DOCSLIB.ORG

45-52 Imaging Diagnosis.P65

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
45-52 Imaging Diagnosis.P65 Review Article Imaging diagnosis of nasopharyngeal tumors IMAGING DIAGNOSIS OF NASOPHARYNGEAL TUMORS* Ilka Yamashiro1, Ricardo Pires de Souza2 Abstract The nasopharynx is located in the upper aerodigestive tract. Its roof is formed by the basisphenoid, basiocciput and the anterior aspect of the first two cervical vertebrae, in front of the clivus. The lateral walls are formed by the margins of the superior constrictor muscle and the pharyngobasilar fascia, pharyngeal recess, torus tubarius and pharyngeal opening of auditory tube. The inferior margin of the nasopharynx is a horizontal plane passing through the hard palate and palatopharyngeal muscle. Anteriorly, it is in direct continuity with the nasal cavity through the posterior choanae. It is approximately 2.0 cm in anteroposterior diameter and about 4.0 cm in craniocaudal extent. Squamous cell carcinoma accounts for about 70% to 98% of nasopha- ryngeal malignant lesions found in adults. This tumor presents a high incidence in Asians, most frequently in men, and is the third most frequent cancer in women. The clinical presentation of this disease depends on the size and site of the lesion, with small-sized lesions being asymptomatic. Computed tomography and magnetic resonance imaging play essential and complementary roles in the staging and treatment of pa- tients with nasopharyngeal cancer. Keywords: Computed tomography; Nasopharynx; Tumor; Carcinoma. Resumo Diagnóstico por imagem dos tumores da nasofaringe. A nasofaringe é a parte mais superior das vias aéreas superiores. Seu limite superior é a base do osso esfe- nóide e occipital, situa-se anteriormente às duas primeiras vértebras cervicais e à frente do clivo. Seus limi- tes laterais são formados pelas margens do músculo constritor superior da faringe e pela fáscia faringobasi- lar, recessos faríngeos, toro tubário e tuba auditiva. O limite inferior é um plano horizontal que passa pelo palato duro e pelo músculo palatofaríngeo. Anteriormente, comunica-se com a cavidade nasal via coana posterior. Mede cerca de 2,0 cm de diâmetro ântero-posterior e cerca de 4,0 cm de extensão crânio-caudal. O carcinoma de células escamosas compreende aproximadamente 70% a 98% de todas as neoplasias ma- lignas da nasofaringe em adultos. Este tipo de tumor apresenta alta incidência na população asiática, sendo mais comum entre os homens e o terceiro mais comum entre as mulheres. A manifestação clínica do carci- noma da nasofaringe depende do tamanho da lesão e da sua localização, sendo que as lesões de pequenas dimensões são geralmente assintomáticas. A tomografia computadorizada e a ressonância magnética de- sempenham papel essencial e complementar no estadiamento e no tratamento dos pacientes portadores de câncer da nasofaringe. Unitermos: Tomografia computadorizada; Nasofaringe; Tumor; Carcinoma. ANATOMICAL SUBSTRATE riorly, and the carotid spaces laterally. The membrane, and does not represent a signifi- inferior margin of the nasopharynx is a cant barrier to neoplastic or infectious dis- The nasopharynx is the upper part of the horizontal plane passing through the hard semination from the nasopharynx into ad- superior aerial tract, and corresponds to the palate and palatopharyngeal muscle. Later- jacent spaces(3,4). Laterally, it covers the superior end of the pharynx. It contains the ally, it is limited by the margins of the su- pharynx, superiorly inserting into the skull lateral pharyngeal recess, the torus tubarius perior constrictor muscle, the pharyngo- base through the pharyngeal tubercle, with and the pharyngeal tonsil. basilar fascia and by the parapharyngeal the superior constrictor muscle, pharyngo- The nasopharynx is situated at the cen- space(1). Its wall is formed by three layers: basilar fascia, and in the posterior margin ter of the skull base. The anatomical rela- a mucous lining, a muscular layer and a of the medial pterygoid plate. tions of the nasopharynx include the clivus fibrous membrane denominated pharyngo- The structural protrusion and the tissues posteriorly, the posterior nasal cavity ante- basilar fascia. of the pharyngeal wall give shape to the It is approximately 2.0 cm in anteropos- mucosal lining of the nasopharynx, deter- terior diameter and about 4.0 cm in cranio- mining anatomical landmarks utilized in * Study developed at Service of Diagnostic Imaging – Hospi- caudal extent(2). clinical evaluations and interpretation of tal Heliópolis Department of Radiology, São Paulo, SP, Brazil. 