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بسم الله الرحمن الرحيم. ORL IMAGING Plain X-Rays Nasal Bones.

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Presentation on theme: "بسم الله الرحمن الرحيم. ORL IMAGING Plain X-Rays Nasal Bones."— Presentation transcript:

1 بسم الله الرحمن الرحيم

2 ORL IMAGING

3 Plain X-Rays Nasal Bones

4 Normal Bony Nasal skeleton

5 Plain x-rays nasal bones # Nasal bones Normal

6 CT nasal bones

7 Important Note Radiology is NOT NECESSARY for the management of fractured nasal bone Radiology is NOT NECESSARY for the management of fractured nasal bone The main factor that determine the treatment is the CLINICAL APPEARANCE of the nose The main factor that determine the treatment is the CLINICAL APPEARANCE of the nose

8

9 PARANASAL SINUSES

10 IMAGING OF THE PARANASAL SINUSES Plain X-Rays Plain X-Rays CT scan CT scan MRI MRI

11 PLAIN X-RAYS OF THE PARANASAL SINUSES Occipitomental Occipitofrontal

12 OCCIPITOMENTAL VIEW (WATER ’ S VIEW)

13 OCCIPITO-FRONTAL VIEW (CALDWELL VIEW)

14 LATERAL VIEW

15 Occipito mentalOccipito frontal Lateral

16 Indication X Ray Paranasal Sinuses Management of sinusitis if CT is not available Management of sinusitis if CT is not available

17 Acute & Chronic Sinusitis

18 Mucosal thickening

19 Fluid Level

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21

22 Complete opacity

23 CT SINUSES Axial (Transverse)Coronal

24 Normal Axial

25 Normal coronal

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27 SINUSITIS

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29 SINUSITIS

30 Radiology of Fungal sinusitis Heterogeneous opacity Heterogeneous opacity Bone destruction Bone destruction

31 FUNGAL SINUSITIS

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33

34 COMPLICATIONS OF BACTERIAL SINUSITIS Pharyngeal, laryngeal and ear infections Pharyngeal, laryngeal and ear infections Mucocele Mucocele Osteomyelitis Osteomyelitis Orbital complications Orbital complications Intracranial complications Intracranial complications

35 MUCOCELE

36

37 Osteomyelitis

38 Plain X rays

39 CT

40 CT

41 ORBITAL COMPLICATIONS OF BACTERIAL SINUSITIS Periorbital inflammatory edema Orbital cellulitis Subperiosteal abscess Orbital abscess Cavernous sinus thrombosis

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43 ORBITAL COMPLICATIONS OF SINUSITIS

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45 Periorbital edema

46 ORBITAL COMPLICATIONS OF SINUSITIS Subperiosteal abscessOrbital cellulitis

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48 Superior Subperiosteal abscess

49 ORBITAL COMPLICATIONS OF SINUSITIS Orbital abscess

50 ORBITAL COMPLICATIONS OF SINUSITIS Cavernous sinus thrombosis

51 INTRACRANIAL COMPLICATIONS

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53 Subdural abscess Frontal lobe abscess

54 BENIGN SWELLINGS Simple nasal polypi

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57 Antro-choanal polyp

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59 Inverted papilloma

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61 Osteoma

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63 MALIGNANT TUMORS

64 SINUSES ’ TRAUMA

65 Blow-out fracture

66 BLOW-OUT FRACTURE Tear-drop sign

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68 MRI PARANASAL SINUSES Cavernous sinus thrombosis

69 IMAGING OF THE NECK AND PHARYNX

70 Anatomy

71 Normal Lateral Plain X-rays Neck

72 Lateral View nasopharynx Normal Nasopharynx Soft tissue swelling Nasopharynx

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75 PLAIN X-RAYS NECK & PHARYNX Normal Pharyngeal or retropharyngeal swelling

76 FOREIGN BODIES PHARYNX

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78 Retropharyngeal abscess + FB

79 CT NASOPHARYNX Normal Unilateral choanal atresia Bilateral choanal atresia

80 CT NASOPHARYNX Angiofibroma

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82 CT NASOPHARYNX Carcinoma nasopharynx Normal

