Abstractbook als PDF downloaden - hno kongress 2011

Histologie: Ektopes SD-Gewebe im Bereich des Zungengrundes.
Postoperativ besteht eine diskrete Dysphagie und eine leichte subklin. Hypothyreose.
Szintigraphie: Der präoperative Speicherfokus ist nicht mehr vorhanden.
Labor (postoperativ): Anhaltend subklinische Hypothyreose mit massiv erhöhtem TSH –
die Substitution mit L-Thyroxin wird erhöht.
Schlussfolgerung: Zungengrundstrumen stellen eine Rarität dar. Orthotopes SD-Gewebe
ist im vorliegenden Fall nicht vorhanden, klinisch bestehen die typ. Symptome einer
Hypothyreose. Bei geringer operativer Komplikationsrate, ist der Eingriff auch bei niedrigem
Entartungsrisiko gerechtfertigt. Alternativ: engmaschige Kontrollen. Prä- und postoperative
SD-Kontrolluntersuchungen sind wichtig, ebenso die Substitution mit L-Thyroxin.
G6/2 – O6
Prevertebral Tendinitis or Benign Prevertebral Effusion - an uncommon
differential diagnosis of retropharyngeal abscess formation
Georg Philipp Hammer 1 , Robert Vollmann 2 , Josef Simbrunner 2 , Karl Kiesler 1 ,
Gerhard Friedrich 1
1
Universitäts-Klinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Graz, Austria
2
Universitäts-Klinik für Radiologie, Medizinische Universität Graz, Austria
Purpose: The prevertebral tendinitis is an inflammatory process, which affects the
cervicothoracic prevertebral muscles. This extremely rare entity was first described by
Hartley and Fahlgren in 1964 and until now there exist just some case reports or case series
dealing with this process.
Unfortunately it is quite easy to misdiagnose or mistake the prevertebral tendinitis as an
abscess, because of the imaging features.
The aim of this study is to offer pathways in the diagnosis of this rare disease and to prevent
unnecessary surgery.
Methods and Materials: Six patients with already by imaging or retrospectively after surgery
by pathologic report diagnosed prevertebral tendinitis were included in this study. Three
patients just received contrast enhanced computed tomography (CT) and another group of
three patients received magnetic resonance imaging (MRI). In two out of three MRI
examinations, we additionally performed diffusion weighted images (DWI) and calculated the
apparent diffusion coefficient (ADC) map.
Results: In two out of three patients, who received CT examinations, the prevertebral
inflammatory changes were misdiagnosed as an abscess. This diagnosis was corrected after
surgery by pathologic report.
All patients revealed a prevertebral effusion. Five out of six patients showed
amorphous calcifications in the tendon of the prevertebral muscles. In all cases a slight
elevation of CRP and a normal WBCC was observed.
Conclusion: The prevertebral tendinitis can easily be mistaken as an abscess in CT scans.
Howeverit is necessary to make a clear diagnosis to avoid unnecessary surgery. According
to ourpatients the best imaging feature is MRI with DWI and ADC map to exclude an abscess
and reveal the benign prevertebral effusion to confirm the diagnosis of prevertebraltendinits.
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