1. MD, Trainee at Service of Diagnostic Imaging – Hospital The middle layer of the deep cervical computed tomography (CT) and magnetic Heliópolis Department of Radiology, Master Degree Student in fascia or buccopharyngeal fascia is charac- resonance imaging (MRI) cross-sectional Health Sciences at Hospital Heliópolis. 2. Coordinator for Medical Residence in Diagnostic Imaging terized by a condensation of cellular tissue slices, as follows: a) torus tubarius – is the at Service of Radiology of Hospital Heliópolis. surrounding the lateral and posterior por- most prominent of these structures, corre- Mailing Address: Dra. Ilka Yamashiro. Rua Afonso Celso, 1637, ap. 33, Chácara Inglesa. São Paulo, SP, 04119-062 – Brazil. tions of the nasopharynx, providing it with sponding to a projection of the cartilagi- E-mail: [email protected] a fascial limit as an interface with the nous portion of the auditory tube. It is vi- Received October 28, 2004. Accepted after revision March 17, 2005. neighboring structures. It is a tender, subtle sualized as a protrusion projecting into the Radiol Bras 2007;40(1):45–52 45 Yamashiro Y, Souza RP lateral wall of the nasopharyngeal cavity, (palatopharyngeal, stylopharyngeal and Abundant lymphoid tissue in the chorium both on CT and MRI; b) pharyngeal ostium salpingopharyngeal), palatoglossus, tensor forms a part of the pharyngeal lymphatic of auditory tube – localized antero-inferi- palati and levator palati, and the palatopha- ring, a probable site for development of orly to the torus tubarius(5). On CT and MRI ryngeal muscle; non-Hodgkin lymphoma, the most frequent axial slices, it is observed as a small recess b) a fibrous structure or pharyngobasilar malignant nasopharyngeal neoplasm(2,10). in the nasopharynx lateral wall; c) The sal- fascia situated between the muscular tunica Smaller salivary glands are present in the pingopharyngeal fold, a mucosal protru- and mucosa, extending uninterruptedly sub-mucosa surrounding the auditory sion determined by the submucosal tract of from the upper to the lower end of the phar- tubes, and might be a focus for benign or the salpingopharyngeal muscle forming the ynx, absent in the anterior portion, except malignant nasopharyngeal lesions. anterior limit of the lateral pharyngeal re- in the attachment to the larynx where it is The knowledge of anatomical variations cess; d) the lateral pharyngeal recess, pos- circular(1). Cranially, where its external sur- of this region is important to avoid confu- teriorly located, and extending superiorly face is not covered by a muscular layer (be- sion between normal alterations and dis- to the salpingopharyngeal fold and torus tween the skull base and the inferolateral ease. tubarius (Figures 1 and 2). It is the most fre- portion of the auditory tube cartilage), there Asymmetry of mucosal landmarks, es- quent site of origin for nasopharyngeal is a lateral space denominated Morgagni pecially the pharyngeal recess asymmetry, squamous cell carcinoma(6). It originates in sinus. It is through this space that the au- is a frequent variation. A decrease in depth a subtle mucosal herniation through the ditory tube and the levator palati penetrate of the pharyngeal recess, or even its col- Morgagni sinus, a region on the pharyngeal into the nasopharynx internal portion. The lapse as a normal finding should be differ- wall where muscular fibers are absent. The Morgagni sinus, because of its anatomical entiated from disease. The analysis of ad- degree of distensibility is highly variable. characteristic, is an important route for the jacent, deep planes showing their integrity It tends towards being symmetrical, al- carcinoma dissemination from the na- or symmetry suggests normality (Figure 3). though subtle asymmetries are not uncom- sopharynx towards adjacent spaces like the Also, the acquisition of CT images during mon to be found at MRI and CT(7). In parapharyngeal space; modified Valsalva maneuver or wide open- youngsters, it presents with less amplitude c) a mucosal membrane or internal tu- ing of the mouth might be useful. The because of the presence of retropharyngeal nica lining internally the pharyngobasilar modified Valsalva maneuver results in a lymphoid tissue(8). fascia, continuing with the mucosal lining maximum distention of the auditory tube The nasopharynx is formed by: of the nasal cavity and oropharynx. It is ostium and pharyngeal