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 characterization if possible.
(FNAC)
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
Large ethmoid bulla
Uncinate process
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, 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
Acoustic
Neuromas
Cholestatomas
Mets from SCC
Normal Lymph node
Met. Papillary Ca.
Tubercular node
Normal Thyroid
Papillary Carcinoma thyroid
Benign hyperplastic
nodule
Chronic Thyroiditis
Chronic Thyroid Cyst