methods: Patient examination and demographical information were gathered from metadata analysis of DICOM header data. Average patient thicknesses were measured for head, chest, abdomen, knees, and hands using volumetric images from CT. Patient entrance skin air KERMA (ESAK) was calculated by first looking up examination technique factors taken from DICOM header metadata (i.e., kVp and mAs) to derive air KERMA (kair), and then scaling kair with a backscatter factor, derived from examination kVp, and for patient thickness. Finally, patient entrance skin dose (ESD) was calculated by multiplying ESAK with a mass-energy attenuation coefficient ratio. ESD to effective dose (E) conversion factors were used to estimate patient population E. ESD and E were computed for common DR examinations at our institution: dual-view chest, anteroposterier (AP) abdomen, lateral (LAT) skull, dual-view knee, and bone age (left hand only) examination. Results: ESD was calculated for 3794 patients; mean age 11 ± 8 years (range 2 months to 55 years). ESD range was: 0.19–0.42 mGy for dual-view chest, 0.28–1.2 mGy for AP abdomen, 0.18–0.65 mGy for LAT skull, 0.15–0.63 mGy for dual-view knee, and 0.10–0.12 mGy for bone age examinations. Effective dose values were calculated for dual-view chest 0.04 mSv (± 0.02 mSv), AP abdomen 0.05 mSv (± 0.15 mSv), LAT skull 0.004 mSv (± 0.002 mSv), dual-view knee 0.003 mSv (± 0.002 mSv), and bone age 0.001 mSv (± 0.0002 mSv). Conclusion: A methodology combining DICOM header metadata and basic x-ray tube characterization was demonstrated. In a regulatory era where patient dose reporting has become increasingly in demand, this methodology was used to establish an automated dose reporting program for DR to perform patient dose related QA for digital x-ray imaging.

Congenital Muscular Torticollis and Positional Plagiocephaly

Congenital Muscular Torticollis and Positional Plagiocephaly

Congenital Muscular Torticollis and Positional Plagiocephaly

On the basis of observational studies, child health practitioners in primary care settings should consider the diagnosis of congenital muscular torticollis (CMT)in infants with risk factors from birth history for intrauterine malpositioning or constraint (C). On the basis of observational studies, CMT is often associated with other conditions, including positional plagiocephaly and gross motor delays from weakened truncal muscles and/or lack of head control in early infancy (C). On the basis of observational studies, child health practitioners should counsel parents that infants should be on their stomachs frequently whenever they are awake and under direct adult supervision to develop their prone motor skills (C). On the basis of consensus, early identification of CMT(with or without positional plagiocephaly) and prompt referral to a physical therapist experienced in the treatment of CMT should be considered to avoid more costly or invasive treatments, such as cranial orthoses or surgery (D).

Could idiopathic osteosclerosis have correlations with palatally impacted maxillary canines?

AIM: To investigate the association between palatally impacted maxillary canines (PIC) and idiopathic osteosclerosis. METHODS: A sample of 54 subjects (28 females and 26 males, mean age of 12.98±1.59 years) with PIC was selected from the records of 1,650 orthodontic patients treated at the Discipline of Orthodontics clinics at the Dental School of the Pontifical Catholic University of Parana (PUCPR), in Curitiba, PR, Brazil. A control group of 54 subjects with normally erupted canines was also selected from the same files (mean age of 12.93±1.58 years). Panoramic, lateral skull, postero-anterior skull, periapical and occlusal radiographs, as well as stone casts of the patients were examined. The Kolmogorov-Smirnov test revealed a normal distribution of gender and age in the groups. The results were analyzed with the Chi-square test (α=0.05). RESULTS: There were no statistically significant differences (p>0.05) between the groups. Four patients from each group had idiopathic osteosclerosis (7.41%), a rate that falls in the prevalence range reported in the literature. CONCLUSIONS: No correlation was observed between palatally impacted maxillary canines and idiopathic osteosclerosis.

Dosisreduktion unter Betrachtung der erforderlichen Bildqualität - Wie viel Dosis braucht ein Bild?

