E-Book, Englisch, 880 Seiten, ePub
Mafee / Valvassori / Becker Imaging of the Head and Neck
2. Auflage 2004
ISBN: 978-3-13-257876-0
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
E-Book, Englisch, 880 Seiten, ePub
ISBN: 978-3-13-257876-0
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
A Thieme classic in a revised and updated second edition!
More than 3,700 illustrations and systematic coverage of the latest technical developments make the new edition of Valvassori's world-famous text your complete guide to head and neck imaging. Fully revised and updated to include a wider range findings in both adults and children, the book provides in-depth discussions of the eye and orbit, lacrimal drainage system, skull base, mandible and maxilla, temporomandibular joint, and suprahyroid and infrahyroid neck. CT and MRI scans acquired with the most advanced high-resolution equipment show all anatomic structures and pathological conditions, with actual cases clarifying every concept.
With thorough coverage of the newest imaging modalities, an abundance of high-quality graphics, and the expertise of worldwide leaders in the field, this is the reference of choice on head and neck imaging for experienced practitioners and residents-in-training.
Zielgruppe
Ärzte
Autoren/Hrsg.
Fachgebiete
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Klinische und Innere Medizin Rheumatologie, Muskelerkrankungen
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Bildgebende Verfahren, Nuklearmedizin, Strahlentherapie Neuroradiologie
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Orthopädie, konservativ
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Klinische und Innere Medizin Neurologie, Klinische Neurowissenschaft
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Bildgebende Verfahren, Nuklearmedizin, Strahlentherapie Radiologie, Bildgebende Verfahren
Weitere Infos & Material
Section I: Temporal Bone
Chapter 1: Imaging of the Temporal Bone
Section II: Eye and Orbit, Base of the Skull
Chapter 2: Eye and Orbit
Chapter 3: Base of the Skull
Section III: Nasal Cavity and Paranasal Sinuses
Chapter 4: Imaging of the Nasal Cavity and Paranasal Sinuses
Section IV: Masticatory System
Chapter 5: Temporomandibular Joint
Chapter 6: Mandible and Maxilla
Section V: Suprahyoid Neck
Chapter 7: Nasopharynx
Chapter 8: Parapharyngeal and Masticator Spaces
Chapter 9: Salivary Glands
Chapter 10: Oral Cavity and Oropharynx
Section VI: Infrahyoid Neck
Chapter 11: Larynx and Hypopharynx
Chapter 12: Other Infrahyoid Neck Lesions
1 Imaging of the Temporal Bone
Galdino E. Valvassori
Sectional Anatomy of the Temporal Bone
Anatomical Notes
Mastoid
The mastoid air cells are a series of intercommunicating cavities lined by mucous membrane. The mastoid antrum is the largest air cell and communicates anteriorly with the attic through an opening called the aditus.
External Auditory Canal
The canal is approximately 2.5–3.5 cm long and 6–9 mm wide. The outer one-third is formed by an extension of the cartilage of the auricle, the inner two-thirds by the incomplete ring of the tympanic bone. The canal and the outer surface of the tympanic membrane are lined by skin.
Tympanic Membrane
The membrane separates the external auditory canal from the middle ear cavity and consists of a fibroelastic layer covered on the outer surface by the canal skin and on the medial surface by the middle ear mucosa. The circumference of the membrane is thickened and forms a fibrocartilage ring (annulus) that is open anterosuperiorly. The adjacent triangular segment of the membrane bordered by the mallear folds is devoid of fibroelastic layer, thus dividing the membrane into a small pars flaccida and a large pars tensa. The membrane is convex medially and the handle of the malleus, which is firmly attached to the inner surface of the membrane, reaches the point of greatest convexity, called the umbo.
Middle Ear
The middle ear or tympanic cavity is an air-filled irregular space bounded laterally by the tympanic membrane and above it by the lateral attic wall, medially by the capsule of the inner ear, superiorly by the tegmen tympani, and inferiorly by the hypotympanic floor. It is divided into three portions: medial to the tympanic membrane, the mesotympanum; above the epitympanic recess or attic; and below the level of the canal floor, the hypotympanum, which covers the jugular bulb. The eustachian tube and the tensor tympani canal open in the anterior wall. In the posterior wall of the mesotympanum is the pyramidal eminence, a hollowed conical bony protrusion that houses the stapedius muscle and transmits its tendon. Lateral to the pyramidal eminence is the facial recess, which covers the upper portion of the mastoid segment of the facial canal; medial is the sinus tympani, a posterior pocket of mesotypanum of variable depths.
The medial or labyrinthine wall of the middle ear presents an upper bulge formed by the horizontal semicircular canal and a lower rounded elevation (the promontory) due to the lateral aspect of the basal turn of the cochlea. Posterior to the promontory are the depression of the oval (vestibular) and round (cochlear) windows.
Within the middle ear space is an ossicular chain made up of three small ossicles. In the attic, the head of the malleus articulates with the incus body, which narrows posteriorly to form its short process. The malleus handle extends inferiorly to the tympanic membrane; the long process of the incus articulates with the head of the stapes.
