Introduction: The sinus are very important on the upper respiratory tract, formed by the ostrich complex (COM) and by the paranasal sinuses. The deep knowledge of the anatomy and variations of the ostium-meatal complex and the paranasal sinuses is a skill expected from the radiologist as well the possible variations with the disease states. Objective: The aim of this study was to evaluate the prevalence of anatomic variations and pathological processes in the paranasal sinuses and the ostiomeatal complex in a population of a large city. Furthermore, association among the presence and localization of anatomic variations and the occurrence of pathological processes was also accessed. Materials and Methods: This study evaluated 1005 CT scans of the sinuses obtained by multislice technique (64 apparatus detectors) with axial and coronal reconstructions, both with 1 and 2 mm thick. Patients of both sexes, aged between 12 and 92 years, who were referred by otolaryngologists were included. Results: Our results showed high prevalence of paranasal sinus CT alterations. The most common were: septal deviation (80.7%), concha bullosa (35.1%), Haller cells (9.6%), and ethmoidal bulla (3.3%). Among the pathological processes, mucoperiosteal thickening associated with acute and chronic inflammation of the sinuses were the most frequent. Ocasionally, it caused obstruction of drainage ostiomeatal complex, in addition to sinusitis (acute and chronic). Odontogenic sinusitis, fungal sinusitis, osteomas, fibrous dysplasia and nasal diseases were also found. There was no association among anatomical variations (changes in the nasal septum, bone spur, concha bullosa, nasal turbinate hypertrophy) and increased chances of obstruction of drainage of frontal, ethmoid and maxillary sinuses. Conclusion: Association between obstruction of the drainage and the occurrence of sinusitis on all paranasal sinuses were also detected. As the population has a high frequency of anatomical variations of the paranasal sinuses, the incorrect interpretation of the images of the sinonasal complex should cause misdiagnosis, compromising patient care. In conclusion, knowledge of the prevalence and characteristics of paranasal sinus CT alterations should be useful for defining specific diagnosis criteria.
Introduction: Cardiovascular diseases and stroke in particular are the leading causes of death worldwide. The most common reason for this interruption is a buildup of fatty deposits on the inner walls of blood vessels; upon calcification, these deposits are termed atheromas. Objective: The aim of this study was to identify calcified atherosclerotic plaque-like soft tissue calcifications in obese subjects using panoramic radiography. Materials and Methods: Sixty-three obese patients undergoing digital panoramic radiography in a radiology clinic in Belo Horizonte, Brazil, were selected and diagnosed with grade II obesity with comorbidities and grade III obesity according to the World Health Organization (WHO) body mass index (BMI) score table. The radiographs were examined by two trained oral and maxillofacial radiologists, and their evaluations were analyzed using the kappa test. Statistical analysis was performed using the X2 test, and the odds ratio was determined with a 95% confidence interval. A 5% significance level was used. Results: The weight and BMI (p < 0.01) differed significantly between individuals in the grade II with comorbidities and grade III groups, but no difference was observed for age and height. Of 63 radiographs, 45 (71.42%) showed calcifications in the cervical region, with no statistically significant difference between the grade II and grade III groups. Neither gender nor side was significantly correlated with the presence of soft tissue calcification. Conclusion: This study demonstrates the importance of panoramic radiography in identifying calcified atheromatous plaques. Such images may have critical diagnostic value for the early detection of carotid artery atheromas in obese subjects and thus may contribute to an increase in the length and quality of life of such individuals.
Introduction: Dens in dente or dens invaginatus is an anomaly of tooth formation, result of the invagination of coronary tissue in the pulp chamber, which occurs previously to tissue calcification. The majority of dens in dente cases are discovered by routine imaging exams, in which it is possible to identify an invagination of enamel into the pulp chamber, where the enamel appears well delineated, giving the impression of “a small tooth inside the other”. Objective: Approach the clinical and radiographic aspects, as well as diagnose this pathology using imaging exams, through an atypical clinical case report of Oehlers type II dens in dente in the left maxillary third molar. Case report: Female patient, 20 years old, went to the Dental Clinic of the Odontology Scholl at PUC Minas, to have the third molars extracted. The panoramic radiograph examination showed shape change in the left maxillary third molar. Considering the atypical form, a cone beam computed tomography was requested. Conclusion: The case related showed how important are the image exams to do the precise diagnosis on this anomaly. The cone bean computer tomo- graphy should be ask if the conventional imaging tests aren’t able to value the disease and plan the treatment.
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