Résumé
BACKGROUND AND OBJECTIVES: The parapharyngeal tumors are rare and treated mostly by surgical removal. The preoperative diagnosis of parapharyngeal tumors is very important because the surgical removal of neurogenic tumor, which is the main mass in the parapharyngeal space, can induce severe complications. There are many diagnostic tools for parapharyngeal tumors and their effectiveness are variable. In this study, we focused on the diagnostic accuracy of each diagnostic tool. SUBJECTS AND METHOD: We compared the preoperative diagnostic results with the final pathologic reports of 56 parapharyngeal tumors. Diagnostic tools used were computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US), and fine needle aspiration biopsy (FNAB). RESULTS: The diagnostic accuracy of MRI, CT and US was 68.2%, 51.6% and 42.8%, respectively. The sensitivity (83%) and specificity (87.5%) of FNAB for neurogenic tumor are higher than those of MRI (75%, 50%). CONCLUSION: These results suggest that FNAB is the most precise and reliable diagnostic tool and MRI is the most reasonable and effective imaging study.
Sujets)
Biopsie , Cytoponction , Ponction-biopsie à l'aiguille , Diagnostic , Imagerie par résonance magnétique , Sensibilité et spécificité , ÉchographieRésumé
BACKGROUND AND OBJECTIVES: Middle ear barotrauma is a damage of the ear resulting from the pressure difference between the middle ear and the atmospheric environment. We investigated the effects of chewing gum and administering the systemic decongestant in hyperbaric oxygen therapy. MATERIALS AND METHOD: We investigated the cases of the middle ear barotrauma which came from hyperbaric oxygen therapy for finger replantation. We studied 81 patients without E-tube dysfunction. They were divided into three groups: the non-treated patients, the patients chewing gums and receiving high-pressure treatment, and the patients receiving the systemic decongestant. We investigated the patients for symptoms, otoscopic findings, tympanometry, and PTA. Otoscopic findings were classified by modified Teed classification. RESULTS: In the first group, 36 of 60 (60%) ears had otologic symptoms, 37 of 60 (62%) ears were above the grade 1, 31 of 60 (52%) ears were B or C type in tympanometry and 20 of 60 (33%) ears were above 20dB in AB gap (air-bone gap). In the second group, 23 of 60 (38%) ears had the otologic symptom, 26 of 60 (43%) ears were above the grade 1, 19 of 60 (32%) ears were the B or C type and 10 of 60 (17%) ears were above 20dB in AB gap. In the third group, 18 of 42 (43%) ears had the otologic symptoms, 19 of 42 (45%) ears were above the grade 1, 15 of 42 (36%) ears were the B or C type and 7 of 42 (17%) ears were above 20dB in the AB gap. CONCLUSION: The second group was better than the first group with regard to otologic symptom, otoscopic findings, tympanometry, PTA, and showed statistical significance. On the other hand, the third group was effective but did not show statistical significance.