Der Hals - eine sonographisch ergiebige Region für viele Disziplinen

Abstract

The soft tissues of the neck can be examined at the highest resolution with ultrasound probes of high frequencies due to their superficial position. There are many clinically important diagnostic issues concerning the thyroid gland, the parathyroid, lymph nodes, vessels of the neck, salivary glands and other structures of the field of ENT and even the nerves of this region. Numerous different medical departments therefore work in this field either together or I a parallel fashion. In addition to different sub-specialties of internal medical and surgical departments, radiologists, neurologists, ENT doctors, gnathologists and radio-oncologists are all active here. Even intensive care personnel and anaesthesiologists use ultrasound for sonographically guided punctures. It is therefore obvious that the cervical region is of special importance for an interdisciplinary journal, constituting a large part of publications. In the last 2 (1/2) years, we published two articles about cervical lymph nodes , eight concerning the topic of vessels , two articles about salivary glands and three dealing with the parathyroid glands . The present issue again contains three publications concerning this area, characteristically from three different medical specialties, each of great significance for various medical fields. An important article deals with deQuervain thyroiditis . Albeit this is not a common disease, any clinician working on the cervical region should be well aware of this entity, as the patients concerned often go through a medical "odyssey" with different specialists before the right diagnosis is made. An important addition to sonographical interventional techniques is percutaneous instillation therapy for focal autonomous adenomas of the thyroid : it is fast acting and effective, representing a genuine therapeutic alternative to surgery or radioactive iodine treatment in many cases. The case report on a - fortunately non-permanent - partial laryngeal necrosis resulting from the instillation of 96 % alcohol demonstrates the potential damage an established method can cause if applied without expertise. It is therefore mandatory to be aware of potential side effects and carry out the intervention proficiently, strictly keeping in mind the indication for therapy. A further case report demonstrates in an impressive way the importance of cervical sonography for the detection and landmarking of parathyroid adenomas. The fact that the author is a surgeon might serve as valid proof, as the surgery of parathyroid glands almost solely depended on the experience and the explorative skill of the surgeon until recently.

Sonographische Diagnostik eines Nebenschilddrüsenkarzinoms

“…Voraussetzung für die optimale Behandlung ist die präoperative Erkennung des Nebenschilddrüsenkarzinoms anhand der prä-operativen Befunde, was jedoch häufig nicht gelingt, da sich ein den benignen Nebenschilddrüsenadenomen ähnliches Bild anhand von Klinik und Laborstatus präsentiert. Der präoperativen Sonographie kommt zunehmend eine wichtige Rolle zu [18,19], da sie in der Lage ist, entscheidende und richtungsweisende Befunde zu liefern, die auf das Vorliegen eines Nebenschilddrüsenkarzinoms hindeuten oder aber das Vorliegen mit großer Wahrscheinlichkeit aufzeigen. Normale Nebenschilddrüsen messen ca.…”