الرحيم الرحمن الله الرحيم بسم الرحمن الله بسم

ORL IMAGINGORL IMAGING

Plain X-Rays Nasal BonesPlain X-Rays Nasal Bones

Normal Bony Nasal skeletonNormal Bony Nasal skeleton

Plain x-rays nasal bonesPlain x-rays nasal bones

# Nasal bonesNormal

CT nasal bonesCT nasal bones

Important NoteImportant Note

Radiology is NOT NECESSARY for the Radiology is NOT NECESSARY for the

management of fractured nasal bone management of fractured nasal bone

The main factor that determine the The main factor that determine the

treatment is the CLINICAL treatment is the CLINICAL

APPEARANCE of the noseAPPEARANCE of the nose

PARANASAL SINUSESPARANASAL SINUSES

IMAGING OF THE PARANASAL IMAGING OF THE PARANASAL SINUSESSINUSES

Plain X-RaysPlain X-Rays

CT scanCT scan

MRIMRI

PLAIN X-RAYS OF THE PLAIN X-RAYS OF THE PARANASAL SINUSESPARANASAL SINUSES

OccipitomentalOccipitomental Occipitofrontal

OCCIPITOMENTAL VIEW OCCIPITOMENTAL VIEW (WATER(WATER’’S VIEW)S VIEW)

OCCIPITO-FRONTAL VIEW OCCIPITO-FRONTAL VIEW (CALDWELL VIEW)(CALDWELL VIEW)

LATERAL VIEWLATERAL VIEW

Occipito mental Occipito frontal

Lateral

Indication X Ray Paranasal Indication X Ray Paranasal SinusesSinuses

Management of sinusitis if CT is not Management of sinusitis if CT is not

availableavailable

Acute & Chronic SinusitisAcute & Chronic Sinusitis

Mucosal thickening

Fluid Level

Complete opacity

CT SINUSESCT SINUSES

Axial (Transverse) Coronal

Normal Axial

Normal coronal

SINUSITIS

http://nosephotographs.hawkelibrary.com/album24/CT_Cyst_Case_8a?full=1

SINUSITISSINUSITIS

Radiology of Fungal sinusitisRadiology of Fungal sinusitis

Heterogeneous opacityHeterogeneous opacity

Bone destructionBone destruction

FUNGAL SINUSITIS

FUNGAL SINUSITIS

COMPLICATIONS OF COMPLICATIONS OF BACTERIAL SINUSITISBACTERIAL SINUSITIS

Pharyngeal, laryngeal and ear infectionsPharyngeal, laryngeal and ear infections

MucoceleMucocele

OsteomyelitisOsteomyelitis

Orbital complicationsOrbital complications

Intracranial complicationsIntracranial complications

MUCOCELEMUCOCELE

OsteomyelitisOsteomyelitis

Plain X raysPlain X rays

CTCT

CTCT

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

Subperiosteal abscessOrbital cellulitis

Superior Subperiosteal Superior Subperiosteal abscessabscess

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 SWELLINGSBENIGN SWELLINGS

Simple nasal polypi

Antro-choanal polypAntro-choanal polyp

Inverted papillomaInverted papilloma

OsteomaOsteoma

MALIGNANT TUMORSMALIGNANT TUMORS

SINUSESSINUSES’’ TRAUMA TRAUMA

Blow-out fractureBlow-out fracture

BLOW-OUT FRACTUREBLOW-OUT FRACTURE

Tear-drop sign

MRI PARANASAL SINUSESMRI PARANASAL SINUSES

Cavernous sinus thrombosis

IMAGING OF THE NECK IMAGING OF THE NECK AND PHARYNXAND PHARYNX

AnatomyAnatomy

Normal Lateral Plain X-rays Normal Lateral Plain X-rays NeckNeck

Lateral View nasopharynxLateral View nasopharynx

Normal Nasopharynx

Soft tissue swelling Nasopharynx

http://www.learningradiology.com/caseofweek/caseoftheweekpix2006/cow233arr.jpg

PLAIN X-RAYS NECK & PLAIN X-RAYS NECK & PHARYNXPHARYNX

NormalPharyngeal or

retropharyngeal swelling

FOREIGN BODIES PHARYNXFOREIGN BODIES PHARYNX

FOREIGN BODIES PHARYNXFOREIGN BODIES PHARYNX

Retropharyngeal abscess + FB

CT NASOPHARYNXCT NASOPHARYNX

NormalUnilateral

choanal atresiaBilateral

choanal atresia

CT NASOPHARYNXCT NASOPHARYNX

Angiofibroma

CT NASOPHARYNXCT NASOPHARYNX

Carcinoma nasopharynxNormal

CT OROPHARYNXCT OROPHARYNX

Normal

Acute retropharyngeal Acute retropharyngeal abscessabscess

Parapharyngeal abscessParapharyngeal abscess

Retropharyngeal Parapharyngeal Combined

THE ESOPHAGUSTHE ESOPHAGUS

PLAIN X-RAYSPLAIN X-RAYS

BARIUM SWALLOWBARIUM SWALLOW

Zenker’s (pharyngeal) pouch

BARIUM SWALLOWBARIUM SWALLOW

Achalasia Leiomyoma

WebWeb

Carcinoma esophagus

PLAIN X-RAYS OF THE PLAIN X-RAYS OF THE LARYNXLARYNX

Thumb sign

Normal

Acute epiglottitis

ACUTE EPIGLOTTITISACUTE EPIGLOTTITIS

ACUTE LARYNGO-TRACHEO-ACUTE LARYNGO-TRACHEO-BRONCHITIS BRONCHITIS ““CROUPCROUP””