recess. The wide a) A muscular layer formed by the up- formed by ciliated pseudo-stratified epithe- opening of the mouth distends the pharyn- per, middle and lower pharyngeal constric- lium and chorium with a plenty of mucipa- geal recess and increases the auditory tube tor muscles, pharyngeal levator muscles rous glands and lymphoid follicles(9). ostium depth(7). Figure 1. Scheme of axial view, in slightly different planes: SM, maxillary sinus; TM, middle Figure 2. Contrast-enhanced CT axial view: normal anatomy. SM, turbinate; P, posterior choana; N, nasopharynx; LM, medial pterygoid lamina; F, pterygoid maxillary sinus; TM, middle turbinate; P, posterior choana; N, fossa;
Load more

Recommended publications
  • Fossa of Rosenmüller Rosenmüller
    Quick Review: Fossa of pharyngeal recess or the fossa of Rosenmüller Rosenmüller. The nasopharynx is a fibromuscular sling suspended from the skull base. The human nasopharynx is mainly derived from the primitive pharynx. It represents the nasal portion of the pharynx behind the nasal cavity and above the free border of the soft palate. The nasopharynx communicates with the nasal cavities through posterior nasal apertures. The choanal orifices along with the posterior edge of the Saggital section of the postnasal space (L E Loh et al 1991) nasal septum form the anterior boundary of the nasopharynx. The The superior constrictor muscle does superior surface of the soft palate not reach the base of skull hence a constitutes its floor and lateral gap (sinus of Morgagni) is velopharyngeal isthum provides created. Fossa of Rosenmüller is a communication between nasopharynx herniation of the nasopharyngeal and oropharynx. The body of mucosa through this deficiency sphenoid, basiocciput and first and between skull base and superior most second cervical vertebrae combine to fibers of the superior constrictor form roof of the nasopharynx. muscle. Through this gap bridged only by the pharyngobasilar fascia, the The part of nasopharynx proximal to eustachian tube enters the the tubal orifice is innervated by the nasopharynx with its two muscles, one maxillary division of the trigeminal (V) on each side. Along the inferior border nerve, and that posterior to the tubal of the two muscles the Fossa of orifice by the glossopharyngeal (IX) Rosenmüller is separated from the nerve. parapharyngeal space by mucosa and pharyngobasilar fascia. Functional studies with contrast and cinefluorography reveal structural The borders of the Fossa of differences between the two Rosenmüller are: components.
    [Show full text]
  • Anatomy, Histology, and Embryology
    ANATOMY, HISTOLOGY, 1 AND EMBRYOLOGY An understanding of the anatomic divisions composed of the vomer. This bone extends from of the head and neck, as well as their associ- the region of the sphenoid sinus posteriorly and ated normal histologic features, is of consider- superiorly, to the anterior edge of the hard pal- able importance when approaching head and ate. Superior to the vomer, the septum is formed neck pathology. The large number of disease by the perpendicular plate of the ethmoid processes that involve the head and neck area bone. The most anterior portion of the septum is a reflection of the many specialized tissues is septal cartilage, which articulates with both that are present and at risk for specific diseases. the vomer and the ethmoidal plate. Many neoplasms show a sharp predilection for The supporting structure of the lateral border this specific anatomic location, almost never of the nasal cavity is complex. Portions of the occurring elsewhere. An understanding of the nasal, ethmoid, and sphenoid bones contrib- location of normal olfactory mucosa allows ute to its formation. The lateral nasal wall is visualization of the sites of olfactory neuro- distinguished from the smooth surface of the blastoma; the boundaries of the nasopharynx nasal septum by its “scroll-shaped” superior, and its distinction from the nasal cavity mark middle, and inferior turbinates. The small su- the interface of endodermally and ectodermally perior turbinate and larger middle turbinate are derived tissues, a critical watershed in neoplasm distribution. Angiofibromas and so-called lym- phoepitheliomas, for example, almost exclu- sively arise on the nasopharyngeal side of this line, whereas schneiderian papillomas, lobular capillary hemangiomas, and sinonasal intesti- nal-type adenocarcinomas almost entirely arise anterior to the line, in the nasal cavity.