Today, imaging of nose, paranasal sinuses and temporal bone by CT is standard in preoperative diagnostics. The need of reduction of applied dosage leads to the necessity of research in necessary imaging quality. Therefore this paper deals with new developed anatomical checklists and the analysis of imaging quality on anterior and lateral skull base. With 3 human complete heads over 400 examinations were performed on one cone beam CT device under varying x-ray-tube adjustments. 31 anatomic parameters were evaluated (Excellent, well, poor, not evaluable) for every data set. A summation score was built for every examination. As well for paranasal sinuses as for temporal bone a constant excellent imaging quality could be seen in high dosages. Certainly, in low dosages a reduction of imaging quality was detected. The optimal range (all parameters visualized well as average) could be evaluated for paranasal sinuses between 2,0 and 3,0 mGy and between 3,0 and 4,0 mGy for temporal bone. So, a reduction of 70-80% in comparison to highest adjustments of today is possible and realistic. In comparison to standard protocols, a reduction of about 50% can be reached. The possibility of dose reduction by discussion of the necessary imaging quality from clinical point of view could be shown.

Anterior and medial angulations of the styloid process in subjects with TMD: clinical and radiographic findings

This study investigated the existence of association between the angulation of the styloid process on the anterior and medial directions with the intensity of temporomandibular dysfunction (TMD) symptoms. Fifty patients (8 men and 42 women) aged 25 to 70 years, with relevant TMD symptoms were evaluated. Clinical examinations were performed to determine the severity of TMD symptoms (orofacial pain, headache, tinnitus and dizziness) based on the RDC/TMD criteria and the visual analogue scale (VAS), and digital radiographic images of the styloid process were obtained: lateral cephalometric skull radiograph (analysis of anterior angulation) and posteroanterior skull radiograph (reverse Towne's projection) (analysis of medial angulation). The anterior angulation average of the styloid process was 20.89° while the medial angulation average was 19.1° in the right side and 19.04° in the left side. There was no statistically significant difference among the patient groups (severe, moderate and mild symptoms) associating the TMD symptoms and the anterior or medial angulation of the styloid process (p>0.05). There was no correlation between the intensity of the TMD symptoms and the measurements of anterior and medial angulation of the styloid process using either lateral cephalometric or posteroanterior radiographs (reverse Towne's projection).

Cervicofacial and Cervicothoracic Rotation Flaps: An Update

Objective: 1) Understand the indications for use of the cervicofacial and cervicothoracic advancement flaps in head and neck reconstruction. 2) Learn the surgical technique for constructing cervicofacial and cervicothoracic advancement flaps in head and neck reconstruction. 3) Describe the varying defects that can be reconstructed with cervicofacial and cervicothoracic advancement flaps. Method: Retrospective review of medical records at a university-based head and neck cancer center. Patients were operated on between 2001 and 2012. Patients had varying lesions that were amenable to cervicofacial and/or cervicothroacic advancement flaps. After a thorough description of indications and defect locations, complications and flap viability were evaluated. Results: Sixty-nine patients were identified, with a mean age of 66 years. Primary or recurrent skin neoplasms made up the most common surgical indication, followed by primary parotid tumors and cervical metastases from aerodigestive tract malignancies. Defects of the cheek, orbit, periauricular region, and neck were reconstructed with cervicofacial or cervicothoracic flaps. Larger wounds required extension of the incision onto the chest wall. Other reconstructive modalities were used in 38 cases to increase tissue bulk or provide internal lining. Minor wound complications occurred in 15 patients. There was no statistically significant association between wound complications and smoking or previous radiation therapy. Conclusion: Compound cervicofacial and cervicothoracic rotation flaps provide a straightforward, reliable, and efficient means to reconstruct compledefects of the face, lateral skull.

