Imaging plays an important role in head and neck cancer by aiding in diagnosis, staging, treatment planning, response evaluation, and detecting recurrence. Common imaging modalities used include panoramic x-ray, x-ray of the paranasal sinuses, ultrasound of the neck, CT, MRI, and PET-CT. Each modality has advantages and limitations for evaluating the oral cavity, neck lymph nodes, and distant metastases. CT is often the initial study due to its wide availability and ability to detect bone invasion and lymph node metastases. MRI provides better soft tissue contrast for evaluating nerve and muscle involvement. PET-CT can detect occult primary tumors and distant metastases.
Salivary gland imaging radiology ppt . This powerpoint presentation includes important anatomy and important pathology of salivary gland with its imaging feature as well as its ct mri image. This will help alot. this will help for radiology resident as well as ent .
Salivary gland imaging radiology ppt . This powerpoint presentation includes important anatomy and important pathology of salivary gland with its imaging feature as well as its ct mri image. This will help alot. this will help for radiology resident as well as ent .
uses and indication of radiology in surgeryanimesh kunwar
1.Introduction
2.Diagnostic modalities in radiology
3.Role of radiological imaging in emergency surgical situation
4.Role of radiological imaging in elective surgical situation
5.Conclusion
Physical Models For Time Dose & FractionationIsha Jaiswal
Physical Models For Time Dose & Fractionation
Strandqvist Plot
Cohen’s Formula
Fowler Concepts
NSD Model
TDF model
Target Theory
L Q model
BED calculation of different fractionation regimen
Introduction
Time dose & fractionation
Therapeutic index
Four R’s Of Radiobiology
Radiation response
Survival Curves Of Early & Late Responding Cells
Various fractionation schedules
Clinical trials of altered fractionation
General management
Management of low grade gliomas: overview
Pilocytic astrocytoma
non pilocytic/diffuse infiltrating gliomas
Management of high grade gliomas: overview
Anaplastic gliomas
Glioblastoma multiformae
EBCTCG METAANALYSIS
INDICATION OF POST OP RADIOTHERAPY
Immobilization devices
Conventional planning
Alignment of the Tangential Beam with the Chest Wall Contour
Doses To Heart & Lung By Tangential Fields
describes relationship between radiation dose and the fraction of cells that “survive” that dose
model of cell killing
target model
linear quadratic model
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
RADIO LOGICAL ANATOMY OF HEAD AND NECK CANCERS
1. Role Of Imaging & Normal Radiological
Anatomy Of Head & Neck
With Emphasis On
Oral Cavity
Presenter :Dr Isha Jaiswal
Senior Resident Radiotherapy
Date 10th September 2018
2. ROLE OF IMAGING IN HEAD & NECK CANCER
• For Diagnosis & Staging
• For Treatment Planning (both surgery & radiotherapy)
• For Response Evaluation
• For Detection Of Recurrences
3. TYPES OF IMAGING
XRAY
• Panoramic Xray oral cavity
• Paranasal sinus
• X ray lateral Face And Neck
USG Neck
CECT Face And Neck
MRI Face And Neck
Whole body PET-CT Scan
4. Panoramic Xray oral cavity
Indication
• for determining bone invasion
• for planning dental treatment of oral cavity prior to chemotherapy and radiation to reduce
subsequent complications
• for early detection of maxillofacial complications of cancer therapy when they do occur;
• for detection of recurrent tumors within the maxillofacial complex.
5. characteristic features of malignant lesions in plain radiographs include
• atrophy of cortical lamina
• osteolytic defects
• in later stages, teeth lose their bony support at the site of infiltration
bone defect in the left mandibular body. The osteolytic lesion reaches the alveolus of
the lower left canine that had lost bony support
Discrete radiolucency in
mandible on right side.