Steeple signNormal PA plain X ray neck

RADIOLOGY OF RADIOLOGY OF TRACHEOBRONCHIAL F.BTRACHEOBRONCHIAL F.B’’SS

1. Normal

2. Radio-opaque FB

3. Emphysema 4. Collapse 5. Bronchopneumonia

RADIOLOGY OF SALIVARY RADIOLOGY OF SALIVARY GLANDSGLANDS

Plain X-RaysPlain X-Rays

SIALOGRAMSIALOGRAM

Stone Sialectasia

CT SALIVARY GLANDSCT SALIVARY GLANDS

Pleomorphic adenoma Malignant parotid

IMAGING OF TEMPORAL IMAGING OF TEMPORAL BONEBONE

PLAIN X-RAYS MASTOIDSPLAIN X-RAYS MASTOIDS

TYPES OF MASTOID TYPES OF MASTOID AEREATIONSAEREATIONS

Cellular Diploic Acellular (Sclerotic)

CT TEMPORAL BONECT TEMPORAL BONE

CT TEMPORAL BONECT TEMPORAL BONE

Trauma

Infection

Tumor

FRACTURE TEMPORAL BONEFRACTURE TEMPORAL BONE

Longitudinal # Transverse #

Infection

Chronic suppurative otitis media

CT in CSOMCT in CSOM

Preoperative to display the normal Preoperative to display the normal anatomyanatomy

NormalNormal

i = internal i = internal auditory canalauditory canalc = cochleac = cochleav = vestibulev = vestibulef = facial nervef = facial nervem = malleusm = malleusin = incusin = incusme = middle earme = middle eara = aditus a = aditus

NormalNormal

e = external e = external auditory auditory canalcanali = internal auditory i = internal auditory canalcanalv = vestibulev = vestibulein = incusin = incusf = facial nervef = facial nervec = cochleac = cochleablack arrow = oval black arrow = oval windowwindowwhite arrow = stapeswhite arrow = stapes

CT in CSOMCT in CSOM

Preoperative to display the normal Preoperative to display the normal

anatomyanatomy

Shows the extent of the diseaseShows the extent of the disease

CholesteatomaCholesteatoma

CT in CSOMCT in CSOM

Preoperative to display the normal Preoperative to display the normal

anatomyanatomy

Shows the extent of the diseaseShows the extent of the disease

Shows the possible complicationsShows the possible complications

COMPLICATIONS OF COMPLICATIONS OF SUPPURATIVE OTITIS MEDIASUPPURATIVE OTITIS MEDIA

Extracranial complicationsExtracranial complications

Cranial (intra-temporal) complicationsCranial (intra-temporal) complications

Intracranial complicationsIntracranial complications

EXTRACRANIAL EXTRACRANIAL COMPLICATIONSCOMPLICATIONS

Otitis externaOtitis externa

Retropharyngeal abscessRetropharyngeal abscess

SepticemiaSepticemia

CRANIAL (INTRATEMPORAL) CRANIAL (INTRATEMPORAL) COMPLICATIONSCOMPLICATIONS

Acute mastoiditisAcute mastoiditis

PetrositisPetrositis

Facial nerve paralysisFacial nerve paralysis

Labyrinthine fistula and labyrinthitisLabyrinthine fistula and labyrinthitis

INTRACRANIAL INTRACRANIAL COMPLICATIONSCOMPLICATIONS

Extradural abscessExtradural abscess Lateral sinus thrombophlebitisLateral sinus thrombophlebitis Subdural empyemaSubdural empyema MeningitisMeningitis Brain abscessBrain abscess Otitic hydrocephalusOtitic hydrocephalus

Fistula lateral SCC

Mastoid abscess

Apical petrositisApical petrositis

Mastoid abscess + Cerebellar Mastoid abscess + Cerebellar abscessabscess

Extradural abscess

Lateral sinus thrombophlibitis

Temporal lobe abscess Cerebellar abscess

Otitic hydrocephalus

ACOUSTIC NEUROMAACOUSTIC NEUROMA

CT INTERNAL AUDITORY CT INTERNAL AUDITORY MEATIMEATI

Normal IAM Wide IAM

THANK YOUTHANK YOU

Yousry El-SayedYousry El-Sayed

http://faculty.ksu.edu.sa/http://faculty.ksu.edu.sa/yousryelsayedyousryelsayed