Computerised tomography of the head and neck - abstract

The main advantage of computerised tomography (CT) over conventional radiography is the supreme ability to distinguish radiologically between different soft tissue densities, while simultaneously producing images with extremely sharp bony detail. With each succeeding generation of scanners have come faster scanning times, increased capability in software and the ability to RECONSTRUCT images on different planes from data stored in the computer. It is now possible to visualise and magnify minute, complex anatomical areas such as the middle ear - areas not previously clearly visible by conventional radiography. Close co-operation between the otolaryngologist and the radiologist is mandatory - the one to define the problem, the other to apply the most relevant technology to visualise it. With such co-peration, the otolaryngologist is better able to define submucosal spread of inflammatory or malignant disease in the head, sinuses and neck, and/or the extent of lymph node metastasis in the neck. Fractures involving the skull, facial skeleton and orbit, or the cartilaginous framework of the larynx in acutely traumatised patients, may now be easily visualised by CT scanning and the extent of displacement accurately assessed. This is a distinct advantage in planning and executing treatment. Patients with vertigo or migraine headaches, common symptoms in ENT practice, can now be safely evaluated with the aid of CT scan (AU)

Thymic cyst of the neck

A case of cervical thymic cyst in a 16-year old male is described. The lesion is quite rare and was seen for the first time at the University Hospital of the West Indies. The literature has been reviewed and the embryology and pathogtenesis of the condition have been discussed. A pre-operative diagnosis of thymic cyst in the neck is difficult and should be included in the differential diagnosis of swellings in the neck (AU)

The neck region of the spermatozoon of discus rotundatus (muller) (pulmonata, stylommatophora)

The neck region of the mature spermatozoon of discus rotundatus is described. No evidence for a centriole or centriolar derivative is obtained. Nine striated coarse fibres and the two central fibres of the axoneme extend into the base of the implantation fossa. The axonemal doublet system is disrupted in the neck region. There are two fibrous acessory structures located between the central doublet and the striated coarse fibres (AU)

Suppurative soft tissue infection of the head and neck

Antibiotics have modified the frequency and severity of seosis in the head and neck and continue to play the major role in therapy. Surgical treatment is of importance in decompressing sepsis in closed spaces in order to abort the additional tissue destruction which occurs from avascularity, in limiting the spread of infection and in terminating infection once suppuration has occurred. To be effective surgical intervention must be properly timed. Incisions should be large enough to accomplish adequate drainage and should be so placed as to minimize the resultant scarring. An understanding of the surgical anatomy of this area is essential in the management of these problems. Mention has been made of spread to the carotid sheath and down this sheath into the mediastinum. Carotid arterial and internal jugular venous thrombosis as well as suppurative pericarditis have been illustrated with case reports. The possibility of fatal haemorrhage from carotid arterial erosion has been mentioned. Suppurative infection in the head and neck is potentially lethal. The dangers of suppuration involving the face and lips have been re-emphasized and the possibilities of cavernous sinus thrombophlebitis and bilateral central retinal artery thrombosis have been recorded. Crepitant non-clostridial cellulitis has been discussed and attention has been drawn to the dangers of sub-aponeurotic infection of the scalp. The association of suppurative thyroiditis with carcinoma of the larynx has been once more recorded (AU)

Head and neck burn reconstruction

Two major aspects of burn face reconstruction is discussed: (10) reconstructive techniques usable in facial reconstruction and (2) several guiding principles underlying the application of such techniques