RESUMO
This prospective study based on 48 patients showed that FDG-PET has a significantly higher sensitivity for the detection of lymph node metastases compared with palpation and it appears that FDG-PET has a similar sensitivity to CT-scanning. According to our data, FDG-PET is a highly specific method in the evaluation of neck nodes. This new imaging technique allows a tridimensional study and is easy to interpret. Therefore, FDG-PET seems to be a valuable imaging technique for the detection of cervical lymph node metastasis.
Assuntos
Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Desoxiglucose/análogos & derivados , Linfonodos/patologia , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/patologia , Orofaringe/patologia , Tomografia Computadorizada de Emissão , Vértebras Cervicais/patologia , Feminino , Fluordesoxiglucose F18 , Humanos , Linfoma/diagnóstico , Linfoma/patologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/patologia , Tomografia Computadorizada por Raios XRESUMO
The distribution of specific radiolabeled biological compounds in tumor tissues can be imaged by positron emission tomography (PET). The substance used is fluorodeoxyglucose, labeled with the positron emitter fluorine-18. This substance is partly trapped in tumor cells with increased glucose metabolism. This noninvasive imaging technique allows to assess quantitatively and in three dimensions the extent of metastatic disease in ENT cancer. The case presented illustrates the important value we foresee for this new imaging modality in the presurgical staging of cervical metastatic disease of ENT tumors. Sensitivity and specificity of the PET-FDG imaging technique for the loco-regional staging of ENT cancer are, according to preliminary results of an ongoing, prospective clinical study, very high.
Assuntos
Neoplasias Otorrinolaringológicas/diagnóstico por imagem , Tomografia Computadorizada de Emissão , Idoso , Terapia Combinada , Desoxiglucose/análogos & derivados , Feminino , Fluordesoxiglucose F18 , Humanos , Metástase Linfática/diagnóstico por imagem , Pescoço , Estadiamento de Neoplasias , Neoplasias Otorrinolaringológicas/patologia , Neoplasias Otorrinolaringológicas/terapia , Dosagem Radioterapêutica , Radioterapia de Alta EnergiaRESUMO
Mastoid tympanoplasty with a canal wall-up technique provides better conditions for a healthy skin lining than canal wall-down techniques. The formation of retraction pockets in residual pneumatized cavities is however a major cause of cholesteatoma recurrence with canal wall-up techniques. We have therefore attempted to combine the advantages of both canal wall-down and canal wall-up techniques. The posterior wall is kept up, the mastoid is obliterated with adipose tissue, the attic is exteriorized in the ear canal and hearing is restored with a minimal-size hypotympanic cavity only. Preliminary results from 41 cases with a follow-up of 6 months to 6 years suggest that skin conditions in the enlarged ear canal are adequate and that cholesteatoma do not recur.