Hugh D. Curtin MD, Presenter: Nothing to Disclose

1) The participant will be able to identify the key "fat pads" at the exit points of those cranial nerves most often affected by perineural spread. 2) The participant will be able to describe the fasical organization of the parapharyngeal region. 3) The participant will be able to locate the laryngeal ventricle using axial and coronal imaging.

Important Anatomy Head and neck imaging relies heavily on an undestanding of the intricate and often difficult anatomy. The session will focus on identification of anatomy that is crucial in a defining the margins and patterns of spread of pathology. Other landmarks that are key to description of the location of lesions are also covered. For instance, there is a small amount of fat located just external to each neural foramen through which perineural spread of carcinoma may pass. The most important of these primary "fat pads" are located in the pterygopalatine fossa (external to foramen rotundum), just inferior to foramen ovale (trigeminal fat pad), and the stylomastoid foramen (facial nerve) fat pad. These fat pads should be examined for potential obliteration as tumor approaches the foramen. The laryngeal ventricle is key to the organization of the larynx and reports should localize lesions related to this important structure. The ventricle may not be directly visible depending on the phase of respiration of an imaging scan. However the lateral wall of the larynx transitions from fat to muscle at the level of the ventricle. The ventricle is located at the upper margin of the thyroarytenoid muscle that makes up the bulk of the true vocal cord. The parapharyngeal spaces are crossed by several substantial fascial layers. The fascia organize the region into compartments that help the radiologist predict the identity of tumors in that location. Specfically, the anatomy makes it possible to separate tumors that are almost certainly of salivary origin from those that are not. Other specific anatomic points useful in interpretation or characterizaton will also be discussed.

Curtin, H, Important Head and Neck Anatomy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000610.html