Facial Nerve
The facial nerve exits the brain about 2 mm anterior to the eighth cranial nerve, crosses the cerebellopontine cistern, and enters the internal auditory canal anterosuperior to the acoustic nerve. At the fundus of the canal, the facial nerve enters the facial or fallopian canal, which runs anterolaterally to the geniculate ganglion (labyrinthine or petrous segment) where the greater petrosal nerve leaves the ganglion to join the deep petrosal nerve and thus forming the vidian nerve. At the geniculate ganglion, the nerve makes a sharp turn (anterior genu) and then follows the entire medial wall of the middle ear, passing just above the oval window (tympanic segment). At the level of the pyramidal eminence, the facial nerve turns again (pyramidal turn) and passes downward to the stylomastoid foramen (mastoid segment), where it exits the temporal bone to enter the parotid gland.
Inner Ear
The bony labyrinth, which lies within the petrous pyramid, is filled with perilymph. The smaller membranous labyrinth, which contains endolymph, lies within the bony labyrinth and floats in the perilymph. The perilymphatic space is in direct communciation with the subarachnoid space via the cochlear aqueduct. The endolymph-filled spaces have no connection with the subarachnoid space and terminate in the closed endolymphatic sac, which lies under the dura of the posterior cranial fossa.
The bony labyrinth consists of the cochlea, vestibule, and semicircular canals. The membranous labyrinth includes the cochlear duct within the cochlea, the utricle and saccule within the vestibule, and the membranous semicircular canals. The overall volume of the bony labyrinth is 0.2 cm3 or 200 µl.3 The membranous labyrinth volume is approximately one-fifth of the bony labyrinth, namely 0.04 cm3 or 40 µl.
Sectional Anatomy
The normal sectional anatomy will be illustrated by macrosections of the temporal bone obtained in the axial, coronal, 20° coronal oblique, and sagittal planes. Each section will be compared to the corresponding microradiograph and CT image.31 However, whereas all microradiographs and sagittal CT images were obtained from the same temporal bone as the macrosections, the axial, coronal, and 20° coronal oblique CT images are from other studies on living objects. This explains why the CT sections are similar but not identical to the corresponding macrosections and microradiographs.
Axial Sections
Figure 1.1 exposes structures in a 2 mm thick axial section of a right adult temporal bone, 2 mm inferior to the arcuate eminence. The mastoid air cells occupy the lateral portion of the section; the anterior and posterior limbs of the superior semicircular canal are in the center. Subarcuate vessels pass between the limbs of the superior canal. The superior petrosal sinus courses along the superior margin of the petrous apex.
Fig. 1.1a Axial macrosection 2mm below the arcuate eminence.
b CT corresponding to a.
c Structures seen at this level.
d Microradiograph corresponding to a, b.
Figure 1.2 shows the structures in a 2 mm thick axial section of a right adult temporal bone immediately inferior to Figure 1.1. The aditus of the mastoid antrum opens into the epitympanum. Mastoid air cells surround the epitympanum and antrum. Superior portions of the malleus head and incus body appear in the epitympanum. The nonampullated limbs of the superior and posterior semicircular canals join at the crus commune. The subarcuate vessels pass from the subarcuate fossa laterally between the limbs of the superior semicircular canal. The horizontal semicircular canal forms the medial wall of the antrum, and the ampullated portions of the horizonal and superior semicircular canals open into the superior portion of the vestibule. This section also exposes the roof of the internal auditory canal.
Figures 1.3 and 1.4 reveal the structures seen in the upper and lower surfaces of a 2 mm thick axial section of a right adult temporal bone immediately inferior to Figure 1.2. Mastoid air cells surround the antrum and extend lateral to the epitympanum. The malleus head and incus body occupy the epitympanum, and the incus short process rests in the fossa incudis. The cavity of the epitympanum assumes a somewhat triangular shape at this level. The medial and lateral epitympanic walls converge posteriorly at the aditus, while the base of the triangle lies anteriorly. The medial wall forms a 20–25° angle with the sagittal plane crossing the fossa incudis. The lateral wall forms a 10° angle lateral to the sagittal plane through the fossa incudis.
The ampullated end of the horizontal semicircular canal enters the vestibule anteriorly (Fig. 1.3), and the nonampullated end opens into the posterior portion of the vestibule (Fig. 1.4) The posterior semicircular canal extends posterolaterally from the crus commune. The macula of the utricle stretches across the upper portion of the vestibule (Fig. 1.4a). The facial and superior vestibular nerves occupy the internal auditory canal. The superior vestibular nerve arches toward the utricular macula and the ampullae of the horizontal and superior semicircular canals (Fig. 1.3 a). The petrous or labyrinthine portion of the facial nerve extends from the internal auditory canal to the geniculate ganglion. At the geniculate ganglion, the facial nerve turns sharply into the horizontal portion and extends posteriorly along the medial wall of the tympanum just below the horizontal semicircular canal (Figs. 1.3 a, 1.4b). Superior portions of the basal and middle coils of the cochlea appear anterior to the fundus of the internal auditory canal. The superior turn of the vestibular aqueduct passes adjacent to the posterior semicircular canal (Figs. 1.3b, 1.4b).
Fig. 1.2a Axial macrosection immediately inferior to Fig. 1.1a.
b CT corresponding to a.
c Structures seen at this level.
d Microradiograph corresponding to a, b.
Fig. 1.3a Upper surface of an axial macrosection immediately inferior to Fig. 1.2a.
b CT corresponding to a.
Figures 1.5 and 1.6 demonstrate the structures seen in the upper and lower surfaces of a 2 mm thick axial section of a right, adult temporal bone, immediately inferior to Figure 1.4. The...
