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Imaging for ENT. Dr. V Malhotra Consultant 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. .

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imaging for ent

Imaging for ENT

Dr. V Malhotra

Consultant Radiologist

WHHT

slide2

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.

slide3

Role of Radiology:-

  • Detection of disease .
  • (Modern ENT clinics are equipped with advanced
  • audiological and electrophysiological equipments already)
  • Pathological characterizationif possible.
  • (FNAC)
  • For ENT surgeon –to know the extent of disease.
slide4

THE NOSE AND PARANASAL SINUSES

  • Rhinosinusitis
  • This is an extremely common condition which is usually treated medically.
  • Radiological investigation is rarely required unless surgical intervention is contemplated.
  • Common problems requiring imaging include:
                  • Nasal Polyposis
                  • Antrochoanal polyp
                  • Mucocoeles
                  • Fractures
                  • Epistaxis
                  • Nasal and paranasal tumours
slide5

Osteomeatal complex (OMC)

Common drainage pathways of the maxillary,

anterior ethmoid and frontal sinuses

mucociliary drainage routes
Mucociliary drainage routes

Maxillarysinus

Frontal sinus

concha bullosa

Middle meatus

Uncinate process

*

*

Ethmoid infundibulum

Concha bullosa
large ethmoid bulla

Frontal recess

Ethmoid infundibulum

Uncinate process

Large ethmoid bulla

Large ethmoid bulla
functional endoscopic sinus surgery fess main goal enlarge the natural sinus ostia
Functional Endoscopic Sinus Surgery (FESS)Main goal: enlarge the natural sinus ostia

Uncinectomy, middle meatal anterostomies, partial ethmoidal resection

nasal polyposis
Nasal Polyposis

Antrochoanal polyp

slide14

Mucocoele

Sinonasal Tumours

slide15

The EAR

  • 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.
slide16

Normal 7th & 8th nerves

Acoustic Neuroma

slide20

Mets from SCC

Normal Lymph node

slide21

Met. Papillary Ca.

Tubercular node

slide23

Papillary Carcinoma thyroid

Benign hyperplastic

nodule

slide24

Chronic Thyroiditis

Chronic Thyroid Cyst

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