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Imaging for ENT

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

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  1. Imaging for ENT Dr. V Malhotra Consultant Radiologist WHHT

  2. 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.

  3. 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.

  4. 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

  5. Osteomeatal complex (OMC) Common drainage pathways of the maxillary, anterior ethmoid and frontal sinuses

  6. Mucociliary drainage routes Maxillarysinus Frontal sinus

  7. Mucociliary drainage routes

  8. Acute Rhinosinusitis

  9. Middle meatus Uncinate process * * Ethmoid infundibulum Concha bullosa

  10. Frontal recess Ethmoid infundibulum Uncinate process Large ethmoid bulla Large ethmoid bulla

  11. Agger nasi cells Agger nasi cells Frontal recess

  12. Functional Endoscopic Sinus Surgery (FESS)Main goal: enlarge the natural sinus ostia Uncinectomy, middle meatal anterostomies, partial ethmoidal resection

  13. Nasal Polyposis Antrochoanal polyp

  14. Mucocoele Sinonasal Tumours

  15. 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.

  16. Normal 7th & 8th nerves Acoustic Neuroma

  17. Acoustic Neuromas

  18. Cholestatomas

  19. Mets from SCC Normal Lymph node

  20. Met. Papillary Ca. Tubercular node

  21. Normal Thyroid

  22. Papillary Carcinoma thyroid Benign hyperplastic nodule

  23. Chronic Thyroiditis Chronic Thyroid Cyst

  24. Thank You

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