    [Show full text]
  • Approach to the Upper Airway in the Field
    Approach to the upper airway in the field Sophie H. Bogers, BVSc, MVSc, PhD, DACVS-LA Session Description: This session will provide a general overview of approaches to the diagnosis of upper airway conditions. The use of endoscopy, radiography and ultrasound to distinguish between commonly confused conditions will be discussed. The indications and techniques for field upper airway surgery including tracheostomy and sinus trephination will be discussed. Speaker Notes: 1. The diagnostic approach to the upper airway case often follows a similar pattern. The results of the history, physical examination and resting endoscopy will allow you to focus more on techniques specific to the sinus or nasal passages or the larynx and pharynx 2. Endoscopy helps you to pin-point what structures in the upper airway are affected. There are exceptions if you don’t have an endoscope e.g. for suspected dental sinusitis that causes foul smelling nasal discharge an oral examination can be done first and if no obvious occlusal abnormalities are seen then endoscopy can be performed after to confirm that the drainage is coming from the paranasal sinuses. a. The endoscopic examination should be thorough with assessment of all of the structures below: i. Larynx (make swallow several times – see EE/subepiglottic cyst/abduction of arytenoid maximal) 1. Assessment of larynx when not sedated (may sedate for remainder) ii. Trachea iii. Dorsal pharyngeal recess and pharynx iv. Guttural pouch 1 v. Ethmoid turbinates vi. Sinus drainage angle vii. Nasal passage 1 – nasal septum, ventral conchal bulla viii. Change sides 1. Guttural pouch 2 2. Nasal passage 2 b.
    [Show full text]
  • Radiological Profiles of Nasopharyngeal Anatomy As Seen
    International Journal of Otorhinolaryngology and Head and Neck Surgery Rajamani SK et al. Int J Otorhinolaryngol Head Neck Surg. 2019 Nov;5(6):1489-1495 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20194604 Original Research Article Radiological profiles of nasopharyngeal anatomy as seen in computed tomography scans of normal patients undergoing brain scans for other neurological problems in Konkani population Santhosh Kumar Rajamani1, Nayanna Karodpati2*, Dilesh A. Mogre1, Rashmi Prashant2 1Department of ENT, B.K.L Walawalkar Rural Medical College, Chiplun, Ratnagiri, Maharashtra, India 2Department of ENT, D Y Patil Medical College, Pune, Maharashtra, India Received: 28 August 2019 Revised: 05 October 2019 Accepted: 07 October 2019 *Correspondence: Dr. Nayanna Karodpati, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Nasopharyngeal carcinoma arises from interactions between underlying genetic and racial predilection and variety environmental factors. It is locally aggressive and presents with occult cervical nodal metastasis. A thorough understanding of radiological regional anatomy of the nasopharynx in Indians particularly Konkani population is important for early detection of nasopharyngeal carcinoma. Methods: Routine computed tomography of brain, head and neck for other neurological problems like stroke clearly delineates the loco-regional anatomy of the nasopharynx. Computed tomography (CT) images stored in the computer system were studied to delineate the normal loco-regional anatomy of nasopharynx with special reference to anatomical structure of fossa of Rosenmueller and to find out the normal dimensions of nasopharynx in Konkani population.
