How to read a sinus CT Flashcards
The standard radiographic study for evaluation of sinus disease is the sinus CT scan performed in the coronal plane (with/without) contrast
WITHOUT
What are 4 radiographic densities ?
Air
Bone
Water
fat
What 3 things do you always have to look at on radiographic studies?
- name
- date
- orientation
What is the order in which you should evaluate a sinus CT?
Orbits, orbit walls, skull base, maxillary alveolus, nasal septum, and sinuses
3 common anatomic variants on coronal CT scans of sinuses
- deviated nasal septum
- asymmetry of sinuses (size, shape, septas)
- air cell w/in middle turbinate (concha bullosa)
What is the most significant area to examine in a patient with sinus complaints?
coronal view of the osteomeatal complex (OMC)
What is the osteomeatal complex?
region through which the maxillary, ethmoid, and frontal sinuses drain in the nose
obstruction of the OMC will frequently lead to ___, and is often due to mucosal edema or anatomic abnormalities
sinusitis
The anterior-most ethmoid sinus called ____ is freq clouded and may be associated with obstruction of the nasal frontal duct and results in ____ sinusitis
agger nasi cell
frontal sinusitis
Sinusitis is manifested by loss of aeration of (one/multiple) sinus(es)
Multiple
Clouding of a single sinus suggests what?
Tumor - commonly inverting papilloma (benign growth caused by HPV)
When do you get a sinus CT?
Medical therapy has failed or there is concern for neoplasm (eg unilateral)
All patients with ____ have chronic sinusitis, typically involving all sinuses
nasal polyposis
Mucosal thicking of which sinuses typically occur after a URI? How long does it persist?
Ethmoid
6-8 wks
When should CT scans be obtained? Why is timing important?
After pt has been maximally treated bc the general pop has a high incidence of mucosal thickening - hard to differentiate bw sinus clouding due to common cold vs bacterial sinusitis
