Vamsi Kunam MD, Presenter: Nothing to Disclose

Deborah L. Reede MD, Abstract Co-Author: Nothing to Disclose

Roy Andrew Holliday MD, Abstract Co-Author: Nothing to Disclose

Wendy R. K. Smoker MD, Abstract Co-Author: Nothing to Disclose

After viewing this module the user will know the: 1. Normal gross and imaging anatomy of nerves commonly involved in perineural tumor spread (PNTS) with emphasis on their relation to various spaces/ locations in the head and neck (H&N) 2. Imaging findings of PNTS and common pathways of spread encounter with lesions in specific locations 3. Clinical findings and significance of PNTS  

Cross sectional images and illustrations are used to demonstrate the anatomy of pertinent nerves most commonly involved by PNTS (CN V, CNVII and Greater Auricular), and their relationship to various spaces of the H&N. Common connections between these nerves are reviewed, followed by a discussion of pathophysiology, clinical findings, therapeutic and prognostic implications. Direct and indirect imaging findings of PNTS are presented. Cases are used to demonstrate common pathways of PNTS associated with tumors in specific locations. Lesions locations and common patterns of nerve involvement (including retrograde spread) include: Nasopharyngeal tumors (V2 and V3), masticator space (V3), parotid space (VII, auriculotemporal branch and greater auricular nerve), supraorbital lesions (V1), maxillary sinus and buccal space lesions (V2) and hard palate (palatine nerve to the pterygopalatine ganglion, vidian nerve and V2).  

http://abstract.rsna.org/uploads/2014/14016573/14016573_pqyk.pdf

Kunam, V, Reede, D, Holliday, R, Smoker, W, Where Are You Going?: Geographic Approach for the Evaluation of Perineural Tumor Spread in the Head and Neck.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016573.html