Rhinology | Radiology of the nose and paranasal sinuses | Dr Steve Connor

ENT Grand Rounds Online, 28th April 2020, Dr Steve Connor, Consultant Head and Neck Radiologist, Guy's and St Thomas' Hospitals NHS Trust See below to skip to clips Curriculum topics (UK Otolaryngology Higher Surgical Training 2017) 1. Rhinology - Nose and sinus infections; Nasal polyps; Congenital abnormalities of the nose and sinuses; Granulomatous conditions; Sinonasal neoplasms including including anterior skull base lesions 01:30 - Patterns of pathological change on CT: 1. Sinonasal inflammation 04:33 - Ostio-meatal complex 04:53 - Patterns of sinonasal disease: ostio-meatal complex pattern; frontal recess pattern; posterior OMU patterns - sphenoethmoidal recess and superior meatus 09:08 - OMC and anterior skull base variants not to miss 2. Calcification and hyperdensity 11:31 - Chronic inflammation and fungal disease 12:25 - Calcified sinonasal tumours - osteoma, fibrous dysplasia and sarcoma 14:33 - Hyperdensity 3. Bony remodelling/erosion/post-surgical defects 16:45 - Bony erosion and sclerosis - aggressive (neoplastic/non-neoplastic), intermediate and benign patterns 18:40 - Post-surgical bony defects 4. Small maxillary antrum 19:52 - Silent sinus syndrome v small maxillary antrum 5. Benign patterns of sinonasal polypoid soft tissue 21:17 - Retention cysts, sinonasal polyps and antrochoanal polyps 6. Upper jaw aetiology 22:51 - Odontogenic sinusitis and benign sinonasal lesion 7. Midline destructive nasal lesions 23:55 - Sarcoid and T-cell lymphoma, GPA and cocaine 25:15 - Red flag features on CT/MRI: 1. Isolated sinonasal disease/polyp 26:25 - Intrasinus malignancy 28:49 - Inverted papilloma, benign tumours and polyps 30:14 - Juvenile angiofibroma and vascular tumours 31:40 - Mucocele, pyocele and mycetoma 33:48 - Meningocele/skull base developmental lesions 2. Extra-sinus soft tissue 35:46 - Subperiosteal abscess 36:38 - Cavernous sinus thrombosis 37:38 - Frontal extradural empyema/abscess 38:08 - Invasive fungal sinusitis 40:43 - Malignant sinonasal tumour 42:20 - Summary Questions 43:55 - Imaging in CSF rhinorrhoea 48:30 - Follow-up for incidental benign unilateral cysts and lesions 49:53 - Clariftying rationale for MRI/contrast CT for cavernous sinus thrombosis 51:40 - T1 v T2w v Gadolinium enchanced images for investigating sinonasal tumours 55:26 - STIR/FLAIR sequences