6. Xray paranasal sinus
• PARANASAL SINUS:
Paired structure
Frontal sinus located between inner & outer table of skull bone
posterior to glabella
Ethmoid sinus in labyrinth of ethmoid bone
Maxillary sinus within body of maxilla
Sphenoid sinus in body of sphenoid bone behind shella turcica
• XRAY PNS
Standard views include the Water’s, Caldwell, lateral and basal
views.
Usually filled with air
Abnormal Xray may show fluid or mass
7. Water’s (occipitomental)
Extend neck, nose & chin of pt. touches film/table
OML will be 37 degree from table
Structures seen
• Maxillary sinus (seen best)
• Frontal sinus
• Sphenoid sinus (if mouth open )
8. Caldwell’s (occipitofrontal) view
Pt. place nose & forehead against upright table with
neck extended to elevate OML 15 degree from
horizontal
Structures seen
• Frontal sinus (seen best)
• Ethmoid sinus
• Maxillary sinus
10. Pt. raise chin, hyperextend neck
until OML is parallel to film, head rests on
vertex. Vertex near film .Xray taken from sub
mental area
Structures seen
• Sphenoid sinus (seen best)
• Post Ethmoid sinus
• Maxillary sinus
Basal (submentovertical) view
11. XRAY lateral soft tissue neck
Indication
• Useful in assessing patients with potential pathology of upper aerodigestive tract.
• Detects foreign bodies ,airway compromise, trauma and infections such as croup, epiglottitis deep neck
infections such as retropharyngeal abscesses
• determination of the distribution of detected malignancies in vertebra
Advantages
• cheap, non invasive, readily available investigation tool
• Useful in planning for conventional radiotherapy
Drawbacks
• Poor visualisation of oral cavity and oropharynx
• Limited use in oncology
12. XRAY LATERAL NECK
1. Hard Palate
2. Soft Palate
3. Nasopharynx
4. Oropharynx
N
O
13. XRAY LATERAL NECK
1. Calcified tracheal cartilage rings
2. Hyoid bone
3. Epiglottis
4. Thyroid cartilage
5. Cricoid cartilage
T
C
H
E
14. Ultrasound
Advantages
• Availability
• Cheap
• No radiation
• Differentiate solid vs cystic
• Real time
• Colour Doppler vascularity identified
Disadvantages
• Cannot be used for deep seated tumors
• Air and acoustic window interference
• Interobserver variability
• Lack of reproducibility
• Cannot be incorporated into TPS
Indications
• used to evaluate superficial lesions
• For clinically occult nodal evaluation
• For evaluation of Thyroid gland
• for image guided fnac & biopsy
15. USG FEATURE OF MALIGNANT L.N
• increase in size
• Nodal parenchyma exhibited inhomogeneous low or mixed echogenicity.
• Irregular margin with round shape.
• Sharp borders.
• Loss of normal hilar echogenicity.
• Doppler sonograms, has peripheral or mixed vascular pattern
16. • usually the first modality used because it is widely available, relatively cheap, quick and easy to
perform and reproducible.
• The examination time is short with less motion artefacts than an MR scan.
• Thin slice, high resolution image acquisition allows high quality Multiplanar reconstructions with
superior evaluation of bony structures and calcifications.
• Evaluation of CT images is also easier than evaluation of MR images.
CECT Face & Neck Scan
17. CECT SCAN
Feature Of Malignancy
• Tumours appear as asymmetrical
thickening of the mucosa (a)
• can show areas of necrosis (b)
• enhances according to its
vascularity (a star)
Patient with cancer of the right pyriform sinus.
CECT scan a showing asymmetrical thickening of the pyriform sinus (arrow) on the right.(a;above)
slight thickening of the posterolateral hypopharyngeal wall (b;arrowhead)
lymph node with central necrosis (b;arrow) indicating metastasis
18. • More than 1cm size except jugulodigastric(1.5 cm) (short axis)
• Shape: spherical rather than ellipsoidal; Heterogeneous enhancing pattern
• Eccentric cortical hypertrophy.
