title: Dynamic maneuvers in local staging of head and neck malignancies with current imaging techniques: principles and clinical applications.
abstract: Imaging has been widely demonstrated to be important in local staging of head and neck malignancies as a complement to clinical examination, including endoscopy. Recent developments in multidetector row computed tomography (CT) provide better anatomic resolution within a shorter acquisition time and wider anatomic coverage. However, in many cases lesions still remain undefined. In such cases, performance of dynamic maneuvers could provide useful information about the local extent of a tumor. The usefulness of dynamic maneuvers has increased with the improvement in temporal and spatial resolution that resulted from the most recent techniques of multidetector row CT. The puffed cheek technique and the modified Valsalva maneuver allow evaluation of a lesion that was poorly demonstrated owing to apposition of mucosal surfaces. In some cases, phonation improves demonstration of small lesions of the vocal cords and allows more precise anatomic localization. The open mouth technique allows demonstration of a lesion that was previously overlooked due to dental amalgam artifacts.
authors.affiliation: Department of Radiology, Centre Alexis Vautrin, Ave de Bourgogne, 54511 Vandoeuvre-lès-Nancy, France. p.henrot@nancy.fnclcc.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Henrot
authors.forename: Alain
authors.initials: A
authors.lastname: Blum
authors.forename: Bruno
authors.initials: B
authors.lastname: Toussaint
authors.forename: Philippe
authors.initials: P
authors.lastname: Troufleau
authors.forename: Joseph
authors.initials: J
authors.lastname: Stines
authors.forename: Jacques
authors.initials: J
authors.lastname: Roland
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology*; D006257:Head / Q000000981:diagnostic imaging; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D009333:Neck / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D011187:Posture; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000639:trends*