Michelle A. Michel MD, Presenter: Author, Amirsys, Inc Co-editor, Amirsys, Inc Consultant, Amirsys, Inc

1) Understand relevant normal and variant sinonasal anatomy, patterns of inflammatory disease, and complications of acute rhinosinusitis. 2) Recognize lesions that mimic inflammatory disease and identify additional findings outside of the sinonasal cavities that may be present on imaging studies. 3) Improve your basic knowledge and skills relevant to assessing the pediatric temporal bone. 4) Apply principles of critical thinking to provide temporal bone reports that are clinically relevant and of use for parental counseling and surgical planning. 5) Understand the importance of accurately localizing the tumor to a subsite in the head and neck. 6) Apply staging details from the AJCC 7th edition to tumors that have been identified.

In order to create an accurate and clinically helpful sinonasal CT report, the radiologist must have knowledge of sinonasal anatomy and correct terminology of surgical procedures. Reports for sinus CT in the setting of inflammatory disease should include an objective description of the amount of mucosal disease in the sinuses. The drainage pathways of the sinuses should be evaluated keeping in mind patterns of inflammatory disease. The radiologist should be familiar with the variety of orbital, bone/soft tissue, and intracranial complications of sinusitis. Whenever there is clinical suspicion of an intracranial complication of sinusitis, gadolinium-enhanced MRI of the brain is indicated. CT is often performed for the evaluation of the patient after ESS. The examination may be performed to evaluate for improvement in sinus ventilation, causes of ESS failure, or complications of surgery. Sinus CT “red flags” include odontogenic maxillary disease, isolated sphenoid sinus and olfactory recess inflammatory opacification. It is also important to review the compartments adjacent to the sinonasal cavities in search of additional findings.

Michel, M, Reporting Sinus Studies.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000641.html