Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Feb 2022
ReviewImaging of the Postoperative Jaws and Temporomandibular Joints.
Surgical procedures in the oral cavity and maxillofacial complex are diverse and involve multiple tissues unique to this region. These procedures are used to remove pathology and infection, restore function, optimize occlusal relationships, prosthetically replace teeth and temporomandibular joints, improve esthetics, and increase upper respiratory tract dimensions. Procedures in the oral cavity are often complicated by infection stemming from the naturally occurring oral flora, but can also be complicated iatrogenically. This article explores the more commonly encountered surgical procedures through examination of the indications, anatomy to consider, and the radiographic imaging of success and failure of these procedures.
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Posttreatment imaging evaluation of sinuses encompasses a wide gamut of procedures, ranging from endoscopic procedures for sinonasal inflammatory diseases to markedly radical surgeries for malignant neoplasms (with or without reconstructions), as well as providing access for surgeries involving the anterior and central skull base. Advances in both techniques and devices have expanded the use of endoscopic approaches in managing both benign and malignant lesions, in addition to being the primary surgical method for treating all medically refractive sinonasal inflammatory disorders. Familiarity with the complex anatomy in the sinonasal region and knowledge of the various procedures is indispensable in interpreting these imaging studies.
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Evaluation of the postoperative temporal bone can be difficult given the complex anatomy of this region and the myriad surgical approaches for management of a variety of conditions. This article provides an understanding of common postsurgical changes of the temporal bone and their typical imaging appearances. Ultimately, greater radiologist knowledge of postoperative temporal bone imaging findings will help to serve patients and referring clinicians with prompt diagnosis and recognition of expected postintervention changes compared with postoperative complications and/or disease recurrence.
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Neuroimaging Clin. N. Am. · Feb 2022
ReviewSurgical Free Flaps and Grafts in Head and Neck Reconstruction: Principles and Postoperative Imaging.
This review article discusses the basic principles behind the use of flaps and grafts for reconstructive surgery in the head and neck, with a special emphasis on the types of commonly used free flaps, their imaging appearance as well as some frequently encountered postoperative complications. Given the ubiquity and complexity of these reconstructive techniques, it is essential that head and neck radiologists be familiar in distinguishing between the expected evolving findings, complications, and tumor recurrence.
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Chemoradiation for head and neck cancer is associated with a variety of early and late complications. Toxicities may affect the aero-digestive tract (mucositis, salivary gland injury), regional osseous and cartilaginous structures (osteoradionecrosis (ORN) and chondronecrosis), vasculature (progressive radiation vasculopathy and carotid blow out syndromes), and neural structures (optic neuritis, myelitis, and brain injury). ⋯ Secondary radiation-induced malignancies include thyroid cancer and a variety of sarcomas that may manifest several years after treatment. Checkpoint inhibitors can cause a variety of adverse immune events, including autoimmune hypophysitis and encephalitis.