Objectives/Hypothesis
To validate a follow‐up protocol based on the long‐term outcomes and recurrence rates in patients who have undergone surgical treatment for olfactory neuroblastoma.
Methods
A ...prospective review of all patients treated for olfactory neuroblastoma at our institution over a 35‐year period.
Results
Ninety‐five patients were treated from 1978 to 2013, with craniofacial (65 patients) or endoscopic resection (30 patients). Duration of follow‐up ranged from 1 to 309 months (mean, 88.66 months). Fifty‐six patients were alive and well, and 13 were alive with recurrent disease. Twenty‐one patients had died of disease, and three had died of intercurrent disease. Overall survival was 83.4% at 5 years and 76.1% at 10 years. Disease‐free survival at 5 years was 80% and at 10 years was 62.8%. A Cox regression analysis showed orbital extension and intracranial involvement to be significant independent factors affecting outcome. Local and regional recurrence occurred after an average of 49 months but with a range of 3 to 233 months.
Conclusions
In our series, olfactory neuroblastoma most commonly recurred within the first 4 years but can recur very late, after 19.4 years in one case. There is currently no universally accepted follow‐up regime, but even late recurrence is eminently treatable. We therefore propose a protocol for lifelong follow‐up with both clinical examination and serial imaging, including the neck and entire intracranial compartment.
Level of Evidence
4 Laryngoscope, 124:1542–1549, 2014
Anatomy is the foundation on which the understanding of pathological processes in radiology is based. This article describes the anatomy of the sinonasal region and the clinically relevant anatomical ...variants, highlighting the need for multiplanar reconstructions as a routine part of the examination when reviewing this region.
Imaging of Sinonasal Tumors Madani, Gitta, FRCR; Beale, Timothy J., FRCR, FRCS; Lund, Valerie J., FRCS
Seminars in ultrasound, CT, and MRI,
02/2009, Letnik:
30, Številka:
1
Journal Article
Recenzirano
This article reviews the role of imaging in the diagnosis of sinonasal tumors, illustrating the diversity of tumors affecting this region. The symptoms of sinonasal tumors are nonspecific; imaging ...plays a critical role in distinguishing benign and malignant disease and may occasionally illustrate characteristic radiological features of specific tumors. The patterns of local and distant spread of sinonasal malignancy are demonstrated and the respective roles of computed tomography and magnetic resonance imaging are explained. Critical imaging review areas are discussed together with accurate staging, including orbital and intracranial involvement, which determine the appropriate surgical approach. The sites and patterns of tumor recurrence and the imaging features of recurrent tumor are also discussed.
Differential Diagnosis in Sinonasal Disease Madani, Gitta, FRCR; Beale, Timothy J., FRCR, FRCS
Seminars in ultrasound, CT, and MRI,
02/2009, Letnik:
30, Številka:
1
Journal Article
Recenzirano
This article summarizes the imaging features that aid in distinguishing inflammatory from neoplastic disease and benign from malignant conditions. Diagnostic pitfalls are highlighted.
Inflammatory sinus disease is ubiquitous. Patients with recurrent or unilateral disease and those who do not respond to treatment require imaging. Computed tomographic scanning is the mainstay of ...investigation; magnetic resonance imaging is used as a problem-solving tool. The imaging characteristics of sinonasal inflammatory conditions are varied. The role of imaging is to identify patterns of disease, provide a roadmap for the endoscopist, identify anatomical variants that impact on drainage, and exclude aggressive pathology.
To report on the use of RFA for the treatment of symptomatic benign and autonomously functioning thyroid nodules (AFTNs) in the first reported UK cohort.
Patients treated over a 19-month period were ...retrospectively reviewed. Nodules were assessed pre-treatment and at 1 and 6 months post-treatment. Nodule volume was calculated and cosmetic assessment and thyroid-related quality of life (QoL) scores were recorded at each time point. Thyroid function tests (TFTs) were recorded at all three time points for patients with ATFNs.
46 patients with 50 nodules were treated with no complications. The mean volume reduction 1-month post-treatment was 53 +- 14.9 % (
< 0.0001). Six month data was available for 31 nodules and showed a mean 67 +- 17.6% vol reduction (
< 0.0001). Five of the six patients with ATFNs were euthyroid at 1-month post-procedure. 6-month data was available on three of these patients, and all remained euthyroid. The thyroid-related QoL and cosmetic scores also improved. Data from 23 patients was available pre-treatment and at 6 months post-treatment and there was a significant (
< 0.0001) reduction in QoL score. Pre-treatment, 82 % of nodules were readily visible at rest, decreasing to 12.5 % 6 months after treatment (
< 0.0001).
Results align with published data suggesting that RFA is effective at reducing nodule volume and at treating ATFNs and leads to improvement in thyroid-related QoL and cosmetic scores.
This early UK experience demonstrates that day-case radiofrequency ablation can provide safe and effective treatment of benign symptomatic thyroid nodules.
Although US is one of the most used modalities for head and neck imaging, its use in the diagnosis of laryngeal abnormalities is much less widespread. The standard assessment of laryngeal ...abnormalities currently involves direct laryngoscopy and cross-sectional imaging (either CT or MRI) but rarely US. US is readily available, noninvasive, and radiation free, and it allows real-time imaging (with video for dynamic assessment), higher resolution than that of cross-sectional imaging, and the performance of targeted fine needle aspiration cytology or biopsy. This modality, particularly with the advent of high-resolution US, has been found to be at least comparable to CT or MRI for diagnosis of malignant lesions and benign abnormalities such as vocal nodules, polyps, cysts, and Reinke edema. Furthermore, it has been found to be more sensitive for diagnosis of abnormalities such as small glottic tumors, and its dynamic capability can be used to identify functional abnormalities such as vocal cord palsy. The authors outline the technique of laryngeal US, which includes strategies to avoid calcified laryngeal cartilage by imaging through the thyrohyoid and cricothyroid membranes with a five-sweep strategy supplemented by cine film of the technique. They also provide US images of common laryngeal abnormalities such as tumors with and without extralaryngeal extension; vallecular, thyroglossal, and vocal cord cysts; laryngeal mucoceles; and vocal cord palsy.
RSNA, 2020.
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