ABSTRACT
The authors report their original observations of rare and difficultto diagnose atypical localization of the petrosquamosal venous sinusis in the patients presenting with chronic suppurative otitis media. Such localization of this sinus was shown to hamper surgical interventions for sanative treatment.
Subject(s)
Cholesteatoma , Otitis Media, Suppurative , Cholesteatoma/diagnosis , Chronic Disease , Humans , Otitis Media, Suppurative/surgery , Paranasal Sinuses , SuppurationABSTRACT
Computed tomography (CT) was made in 25 patients with otitis media purulenta chronica (OMPC). Of them 17 patients had meso- or mesoepitympanitis and 8 patients had the history of radical operations on the ear. At first, CT was made of the temporal bone without contrast medium, then with instillation of the contrast medium through the external acoustic meatus and tympanic cavity into the auditory tube. Native computer tomograms of the temporal bones of 43 persons without any middle ear pathology were used as control. Non-contrast computer tomograms showed air in the lumen of the bone part of the auditory tube of all the examinees. It was impossible to obtain the image of the cartilage part of the auditory tube. None of 25 OMPC patients showed the signs of peritubal pneumatisation while it was registered in 14 healthy controls. By CT data, 14 of 17 patients with perforative OMPC had passable auditory tube even in aggravated inflammatory process, 3 of them had unpassable one. All 8 patients after radical operation had unpassable auditory tube. Thus, the method of contrast computer tomography determines passability of the auditory tube in the direction from the tympanic cavity to the nasopharynx and specifies the level of obstruction that is important to know before hearing improving operations of tympanoplasty type. Evaluation of the drainage function of the auditory tube basing on the time of evacuation of the contrast medium from the tympanic cavity to the nasopharynx was declared useless.
Subject(s)
Ear, Inner/diagnostic imaging , Otitis Media, Suppurative/diagnostic imaging , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Chronic Disease , Female , Humans , Male , Middle AgedABSTRACT
The diagnostic sensitivity of USI for localization of a tumor of the pancreatic head was 89.3%, specificity--69.7%, exactness--84.4%. When the tumor was localized in the body-tail these indices were 85.7%, 73.4% and 78.7% respectively. The sensitivity of CT in cases when the localization of the tumor was in the head of the pancreas was 84.9%, specificity--72.2%, exactness--76.5%. When the tumors were localized in the body-tail these indices were 89.5%, 75.4% and 80.9% respectively. An associated analysis of information of the ultrasound and CT concerning the structure of the pancreas made the exactness of the diagnosis of malignization as high as 87.6%, specificity as high as 81.3%, sensitivity as high as 93.7%. The informative value of USI and CT depended on the tumor size, the presence of an inflammatory reaction of the pancreas, the character of a complication, if any, or of their combinations, localization and size of the pathological focus. In the investigation no alterations in the pancreas characteristic only of cancer were found. Thus, a comparison of diagnostic potentials of USI and CT has shown that one method does not exclude, but only supplements the other. CT gives more reliable results in the assessment of the process spread to the surrounding tissues and regional lymph nodes, especially when the tumor is localized in the area of the pancreas tail. USI helps to make more exact assessment of the involvement in the process of the common bile duct, pancreatic duct, and of the visceral vessels by the Doppler examination.
