10. Head and Neck Imaging Flashcards
What is included in the head and neck region?
- orbit
- skull base
- paranasal sinuses
- oral cavity, tongue, salivary glands
- pharynx and larynx
- hearing and balance system
- thyroid, parathyroid and other superficial structures of the neck
- temporo-mandibularis joint
Imaging of paranasal sinuses
- paranasal sinus X-ray is not specific enough an overall does not help the therapeutic decision making
- low dose CT is better for visualizing the sinuses
What are the indications for barium swallow?
- dysphagia
- achalasia
- foreign body
- gastro-esophageal reflux
Radio-chemotherapy for tongue lung cancer
even in advanced / non-surgical disease, a complete regression can be achieved with radio-chemotherapy: especially in HPV associated planocellular cancer (p16+).
Imaging of the ear
- outer ear and middle ear are visualized by CT
- inner ear and cerebellopontine angle is visualized by MRI
- acute otitis media doesn’t requiring any imaging; it can be diagnosed with history and physical examination
What is neural hearing loss?
- damage to the inner ear, and can be accompanied with peripheral vertigo
- examined using MRI
- cochlear implants need to be checked for MRI compatibility
What is conductive hearing loss?
- sound cannot get through the outer and middle ear
- could be because of underdeveloped external auditory canal or mastoid cell system
- could be caused by otosclerosis
What to beware of in cystic neck mass?
when over 30 it most commonly is due to lymphadenopathy
Treatment of papillary thyroid cancer
metastatic papillary thyroid cancer can be treated with iodine 131; if iodine is administered as a contrast agent and fills up the cells for upto 6 months, then radioactive treatment cannot be effective
Neck masses in children and young adults
- adenitis associated with infection
- congenital lesions
- malignancy
Neck masses in adults
- metastatic lymph node
- infection
- thyroid node
