2.6: ENT Radiology

Question 1

What can radiology be used to investigate?

- Give some examples

Answer 1

Dysphagia
Stridor
Deafness
Neck Lumps
Stage Head and Neck Cancers

Question 2

Describe clinical procedures involving radiology?

Answer 2

Ultrasound Guided Fine Needle Aspiration
Dilating oesophageal strictures with imaging guidance
Embolize blood vessels

Question 3

Name some types of radiology commonly used in ENT?

Answer 3

CT
MRI
X-Ray (Plain Film)
Barium Swallow
Ultrasound

Question 4

Describe radiography in foreign bodies?

Answer 4

Use plain film

Take AP and Lateral

Question 5

Describe investigation of Dysphagia?

• First line?
• If no abnormality is found, move on to..?
• Other examples where the 2nd line investigation would be used?

Answer 5

Endoscopy is the first line
Move onto Barium Swallow if there is no obvious abnormality
Also used in:
- Pharyngeal pouches
- Strictures (after cricopharyngeus)
- Dysmotility

Question 6

If patients will not tolerate endoscopy, what investigation can be used?

Answer 6

Barium Swallow

Question 7

If patient has an endoscopy/barium swallow and malignancy is found, what is the next step?

Answer 7

CT/MRI to stage

Question 8

Uses for ultrasound?

Answer 8

Neck Lumps
Investigation and FNA of thyroid
Investigation of salivary gland disease
Investigation of inflammatory masses

Question 9

Best imaging for children?

Answer 9

Ultrasound - doesn’t expose them to radiation

Question 10

First line in neck lumps?

- What are you trying to find out?

Answer 10

Ultrasound
Is this a lymph node?
Malignant/Benign?
Location?

Question 11

Describe the use of ultrasound in sample taking?

Answer 11

Used in ultrasound guided fine needle aspiration

Question 12

Describe how you evaluate lymph nodes?

Answer 12

Size isn’t everything
Look at shape
Blood Flow

Question 13

Describe a benign lymph node?

Answer 13

Oval
Central Fatty Fibre
Central core of blood supply

Question 14

Describe a malignant lymph node?

Answer 14

Circular

Disorganised blood supply

Question 15

Describe thyroid masses

- How many are malignant, how many benign?

Answer 15

80% are benign hyper plastic nodules

Question 16

Investigation of thyroid mass?

Answer 16

Ultrasound guided Fine Needle Aspiration

Question 17

If you suspect thyroid malignancy, what else should you look at?

Answer 17

Local Lymph Nodes

Question 18

Cross Sectional Imaging?

Answer 18

CT and MRI

Question 19

Use of CT/MRI in ENT

Answer 19

Throat - Neck masses, vocal chord palsy, trauma, infection
Nose - Paranasal Sinuses, Tumours
Ears - Hearing loss, tumours, Trauma

Question 20

Describe cancer staging in ENT?

Answer 20

Head and Neck CT

Question 21

What are the pathologies that could cause:

• Sensorineural hearing loss
• Conductive hearing loss?

Answer 21

S = Vestibular Schwannoma
C = Cholesteatoma

Question 22

Best imaging for sensorineural?

Answer 22

MRI (nerves)

Question 23

Best imaging for conductive?

Answer 23

CT (ossicles)