HEENTradiology Flashcards
(68 cards)
When would you get plain views for HEENT
Adequate for upper airway compromise, routine sinus problems and initial work up of facial trauma
When do you do endoscopy in evaluation of HEENT?
Preferable where direct visualization and Biopsy are possible. Laryngoscopy and nasopharyngoscopy
Cold nodules indicate what in thyroid nuclear scan?
Cancer
Barium swallow is good for detecting what diseases?
Dysphagia, strokes, ALS, myasthenia, aspiration pneumonia and esophageal diverticula (Zenkers)
Reasons for ordering ENT studies
Atypical presentation, progressive symptoms or signs, determine the extent of a disease process, treatment failures, determine the need for referral to ENT, to define surgical options
ENT red flags
Chronic hoarseness in a smoker, neck masses, retroauricular pain and swelling, stridor, difficulty swallowing liquids, weight loss, unexplained fevers, sinus pain, antibiotic failures, clear rhinorrhea post-trauma, retrotympanic mass, unilateral hearing loss, tinnitus, loss of balance, facial weakness, facial trauma with palpable deformity, focal bone tenderness with fever and septic source, refractory sinus infection, pulsatile tinnitus and focal cranial nerve abnormalities
What are AP and Lateral views used for
Soft tissue detail for evaluation of the overall contour of the soft tissues of the neck
What views are required to view the odontoid process?
AP, lateral, right anterior oblique, left anterior oblique and open mouth AP
What sinuses does the lateral view evaluate?
Frontal, maxillary and sphenoid sinuses
What does the Waters view evaluate
Maxillary and frontal sinuses, anterior ethmoid air cells and orbital floors
What structures does the Caldwell view evaluate
Frontal sinuses and posterior ethmoid air cells
When might you get a head CT with contrast?
If you are looking for a tumor that might be vascular. Contrast enhances the images
What should you think of with pulsatile tinnitus
Glomus tumor- rare, slow-growing, hypervascular tumors that arise within the jugular foramen of the temporal bone
In what patients are MRIs contraindicated
Cardiac pacemaker (ferromagnetic), cochlear implants (aneurysm clips), and women in 1st trimester (avoid if possible)
What imaging study would you get to evaluate bone erosion associated with squamous/basal cell cancer with local invasion?
CT scan- high resolution
What imaging study would you get to evaluate soft tissue mass delineation associated with squamous/basal cell cancer with local invasion?
MRI
What causes exostoses?
Exposure to cold water
Who are at risk for developing malignant otitis externa? What are you concerned about with this? What imaging should you get for it?
Elderly, diabetic (increased risk of pseudomonas), osteomyelitis of outer petrous bone. Ct scan
What structures are considered external ear?
Auricle/pinna, External ear canal
What structures are considered middle ear?
TM, ossicles, middle ear cleft (chamber)
What is chronic suppuritive OM, and what is a complication that can occur with this? What is the Tx?
Perforated TM with persistent drainage from middle ear (lasting >6-12 weeks), can cause a cholesteatoma. Tx always includes tympanomastoid surgery
What imagine study would you use to evaluate chronic suppuritive OM, why?
CT- concerned for bone destruction by cholesteatoma
What is otosclerosis? What are the two types? What imaging study would you getto evaluate?
Hardening of the bony tissue in the ear caused by abnormal bone remodeling in the middle ear. Fenestral and restrofenestral. CT scan –high resolution
What is Fenestral otosclerosis
Stapes foot plate fused to oval window
