[Sonography and scintigraphy in the diagnosis of cystadenolymphomas (warthin tumor)]. / Wertigkeit der Szintigraphie und der Sonographie in der Diagnostik der Zystadenolymphome der Glandula parotis.

BACKGROUND: Is scintigraphy in the preoperative diagnosis of cystadenolymphomas dispensable? PATIENTS AND METHODS: In this prospective study 35 patients with tumors of the parotid gland were examined sonographically and scintigraphycally and the results were compared with the histological findings. RESULTS: By means of sonography 88 % (22/25) of the cystadenolymphomas were correctly diagnosed and by means of scintigraphy 80 % (20/25). CONCLUSIONS: Sonography is recommendable as the first-line diagnostic procedure in cystadenolymphomas because it is without radiation load, the free choice of the echographic plane, and it can be repeated as often as desired. Scintigraphy adds in selected cases, as in elder patients, additional informations. The combination of sonography and scintigraphy confirms the presence of cystadenolymphoma and allows the surgeon to make a decision and to avoid surgery especially in high-risk patients.

Massive epistaxis after rupture of intracavernous carotid artery aneurysm. Case report.

We present a case of massive epistaxis caused by an internal carotid artery aneurysm. The initial treatment with endovascular balloon embolization failed as a result of balloon displacement. After rebleeding, the intracavernous aneurysm was treated with an endovascular detachable balloon embolization technique, which resulted in cessation of epistaxis. The different treatment options for interventional radiology and management of ruptured carotid artery aneurysms are discussed.

[Value of B-image ultrasound in diagnosis of paranasal sinus diseases in comparison with computerized tomography]. / Wertigkeit der B-Bild-Sonographie in der Diagnostik von Nasennebenhöhlenerkrankungen im Vergleich zur Computertomographie.

BACKGROUND: In diagnostic imaging of the paranasal sinuses, the A-mode technique is increasingly being substituted by B-mode ultrasonography. To assess the value of B-mode sonography we compared in a double-blind study computed tomography with our ultrasound findings. PATIENTS AND METHODS: Seventy-eight patients were examined by CT and subsequently by ultrasound, two-thirds before endonasal surgery and one-third for diagnosis of serious facial pain and swelling. RESULTS: Among 114 pathological maxillary sinus tomograms, 83 findings could also be diagnosed by ultrasound (sensitivity 72.8%). In the frontal sinuses only 12 of 52 of pathological findings could be detected (23.1%) and only 9 of 80 in the frontal ethmoid (11.3%). Except for circumscribed polyps and moderate general swelling of the mucosa, the detection rate by sonography was 97.4% for the maxillary sinuses, 31.5% for the frontal and 18% for the ethmoid sinuses. CONCLUSIONS: Ultrasound usually only demonstrates the presence of absence or unspecific findings. Differential diagnosis between tumors and sinusitis is generally difficult. The healthy individual is correctly assessed as healthy due to the total reflection of the air-filled healthy sinus. According to our findings ultrasound has a certain value in the diagnosis of maxillary sinuses. It can be used to obtain a preliminary diagnosis and as a screening method although a negative result never excludes a disease of the sinuses. As it does not involve radiation exposure, ultrasonography can be recommended as first step in diagnosis for children, pregnant women, and young women especially in acute sinusitis, because in acute sinusitis the maxillary sinuses are generally affected.