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Pediatric radiology in oto-rhino-laryngology.

von Kalle T, Koitschev A - GMS Curr Top Otorhinolaryngol Head Neck Surg (2014)

Bottom Line: It is most likely to be successful in a close interdisciplinary cooperation of pediatric ENT specialists and radiologists as well as pediatric anesthesiologists in selected cases.In many of these young patients, the outcome and the probability of survival are directly associated with the initial diagnostic and therapeutic strategies, which should therefore be in accordance with the current guidelines of pediatric oncology therapy studies.It shows the significance of a special knowledge in embryology and normal postnatal development for the differentiation of normal variants from pathological findings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Radiology, Olgahospital, Klinikum Stuttgart, Germany.

ABSTRACT
Head and neck diseases in children and adolescents present special diagnostic and differential diagnostic challenges to ENT surgeons as well as to radiologists. Both disciplines have to adapt the latest radiological and interventional technologies to the needs of the pediatric patient in order to enable a minimally invasive but successful diagnostic procedure. High quality sonography by an experienced examiner is often the only imaging technique that is necessary in children and adolescents. Radiographs are rarely indicated in pediatric head and neck diseases. MRI, compared to computed tomography, has the advantage of absent radiation exposure. Additionally, due to current advances in high resolution techniques to delineate very small details or in visualization of different tissue characteristics, it has become an integral part of pre- and postoperative imaging. However, children should not be denied an adequate diagnostic procedure even if it includes sedation, intervention, or exposure to radiation. The responsible use of the diagnostic options under consideration of the therapeutic consequences is essential. It is most likely to be successful in a close interdisciplinary cooperation of pediatric ENT specialists and radiologists as well as pediatric anesthesiologists in selected cases. Although benign diseases predominate in children and adolescents, the possibility of malignancy has to be considered in cases of atypical clinical and radiological findings. In many of these young patients, the outcome and the probability of survival are directly associated with the initial diagnostic and therapeutic strategies, which should therefore be in accordance with the current guidelines of pediatric oncology therapy studies. Our collection of clinical cases consists of representative examples of useful diagnostic approaches in common and age specific diagnoses as well as in rare diseases and malformations. It shows the significance of a special knowledge in embryology and normal postnatal development for the differentiation of normal variants from pathological findings. Only in considering the results of imaging studies in their clinical context, it is possible to succeed in detecting a syndrome behind a single malformation or adequately caring for patients with a chronic disease such as cystic fibrosis.

No MeSH data available.


Related in: MedlinePlus

Case report 16. 14-year-old boy with fracture of the right temporal bone. Transverse sections of CT scan. The subtle, but diagnostically important findings of trapped air in the soft tissue medial and posterior to temporal bone (arrows) are well displayed in the CT scan (the actual fracture lines are not visible), however, both findings would not be reliably identified by MRI. (Courtesy of Prof. Hans Henkes, Department of Neuroradiology, Klinikum Stuttgart, Germany).
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Figure 19: Case report 16. 14-year-old boy with fracture of the right temporal bone. Transverse sections of CT scan. The subtle, but diagnostically important findings of trapped air in the soft tissue medial and posterior to temporal bone (arrows) are well displayed in the CT scan (the actual fracture lines are not visible), however, both findings would not be reliably identified by MRI. (Courtesy of Prof. Hans Henkes, Department of Neuroradiology, Klinikum Stuttgart, Germany).

Mentions: Diagnosis. Temporal bone fracture (Figure 19 (Fig. 19)).


Pediatric radiology in oto-rhino-laryngology.

von Kalle T, Koitschev A - GMS Curr Top Otorhinolaryngol Head Neck Surg (2014)

Case report 16. 14-year-old boy with fracture of the right temporal bone. Transverse sections of CT scan. The subtle, but diagnostically important findings of trapped air in the soft tissue medial and posterior to temporal bone (arrows) are well displayed in the CT scan (the actual fracture lines are not visible), however, both findings would not be reliably identified by MRI. (Courtesy of Prof. Hans Henkes, Department of Neuroradiology, Klinikum Stuttgart, Germany).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4273164&req=5

Figure 19: Case report 16. 14-year-old boy with fracture of the right temporal bone. Transverse sections of CT scan. The subtle, but diagnostically important findings of trapped air in the soft tissue medial and posterior to temporal bone (arrows) are well displayed in the CT scan (the actual fracture lines are not visible), however, both findings would not be reliably identified by MRI. (Courtesy of Prof. Hans Henkes, Department of Neuroradiology, Klinikum Stuttgart, Germany).
Mentions: Diagnosis. Temporal bone fracture (Figure 19 (Fig. 19)).

Bottom Line: It is most likely to be successful in a close interdisciplinary cooperation of pediatric ENT specialists and radiologists as well as pediatric anesthesiologists in selected cases.In many of these young patients, the outcome and the probability of survival are directly associated with the initial diagnostic and therapeutic strategies, which should therefore be in accordance with the current guidelines of pediatric oncology therapy studies.It shows the significance of a special knowledge in embryology and normal postnatal development for the differentiation of normal variants from pathological findings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Radiology, Olgahospital, Klinikum Stuttgart, Germany.

ABSTRACT
Head and neck diseases in children and adolescents present special diagnostic and differential diagnostic challenges to ENT surgeons as well as to radiologists. Both disciplines have to adapt the latest radiological and interventional technologies to the needs of the pediatric patient in order to enable a minimally invasive but successful diagnostic procedure. High quality sonography by an experienced examiner is often the only imaging technique that is necessary in children and adolescents. Radiographs are rarely indicated in pediatric head and neck diseases. MRI, compared to computed tomography, has the advantage of absent radiation exposure. Additionally, due to current advances in high resolution techniques to delineate very small details or in visualization of different tissue characteristics, it has become an integral part of pre- and postoperative imaging. However, children should not be denied an adequate diagnostic procedure even if it includes sedation, intervention, or exposure to radiation. The responsible use of the diagnostic options under consideration of the therapeutic consequences is essential. It is most likely to be successful in a close interdisciplinary cooperation of pediatric ENT specialists and radiologists as well as pediatric anesthesiologists in selected cases. Although benign diseases predominate in children and adolescents, the possibility of malignancy has to be considered in cases of atypical clinical and radiological findings. In many of these young patients, the outcome and the probability of survival are directly associated with the initial diagnostic and therapeutic strategies, which should therefore be in accordance with the current guidelines of pediatric oncology therapy studies. Our collection of clinical cases consists of representative examples of useful diagnostic approaches in common and age specific diagnoses as well as in rare diseases and malformations. It shows the significance of a special knowledge in embryology and normal postnatal development for the differentiation of normal variants from pathological findings. Only in considering the results of imaging studies in their clinical context, it is possible to succeed in detecting a syndrome behind a single malformation or adequately caring for patients with a chronic disease such as cystic fibrosis.

No MeSH data available.


Related in: MedlinePlus