• Necrotic center: hypo-dense
• Cluster of 3 or more borderline nodes
• Margin :ill defined
CT FEATURES OF MALIGNANT LYMPH NODE
19. CECT Scan Face & Neck
Advantages
• Widely available
• Fast imaging
• Detail crossectional images
• Good bony details
• Detect clinically occult metastatic L.N
• multiplanar reconstructions
• Aids in RT planning
• Gives electron density information
• less motion artefacts
Disadvantages
• Radiation exposure
• Relatively expensive
• Poor Soft tissue contrast
• Artifact due to dental fillings
• Underestimating ulcerative and infiltrative lesions
• overestimating tumor extent due to inflammation/
oedema & distortion of adjacent normal structures
• Contraindicated in allergy to contrast media,
kidney failure
20. MRI FACE AND NECK: features of malignancy
• On MRI, the tumour is usually hyperintense to muscle on T2-
weighting and hypointense or isointense to muscle on T1-
weighting.
• The plain T1-weighted images are particularly useful in
differentiating tumour from surrounding fat, detecting
neurovascular bundle and bone marrow involvement.
• Patient with Ca pleomorphic adenoma of submandibular
gland on left with invasion of mandible.
• In T2-MR image lesion is heterogenously hyperintense to
muscle and there is loss of the cortical hypointense line
indicating bone invasion (arrow). (a)
• In T1-weighted image lesion is hypointense to muscle
and there is replacement of the normal marrow fat by the
tumour. (b)
• The contrast T1-weighted image shows some
enhancement of the lesion. (c)
21. CT SCAN & PET SCAN FOR SAME CASE
• Contrast enhanced CT scan at the same level d shows the heterogenously enhancing mass which extends into the
mandible.
• The cortical bone erosion (arrow) is seen better in the bone window setting e.
• The PET-CT scan at the same level showing the increased glucose uptake by the tumour with extension into the
mandible
22. (B,C ) Coronal T1-weighted image through the hard palate and soft palate, respectively
MRI Anatomy Of Oral Cavity :coronal images at level of hard & soft palate
( A ) Coronal illustration through the hard
palate. Note the mylohyoid muscle forming the
inferior and lateral borders of the OC,, and the
extrinsic tongue muscles (hyoglossus and
genioglossus).
23. (C) Axial illustration at level of tongue
demonstrating tongue & RMT.
PMR, pterygomandibular raphe (facial
band connecting buccinator & sup.
constrictor ).
MRI Anatomy Of Oral Cavity :coronal at level of FOM &Tongue
( A ) Axial illustration at level of FOM
demonstrating extrinsic muscles
( B ) Axial T2wt image at the level of the FOM (D)Axial T2-wt image at the level of oral tongue.
24. Advantages
• Multiplanar scanning
• better soft tissue contrast
• can determine the involvement of local soft tissues, as
well as vessels and nerves.
• Better for perineural infiltration & intracranial extension,
bone marrow involvement
• May differentiate recurrent tumor and post treatment
fibrosis and radiation necrosis
• less artifact from dental fillings.
Disadvantages
• higher costs
• longer acquisition time
• No electron density information
• Contraindicated in pts with pacemaker
and implants
• Poor bone visualisation
• potential artefacts (motion artefacts, flow
artefacts, field distortion artefacts due to
metal or at air bone interfaces or with
blood products
MRI Face & Neck
25. 18 FDG PET
Features of malignancy
• On PET-CT, the morphological changes due to the tumour are seen as in CT with increased uptake of glucose
in those tumours which are FDG avid ,
• other processes resulting in glucose uptake like infection, inflammation show false positive results
• It is a nuclear medicine functional imaging technique used to observe metabolic processes in the body
detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide, most commonly FDG
• the concentrations of tracer imaged will indicate tissue metabolic activity
26. 18FDG PET-CT
Indications
Advantages
• Functional imaging
• In detection of unknown /small primary tumor
• In evaluating clinically occult nodal
involvement
• To detect distant mets
• In follow up to differentiate between
recurrent tumor and post treatment fibrosis
and radiation necrosis
Disadvantages
• Limited availability
• Costly
• False Positive uptake in inflammation and
infections
28. Oral Cavity Radiological Anatomy & Presentation
Of Cancer
• Lip
• Buccal Mucosa
• Anterior Tongue
• Floor Of Mouth
• Alveolus
• Hard Palate
• Retromolar trigone
29. Axial CECT Neck
At Level Of C4
Bone
Muscles: Tongue, SCM, Trapezius
Gland
Vessels
Vallecula
Epiglottis
pharynx
30. • CT is complemented by the puffed cheek technique (PCT), when oral cavity lesion suspected.
