ENT Radiology for Undergraduat

esby

Professor Dr

Hassan WahbaORL Department

Faculty of MedicineAin Shams University

Radiologic views in Ear, Nose & Throat:

• Oblique lateral (Mastoid)

• Lateral skull

• Lateral neck

• Barium swallow esophagus

• Chest

• CT scan nose & paranasal sinuses

Pneumatised mastoid: air spaces separated by bony partitions

Non-pneumatised (sclerosed)

mastoid no air spaces

Chronic suppurative otitis media

showing pathological

cavity (cholesteatoma)

which is irregular, non-anatomical & contains bone sequestra in a

sclerosed mastoid

Post-operative cavity of mastoidectomy: regular,

anatomical & clean

Nasopharynx ,palate, posterior choana, sella, frontal and sphenoid sinuses

Lateral skull

Fracture nasal bones

Adenoid

Nasopharyngeal tumor: soft tissue

shadow in the nasopharynx causing

narrowing of the airway in an adult.

Antrochoanal polyp soft tissue shadow in the

nasopharynx pedunculated from the nose on the upper surface of the palate

Congenital choanal atresia Absence of

the posterior

nasal openings into the

nasopharynx as shown by dye in the nose

Nasal foreign body (nail)

Pituitary tumor enlarged

sella turcica

Lateral neck

Hypopharyngeal malignancy: wide

prevertebral space pushing the airway

anteriorly in the lower half of the

neck

Acute retropharyngea

l abscess wide prevertebral space flexed neck

Chronic retropharyngeal abscess

wide prevertebral space and destroyed bodies of cervical

vertebrae

Cancer larynxSoft tissue shadow causing

obstruction of the laryngeal airway – tracheostomy

Barium swallow esophagus:

Normal: no stenosis

Post-corrosive: narrow long or short segment stricture with smooth conical beginning

Cancer: irregular filling defect (shoulder appearance or rat tail appearance)

Cardiac achalasia: at the lower esophagus with huge prestenotic dilataion

Post-corrosive stricture: long or short segment with smooth usually conical beginning and small to moderate prestenotic dilatation

Cancer esophagus: irregular filling defect causing esophageal stenosis

Cardiac achalasia

:

Lower esophageal stenosis with huge prestenoti

c dilatation

COMPARE

Pharyngeal

pouch

Normal PA

Chest

Inhaled radio-opaque

foreign body

Inhaled radioluscent foreign body:

Non-aerated lung

Narrow intercostal space

Shifted mediastinum

Raised copula of diaphragm

= absorption collapse

Right upper lung lobe collapse

Inhaled radioluscent foreign body:

Both lungs aerated

Wide intercostal spaces

Shift in the mediastinum away

Depressed copula of diaphragm

= obstructive emphysema (check valve)

Swallowed

foreign body

Sinus

view no

longer of any value replaced

by CT scan

CT scan paranasal sinuses and nose coronal view is the best

to study the paranasal sinuses and nose

Concha bullosa

Concha paradoxa

Deviated Septum

Maxillofacial trauma

sinusitis

Right frontal Left maxillary

Bilateral maxillary

CystFluid

Right ethmoid

Allergic Polyps

Antrochoanal polyp

Fungal

sinusitis opaque sinus with areas of increased

radiodensity

Mucopyocele opaque sinus

with expanded wall with no wall destruction

Angiofibroma enhanceable pear shaped swelling in the

nose and nasopharynx

CANCEROpaque destroyed wall & lost anatomical

landmarks

EAR NOSE & THROAT

by

Professor Dr Hassan Wahba

Professor of Ear, Nose and Throat

Faculty of Medicine Ain Shams University

1000 MCQs in ENT

by Professor Dr Hassan Wahba

Professor of Ear, Nose and Throat Faculty of Medicine

Ain Shams University

Text and references to help the fourth year

undergraduate student