A CT of the sinus can help your physician to assess any injury, infection or other abnormalities. Any of these conditions may increase the risk of an adverse effect. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ It does not imply the use of a contrast agent. 4000 HU), soft tissue kernel (e.g. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Then, the table will move slowly through the machine for the actual CT scan. Sinuses - Landmark Protocol Indications o Pre-surgical planning Sequences MRI allows better differentiation of soft tissue structures within the sinuses. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ /XObject <>>> inbqo@O[nF{su:t(//A (hA222=h)D'@/w8}{aaaEB[xxeqJyg-w3h7 . `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Deviated Septum The nasal septum has cartilage and bone that divide your nose's nasal cavity in two. To use the navigation system, a computer tomography (CT) scan of the sinuses or the skull base of the patient is performed using a specific navigation protocol (in some cases the CT scan is saved into a DICOM format). 1`,n::&a?k4zeCn7|Q6qInl|@@@@@?}6}'7n5~e&>'Sj&1 ;jo/Nv$[fo|wPt&Gspl?So.rE%?;~ > N+[LW{ Recognition and utilization of surgical landmarks is imperative for the surgeon. See permissionsforcopyrightquestions and/or permission requests. Able to normal, ct sinus landmarx protocol: sedo nor does not to perform cosmetic and only your browser that use during a pain in prevention. Risk factors for complicated infections include prolonged tobacco use and chronic occupational exposure to wood dust, nickel, or chrome pigment. Although rare, complications from sinusitis can be serious if not promptly diagnosed and adequately treated. If so, your doctor will explain why. The contents of this web site are for information purposes only, and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. no financial relationships to ineligible companies to disclose. 3 above) and is positioned accordingly once the bracket is secured to the bed frame as demonstrated in figure 5. Any motion, including breathing and body movements, can lead to artifactson the images. Which test, procedure or treatment is best for me? Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical imaging test. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ provide additional information about tumors of the nasal cavity and sinuses. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Wanted to be landmarx try a much lower radiation exposures for the symptoms may need while remaining at the site. 28K views 4 years ago This video provides a basic tutorial for anybody without a medical background to look at a CT Sinus scan and understand what they are looking at. You may lie on your back, or you may lie face-down with your chin raised. Outside links: For the convenience of our users, RadiologyInfo.org provides links to relevant websites. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Wear comfortable, loose-fitting clothing to your exam. Possible findings in acute sinusitis include mucosal thickening, air-fluid levels, and complete opacification of the involved sinus. Figure 3A, 3B shows the CT appearance after FESS. It is usually performed as a non-contrast study. Imaging Protocols for the Cranial, DBS, Spine, and ENT Applications Technical Support Line c 800.595.9709 or (+1) 720.890.3200 The following requirements apply to all scans taken for the Cranial, DBS, Spine and ENT applications. sinus CT scans are, therefore, considered to be of minimal . `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Sometimes a follow-up exam further evaluates a potential issue with more views or a special imaging technique. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. Sinusitis is one of the most common conditions encountered by primary care physicians, accounting for approximately 25 million office visits annually1 and costing more than $2 billion annually in direct medical expenses.2,3 According to the National Ambulatory Medical Care Survey, sinusitis is the fifth most common medical diagnosis for which antibiotics are prescribed.4,5. It is used occasionally in cases of suspected tumors or fungal sinusitis.1719 Otherwise, MRI has no advantages over CT scanning in the evaluation of sinusitis. The technologist or nurse, under the direction of a physician, may offer you some medication to help you tolerate the CT scanning procedure. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Iowa City, IA 52242-1089, Editor: Henry Hoffman, MD Stereotactic anatomical localization in complex sinus surgery: A systematic review and meta-analysis. Roy J. and Lucille A. His ears were clear bilaterally. How the Test is Performed the ct also deployed in the surgical system. Allergy induction protocol used to induce allergic rhinosinusitis in guinea pigs with intranasal (i.n.) A computed tomography (CT) scan of the sinus is an imaging test that uses x-rays to make detailed pictures of the air-filled spaces inside the face (sinuses). 7 0 obj The purpose of this review is to illustrate important anatomic variants and landmarks on the preoperative sinus CT with a focus on those that predispose patients to surgical complications. If you've battled sinus pain, headaches, and emotional drain for 12 weeks or more, you may have chronic sinusitis. He received multiple courses of oral antibiotics, nasal steroids, and decongestants, with only temporary relief. What will I experience during and after the procedure? The use of image-guided surgery in endoscopic sinus surgery: an evidence-based review with recommendations. Doctors do not generally recommend CT scanning for pregnant women unless medically necessary because of potential risk to the unborn baby. 2015;5(8):761-763, Bernardeschi D, et al. For a CT scan of the sinuses, the patient is most commonly positioned lying flat on the back. This allows us to minimize radiation while providing a high tech three-dimensional image of the sinuses. Neuro patties, x , x 1, x 3. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Our understanding and management of paranasal sinus infections have improved since the introduction of nasal endoscopy, CT scans, and MRI. This difference allows the doctor to distinguish body parts from one another on an x-ray or CT image. Although air-fluid levels and complete opacification of a sinus are more specific for sinusitis, they are only seen in 60 percent of cases. 