• PCT involves voluntary blowing of the oral cavity with air during the CT. Compliance with the technique is variable,
Puffed Cheek Technique
T
ALV
HP
BM
FOM
31.
32. Retromolar trigone
Triangular region bounded
• ant: post surface of last molar
• Post: ant tonsillar pillar
• Lat:buccal mucosa
• Apex: pterygoid hamulus
33.
34. FLOOR OF MOUTH
• Floor of the mouth is a U-shaped area formed by 2 mylohyoid muscle & hyoglossus
• Anteriorly is bounded by the gingiva of the mandible and posteriorly by the anterior faucial pillar.
• Contains sublingual space: fatty connective tissue space within the floor of mouth, contains sublingual salivary
glands, submandibular duct ( warthon duct), lingual artery, vein and nerve and hypoglossal nerve (XII C.N.)
37. Presentation
ulcer along the lateral border of the Lt tongue.
• CE CT demonstrates an enhancing mass located on the lateral aspect of anterior tongue on left.
• does not cross the midline and is limited to the intrinsic muscle of the tongue.
• no extension to the gingival mucosa or involvement of the adjacent mandibular bone.
• No enlarged lymph nodes are identified
38. Carcinoma tongue: CT axial ,coronal & bone window
Ulcerated lesion involving the left posterolateral tongue No enlarged submental or submandibular lymph nodes.
Edentulous mandible and maxilla. No osseous destruction
39. Carcinoma Tongue: MRI
large oral tongue lesion is seen arising from left half. involves the entire extent of the left tongue from tip to level of
circumvallate papillae, predominantly involves ventral aspect with deep invasion into the intrinsic muscles. Anteriorly
crossing the midline with involvement of the right tongue
40. CARCINOMA BUCCAL MUCOSA
CT image showing a malignant
lesion in the left buccal mucosa.
CT image showing a mass from the Lt
buccal mucosa extending to the RMT
and involving submandibular region
Advanced lesion infiltrating mandible
41. Presentation
Swelling and pain in right cheek. Chronic tobacco chewerCARCINOMA BUCCAL MUCOSA
Serial section of CECT neck showing heterogenously enhancing mass lesion in the right buccal mucosa with multiple
enlarged right Level Ib lymph nodes
43. CARCINOMA FLOOR OF MOUTH
• patient presented with a large ulcer at the left floor of the mouth
CT showed an infiltrating tumour with irregular borders at the anterior left floor of the mouth and gingivo-buccal
sulcus, that crossed the midline and eroded the mandibular bone.
There was a centrally necrotic lymph node metastasis at the anterior border of the left sternocleidomastoid muscle.
49. CARCINOMA BASE OF TONGUE
(A)axial: ulcerated contrast enhancing soft tissue mass in BOT (arrowheads)lesion crosses midline with large level II
L.N. lingual artery involved (curved arrow)
(B)Sagittal image: ant. Spread in FOM(white arrowhead)lesion extend into vallecula (black arrowhead);preepiglottic
space (asterisk) not involved
63. Nose & Paranasal Sinus Radiological
Anatomy & Presentation Of Cancer
64. 64
An CT face axial 7 coronal section showing the nasal cavity with the paranasal sinuses.
