Learning objectives
To discuss the clinical manifestations and predisposing conditions of abnormal air in CT imaging of the head and neck.
To be aware of its importance and to describe its characteristic radiologic features.
To recognize normal air locations,
typical pitfalls and differentiate benign conditions to life-threatening emergencies.
Background
Air lesions of the neck conform a wide range of diseases including trauma,
gas-forming infections,
local tissue necrosis,
herniation (laryngeal or esophagic) and congenital.
The clinical manifestations and severity are very diverse and for that reason is very important to make an early diagnostic differentiation between benign sources of air and life-threatening pathology.
CT plays a key role because is highly sensitive and specific in the detection of abnormal air and capable to accurately identify benign conditions.
In this poster we review air lesions in...
Findings and procedure details
We are going to recognize normal/benign air locations and pathologic gas and its clinical settings on: trauma ,
abscess (retropharyngeal space abscess and oral cavity abscess),
postradiation effects (chondronecrosis),
laryngocele,
diverticulum (Zenker and lateral cervical esophageal) and spontaneous cervical emphysema.
Normal/benign air locations
Remember to check always this anatomic normal gas landmarks (Fig. 1,
Fig. 2).
Pharyngeal recess (fossa of Rosenmuller) ( Fig. 3 ) is located posterior and superior to the ostium of the Eustachian tube.
Key point: Check this recess in search of...
Conclusion
Air neck lesions have heterogeneous etiologies including potentially life-threatening conditions.
CT is the imaging modality of choice as it is both highly sensitive and specific in the detection of abnormal air and capable to reliable identify the benign causes.
Appropriate radiologic evaluation combined with accurate interpretation of findings will ensure optimal management planning and outcome.
Personal information
Contact details: Dr.
Santiago Carbullanca Resident in training.
Department of Radiology,
Hospital del Mar.
Passeig Marítim,
25-29,
08003 Barcelona,
Spain. Email:
[email protected]
References
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Eur Arch Otorhinolaryngol.
271(3):583-8,
2014
2.Postgrad Med J.
2001 Aug;77(910):506-11.Pharyngeal pouch (Zenker's diverticulum).
Siddiq MA1,
Sood S,
Strachan D.
3.Goldstein NA,
Hammersclag MR.
Peritonsillar,
retropharyngeal,
and parapharyngeal abscesses.
In: Textbook of Pediatric Infectious Diseases,
6th ed,
Feigin RD,
Cherry JD,
Demmler-Harrison GJ,
Kaplan SL (Eds),
Saunders,
Philadelphia 2009.
P.177.
4.Hurley MC,
Heran MK Imaging studies for head and neck infections.Infect Dis Clin North Am.
2007;21(2):305.
5.Nazaroglu H et al: Laryngopyocele:...
