CASE Presentation
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Two cases are presented; 1st is about throacic outlet syndrome due to cervical rib. 2nd case is fungal sinusitis.
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This document discusses radiological imaging of lesions in the cavernous sinus. It begins with an overview of cavernous sinus anatomy and venous drainage. Common tumors and lesions that can involve the cavernous sinus are then described, including pituitary adenomas, meningiomas, schwannomas, metastases, and vascular lesions such as aneurysms and carotid-cavernous fistulas. For each type of lesion, key imaging features on CT and MRI are provided.
ANATOMY OF LARYNX
The document provides details on the anatomy and development of the larynx. It discusses the key cartilages that make up the laryngeal skeleton, including the thyroid, cricoid, arytenoid, corniculate and epiglottic cartilages. It also describes the role of the hyoid bone in suspending the larynx and providing attachment points for muscles. The larynx forms from swellings in the branchial arches during early gestation and continues developing through differentiation of cartilage and tissues.
anatomy of larynx by ravindra daggupati
The larynx houses the vocal cords and protects the entrance to the lower respiratory tract. It develops from the foregut in the 4th week of gestation. The larynx is made up of cartilage, including the thyroid, cricoid, and arytenoid cartilages. It attaches to the hyoid bone and contains intrinsic muscles. The larynx has supraglottic, glottic, and subglottic regions and differs in infants due to smaller size and shape. The document provides details on the anatomy, development, features and surgical considerations of the larynx.
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CASE Presentation
- 1. CASE PRESENTATION BY Dr. M Kaleem MD Resident, Radiology LGH
- 2. A 40 years old male presented with History of pain, claudication, numbness and Change in color of right upper limb for 2 weeks. No history of paresthesia/ weakness of hand or forearm. O/E, Right hand looks cold, swollen and Area of gangrene seen on radial aspect of hand. Distal radial pulse was not palpable. CTA right upper limb advised. Case # 1
- 3. CT FINDINGS • Right subclavian artery showing string like narrowing involving a segment measuring 2 cm in length in costoclavicular space between the cervical rib and clavicle. Right axillary and proximal brachial arteries show normal contrast opacification. Distal brachial artery shows partial thrombus & is accompanied by collaterals. Radial artery remains unopacified in distal forearm and hand. Rest of the length of radial artery and ulnar artery show fair contrast opacification.
- 4. Diagnosis: Right sided arterial thoracic outlet syndrome with subclavian artery compression and distal embolic phenomena
- 5. • The thoracic outlet extends from the cervical spine and superior border of the mediastinum to the lateral border of the pectoralis minor muscle. The brachial plexus, subclavian vein, and subclavian artery traverse the thoracic outlet, and when compressed, can result in upper extremity symptoms. Patients with symptoms from compression of the neurovascular bundle in the thoracic outlet are described as having thoracic outlet syndrome.... • which is best thought of as three conditions classified according to which structures are involved: 1: Neurogenic TOS (from compression of the brachial plexus nerves), 2: venous TOS (from compression of the subclavian vein). 3: Arterial TOS (from compression of the subclavian artery)
- 6. • There are three common sites of compression: • 1: Scalene triangle: between scalenus anterior and scalenus medius muscles • 2: Costoclavicular space: between the clavicle and 1st rib • 3: Retropectoralis minor space: between pectoralis minor and coracoid process • The scalene triangle is defined by the first rib and the anterior and middle scalene muscles and is the most medial compartment. The subclavian artery and branches of the brachial plexus pass through the borders of this
- 18. Arterial TOS consists of two components: damage to the subclavian artery at the level of the first rib and distal embolic phenomena. Arterial TOS is almost always associated with underlying bone abnormalities, either a cervical rib, anomalous first rib, or first rib or clavicle fracture
- 22. Case # 2
- 23. • A 25 years old male patient presented with complaint of fever off & on, nasal obstruction & left eye proptosis since 3 months. • No history of DM, HTN & smoking. • His CT PNS was done.
- 26. • Findings Heterogenous expansile soft tissue density lesion in left maxillary, ethmoidal,frontal, sphenoid sinuses and left nasal cavity with internal hyperdensity. There is ballooning, thinning and erosion of left lamina papyracea and left cribriform plate with possible extension into the left orbit. Diagnosis: Chronic invasive Fungal Sinusitis
- 27. Fungal sinusitis is a sinus infection that results from a fungus. TYPES 1- Non-invasive: hyphae do not invade the mucosa e.g: I: Allergic fungal sinusitis II: Sinus fungal mycetoma 2- invasive: hyphae are seen invading mucosa +/- beyond I: Acute invasive fungal sinusitis II: Chronic invasive fungal sinusitis III: Granulomatous invasive fungal sinusitis Fungal sinusitis
- 28. Pathology Infection is believed to originate in the nasal cavity (most often the middle turbinate) with subsequent spread to the paranasal sinuses. The infection can spread rapidly from the sinuses via vascular invasion and bony erosion, potentially leading to an extension to the orbit, brain, cavernous sinus or carotid arteries.
- 29. • Complications • intraorbital extension • intracranial extension – leptomeningeal enhancement – intracranial granulomas – epidural abscess and empyema • vascular invasion – cavernous or dural venous sinus thrombosis – mycotic aneurysm formation – cerebral infarction or hemorrhage – systemic dissemination