65.
66. • Sagittal CT scans showing the frontal, ethmoidal
and sphenoidal sinuses.
• Arrows indicate the hiatus semilunaris
66
67. The Ohngren line.
Sagittal CT shows a squamous cell carcinoma with the origin in the posterior maxillary sinus.
The white line refers to the Ohngren line, where cancer posterior to this line was previously considered
unresectable.
The posterior black line is the border between a T4a and a T4b cancer (AJCC 7th edition).
This tumour erodes the posterior maxillary wall and bulges into the orbital apex
• line that connects the medial canthus of the eye to the angle
of the mandible.
• divides the maxillary sinus into (1) an anterior-inferior part,
and (2) a superior-posterior part.
• Tumours that arise in the anterior-inferior part, i.e. below
Ohngren's line, generally have a better prognosis than those
in the other group
68. 68
CT of a nasal vestibule carcinoma that has spread by direct invasion of the upper lip and gingivolabial sulcus.
CARCINOMA NASAL VESTIBULE
69. Maxillary sinus squamous cell carcinoma.
(a) Axial CT shows erosion of the lateral nasal wall and lacrimal duct (arrow) and growth into the middle meatus (asterisk)
(b) Coronal CT in another patient with a carcinoma mimicking a nasal polyp, however, the lateral nasal wall is eroded
(arrow)
70. (a) Axial CT and (b) T2-weighted MR imaging demonstrate a tumour (black arrowheads)
• extending to the skin of the cheek (white arrowhead) bony erosion of the lateral maxillary sinus wall and the
pterygoid plates (arrows) are better visualized using CT;
• extension of the tumour and distinction from obstructed fluid-filled sinuses and surrounding oedematous soft tissue
are best evaluated using MR imagin
71. Maxillary Sinus Cancers: suprastructure with pattern of spread
Advanced tumor: alveolar process destruction with loosening of a tooth (E) and abutment of the orbital floor
72. Ethmoid sinus adenocarcinoma
(b) Contrast-enhanced coronal CT shows an intracranial component
(arrowheads) verified at
(c) coronal contrast-enhanced T1-weighted MR imaging. There is no
meningeal enhancement due to the dural barrier. The tumour also respects
the orbit and was classified as a T3 cancer.
(a) Coronal CT shows opacification of the
left nasal cavity, anterior ethmoid sinus
and frontal recess. The clue to a malignant
process is the erosion of the lateral
lamella (arrow).
73. • Extends from the level of Hyoid Bone to lower border of Cricoid cartilage.
• Corresponds to C4 - C6 vertebral bodies.
• Subsites-
• Pyriform sinus
• Post cricoid region
• Posterior pharyngeal wall
Hypopharynx Radiological Anatomy & Presentation Of Cancer
76. CARCINOMA HYPOPHARYNX
• abnormal enhancing mass centred upon the right larynx/hypopharynx with large cervical lymph node
• superior extent of the lesion extends from the right aryepiglottic fold, involving the paraglottic right space (without
crossing the midline) and extending into the supraglottic larynx.
• Inferior extent extends to right true cord with likely subglottic spread.
-Behind the nasal cavity
-Extends from skull
Base superiorly to the
soft palate inferiorly
Communicates inferiorly with the oropharynx through the velo-pharyngeal sphincter
The nasopharyngeal tonsil lies in the roof
The pharyngeal opening of ET lies in the lateral wall
ROOF: formed by basiocciput & basispenoid
FLOOR: Formed by soft palate anteriorly; deficient posterior called as nasopharyngeal isthmus via which it communicates with the oropharynx .
Anterior :continuous with the nasal cavity via choanae
Atlas vertebra
Axis vertebra
Sup. Constrictor ms
Buccopharyngeal fascia
Retropharyngeal space
Prevertebral fasciaLateral wall: contain openings of eustachian tube bounded by elevation called as torus tubarius