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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


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 characterizationif possible.

  • (FNAC)

  • For ENT surgeon –to know the extent of disease.


  • 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

Osteomeatal complex (OMC)

Common drainage pathways of the maxillary,

anterior ethmoid and frontal sinuses

Mucociliary drainage routes
Mucociliary drainage routes


Frontal sinus

Mucociliary drainage routes1
Mucociliary drainage routes

Acute rhinosinusitis
Acute Rhinosinusitis

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

Agger nasi cells

Agger nasi cells

Agger nasi cells

Frontal recess

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


Sinonasal Tumours


  • 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.

Normal 7th & 8th nerves

Acoustic Neuroma

Mets from SCC

Normal Lymph node

Met. Papillary Ca.

Tubercular node

Papillary Carcinoma thyroid

Benign hyperplastic


Chronic Thyroiditis

Chronic Thyroid Cyst