بسم الله الرحمن الرحيم
ORL IMAGING
Plain X-Rays Nasal Bones
Normal Bony Nasal skeleton
Plain x-rays nasal bones Normal # Nasal bones
CT nasal bones
Important Note Radiology is NOT NECESSARY for the management of fractured nasal bone The main factor that determine the treatment is the CLINICAL APPEARANCE of the nose
PARANASAL SINUSES
IMAGING OF THE PARANASAL SINUSES Plain X-Rays CT scan MRI
PLAIN X-RAYS OF THE PARANASAL SINUSES Occipitomental Occipitofrontal
OCCIPITOMENTAL VIEW (WATER’S VIEW)
OCCIPITO-FRONTAL VIEW (CALDWELL VIEW)
LATERAL VIEW
Occipito mental Occipito frontal Lateral
Indication X Ray Paranasal Sinuses Management of sinusitis if CT is not available
Acute & Chronic Sinusitis
Mucosal thickening
Fluid Level
Complete opacity
CT SINUSES Axial (Transverse) Coronal
Normal Axial
Normal coronal
SINUSITIS
SINUSITIS
Radiology of Fungal sinusitis Heterogeneous opacity Bone destruction
FUNGAL SINUSITIS
FUNGAL SINUSITIS
COMPLICATIONS OF BACTERIAL SINUSITIS Pharyngeal, laryngeal and ear infections Mucocele Osteomyelitis Orbital complications Intracranial complications
MUCOCELE
Osteomyelitis
Plain X rays
CT
CT
ORBITAL COMPLICATIONS OF BACTERIAL SINUSITIS Periorbital inflammatory edema Orbital cellulitis Subperiosteal abscess Orbital abscess Cavernous sinus thrombosis
ORBITAL COMPLICATIONS OF SINUSITIS
ORBITAL COMPLICATIONS OF SINUSITIS Periorbital edema
ORBITAL COMPLICATIONS OF SINUSITIS Orbital cellulitis Subperiosteal abscess
Superior Subperiosteal abscess
ORBITAL COMPLICATIONS OF SINUSITIS Orbital abscess
ORBITAL COMPLICATIONS OF SINUSITIS Cavernous sinus thrombosis
INTRACRANIAL COMPLICATIONS
INTRACRANIAL COMPLICATIONS
INTRACRANIAL COMPLICATIONS Subdural abscess Frontal lobe abscess
BENIGN SWELLINGS Simple nasal polypi
Antro-choanal polyp
Inverted papilloma
Osteoma
MALIGNANT TUMORS
SINUSES’ TRAUMA
Blow-out fracture
BLOW-OUT FRACTURE Tear-drop sign
MRI PARANASAL SINUSES Cavernous sinus thrombosis
IMAGING OF THE NECK AND PHARYNX
Anatomy
Normal Lateral Plain X-rays Neck
Lateral View nasopharynx Normal Nasopharynx Soft tissue swelling Nasopharynx
PLAIN X-RAYS NECK & PHARYNX Pharyngeal or retropharyngeal swelling Normal
FOREIGN BODIES PHARYNX
FOREIGN BODIES PHARYNX
Retropharyngeal abscess + FB
CT NASOPHARYNX Unilateral choanal atresia Bilateral choanal atresia Normal
CT NASOPHARYNX Angiofibroma
Carcinoma nasopharynx CT NASOPHARYNX Normal Carcinoma nasopharynx
CT OROPHARYNX Normal
Acute retropharyngeal abscess
Parapharyngeal abscess
Retropharyngeal Combined Parapharyngeal
THE ESOPHAGUS
PLAIN X-RAYS
BARIUM SWALLOW
Zenker’s (pharyngeal) pouch
BARIUM SWALLOW Leiomyoma Achalasia
Web
Carcinoma esophagus
PLAIN X-RAYS OF THE LARYNX
Acute epiglottitis Thumb sign Normal
ACUTE EPIGLOTTITIS
ACUTE LARYNGO-TRACHEO-BRONCHITIS “CROUP” Normal PA plain X ray neck Steeple sign
RADIOLOGY OF TRACHEOBRONCHIAL F.B’S Normal Radio-opaque FB
5. Bronchopneumonia Collapse Emphysema
RADIOLOGY OF SALIVARY GLANDS
Plain X-Rays
SIALOGRAM Sialectasia Stone
CT SALIVARY GLANDS Pleomorphic adenoma Malignant parotid
IMAGING OF TEMPORAL BONE
PLAIN X-RAYS MASTOIDS
TYPES OF MASTOID AEREATIONS Cellular Diploic Acellular (Sclerotic)
CT TEMPORAL BONE
CT TEMPORAL BONE Trauma Infection Tumor
FRACTURE TEMPORAL BONE Longitudinal # Transverse #
Infection Chronic suppurative otitis media
CT in CSOM Preoperative to display the normal anatomy
Normal i = internal auditory canal c = cochlea v = vestibule f = facial nerve m = malleus in = incus me = middle ear a = aditus
Normal e = external auditory canal i = internal auditory canal v = vestibule in = incus f = facial nerve c = cochlea black arrow = oval window white arrow = stapes
CT in CSOM Preoperative to display the normal anatomy Shows the extent of the disease
Cholesteatoma
CT in CSOM Preoperative to display the normal anatomy Shows the extent of the disease Shows the possible complications
COMPLICATIONS OF SUPPURATIVE OTITIS MEDIA Extracranial complications Cranial (intra-temporal) complications Intracranial complications
EXTRACRANIAL COMPLICATIONS Otitis externa Retropharyngeal abscess Septicemia
CRANIAL (INTRATEMPORAL) COMPLICATIONS Acute mastoiditis Petrositis Facial nerve paralysis Labyrinthine fistula and labyrinthitis
INTRACRANIAL COMPLICATIONS Extradural abscess Lateral sinus thrombophlebitis Subdural empyema Meningitis Brain abscess Otitic hydrocephalus
Fistula lateral SCC
Mastoid abscess
Apical petrositis
Mastoid abscess + Cerebellar abscess
Extradural abscess
Lateral sinus thrombophlibitis
Temporal lobe abscess Cerebellar abscess
Otitic hydrocephalus
ACOUSTIC NEUROMA
CT INTERNAL AUDITORY MEATI Normal IAM Wide IAM
Yousry El-Sayed http://faculty.ksu.edu.sa/yousryelsayed THANK YOU Yousry El-Sayed http://faculty.ksu.edu.sa/yousryelsayed