A new CT dynamic maneuver “Mouth Opened with Tongue Extended” can improve the clinical TNM staging of oral cavity and oropharynx squamous cell carcinomas

Bron, Guillaume; Scemama, Ugo; Villes, Virginie; Fakhry, Nicolas; Salas, Sébastien; Chagnaud, Christophe; Bendahan, David; Varoquaux, A.

doi:10.1016/j.oraloncology.2019.04.023

Cited by 8 publications

(7 citation statements)

References 25 publications

(34 reference statements)

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“…For instance, to improve the evaluation of the buccal space, dynamic maneuver such as puffed cheek technique can be used [5,12]; but, the usefulness of this technique is limited to the oral cavity. Among the dynamic maneuvers, the open mouth technique can provide wider indications for increasing visibility of the tumor in the oral cavity and oropharynx [5][6][7]. Although seemingly effective, only few studies have confirmed the usefulness of the open mouth maneuver in real clinical settings [5,7].…”

Section: Discussionmentioning

confidence: 99%

“…Among the dynamic maneuvers, the open mouth technique can provide wider indications for increasing visibility of the tumor in the oral cavity and oropharynx [5][6][7]. Although seemingly effective, only few studies have confirmed the usefulness of the open mouth maneuver in real clinical settings [5,7]. Recently, in 2019, Bron et al [7] examined the open mouth procedure and the additional tongue extended maneuver on clinical tumor staging of the oral cavity and oropharyngeal squamous cell carcinoma and showed that these maneuvers could improve the assessment of local tumor extension.…”

Section: Discussionmentioning

confidence: 99%

“…Although seemingly effective, only few studies have confirmed the usefulness of the open mouth maneuver in real clinical settings [5,7]. Recently, in 2019, Bron et al [7] examined the open mouth procedure and the additional tongue extended maneuver on clinical tumor staging of the oral cavity and oropharyngeal squamous cell carcinoma and showed that these maneuvers could improve the assessment of local tumor extension. However, additional extension of the tongue would likely cause a significant amount of inconvenience to patients and additional motion artifacts.…”

Section: Discussionmentioning

confidence: 99%

“…To avoid such artifacts, a dynamic maneuver called "open mouth" has been described to improve tumor delineation by stretching the oral mucosa and the deep spaces in the vicinity [5,6]. Most recently, Bron et al [7] found that post-contrast CT images using the open mouth maneuver could improve the tumor delineation and decrease metallic artifacts in the oral cavity and oropharynx, thereby increasing the clinical advantages for proper tumor staging, comparable to MRI examination.…”

Section: Introductionmentioning

confidence: 99%

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Comprehensive assessments of the open mouth dynamic maneuver and metal artifact reduction algorithm on computed tomography images of the oral cavity and oropharynx

et al. 2021

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Objectives To determine the optimal utility of the open mouth maneuver and Metal Artifact Reduction for the Orthopedic Implants (O-MAR) technique for CT of the oral cavity and oropharynx. Methods Between July 2017 and May 2019, 59 subjects who underwent both conventional and open mouth head and neck CT scans were included in this retrospective study. All images were reconstructed using the O-MAR algorithm. With conventional CT with/without the O-MAR (CTc_O/CTc) and open mouth CT with/without O-MAR (CTo_O/CTo), one reader measured the noise level in multiple anatomic regions of the oral cavity and oropharynx. Visual scores for the streak artifact and overall subjective image quality were assessed by two independent readers. Results For the mobile tongue, retromolar trigone, and palatine tonsil, the mean noise was significantly lower, and the mean visual scores were significantly higher, with CTo than with CTc or CTc_O (all, P < 0.001). The mean visual scores were higher with CTo_O than with CTo for the mobile tongue and palatine tonsil (all, P < 0.001). Contrarily, for the mouth floor and tongue base, the mean noise was significantly higher with CTo_O than with CTc or CTc_O, and the mean visual scores were significantly higher with CTc than with CTo or CTo_O (all, P < 0.001). Conclusions The open mouth maneuver and O-MAR technique can have different influences on the CT image quality according to the anatomical subsites of the oral cavity and oropharynx.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comprehensive assessments of the open mouth dynamic maneuver and metal artifact reduction algorithm on computed tomography images of the oral cavity and oropharynx

