Shehbaz Ansari, Surjith Vattoth, Eric R Basappa, Pokhraj Prakashchandra Suthar, Santhosh Gaddikeri, Miral D Jhaveri
{"title":"Revisiting the \"Puffed Cheek\" Technique: Advantages, Fallacies, and Potential Solutions.","authors":"Shehbaz Ansari, Surjith Vattoth, Eric R Basappa, Pokhraj Prakashchandra Suthar, Santhosh Gaddikeri, Miral D Jhaveri","doi":"10.1148/rycan.230211","DOIUrl":null,"url":null,"abstract":"<p><p>The \"puffed cheek\" technique is routinely performed during CT neck studies in patients with suspected oral cavity cancers. The insufflation of air within the oral vestibule helps in the detection of small buccal mucosal lesions, with better delineation of lesion origin, depth, and extent of spread. The pitfalls associated with this technique are often underrecognized and poorly understood. They can mimic actual lesions, forfeiting the technique's primary purpose. This review provides an overview of the puffed cheek technique and its associated pitfalls. These pitfalls include pneumoparotid, soft palate elevation that resembles a nasopharyngeal mass, various tongue displacements or distortions that obscure tongue lesions or mimic them, sublingual gland herniation, an apparent exacerbation of the airway edema, vocal cord adduction that hinders glottic evaluation, and false indications of osteochondronecrosis in laryngeal cartilage. Most stem from a common underlying mechanism of unintentional Valsalva maneuver engaged in by the patient while trying to perform a puffed cheek, creating a closed air column under positive pressure with resultant surrounding soft-tissue displacement. These pitfalls can thus be avoided by instructing the patient to maintain continuous nasal breathing while puffing out their cheek during image acquisition, preventing the formation of the closed air column. <b>Keywords:</b> CT, Head/Neck © RSNA, 2024.</p>","PeriodicalId":20786,"journal":{"name":"Radiology. Imaging cancer","volume":null,"pages":null},"PeriodicalIF":5.6000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11148836/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiology. Imaging cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1148/rycan.230211","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
The "puffed cheek" technique is routinely performed during CT neck studies in patients with suspected oral cavity cancers. The insufflation of air within the oral vestibule helps in the detection of small buccal mucosal lesions, with better delineation of lesion origin, depth, and extent of spread. The pitfalls associated with this technique are often underrecognized and poorly understood. They can mimic actual lesions, forfeiting the technique's primary purpose. This review provides an overview of the puffed cheek technique and its associated pitfalls. These pitfalls include pneumoparotid, soft palate elevation that resembles a nasopharyngeal mass, various tongue displacements or distortions that obscure tongue lesions or mimic them, sublingual gland herniation, an apparent exacerbation of the airway edema, vocal cord adduction that hinders glottic evaluation, and false indications of osteochondronecrosis in laryngeal cartilage. Most stem from a common underlying mechanism of unintentional Valsalva maneuver engaged in by the patient while trying to perform a puffed cheek, creating a closed air column under positive pressure with resultant surrounding soft-tissue displacement. These pitfalls can thus be avoided by instructing the patient to maintain continuous nasal breathing while puffing out their cheek during image acquisition, preventing the formation of the closed air column. Keywords: CT, Head/Neck © RSNA, 2024.
重新审视 "鼓腮 "技术:优势、谬误和潜在解决方案。
在对疑似口腔癌患者进行颈部 CT 检查时,通常会采用 "鼓腮 "技术。向口腔前庭充气有助于发现小的颊粘膜病变,更好地确定病变的起源、深度和扩散范围。与这一技术相关的误区往往未被充分认识和理解。它们可能会模仿实际病变,从而失去了该技术的主要目的。本综述概述了鼓腮技术及其相关隐患。这些误区包括气胸、类似鼻咽肿块的软腭隆起、掩盖或模仿舌头病变的各种舌头移位或扭曲、舌下腺疝、气道水肿的明显加重、阻碍声门评估的声带内收以及喉软骨骨软化的错误提示。大多数情况都源于一个共同的潜在机制,即患者在试图做膨腮动作时无意中做了瓦尔萨尔瓦动作,在正压下形成了一个封闭的气柱,导致周围软组织移位。因此,可以通过指导患者在图像采集过程中保持持续的鼻腔呼吸,同时鼓起脸颊,防止形成封闭气柱,从而避免这些误区。关键词头颈部 CT © RSNA, 2024.
本文章由计算机程序翻译,如有差异,请以英文原文为准。