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Abstract Objectives Sialendoscopy has become the standard treatment for sialolithiasis; however, larger submandibular calculi may require an incisional technique. This study describes and evaluates an intraoral microscopic‐assisted sialolithotomy (IMAS) as a refined submandibular stone extraction technique. Methods Retrospective case series of 64 submandibular IMAS procedures operated at a tertiary university center and private hospital from 2015 to 2021 were evaluated. Preoperative radiological assessment included noncontrast computed tomography scan ± magnetic resonance sialography. Stone characteristics (side, number, size, and location), operative findings, complications, and postoperative follow‐up were reviewed. Success was defined as successful intraoral stone extraction with no symptoms or stone recurrence for at least 12 months postoperatively. Results The study included 43 males and 19 females, mean age 38 ± 12 years. Two patients had bilateral stones. All but one operated gland had stones extracted (98.4%), however the true success was 93.8% (60/64) as three patients had recurrent/residual stones within a year. Biggest stone longest diameter was 9.8 ± 4.6 mm (range, 5–30 mm). Hilar and intraglandular stone locations were 73.4% and 6.3%, respectively. Median operative time was 55 min. Adjunctive sialendoscopy was performed in 42.2%. Its use is significantly correlated with having ˃3 stones (mean 3.4 vs. 1.2 stones) [P

Abstract Background Conventional MRI has no distinction between high- and low-grade meningiomas, which has a crucial for choice of therapeutic plan, especially skull base meningiomas which need more meticulous endoscopy-approached surgery. The aim of our study was to evaluate role of perfusion by arterial spin labeling and dynamic susceptibility perfusion in grading of skull base meningiomas. Results The relative arterial spin labeling (ASL), tumor blood flow (TBF), and tumor blood volume (TBV) ratios showed significant differences between low- and high-grade meningiomas. Conclusions MRI perfusion is a useful in differentiation between low- and high-grade meningiomas. There is significant correlation between ASL and DSC perfusion supporting possibility of using ASL in clinical practice as an alternative technique to DSC perfusion, particularly for patients with renal impairment where no contrast injection needed.

The most difficult diagnostic challenge in neck imaging is the differentiation between benign and malignant neoplasms. The purpose of this work was to study the role of the ADC (apparent diffusion coefficient) value in discriminating benign from malignant neck neoplastic lesions. The study was conducted on 53 patients with different neck pathologies (35 malignant and 18 benign/inflammatory). In all of the subjects, conventional MRI (magnetic resonance imaging) sequences were performed apart from DWI (diffusion-weighted imaging). The mean ADC values in the benign and malignant groups were compared using the Mann–Whitney test. The ADCs of malignant lesions (mean 0.86 ± 0.28) were significantly lower than the benign lesions (mean 1.43 ± 0.57), and the mean ADC values of the inflammatory lesions (1.19 ± 0.75) were significantly lower than those of the benign lesions. The cutoff value of 1.1 mm2/s effectively differentiated benign and malignant lesions with a 97.14% sensitivity, a 77.78% specificity, and an 86.2% accuracy. There were also statistically significant differences between the ADC values of different malignant tumors of the neck (p, 0.001). NHL (0.59 ± 0.09) revealed significantly lower ADC values than SCC (0.93 ± 0.15). An ADC cutoff point of 0.7 mm2/s was the best for differentiating NHL (non-Hodgkin lymphoma) from SCC (squamous cell carcinoma); it provided a diagnostic ability of 100.0% sensitivity and 89.47% specificity. ADC mapping may be an effective MRI tool for the differentiation of benign and inflammatory lesions from malignant tumors in the neck.

Purpose: To examine the potential of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) for differentiating recurrent laryngeal cancer from post treatment changes. Materials and methods: A prospectively designed study was conducted on 50 patients having laryngeal cancers treated by surgery or chemoradiotherapy or both. In all subjects, conventional MRI sequences were performed apart from DWI and DCE sequences. Mean ADC values in benign and malignant groups were compared. Different patterns of dynamic curves were compared qualitatively and semiquantitatively using washout ratio (WR), time to peak (Tpeak) and maximum contrast enhancement in both groups. Results: ADC cutoff value of 0.9667 × 10−3 mm2/s effectively differentiated benign and malignant lesions with 100% sensitivity, 74.2% specificity and 84% accuracy. Mean WR in benign or inflammatory lesions was significantly lower than in malignant tumors. A cutoff value of WR −7.995 can differentiate benign post treatment changes from malignant recurrence with sensitivity of 96.6%, specificity of 81.2% and overall accuracy of 88.9%. Conclusions: ADC mapping and DCE MRI are effective MRI tools for the differentiation of benign post treatment changes from malignant recurrence in laryngeal cancer.