83 CT OROPHARYNX Normal

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85 Acute retropharyngeal abscess

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88 Parapharyngeal abscess

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90 Retropharyngea l Parapharyngeal Combined

91 THE ESOPHAGUS

92 PLAIN X-RAYS

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94 BARIUM SWALLOW

95 Zenker’s (pharyngeal) pouch

96 BARIUM SWALLOW Achalasia Leiomyoma

97 Web

98 Carcinoma esophagus

99 PLAIN X-RAYS OF THE LARYNX

100 Thumb sign Normal Acute epiglottitis

101

102 ACUTE EPIGLOTTITIS

103 ACUTE LARYNGO-TRACHEO- BRONCHITIS “ CROUP ” Steeple sign Normal PA plain X ray neck

104 RADIOLOGY OF TRACHEOBRONCHIAL F.B ’ S 1.Normal 2.Radio-opaque FB

105

106

107 3.Emphysema 4.Collapse 5. Bronchopneumonia

108 RADIOLOGY OF SALIVARY GLANDS

109 Plain X-Rays

110 SIALOGRAM Stone Sialectasia

111

112 CT SALIVARY GLANDS Pleomorphic adenomaMalignant parotid

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114 IMAGING OF TEMPORAL BONE

115 PLAIN X-RAYS MASTOIDS

116 TYPES OF MASTOID AEREATIONS Cellular DiploicAcellular (Sclerotic)

117 CT TEMPORAL BONE

118 Trauma Infection Tumor

119 FRACTURE TEMPORAL BONE Longitudinal # Transverse #

120 Infection Chronic suppurative otitis media

121 CT in CSOM Preoperative to display the normal anatomy Preoperative to display the normal anatomy

122 Normal i = internal auditory canal c = cochlea v = vestibule f = facial nerve m = malleus in = incus me = middle ear a = aditus i = internal auditory canal c = cochlea v = vestibule f = facial nerve m = malleus in = incus me = middle ear a = aditus

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124 Normal e = external auditory canal i = internal auditory canal v = vestibule in = incus f = facial nerve c = cochlea black arrow = oval window white arrow = stapes e = external auditory canal i = internal auditory canal v = vestibule in = incus f = facial nerve c = cochlea black arrow = oval window white arrow = stapes

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127 CT in CSOM Preoperative to display the normal anatomy Preoperative to display the normal anatomy Shows the extent of the disease Shows the extent of the disease

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129 Cholesteatoma

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131 CT in CSOM Preoperative to display the normal anatomy Preoperative to display the normal anatomy Shows the extent of the disease Shows the extent of the disease Shows the possible complications Shows the possible complications

132 COMPLICATIONS OF SUPPURATIVE OTITIS MEDIA Extracranial complications Extracranial complications Cranial (intra-temporal) complications Cranial (intra-temporal) complications Intracranial complications Intracranial complications

133 EXTRACRANIAL COMPLICATIONS Otitis externa Otitis externa Retropharyngeal abscess Retropharyngeal abscess Septicemia Septicemia

134 CRANIAL (INTRATEMPORAL) COMPLICATIONS Acute mastoiditis Acute mastoiditis Petrositis Petrositis Facial nerve paralysis Facial nerve paralysis Labyrinthine fistula and labyrinthitis Labyrinthine fistula and labyrinthitis

135 INTRACRANIAL COMPLICATIONS Extradural abscess Extradural abscess Lateral sinus thrombophlebitis Lateral sinus thrombophlebitis Subdural empyema Subdural empyema Meningitis Meningitis Brain abscess Brain abscess Otitic hydrocephalus Otitic hydrocephalus

136 Fistula lateral SCC

137 Mastoid abscess

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139 Apical petrositis

140 Mastoid abscess + Cerebellar abscess

141 Extradural abscess

142 Lateral sinus thrombophlibitis

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145 Temporal lobe abscess Cerebellar abscess

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147 Otitic hydrocephalus

148 ACOUSTIC NEUROMA

149 CT INTERNAL AUDITORY MEATI Normal IAMWide IAM

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151

152

153 THANK YOU Yousry El-Sayed


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