Mini-screw implant or transpalatal arch-mediated anchorage reinforcement during canine retraction: A randomized clinical trial

To compare mesial movement of upper first molars during maxillary canine retraction using a pre-adjusted edgewise appliance provided by anchorage reinforcement and a transpalatal arch or mini-screw implant. Randomized clinical trial. Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, India. From a cohort of subjects requiring the extraction of both upper first premolars and pre-adjusted edgewise appliances to correct their malocclusion, a total of 30 were randomly allocated to receive two different forms of anchorage reinforcement: group A--receiving mini-screw implant and group B--receiving a transpalatal arch Group A subjects received titanium mini-screw implants placed at the start of treatment between the maxillary second premolar and maxillary first molar. Maxillary second premolars were secured to the mini-screw implants using of 0.010-inch stainless steel ligature wire. Group B subjects received a custom-made transpalatal arch which was soldered to maxillary first molar bands. Active canine retraction was initiated in both groups on placement of a 0.019×0.025-inch stainless steel archwire using nickel titanium closed coil springs. Mesial movement of the upper first molars as measured on pre- (T1) and post-treatment (T2) lateral skull radiographs. The results showed that in group A the mean mesial movement of the first molars between T1 and T2 was 0.0 mm (SD 0.02; P = 0.90), whereas in Group B there was a mean forward movement of the first maolars of 2.48 mm (SD 0.71; P<0.001). In this trial, mini-screw implants placed prior to levelling and aligning were able to provide absolute anchorage during maxillary canine retraction, in contrast to a transpalatal arch.

Factors influencing compliance with continuous positive airway pressure ventilation in obstructive sleep apnea syndrome

Positive pressure ventilation is considered first line therapy in obstructive sleep apnea syndrome however compliance is limited by various factors. We aimed to investigate possible factors influencing compliance. One hundred and forty patients were prescribed positive pressure ventilation for obstructive sleep apnea during June 2006-June 2008. Of these patients, 77% (n= 108) were reached by telephone and a questionnaire was administered regarding factors influencing treatment compliance. Airway passage was measured with C2 vertebrae level and narrowest airway passage on lateral skull radiographs. The mean age was 52.2 ± 12.3 years. Seventy one percent (n= 77) of subjects obtained the prescribed device. There was no difference in sex, age, marital status, educational level, symptoms, co-morbid conditions, and social security coverage between the subjects who have received the prescribed devices and who have not (p> 0.05). No difference was detected between these two groups of patients in view of Epworth sleepiness scale (ESS) and apnea hypopnea index (AHI). Mean duration of device usage was 6.3 ± 2.3 hours. The device use compliance was not affected by any of the following factors: age, gender, level of education, co-morbid diseases, ESS score, AHI, airway passage measurements, application of humidification and education concerning the device (p> 0.05). Patient (p= 0.057) and bed partners (p= 0.001) satisfaction about the device yielded higher compliance rates. Factors influencing compliance rates in obstructive sleep apnea syndrome seems to be related to satisfaction about the device use however upper airway morphology measured with C2 vertebrae level and narrowest airway passage has no impact on treatment compliance.

Feasibility of a novel material for the reconstruction of skull base in a canine

To explore the therapeutic efficacy of a novel complex material of shape-memory alloy brace and artificial dura (nitinol brace and NormalGEN) for the reconstruction of skull base in a canine model with lateral media skull base defect. The complex of nitinol brace and NormalGEN was developed with corresponding apparatus. A common adult dog model with lateral media skull base defect was established and then reconstructed with the complex. At Month 3 post-operation, cranial lateral radiographic projection, three-dimensional reconstruction of computer tomography, 1.5T magnetic resonance imaging and histopathological examination were detected. Five animal models and cranial reconstructions were made. All survived without any complication, such as leakage of cerebrospinal fluid, local tissue eminence and neurological function defect. The imaging detection showed that nitinol brace was distinct and satisfactorily positioned without shift and artifact. And histopathological examination showed that granulation tissue substituted NormalGEN and grew around the brace with numerous fibroblasts. The complex of shape-memory alloy brace and artificial is suitable for the reconstruction of skull base on dog model with lateral media skull base defect.

