imaging in orl
TRANSCRIPT
![Page 1: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/1.jpg)
Imaging in ORL
1. PNS
2. Mastoid
3. Soft tissue neck
4. Sialogram
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What should comment?
1. Patient’s data
2. Type ( plain or contrast)
3. Site
4. View
5. Exposure ( bone or soft tissue setting)
6. Findings
7. Remarks ( not diagnosis)
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1. PNS - What findings?
• Fracture? (MVA, gun-shot, trauma)
• Infection (mucosal thickening, air-fluid level, haziness)
• Tumor (bone erosion, extension)
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PNS - views
1. Occipital mental view (best for maxillary sinus because the petrosal bone don’t block it. It is also for frontal sinus & zygomatic arch)
2. Occipital frontal view (frontal sinus)3. Submento vertical/Axial (ethmoidal &
sphenoidal sinus)4. Lateral (AP depth of frontal sinus)5. Oblique (ethmoidal sinus – 3 groups)
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PNS – lateral
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PNS – occipital mental
•Air-fluid level???
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PNS – occipital mental
•Both side maxillary sinus mucosal thickening?
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PNS – occipital mental
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PNS – occipital mental
•Normal
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PNS – occipital mental
•Both side maxillary sinus mucosal thickening?
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PNS – occipital mental
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PNS – occipital mental
•right side maxillary sinus mucosal thickening?
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PNS – occipital mental
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PNS – occipital mental
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PNS – occipital frontal
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PNS – occipital frontal
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PNS – submento vertical (axial)
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PNS – submento vertical (axial)
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2. Mastoid
• Fracture? (MVA, gun-shot, trauma)
• Infection (mucosal thickening, air-fluid level, haziness)
• Tumor (bone erosion, extension)
• Type of mastoid (acellular, cellular, diploic)
• Look for acoustic neuroma (by submento vertical view – )
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Mastoid - view
1. Occipital frontal/transorbital (internal auditory meatus widening? – look for acoustic neuroma)
2. Submento vertical (look for acoustic neuroma)3. Lateral oblique (mastoid antrum –
cholesteatoma, air cell – if big can be previous infection)
4. AP oblique view (cochlear & tympanic cavity)5. Owen’s view ( ossicles – incus & malleus)
*cholesteatoma common in acellular mastoid
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Example: lateral obliqueAntrum
Maxilla
External auditory meatus
Air cell
Mandible
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Example : owen’s view
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Mastoid lateral oblique
![Page 24: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/24.jpg)
Mastoid lateral oblique
![Page 25: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/25.jpg)
Mastoid lateral oblique
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Mastoid lateral oblique
![Page 27: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/27.jpg)
Mastoid lateral oblique
![Page 28: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/28.jpg)
Mastoid lateral oblique
![Page 29: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/29.jpg)
Mastoid lateral oblique
![Page 30: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/30.jpg)
Mastoid lateral oblique
![Page 31: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/31.jpg)
Mastoid lateral oblique
![Page 32: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/32.jpg)
Mastoid lateral oblique
![Page 33: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/33.jpg)
Mastoid Occipital frontal - Transorbital
![Page 34: Imaging in ORL](https://reader038.vdocuments.mx/reader038/viewer/2022102618/54711ed3b4af9f88038b4623/html5/thumbnails/34.jpg)
Mastoid Transorbital view
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3. Soft tissue neck
• 2 type– Adenoid (mandible must be perpendicular)– Prevertebral tissue (not thicken more the ½ of
vertebra body. C6 & C7 normally thicken)
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Example: soft tissue adenoid true lateral view
Palate
Imaginary line
I
Roof of nasopharynx
IV
III
II
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Sialogram –contrast type
• Lateral view• Inject contrast through submandibular vein• Look for any calculus• Alveoli appearance?• If tumour, the submandibular vein show straight
appearance
*cannot diagnose tumour because the contrast only go into the duct while the tumour can arise from peripheral tissue. The only sign will see is the duct been pushed to one side
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Others
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