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Approach to Pediatric Airway

Introduction Anatomically & functionally, the pediatric airway can be divided into upper & lower segments at the glottis (larynx) or large & small airways at the transition from the cartilage-containing bronchi proximally to the distal airways that lack supporting cartilage. The superimposed disease processes may be extrinsic or intrinsic, & they may manifest as acute or chronic airway compromise at a variety of ages. Broad categories…

Potential Health Risks of Pediatric Imaging

Introduction The parameters below often factor into imaging tests ordered to work-up pediatric diseases. In light of safety concerns associated with these elements, there are some situations where reasonable alternatives to the associated tests (including close clinical follow-up) should be employed as a substitute. However, the risks associated with these imaging facets do not mean that these exams should be avoided when the test is clinically…

Basics of Imaging

Introduction There have been rapid technological advances in medical imaging over the last several decades, generally providing faster, more detailed, & readily available assessments of patients. Clinical work-ups have increasingly incorporated advanced imaging during these years, though not always in an effective or judicious manner. In addition to concerns of financial cost, apprehensions have been increasingly raised about the downsides of several imaging modalities (including the…

Masticator Space Overview

Summary Thoughts: Masticator Space The 3 most frequently encountered abnormalities in the masticator space (MS) are infection, infection, and infection. Odontogenic infection should always cross the clinician's mind 1st when evaluating abnormalities in this space. When evaluating tumors of the MS, the presence of perineural CNV3 tumor spread is of critical importance because it is easily overlooked but can have a dramatic effect on treatment and…

Tonsillar Inflammation

KEY FACTS Terminology Synonym: Tonsillitis/tonsillopharyngitis Definition: Acute, nonsuppurative tonsillar inflammation You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Tornwaldt Cyst

KEY FACTS Terminology Definition: Benign developmental midline cyst in pharyngeal mucosal space (PMS) covered by mucosa anteriorly & bounded by longus muscles posteriorly You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Pharyngeal Mucosal Space Overview

Summary Thoughts: Pharyngeal Mucosal Space Clinically, the upper aerodigestive track is often divided into the naso-, oro-, and hypopharyngeal subsites. Each of these subsites is unified, however, with mucosa that is subject to shared pathology. The pharyngeal mucosal space (PMS) is a key suprahyoid neck (SHN) space that represents the pharyngeal surfac e. The PMS has on its non-airway surface the middle layer of deep cervical…

Parapharyngeal Space Benign Mixed Tumor

KEY FACTS Terminology Parapharyngeal space benign mixed tumor (PPS-BMT): BMT is primarily in PPS, not extension of deep lobe parotid BMT into PPS Imaging Rounded, well-defined ovoid lesion within PPS fat Distinct from parotid deep lobe CECT findings Heterogeneous, moderately enhancing PPS mass MR findings Fat plane between deep lobe parotid & PPS-BMT T1 C+ MR: Uniform enhancement when small – Heterogeneous enhancement when large T2…

Parapharyngeal Space Overview

Summary Thoughts: Parapharyngeal Space The 4 key spaces of the suprahyoid neck (SHN) surround the parapharyngeal space (PPS), which is the fat-filled lateral SHN space. When large lesions of the SHN become hard to localize to a space of origin, the direction of the PPS displacement may be used in combination with the space where most of the tumor is located to make a determination as…

Suprahyoid and Infrahyoid Neck Overview

Imaging Approaches & Indications Neither CT nor MR is a perfect modality for imaging the extracranial H&N. MR is most useful in the suprahyoid neck (SHN) because it is less affected by oral cavity dental amalgam artifact. The SHN tissue is less affected by motion compared with the infrahyoid neck (IHN); therefore, the MR image quality is not degraded by movement seen in the IHN. Axial…

Introduction to Imaging

Introduction Rapid advancement of medical imaging in the last few decades has significantly enhanced the role of imaging in medicine. Imaging plays an integral role in the evaluation of many of the diseases confronted by the otolaryngologist. It is performed for diagnosis, staging of tumors, assessing efficacy of therapy, follow-up, and guidance for procedures. Imaging in the head and neck, like no other area of the…

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Craniopharyngioma

KEY FACTS Terminology Benign, often partially cystic sellar region tumor derived from Rathke pouch epithelium 2 types Adamantinomatous (cystic mass in childhood) Papillary (solid mass in older adults) Imaging General features Multilobulated, often large (> 5 cm) Occasionally giant, multicompartmental CT Cystic (90%), Ca++ (90%), enhancing (90%) MR: Signal varies with cyst contents Cysts variably hyperintense on T1WI and T2WI Solid portions enhance heterogeneously; cyst walls…