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بسم هللا 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 Normal Pharyngeal or retropharyngeal swelling FOREIGN BODIES PHARYNX FOREIGN BODIES PHARYNX Retropharyngeal abscess + FB CT NASOPHARYNX Normal Unilateral choanal atresia Bilateral choanal atresia CT NASOPHARYNX Angiofibroma CT NASOPHARYNX Normal Carcinoma nasopharynx CT OROPHARYNX Normal Acute retropharyngeal abscess Parapharyngeal abscess Retropharyngeal Parapharyngeal Combined THE ESOPHAGUS PLAIN X-RAYS BARIUM SWALLOW Zenker’s (pharyngeal) pouch BARIUM SWALLOW Achalasia Leiomyoma Web Carcinoma esophagus PLAIN X-RAYS OF THE LARYNX Acute epiglottitis Normal Thumb sign ACUTE EPIGLOTTITIS ACUTE LARYNGO-TRACHEOBRONCHITIS “CROUP” Normal PA plain X ray neck Steeple sign RADIOLOGY OF TRACHEOBRONCHIAL F.B’S 1. Normal 2. Radio-opaque FB 3. Emphysema 4. Collapse 5. Bronchopneumonia RADIOLOGY OF SALIVARY GLANDS Plain X-Rays SIALOGRAM Stone Sialectasia 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 THANK YOU Yousry El-Sayed http://faculty.ksu.edu.sa/yousryelsayed
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