PMC2846684_01
Radiotherapy planning I. IMRT plan with the planning target volume (PTV) in one CT cross section, red colours indicate a higher dose; a steep dose gradient can be achieved by using fluence modulation with a multi leaf collimator. Normal tissues are optimally spared.
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fig1
Radiotherapy planning was performed using the solution commercialized by VARIAN with the Eclipse treatment planning system (TPS) and the Clinac accelerator (Figures 1 and 2).
Radiotherapy planning II. Another CT section at the lower PTV boundary. Small insets show the complete extension of the PTV.
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fig2
Radiotherapy planning was performed using the solution commercialized by VARIAN with the Eclipse treatment planning system (TPS) and the Clinac accelerator (Figures 1 and 2).
Radiotherapy positioning. Positioning of the patient on the couch. The thermoplastic mask system is used to prevent the patient from moving during the treatment. The lines marked on the mask system are used for the room lasers which are used to define the exact positioning.
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fig3
The planning CT was carried out with 3 mm step size, positioning was done with a thermoplastic mask system (Figure 3).
Endoscopy of the right nasal cavity following removal of the nasal dressing 2 weeks after the last radiotherapy showed a vast septal perforation due to multiple endonasal interventions. A 3 mm bluish spot at the dorso apical border of the septal perforation and very fine teleangiectatic vessels were the only possible and now inactive sites of the former extensive teleangiectatic lesions.
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Only on the dorso-apical edge of the vast septal perforation we could detect a 3 mm bluish spot as possible spot for an old hemangioma (Figures 4 and 5).
Endoscopic picture of the right nasal cavity with anemic and white nasal mucosa.
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fig5
Only on the dorso-apical edge of the vast septal perforation we could detect a 3 mm bluish spot as possible spot for an old hemangioma (Figures 4 and 5).