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