et al. 2021

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“…Proper instruction and testing of the manoeuvre are required before scanning. This technique reduces artifacts from metal material (for the same reasons of simple open mouth technique, the X-ray beam better penetrates the oral cavity without the interference of dental metal) (Figure 14) and enables a better visualisation of oral cavity/oropharynx tumours, thus allowing a more accurate staging [51]. Lingual protrusion causes "stretching" of the oropharyngeal structures and distends the glosso-tonsillar sulcus.…”

mentioning

confidence: 99%

Techniques, Tricks, and Stratagems of Oral Cavity Computed Tomography and Magnetic Resonance Imaging

et al. 2022

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The oral cavity constitutes a complex anatomical area that can be affected by many developmental, inflammatory, and tumoural diseases. MultiSlice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI) currently represent the essential and complementary imaging techniques for detecting oral cavity abnormalities. Advanced MRI with diffusion-weighted imaging (DWI) and dynamic contrast-enhanced perfusion-weighted imaging (DCE-PWI) has recently increased the ability to characterise oral lesions and distinguish disease recurrences from post therapy changes. The analysis of the oral cavity area via imaging techniques is also complicated both by mutual close appositions of different mucosal surfaces and metal artifacts from dental materials. Nevertheless, an exact identification of oral lesions is made possible thanks to dynamic manoeuvres and specific stratagems applicable on MSCT and MRI acquisitions. This study summarises the currently available imaging techniques for oral diseases, with particular attention to the role of DWI, DCE-PWI, and dynamic manoeuvres. We also propose MSCT and MRI acquisition protocols for an accurate study of the oral cavity area.

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A modified pull-through approach with a pedicled bone flap for oral and oropharyngeal cancer resection: a feasibility study

Neckel,

Hirt

et al. 2024

Surg Radiol Anat

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Purpose Compromised swallowing, speaking, and local complications are the major disadvantages of established approaches to the posterior tongue and oropharynx. The mandibular split involves an esthetically unpleasant bipartition of the lower lip and is prone to bony non-union or sequestration. The conventional pull-through technique on the other hand lacks the secure reattachment of the lingually released soft tissues. Methods The feasibility of a new modified pull-through approach was tested on three anatomical specimens. CAD/CAM cutting guides were used to design a retentive bone flap to properly refixate the genioglossus and geniohyoid muscles after the procedure. The radiographic assessment and treatment planning was performed on 12 cadavers. The entire procedure was tested surgically via dissection in three of those cases. This procedure was then applied in a clinical case. Results Precise repositioning and dynamic compression of bony segments was possible reproducibly and without injury to adjacent structures. In all dissected cases, a median lingual foramen was found and in two cases vessels entering it could be dissected Radiologic anatomical landmarks were sufficient in all 12 cases to perform the clinical planning procedure. Clinically, the osteotomized segment demonstrated good blood supply and plateless repositioning was verified postoperatively via cone beam scan. Conclusion The method presented is safe and easy to perform. Individual cutting guides improve the safety and accuracy of the procedure, potentially eliminating the need for osteosynthesis. We provide the anatomical and radiologic basis for clinical evaluation of this pedicled bone flap procedure and present the clinical application of this modified pull-through approach.

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A new CT dynamic maneuver “Mouth Opened with Tongue Extended” can improve the clinical TNM staging of oral cavity and oropharynx squamous cell carcinomas

Cited by 8 publications

References 25 publications

Comprehensive assessments of the open mouth dynamic maneuver and metal artifact reduction algorithm on computed tomography images of the oral cavity and oropharynx

Comprehensive assessments of the open mouth dynamic maneuver and metal artifact reduction algorithm on computed tomography images of the oral cavity and oropharynx

Techniques, Tricks, and Stratagems of Oral Cavity Computed Tomography and Magnetic Resonance Imaging

A modified pull-through approach with a pedicled bone flap for oral and oropharyngeal cancer resection: a feasibility study

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