    [Show full text]
  • Nose, Nasal Cavity & Paranasal Sinuses & Pharynx
    Nose, Nasal cavity, Paranasal Sinuses & Pharynx Objectives . At the end of the lecture, the students should be able to: . Describe the boundaries of the nasal cavity. Describe the nasal conchae and meati. Demonstrate the openings in each meatus. Describe the paranasal sinuses and their functions . Describe the pharynx and its parts Nose . The external root (anterior ) nares or nostrils, lead to the tip nasal cavity. ala septum external nares Formed above by: 1 Bony skeleton 2 . Formed 3 below by plates of hyaline cartilage. Nasal Cavity . Extends from the external (anterior) nares to the posterior nares (choanae). Divided into right & left halves by the nasal septum. Each half has a: . Roof . Lateral wall . Medial wall (septum) . Floor Roof . Narrow & formed (from 3 2 4 behind forward) by the: 1 1. Body of sphenoid. 2. Cribriform plate of ethmoid bone. 3. Frontal bone. 4. Nasal bone & cartilage Floor • Separates it from the oral cavity. • Formed by the hard (bony) palate. Medial Wall (Nasal Septum) . Osteocartilaginous partition. Formed by: 1. Perpendicular plate of ethmoid 1 bone. 3 2. Vomer. 2 3. Septal cartilage. Lateral Wall . Shows three horizontal bony projections, the superior, middle & inferior conchae . The cavity below each concha is called a meatus and are named as superior, middle & inferior corresponding to the conchae. The small space above the superior concha is the sphenoethmoidal recess. The conchae increase the surface area of the nasal cavity. The recess & meati receive the openings of the: .Paranasal sinuses. .Nasolacrimal duct. Nasal mucosa – Olfactory : – It is delicate and contains olfactory nerve cells. It is present in the upper part of nasal cavity: .
    [Show full text]
  • Anatomy of the Nasal Cavity and Pharynx Respiratory Block - Lecture 2
    Anatomy of the nasal cavity and pharynx Respiratory Block - Lecture 2 Color index: Important In male’s slides only In female’s slides only Extra information, explanation Doctors notes Editing File Objectives: ● Describe the boundaries of the nasal cavity. ● Describe the nasal conchae and meati. ● Demonstrate the openings in each meatus. ● Describe the paranasal sinuses and their functions ● Describe the pharynx and its parts Nose & Nasal cavity Nose: The external (anterior) nares or nostrils, lead to the nasal cavity. 1 - Formed above by: Nasal Cavity: Bony skeleton. - Extends from the external - Formed below by: (anterior) nares to the posterior plates of hyaline cartilage. 2 nares (choanae). - Divided into right & left halves by the nasal septum. - Each half has a: 1- Roof 2- Lateral wall 3- Medial wall (septum) 4- Floor Floor Roof - Separates it from the oral cavity. Narrow & formed ( from behind forward) by the: - Formed by the hard (bony) palate. 1- Body of sphenoid. Formed by: 2- Cribriform plate of ethmoid bone. - Nasal (upper)surface of the hard (bony) palate: 3- Frontal bone. - Palatine process of maxilla, anteriorly. 4- Nasal bone & cartilage. - Horizontal plate of the palatine bone, posteriorly. 2 1 Lateral Wall Medial Wall (Nasal Septum) 4 3 - Shows three horizontal bony projections, the superior, middle & inferior conchae - Osteocartilaginous partition. - The cavity below each concha is called a meatus and are named as superior, middle & inferior corresponding to the - Formed by: conchae. 1- Perpendicular plate of ethmoid bone. - The small space above the superior concha is the 2- Vomer. sphenoethmoidal recess. 3- Septal cartilage. - The conchae increase the surface area of the nasal cavity.
