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. 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 (FNAC) characterization if possible.  For ENT surgeon –to know the extent of disease.

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

Osteomeatal complex (OMC)

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

Maxillary sinus Frontal sinus

* Middle meatus Uncinate process * Ethmoid infundibulum

Frontal recess Uncinate process Large ethmoid bulla Ethmoid infundibulum

Frontal recess Agger nasi cells

Uncinectomy, middle meatal anterostomies, partial ethmoidal resection

Antrochoanal polyp

Mucocoele Sinonasal Tumours

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 otospongiosis.

, ossicular fixation, ossicular erosion, traumatic subluxations and dislocations and • Investigation of acquired sensorineural deafness mainly revolves around excluding vestibular schwannoma and differentiating this from other causes of CP angle masses.

Normal 7 th & 8 th nerves Acoustic Neuroma

Acoustic Neuromas

Cholestatomas

Normal Lymph node Mets from SCC

Tubercular node Met. Papillary Ca.

Normal Thyroid

Benign hyperplastic nodule Papillary Carcinoma thyroid

Chronic Thyroid Cyst Chronic Thyroiditis