Advances in ENT imaging

Abstract

Over the last ten years or so radiology has shown dramatic technological developments especially in cross sectional imaging and the investigation and management of the complex ENT patient has benefitted enormously. Plain radiographs are being utilised less and less as their limitations are becoming more apparent and various studies have shown for example a 75% discrepancy between plain sinus radiographs and coronal sinus CT in children1,2 . The incorporation of small and flexible ultrasound transducers with high-resolution imaging into the tips of endoluminal catheters has allowed good quality endoluminal ultrasound. Recently endolaryngeal ultrasound has been clinically evaluated in 38 patients with a variety of laryngeal pathology including vocal fold polyps, laryngeal cysts, chronic laryngitis, epithelial dysplasia and cancer 5 . Using this technique tumour size and infiltration could be measured and involvement of the thyroid cartilage or anterior commissure could be visualised. Not surprisingly it was not able to detect any specific changes in the sonographic picture of patients suffering from chronic laryngitis, epithelial dysplasia or microinvasive cancer. Although these results are encouraging, its relative lack of availability will result in it only having a limited role in evaluating laryngeal pathology.