    [Show full text]
  • Nose, Nasal Cavity, Paranasal Sinuses & Pharynx
    Nose, Nasal cavity, Paranasal Sinuses & Pharynx Respiratory block-Anatomy-Lecture 2 Editing file Color guide : Only in boys slides in Green Only in girls slides in Purple Objectives important in Red Doctor note in Blue Extra information in Grey At the end of the lecture, the students should be able to: ● Describe the boundaries of the nasal cavity. ● Describe the nasal conchae and meati. ● Demonstrate the openings in each meatus. ● Describe the paranasal sinuses and their functions. ● Describe the pharynx and its parts. Nose & Nasal cavity 3 Nose Nasal cavity nares/nostrils The external (anterior ) nares - Extends from the external (anterior) nares to the posterior nares or nostrils, lead to the nasal (choanae). cavity. - Divided into right & left halves by the nasal septum. - Formed above by: Bony skeleton. - Each half has a: ▪ Roof - Formed below by: ▪ Lateral wall plates of hyaline cartilage. ▪ Medial wall (septum) ▪ Floor Nasal cavity 4 Roof Floor Lateral Medial sphenoethmoidal recess Nasal cavity Superior conchae Superior meatus Inferior conchae Body of Middle conchae sphenoid Inferior meatus Middle meatus Narrow & formed - Separates it from Shows three horizontal bony projections, the Medial Wall (from behind the oral cavity. superior, middle & inferior conchae. (Nasal Septum) forward) by the: Osteocartilaginous - Formed by the hard - The cavity below each concha is called a meatus partition. 1. Body of sphenoid. (bony) palate. (named corresponding to the conchae). 2. Cribriform plate of Formed by: ethmoid bone. - The small space above the superior concha is 1. Perpendicular 3. Frontal bone. the sphenoethmoidal recess. plate of ethmoid 4. Nasal bone & bone. cartilage. - The conchae increase the surface area of the 2.
    [Show full text]
  • Lab 7: Lab Images
    Lab 7: Lab Images • The learning objectives regarding this lab are testable on summative exam 2 and practical exam 2. • Note: On practical exam 2, you can be asked to identify any structure from the structure list on any of the images (photographs, figures, Complete Anatomy images) in this PowerPoint file. Nasal Cavity Nasal Cavity Proper Nasal Cavity * Roof = Floor = Medial wall = * Lateral Wall = Nasal Cavity Frontal Sinus Sphenoid Sinus Nasal Cavity Innervation CN I V1 V2 Sinus Drainage Site Innervation Frontal Middle meatus (semilunar hiatus) Ophthalmic n. (CN V1) Anterior ethmoidal cells Middle meatus (semilunar hiatus) Ophthalmic n. (CN V1) Middle ethmoidal cells Middle meatus from bulla Ophthalmic n. (CN V1) Posterior ethmoidal cells Superior meatus Ophthalmic n. (CN V1) Sphenoidal Sphenoethmoidal recess Ophthalmic n. (CN V1) Maxillary Middle meatus (semilunar hiatus) Maxillary n. (CN V2) All Turbinates have been removed in this dissection photo. Probe passing between Probe passing sphenoethmoidal recess between frontal and sphenoid sinus sinus and middle meatus Semilunar hiatus Ethmoid bulla with Sphenoid opening of middle ethmoid cells Sinus Probe passing between maxillary sinus and middle meatus Probe in nasolacrimal duct Paranasal Sinuses Sinus Drainage Site Innervation Frontal Middle meatus (semilunar hiatus) Ophthalmic n. (CN V1) Anterior ethmoidal cells Middle meatus (semilunar hiatus) Ophthalmic n. (CN V1) Middle ethmoidal cells Middle meatus from bulla Ophthalmic n. (CN V1) Posterior ethmoidal cells Superior meatus Ophthalmic n. (CN V1) Sphenoidal Sphenoethmoidal recess Ophthalmic n. (CN V1) Maxillary Middle meatus (semilunar hiatus) Maxillary n. (CN V2) Paranasal Sinuses https://3d4medic.al/nTJSrmfo Nasal Cavity Highlighted in Green Parnasal Sinus Imaging Different types of radiographic imaging show the paranasal sinuses (below: X-ray, left; CT, right).
