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