RADIOLOGY FOR DETECTED

SPECIAL SENCE DISEASES

Dr.Nurlaily Idris,SpRad
Dr.Sri Asriyani,SpRad
 Radiology Modality

- Ears Plain X-Ray, CT Scan,MRI

- Nose/sinuses Plain X-Ray, CT
Scan,MRI
- Orbita/eye Plain X-Ray, USG,CT
Scan, MRI, Angiografi
 Examination for Sinus Paranasalis

1. Convensional Ro:

- Occipitomental (Waters position )

sinus maxilla, frontal , sphenoid &
os.zygomaticus, septum nasi
- Occipitofrontal ( Caldwell Position)
Frontal, ethmoid, orbita & cavum nasi
- Lateral Frontal, maxillasphenoid, cavum
nasi & nasopharynx
CT Scan/MRI
Paranasal sinus , orbita & soft tissue
 SINUSITIS
Acute :
- Complit partial covering or partial of
sinus
- Air fluid level
- Thickening of mucosa of sinus ( in
allergic case scalloped )
- Polip can be found in several cases
Chronic :
Athropi of the sinus with polipoid
thickening of mucosa
Sclerosis with thickening of sinus
bones
 MUCOCELE

Obstruction of ostium paranasal sinuses

caused acumulation of secret that fulfil the
sinus
Ro :widening of sinus with covering or
erotion of sinus wall or bulging of sinus
wall
Complication :

- Osteomyelitis :
Covering of sinus or loss of sinus wall
border
- Epidural or cerebral abscess rare but
serious
CT Scan is the main modality
 TUMOR
Benign:
Osteoma :
Ivory osteoma : radiopaque, yg dense, the
border or the tumor is clear, rounded or
lobulated, the sinus usually normal (except
there is obstruction of ostium)
Cancellous osteoma : Radioopak (a little bit
high than soft tissue)
Papilloma : same image with polip that expand to
cavum nasi and the sinus wall became thin.
 Micellaneoustumor :
(fibroma, neurifibroma, chondroma &
osteoch
Cholesteatoma : same with mococele
Meningocele & encephalocele
Malignant : usually sinus maxillaris
Ro :
- Soft tissue mass thet fulfil the whole or a part
of sinus
- Can destruct the bone and expansion to
surrounding

CT :- bone destruction more clearly

-mass border more clearly
-the expansion of tumor more clearly
-can detected the necrotic area and
abcess
 a. b.

a. Normal CT Scan,coronal scan

b. Normal CT Scan , axia scanl
c. CT Scan axial, obliterasi fossa
Rossenmuller extra & parafaring area
dextra

c.
 EARS

Plain X-Ray ( Conventional Ro )

- Lateral oblik ( mastoid, meatus ext, middle ear)
- PA supraorbital & cantomeatal (Towne Vincent)
( meatus acus.int,cochlea,mastoid & anthrum
- PA Oblik ( Stenver )
( mastoid,os. petrous, meatus .acusticus .int,
canalsemicir)
CT Scan
MRI
Acute otitis media & mastoiditis :
- Lose of tuba eustachi and meatus
acusticus media radiolucensy
- anthrum mastoid more radiopaque
and covering/ blurred of outter
border of mastoid
Chronic Mastoiditis :
- Sclerosis of air cells mastoid
- Complication of abscess & sequester with
sclerotic of mastoid ( difficult to diff with
cholesteatoma ) if Abscess the border
more clearly
- Can caused extradural& intra cerebral
sepsis
- Can caused serious complication
cholesteatoma
 ORBITS

Radiology modality :
Convensional R :

- occipitofrontal projection
- lateral projection
- oblique, 350
CT-Scan

USG

M R I

Angiography
Conventional X-Ray :
- Difficult to detect abnormality of
intra & extra ocular except if there
are radiopaque density, can detect
fracture
- CT-Scan main modality
Calsification

Rare on soft tisue, but if found

significant sign and patognomonis for
some conditions as :
- Catarac

- Retrolental fibroplasia

- Retinoblastoma
- Cataract sirculer calsification in lens,
7 mm (PA)
- Retrolental fibroplasia little
calsification intravitreal, in advance
condition can found with lenticuler
- Retinoblastoma spotted calsification
that union, and found bilateral
The others calsification can also caused by:
- Angioma - Hematoma
- Aneurisma - AVM
- Meningioma - Kavernous hemangioma
- Glioma
EROSION & DEFECT OF ORBITA BONE :

- Dermoid & Epidermoid : Usually in

superolateral orbita with sclerotic
border
- Glandula lacrimal tumor
- Ca.Nasofaring & sinus paranasalis
INFECTION

CT : coronal/axial
- Thickening of extra okuler muscle
- hipertrofi orbital fat
- edema interstitial of konjungtiva
- degenerasi ekstraokuler muscles
Celulitis

Usually caused by sinusitis & trauma

osteomielitis, septik tromboplebitis,
meningitis, dll.
Plain X Ray : opaque on sinus, destruksi of
bones caused by osteomielitis.
CT-Scan :
- Can be found abses formation ( mass with
unclear border with enhancement)
- Udema preseptal soft tissue
- Udema outline retrobulber structur
- Opague pd sinus paranasalis
(radang/mass)
M R I same with CT Scan, but MRI can
make more different positions & conditions