dr. v malhotra consultant radiologist whht. the introduction of cross-section imaging, ct and mri...

Dr. V MalhotraConsultant Radiologist

WHHT

The introduction of cross-section imaging, CT and MRI has hugely expanded the scope and ability of head and neck radiology to recognize and assess disease.

Plain radiographs and conventional tomography have virtually no place in the assessment of disease in the modern setting.

Contrast medium studies still have a major role in the assessment of disorders of swallowing.

Ultrasound in skilled hands is fast becoming the first line investigation for many neck conditions.

Role of Radiology:-

Detection of disease . (Modern ENT clinics are equipped with advanced audiological and electrophysiological equipments already)

Pathological characterization if possible. (FNAC)

For ENT surgeon –to know the extent of disease.

THE NOSE AND PARANASAL SINUSES

Common drainage pathways of the maxillary, anterior ethmoid and frontal sinuses

Osteomeatal complex (OMC)

MaxillaryMaxillary sinus sinus MaxillaryMaxillary sinus sinus

Frontal sinusFrontal sinusFrontal sinusFrontal sinus

* *Ethmoid infundibulumEthmoid infundibulumEthmoid infundibulumEthmoid infundibulum

Middle Middle meatusmeatusMiddle Middle meatusmeatus

Uncinate processUncinate processUncinate processUncinate process

Large ethmoid Large ethmoid bullabullaLarge ethmoid Large ethmoid bullabulla

Ethmoid infundibulumEthmoid infundibulumEthmoid infundibulumEthmoid infundibulum

Frontal Frontal recessrecessFrontal Frontal recessrecess

Uncinate processUncinate process

Agger nasi Agger nasi cellscells

Agger nasi Agger nasi cellscells

Frontal Frontal recessrecess Frontal Frontal recessrecess

Uncinectomy, middle meatal Uncinectomy, middle meatal anterostomies, partial ethmoidal anterostomies, partial ethmoidal

resectionresection

Uncinectomy, middle meatal Uncinectomy, middle meatal anterostomies, partial ethmoidal anterostomies, partial ethmoidal

resectionresection

Antrochoanal

polyp

Sinonasal Tumours

Mucocoele

• Acquired deafness and tinnitus are common problems and patients should be carefully selected for imaging.

• Conductive deafness is best imaged with HRCT and • Sensorineural deafness with T2 weighted 3D MRI.

• Common causes of conductive deafness; cholesteatoma, ossicular fixation, ossicular erosion, traumatic subluxations and dislocations and otospongiosis.

• Investigation of acquired sensorineural deafness mainly revolves around excluding vestibular schwannoma and differentiating this from other causes of CP angle masses.

The EAR

Normal 7th & 8th nerves

Acoustic Neuroma

Acoustic Neuromas

Cholestatomas

Normal Lymph node

Mets from SCC

Tubercular node

Met. Papillary Ca.

Normal Thyroid

Benign hyperplasticnodule

Papillary Carcinoma thyroid

Chronic Thyroid Cyst

Chronic Thyroiditis