    [Show full text]
  • C12 C13 (1000219, 1000220) 2 Deutschlatin C12 OSSA
    …going one step further C12 C13 (1000219, 1000220) 2 DeutschLatin C12 OSSA A Os parietale d Ostium pharyngeum tubae auditivum B Os frontale e Recessus pharyngeus a Sinus frontalis f Tonsilla pharyngealis C Os nasale g M. orbicularis oris D Os ethmoidale h Dentes incisivi E Os sphenoidale i Uvula palatina b Sinus sphenoidalis k Tonsilla palatina F Os occipitale l Lingua G Maxilla m M. geniohyoideus H Os palatinum n M. mylohyoideus I Mandibula o Pharynx K Os hyoideum p M. genioglossus L Atlas M Axis 23 LARYNX I Epiglottis ENCEPHALON II Cartilago thyroidea I Telencephalon III Cartilago cricoidea II Diencephalon IV Lig. thyrohyoideum medianum III Mesencephalon V Lig. cricothyroideum medianum IV Metencehalon VI M. arytenoideus transversus V Myelencephalon VII Plica vestibularis I, II, III Cerebrum VIII Plica vocalis 1 Sinus sagittalis superior IX Ventriculus laryngis 2 Tentorium cerebelli X Trachea ® 3 Cerebellum XI Oesophagus 3a Arbor vitae 4 Corpus callosum 4a Rostrum corporis callosi 4b Genu corporis callosi 5 Septum pellucidum 6 Fornix 7 Commissura anterior 8 Adhesio interthalamica 9 Commissura posterior 10 Thalamus 11 Foramen interventriculare 12 Aqueductus mesencephali 13 Ventriculus quartus 14 Glandula pinealis 15 Chiasma opticum 16 Hypophysis 17 Corpus mammillare 18 Lamina tecti 19 Velum medullare superius 20 Pons 21 Medulla oblongata 22 Medulla spinalis CAVITAS NASI, CAVITAS PHARYNGIS et CAVITAS ORIS a Concha nasalis superior b Concha nasalis media c Concha nasalis inferior 3 C13 EnglishLatin A Os frontale B Os temporale C Os zygomaticum D Maxilla E Os palatinum F Mandibula 1 Dura mater cranialis 2 Cerebrum 3 Corpus adiposum orbitae cum VI mm.
    [Show full text]
  • Magnetic Resonance Imaging of the Eustachian Tube and the Paratubal Structures in Patients with Unilateral Acquired Cholesteatoma
    J Int Adv Otol 2020; 16(3): 373-7 • DOI: 10.5152/iao.2020.7508 Original Article Magnetic Resonance Imaging of the Eustachian Tube and the Paratubal Structures in Patients with Unilateral Acquired Cholesteatoma Muammer Melih Şahin , Deniz Sözmen Cılız , Melih Çayönü , Seçil Kayalı Dinç , Şeyda Akbal , Süleyman Boynueğri , Adil Eryılmaz Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey (MMŞ, MÇ, SKD, ŞA, SB, AE) Department of Radiology, Ankara Numune Training and Research Hospital, Ankara, Turkey (DSC) ORCID iDs of the authors: M.M.Ş. 0000-0002-1804-2730; D.S.C. 0000-0003-3640-9273; M.Ç. 0000-0001-5542-1898; S.K.D. 0000-0001-9004-8806; Ş.A. 0000-0003-4554-9278; S.B. 0000-0002-1244-7294; A.E. 0000-0003-3754-6317. Cite this article as: Şahin MM, Sözmen Cılız D, Çayönü M, Kayalı Dinç S, Akbal Ş, Boynueğri S, et al. Magnetic Resonance Imaging of the Eustachian Tube and the Paratubal Structures in Patients with Unilateral Acquired Cholesteatoma. J Int Adv Otol 2020; 16(3): 373-7. OBJECTIVES: This study aimed to compare the Eustachian tube (ET) and the paratubal structures between the two sides in subjects with unilateral acquired cholesteatoma and a healthy contralateral ear to determine if there are anatomical differences. MATERIALS and METHODS: Of the 217 patients with cholesteatoma evaluated, 36 patients with unilateral cholesteatoma were included in the study. All of the patients had a healthy contralateral ear with no history of surgery. Nine different paratubal parameters were measured through contrast-enhanced magnetic resonance imaging (MRI). The measurements of the ear with cholesteatoma were compared with those of the healthy ear.
