1. To understand the concept of neck spaces and their boundaries.
2. To review the content of each space with emphasis on differential diagnosis.
3. To become familiar with pathological findings typical for each space.
A knowledge of neck spaces not only allows for better communication between radiologists and specialists familiar with imaging of this region but also aid in diagnosis as each space has a distinct group of pathologies. It considerably narrows down the differential diagnosis. The anatomy of the neck can be divided into suprahyoid and infrahyoid portions: suprahyoid neck which encompasses the deep spaces between skull base and hyoid bone and infrahyoid neck which lies inferiorly between the hyoid bone and both clavicles. These divisions are arbitrary in there is some continuation of suprahyoid neck spaces into the infrahyoid neck spaces and continuation of some infrahyoid neck spaces into the superior mediastinum.
1. To know which technique is best suited to visualise specific anatomical structures of the temporal bone.
2. To recognise the clinically most important anatomical structures of the middle and inner ear.
3. To learn how the anatomical structures of the temporal bone look like in the transverse, coronal and double oblique plane.
The anatomy of the external auditory canal, middle ear and bony inner ear is best studied with CT. The highest resolution can be achieved when ConeBeam CT is used, and this technique also has the advantage that there is no quality loss in the axial, coronal and double oblique plane, the planes needed to study the temporal bone anatomy in detail. Double oblique images are indispensable to visualise the stapes, stapes footplate and oval window. Anatomical knowledge is especially needed at those sites where pathology most frequently occurs and changes the anatomy. The footplate, stapes, lenticular and lengthy process of the incus, facial nerve canal, Jacobson’s canal, the scutum, round window, ligaments etc. are some of these structures and they should be studied in detail in every single patient. MR is better suited to demonstrated the anatomy of the membranous labyrinth, inner ear fluid spaces and nerves in the internal auditory canal. Heavily T2-weighted images are best suited to see these structures, but high resolution is needed. Not only the fluid inside the labyrinth must be evaluated but also the normal size of the different nerve branches in the internal auditory canal must be known in order to be able to detect nerve atrophy or hypoplasia. The most important anatomical structures of the temporal bone, as they can be visualised in different planes on (CB)CT and MR will be illustrated in this presentation.
1. To understand the anatomy and signals of the cartilage framework of the larynx.
2. To learn the surgical subdivision of the paraglottic space of the larynx into key compartments.
3. To learn the anatomy and signals of the muscles within the larynx.
The larynx is a specialised organ placed at the separation between the respiratory and the digestive tracts. Beyond protecting the airways against food aspiration, it is involved in breathing, swallowing and voiced sounds production. These functions are mostly accomplished by the action of three diaphragms: the epiglottis, the false and vocal cords. All of them, when closed, contribute to seal the larynx during swallowing. When opened, they permit the passage of the air into the trachea. The vibration of the vocal cords (the most caudal of the three sphincters) generates voiced sounds. The vibration is produced by the coordinated action of a group of laryngeal muscles. These muscles are inserted on rigid structures, provided in the larynx by a framework of ossified cartilages: cricoid, thyroid and arytenoid. Cricoid and thyroid cartilage form also a rigid box, a sort of shield. Muscle contraction results in a significant shortening and change of shape. To accommodate these changes, a malleable material (fat) fills the "gap" between muscles and the rigid shield. The lateral "fat-filled-gap" between muscles involved in vocal cord vibration and the cartilage framework is named paralaryngeal space. A midline "fat-filled-gap" separates the epiglottis from the rigid thyroid laminae. CT and MR may precisely delineate the submucosal structures: muscles, fat-filled-gaps (paralaryngeal and pre-epiglottic spaces) and depict un-ossified and ossified cartilages.