Computed tomography of healing condylar fractures with some clinical correlations.

A longitudinal study using computed tomographic (CT) examinations has been performed in 79 patients with condylar fracture of the temporomandibular joint (TMJ). CT scans were performed following healing to demonstrate the new condylar shape. Maximal incisor distance was measured in all patients. Patients with mild deformities of the condyles had satisfactory function of the TMJs with a maximal distance between the incisors that was similar to 50 healthy controls (average 45 mm). Fifteen patients with severely deformed condyles and an abnormal shape of the glenoid fossa had an average maximal distance between the incisors of 16 mm which corresponded with severe malfunction of the TMJs. The remaining 42 patients with moderate condylar deformity had an average maximal distance between the incisors of 29 mm and the disability of the TMJs was considered to be moderate. The results were statistically significant. There was no resorption of the fractured condylar head or bone fragment. The correlation of the fractured head or fragment and the remodelling of the condyle during the healing process determined the final alignment of the fractured condyle to the glenoid fossa on which the TMJs' function was dependent.

CT evidence of mucosal thickening in the maxillary antra in patients with nasopharyngeal carcinoma.

CT scans of the maxillary antra in a group of 51 patients with nasopharyngeal carcinoma were compared with those of a control group of 50 patients. Inflammatory thickening of the antral mucosa was demonstrated in 39 of 42 patients with grade WHO (World Health Organization) 2 and 3 nasopharyngeal carcinoma. Biopsy of the antral mucosa in eight of these patients established inflammation and excluded the presence of nasopharyngeal carcinoma in the antrum. In a group of nine patients with WHO 1 tumors, the antral mucosa was normal. Thickening of the antral mucosa was observed in six patients of the control group. The inflammatory thickening of the antral mucosa in the patients with WHO 2 and 3 tumors was obviously more frequent than in the control group. This combination was not found in patients with WHO 1 tumors. The phenomenon cannot be explained by direct extension of nasopharyngeal carcinoma or obstruction of the maxillary osteum. The cause of the mucosal thickening may be immunologic, but remains unclear at this stage. The high frequency of inflammatory thickening of the antral mucosa observed in patients with WHO 2 and 3 tumors should encourage further investigation of causative factors in nasopharyngeal carcinoma.

Epilepsy in patients with brain metastases triggered by intravenous contrast medium.

187 patients with histologically proven primary neoplasms underwent computed tomography (CT) of the brain following intravenous administration of contrast medium. Eight developed focal epileptic seizures 2 to 4 minutes after the start of the injection. In three of these patients, in whom there was CT evidence of bilateral mass lesions of the brain, this epileptic activity became generalised into grand mal seizures, and two died in status epilepticus. In the other five patients with unilateral deposits in the brain, the focal fits corresponded to the site of the lesion shown by CT. Three of the patients had follow-up electroencephalography (EEG) examinations which showed unilateral focal activity, and their EEG foci correlated with the CT findings.

Focal epileptic activity following intravenous contrast material injection in patients with metastatic brain disease.

Four patients with metastatic brain disease were referred for computed tomographic (CT) examination with contrast material injection. Within 2 to 4 minutes after the intravenous administration of water soluble contrast agent, focal epileptic activity occurred. The seizures became generalised in two of the patients who later died following status epilepticus. In the other two patients the focal seizures correlated with the localisation of the metastatic mass lesions. None of the patients had a previous history of epilepsy.

Computerized tomographic findings in the temporomandibular joint in patients with psoriatic arthritis.

Three male patients with psoriatic arthritis of the temporomandibular joint (TMJ) were evaluated by computerized tomography (CT). Only one patient showed changes of the mandibular condyle on the panoramic view, which failed to show the condition in the other 2 patients. All 3 had normal conventional radiographs of the affected TMJ. In all 3 cases the high resolution CT scan demonstrated significant changes of the mandibular condyle and glenoid fossa, which were consistent with the clinical diagnosis of psoriatic arthritis of the TMJ.