Is the tongue position influenced by the palatal vault dimensions?

Summary The influence of the palatal vault dimensions on tongue position is here studied through evaluation of the in‐mouth air cavity (IMAC) volume when the mandible is in maximal intercuspal position. A sample of 35 women (mean age 21·2 ± 1·0) and 15 men (mean age 22·1 ± 0·9) was selected. The sagittal cross‐section area of the IMAC, which is modulated by the tongue position, was measured on lateral cephalograms. Dental casts were used to measure the palatal vault volume, which was defined by the occlusal plane, the hard palate and the posterior face of the second molars. Palatal vault volume allowed deduction of the IMAC volume through a rule of three procedure relating volume to area ratios. No IMAC could be calculated from cephalograms of 10 subjects who had the tongue stuck to the palate. For the 40 other subjects, the IMAC volume was 8·9 ± 4·8 mL. It was 2 mL larger in men (n = 14) than in women (n = 26) and was the largest in skeletal Class III and the smallest in skeletal Class II (P > 0·05). IMAC volume was strongly correlated with palatal vault height but neither with palatal width nor length. It was thus assumed that the height of the palatal vault could influence the most observed position of the tongue but this does not exclude a possible growth influence of the tongue on its surrounding skeletal structures.     

Meningeal melanocytoma of the posterior fossa: case report and literature review

BACKGROUND: Meningeal melanocytomas are rare primary melanotic tumors of the leptomeninges. According to our review of the literature, just 22 cases of meningeal melanocytoma (MM) of the posterior fossa have been previously reported. Some aspects related to diagnosis, radiological appearance, histopathologic features, and management are discussed in this paper. CASE DESCRIPTION: We describe the case of a 42-year-old female presenting with severe headache, nausea, and vomiting. Computed tomography and magnetic resonance imaging demonstrated a posterior fossa lesion that was surgically treated. Histopathologic examination showed a highly cellular melanocytic neoplasm with numerous dark pigments in the cytoplasm. Immunoperoxidase staining S-100 protein and HMB 45 demonstrated immunoreactivity for both, confirming the diagnosis of MM. CONCLUSIONS: In conclusion, MMs are rare histologically benign tumors that can be cured by complete surgical resection alone, which should be the goal of the treatment. These lesions, although rare, should be considered in the differential diagnosis of tumors of the posterior fossa.     

The light bulb sign in pheochromocytoma

Abdominal Radiology -     

Long‐standing ulcerative colitis complicated by right subclavian artery occlusion and upper limbs arteriolitis with digital ischemia

A 48‐year‐old male patient with long‐standing ulcerative colitis since February 2001 which was diagnosed by endoscopy, developed acute digital ischemia affecting both hands with fixed colour changes in the left index finger which was followed shortly by digital ulceration. Magnetic resonance angiography (MRA) of both upper limbs showed evidence of vasculitis affecting digital arterioles on both sided and right subclavian occlusion. The patient received pulse methylprednisolone followed by cyclophosphamide pulse therapy, the latter continuing on a monthly basis for 6 months with appreciable improvement and remission of the vasculitic process; follow‐up MRA showed reperfusion of the previously occluded subcalvian artery. To the authors’ knowledge vasculitis complicating the course of ulcerative colitis is a rare association and is only sporadically reported in the literature. This rare entity should be diagnosed early and aggressively treated; MRA is a very promising diagnostic tool that is suitable for both diagnosis and follow‐up of patients with this rare entity.