SU‐E‐I‐79: Patient Doses Reduction in Simple Radiographic Examinations in Busy Radiology Departments

Purpose: To reduce entrance surface air Kerma (ESAK) of routine radiological examinations in some heavy loaded radiology departments using proper equipments and training.Methods: ESAK for 12 routine radiographic examinations has been measured in 10 high loaded radiology departments belonging to country main health insurance organization after quality control for x_ray units and proper training for all radiographers of each departments to use proper technical charts for each room, mainly according to EUR 16260 and optimized exposure factors. The ESAK were measured according to X‐ray tube output, optimized exposure parameters including tube potential(kVp), tube current (mA), focus to skin distance (FSD) for each technique. Results: .The mean reduced ESAK values after optimization of exposure parameters for abdomen, AP and lateral cervical spine, PA and lateral chest, AP and lateral lumbar spine, pelvis, PA and lateral skull, AP and lateral thoracic spine 4.61, 1.19,1.20, 0.26, 0.59 4.63, 6.56, 4.23, 2.90, 2.55, 3.89 and 4.94 mGy, respectively. There were very significant reduction in ESAK by a factor of 36% for abdomen,28% and 35% for AP and lateral cervical spine,62% and 60% for PA and lateral chest, 41% and 53% for AP and lateral lumbar spine, 35% for pelvis, 27% and 22% for AP and lateral skull, 47% and 53% for AP and lateral thoracic spine. Mean, median, first and third quartile of values of ESAK are reported. Conclusion: Significant dose reduction was achieved with proper and simple training and without considerable change in repeat and reject analysis. This reasonable outcome will lead us to establish optimized National Diagnostic Reference Levels (NDRLs).

Comparison of value of MR and CT and different staging system in the diagnosis of nasopharyngeal carcinoma

Objective To evaluate the value of MR and CT examinations in the diagnosis of nasopharyngeal carcinoma (NPC) and compare 2008 staging system with 1992 staging system and 2002 UICC staging system for NPC. Methods MR and CT images of seventy-six cases with NPC were studied. According to 2008 staging system and taking MR as a standard, differences between these two examinations were evaluated under the new NPC staging system, and three staging system were compared by MR findings. Results MR was inconsistent with CT in eveluating invasion of medial pterygoid muscle(22,24 cases), lateral pterygoid muscle( 15, 11 cases), skull base(35, 32 cases) and intracranial fossa( 11,6 cases), but no statistical diffence existed ( P ＞ 0. 05 ). There were statistical difference ( P ＜ 0. 05 )between MR and CT in determining invasion of parapharyngeal space( 50, 61 cases), retropharyngeal lymph node metastasis(48, 23 cases), stage T1 (18, 11 cases), T2 (15, 22 cases), N0 (18, 24 cases) and N1(33, 27 cases) with differences of 11 cases, 25 cases, 7 cases, 7 cases, 6 cases and 6cases respectively.For invasion of parapharyngeal space, CT showed 11 cases more than MR while 5 cases were comfirmed as compression by local tumor and 6 cases were proved as retropharyngeal lymph node metastasis according to MR. For retropharyngeal lymph node metastasis, MR presented 25 cases more than CT. These two reasons above mainly caused the differences of T-staging and N-staging. For 2008 staging system, when compared with 1992 staging system, there were 9 cases upstaging and 1 case downstaging in T classification, 16 cases upstaging in N classification, and 15 cases upstaging and 1 case downstaging in clinical classification; and when compared with 2002 UICC staging system, there were 7 cases, 10 cases and 12 cases upstaging in T,N, and clinical staging respectively. Conclusions Compared with MR examination which was regarded as standard by 2008 staging system of NPC, there were some differences in demonstrating invasion of parapharyngeal space and retropharyngeal lymph node metastasis by CT. Compared to 1992 staging system and 2002 UICC staging system, 2008 staging system mainly made T and N classification of tumor upstage,resulting in upstaging in clinical classification. Key words: Nasopharyngeal neoplasms; Neoplasm staging; Magnetic resonance imaging; Tomography, X-ray computed