Dr Rekha Swamy MRCPCH FRCRTeleradiology solutions, Bangalore

Approach to assessment Localize the abnormalitySpread / extensionVital structuresSummary

Localise and aid in detection of drainable collections and assess for complications

PediatricCervical lymphadenitis Tonsillitis

Adults DSNIOdontogenic diseaseSialadenitisSinusitisMastoiditis

Suprahyoid

Infrahyoid

Sublingual space: highlighted by the yellow arrows on the leftSubmandibular space on the right

P

M

ParCPrR

Axial and coronal contrast enhanced CT demonstrating a left submandibular duct calculus ( black star) with left submandibular space abscess( yellow arrows)

Axial and coronal contrast enhanced CT demonstrating acute inflammatory changes within the parotid gland

Orbital infections represent more than half of primary orbital disease processes

 The location of an orbital infection is described with respect to the orbital septum, as either preseptal (periorbital) or postseptal (orbital)

Axial and sagittal contrast enhanced CT demonstrating well defined low density non enhancing fluid collection in the retropharyngeal space with ossification of the Longus colli tendon

Acute otitis media and mastoiditis Complications

Epidural abscess, Subdural empyemaPetrous apicitisSigmoid sinus thrombosisBezold’s abscess

Otitis externa

Rarer conditions Infected branchial cleft cystsLudwigs anginaNecrotising fasciitisEpiglottitisPyolaryngcoele

Axial and coronal contrast enhanced CT demonstrating well defined low density lesion in the left level II with mild enhancement situated between the submandibular gland and sternocleidomastoid muscle.

AirwayCirculationCord

Cervical lymphadenitis is common in childrenand is the usual origin of superficial neckabscesses.

Adults are more likely than children to have a DNSI, with odontogenic infection

being the most common source Role of imaging is to localise and aid in

detection of drainable collections and assess for complications.

Questions?

Nontraumatic Orbital Conditions: Diagnosis with CT and MR Imaging in the Emergent Setting . Christina A. LeBedis, MD, and Osamu Sakai, MD, PhD Radiographics, Oct 2008

Imaging of Acute Head and Neck Infections Aldo Gonzalez-Beicos, MD, Diego Nunez, MD, MPH, Radiology Clinics , Volume 50

Head and Neck Infection and Inflammation. Rich S. Rana, MD, Gul Moonis, MD , Radiology clinics

Emergency Imaging Assessment of Acute, Nontraumatic Conditions of the Head and Neck. Erin Frankie Capps, MD, James J. Kinsella, MD, Manu Gupta, MD, Amol Madhav Bhatki, MD, and Michael Jeffrey Opatowsky, MD

Radiographics, Sept 2010 Imaging Features of Invasive and Noninvasive Fungal Sinusitis: A

ReviewManohar Aribandi, MD, Victor A. McCoy, MD2, and Carlos Bazan, III, MD