Interactive Transcript
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So this is a patient that has a
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left glossotonsillar sulcus carcinoma.
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And so when we look at the glossotonsillar sulcus,
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it's actually in a very interesting location.
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So what I'm gonna do is I'm gonna outline the
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normal anatomy of the glossotonsillar sulcus.
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So before I begin to talk about the glossotonsillar
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sulcus, I want to go over the normal anatomy.
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So this area right here...
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This muscle right here extends to the
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genial tubercle to the tongue base.
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And when we look at the tongue base, we can see these
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various transverse fibers that go from right to left.
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So this muscle is the genioglossus muscle.
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So the tongue base is the tongue.
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And Greek for tongue is gloss.
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And Latin for tongue is lingua.
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So that's actually part of the confusion.
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So the normal sulcus that's
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located between the tongue...
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And the lower pole, the tonsil is here, and
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this little area that it stretches out is
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referred to as the glossotonsillar sulcus.
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Now, when patients present with unknown
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primaries, probably one of the most likely
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areas that you can have early, early carcinomas
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is right here in this glossotonsillar sulcus.
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So it's a subtle area, but we
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have to be familiar with it.
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Now on the left-hand side, what we see
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is this mass right here that's involving
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the left glossotonsillar sulcus.
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Now this image on your left
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is actually a non-contrast CT.
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If you're evaluating patients that potentially
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have malignancy involving the neck, and as a
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result, essentially in all neck CTs, you really
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should be performing contrast because when you
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give contrast you can see that there's enhancement
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of this mass, and I would suggest that you
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can see this mass a lot easier with contrast
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than you can without contrast.
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So this is the classic example
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of a glossotonsillar sulcus.
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The other piece of anatomy that I wanna point
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out is that if you look right at the tip of my
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arrow right here, this is the tip of the uvula.
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Everyone see that now?
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Right at the tip of the uvula?
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You're at the level of the circumvallate papillae.
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So when we talked about the circumvallate
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papillae in the introduction, we can
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approximate that location by looking at the
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tip of the uvula on the sagittal images.
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What we have here is this mass involving
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the left lateral aspect of the tongue base,
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extending into the glosso-tonsillar sulcus.
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So that's the cancer.
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And this air right here is actually an ulceration.
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So on the coronal images here, we see the
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normal air right here involving the airway.
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But this area right here where this air is,
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is actually an ulceration extending into
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this left glosso-tonsillar sulcus carcinoma.
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