    [Show full text]
  • Neuroanatomy Objectives
    1 ` 2019 Neuroanatomy Objectives Cerebral Cortex Cortical Lobes Frontal Lobe Parietal Lobe Occipital Lobe Temporal Lobe Limbic Lobe (Insula) Major Cortical Fissures and Lobe Division Landmarks Central Sulcus (CS) Lateral Fissure (LF) Preoccipital Notch Parieto-occipital Fissure (POF) Frontal Lobe Central Sulcus Precentral Gyrus (Primary Motor Cortex – M1) Precentral Sulcus Brocca’s Area (Expressive Speech) Prefrontal Cortex (Cognition) Parietal Lobe Postcentral Sulcus Postcentral Gyrus (Primary Sensory Cortex – S1) Central Sulcus Occipital Lobe Calcarine Fissure Primary Visual Cortex (V1) Temporal Lobe Superior Temporal Sulcus Heschl’s Gyrus (Primary Auditory Area –A1) Wernicke’s Area (Comprehensive Speech Area) Limbic Lobe Structures Cingulate Gyrus (Cognition). Cingulate Sulcus Parahippocampal Gyrus (Memory) Uncus – Near Primary Olfactory Cortex (Smell). Summary of Major Functional Centers of the Cerebral Cortex Head and Neck Motor Control – Precentral Gyrus (M1), cranial nerves V, VII, IX, X, XII. 2 Head and Neck Sensory Perception – Post Central Gyrus (S1), head area receives sensory information largely from cranial nerve V. Speech – Broca’s Area (speech production) and Wernicke’s Area (speech comprehension). Hearing – Primary Auditory Cortex (A1) Vision – Primary Visual Cortex (V1) (within the depths of the calcarine fissure) Smell –Limbic Cortex (Near Uncus) Interhemispheric Commissures Corpus Callosum Anterior and Posterior Commissures Brainstem Diencephalon Thalamus (sensory relay to cortex and motor relay to cortex) Hypothalamus (basic physiologic drives and homeostasis) 3rd Ventricle Midbrain Superior Colliculus (visual system relay) Inferior Colliculus (auditory system relay) Cerebral Aqueduct (Aqueduct of Sylvius) Pons and Cerebellum Superior Cerebellar Peduncle - white matter pathway (i.e., nerve fibers) connecting midbrain and cerebellum. Middle Cerebellar Peduncle -white matter pathway connecting pons and cerebellum.
    [Show full text]
  • Pitfalls in the Staging of Cancer of Nasopharyngeal Carcinoma
    Pitfalls in the Staging of Cancer of Nasopharyngeal Carcinoma Christine M. Glastonbury, MBBSa,*, Karen L. Salzman, MDb KEYWORDS Staging Nasopharyngeal carcinoma Nasopharynx Epstein-Barr virus KEY POINTS Although nasopharyngeal carcinoma (NPC) is the most common primary malignancy of the naso- pharynx, it is an uncommon malignancy in much of the Western world. Over the last several years, there have been important changes in the terminology used for the histologic classification of NPC and important changes to the American Joint Committee on Cancer TNM staging of NPC. Accurate imaging assessment is critical for diagnose, to stage and plan the radiation treatment, and for ongoing follow-up and surveillance. This article emphasizes important nasopharyngeal anatomy landmarks and the imaging appear- ances and pitfalls of nasopharyngeal carcinoma, its patterns of spread, and posttreatment appear- ances. INTRODUCTION posttreatment appearances. The updated histology and new AJCC TNM staging are presented, Although nasopharyngeal carcinoma (NPC) is the emphasizing key changes that are of relevance to most common primary malignancy of the naso- the radiologist. pharynx, it is an uncommon malignancy in much of the Western world where it has an incidence NASOPHARYNGEAL ANATOMY of less than 10 per 1 000 000. Over the last several years, there have been important changes in the The nasopharynx is the most superior portion of terminology used for the histologic classification the tubular pharynx, located immediately caudal of NPC and important changes to the American to the central skull base. The inferior limit of the Joint Committee on Cancer (AJCC) TNM staging nasopharynx is the soft palate, and it is at this level of NPC.
    [Show full text]