2012;126(12):1224-1230. If you have a hard time staying still, are claustrophobic, or have chronic pain, you may find a CT exam to be stressful. CT contrast injection and protocols. After the ostiomeatal complex is accessed through the nostril with a rigid endoscope, the ostia and recesses are targeted, depending on the location and pattern of disease. CT of the sinuses can help plan the safest and most effective surgery. Being the most widely accepted theory, it states that the weakest part of the tympanic membrane (TM), i.e., pars flaccida, retracts because of the negative pressure in the middle ear cavity caused by long-standing eustachian tube dysfunction. NB: This article aims to frame a general concept of a CT protocol for the assessment of the paranasal sinuses. Image-guided surgery (IGS) is the use of a real-time correlation of the operative field to a preoperative imaging data set that reflects the precise location of a selected surgical instrument to the surrounding anatomic structures. The IGS instrumentation and registration protocols will vary with based on the brand and model of the system used. Attachment of ct sinus, ct scans in the radiologist in both before. CAT scan - sinus; Computed axial tomography scan - sinus; Computed tomography scan - sinus; CT scan - sinus. Managing Editors: Sarah Elliott, Kay Klein, Claire Davis 2. The nasal cavity and paranasal sinuses were examined independently in a blinded fashion by four staff neuroradiologists and a staff otolaryngologist with special attention to 10 anatomic landmarks within the ostiomeatal unit that are considered important for preoperative planning. ENT Navigation Solutions Discuss the fees associated with your prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a better understanding of the possible charges you will incur. Surgical Navigation at UIHC is currently achieved with Medtronic Fusion IGS (Image Guided Surgery) system. In many protocols a standard dose is given related to the weight of the patient: Weight < 75kg : 100cc. CT Sinus, Facial Bones, Orbits, Temporal Bones, Maxilla CPT Codes 1. The contrast material will be injected through this line. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ 70486- CT Maxillofacial without contrast For the purposes of this protocol, the setup for Endoscopic sinus surgery will be described. CT is the most reliable imaging technique for determining if the sinuses are obstructed. Clinically and sinuses using landmarx protocol done without any general He continued his nasal steroids and systemic decongestants, and began nasal saline irrigations (recipe: 1 quart water, 2 teaspoons salt, 1 teaspoon baking soda). An effort to determine the presence of chronic sinusitis as a driving cause of her chronic inflammatory nasal disease, CT imaging is indicated. Neuroradiology CT Protocols N 1: Head CT without contrast N 1C: Pre- and post-contrast head CT N 2: Head CT angiography . RadiologyInfo.org, RSNA and ACR are not responsible for the content contained on the web pages found at these links. Contrast agents may be injected before scanning Contiguous, non-overlapping slices Constant slice thickness Axial slices Weight > 90kg : 150cc. DFOV: 25cm . While it is most frequently used by the Otolaryngology service for endoscopic sinus surgery, it can also be utilized for skull base or other H/N cancer cases, ophthalmology, neurosurgical, and joint procedures involving these services. Thus, it should be utilized as the adjunct and should not be viewed as a substitute for surgical knowledge and anatomical familiarity with the surgical region. He has a history of bilateral nasal obstruction and facial pressure pain over a number of years. When you look at a CT scan, bone should be whitish, the air around your head and in the sinuses should be black, and soft tissue is a greyish color. 70480- CT Orbits without contrast 2. Commonly Used CPT Codes for CT | Harrison Imaging Centers . From the raw data, we reformat coronal, axial, and sagittal 2.5-mm-thick contiguous images with bone and soft-tissue algorithms. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ There is always a slight chance of cancer from excessive exposure to radiation. 2019; 46(4): 520-525. Radiology department of the Rijnland Hospital in Leiderdorp, the Netherlands. /Length 40>> stream endstream The patient underwent endoscopic sinus surgery with improvement of his symptoms. The University of Iowa appreciates that supporting benefactors recognize the University of Iowa's need for autonomy in the development of the content of the Iowa Head and Neck Protocols. Helical Position/Landmark: 2-3 cm (20-30 mm) above the vertex. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ 74170, 72194 Pancreatic Protocol or 3-Phase Liver For pain, contrast is needed. The study involved 60 patients aged 15-67 years whose paranasal sinuses were imaged with this modality using one of three different low-dose CT-scan protocols. The radiation dose for this procedure varies. /Matrix [1 0 0 -1 0 792] Intra-Operative Use of Computer Aided Surgery. These multi-slice (multidetector) CT scanners obtain thinner slices in less time. Interpreting findings seen at CT of the neck is challenging owing to the complex and nuanced anatomy of the neck, which contains multiple organ systems in a relatively small area. . A conventional x-ray exam directs a small amount of radiation through the body part under examination. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ STEALTH PROTOCOL REQUEST. Although first developed for neurosurgery, endoscopic sinus surgery (ESS) rapidly became one . Because children are more sensitive to radiation, they should have a CT exam only if it is essential for making a diagnosis. Unlike conventional x-rays, CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, and blood vessels. We hope you find this useful and would appreciate any comments or suggestions that you might have. /G3 gs Start Location: 1 cm inferior to Skull base. Image 4: The electromagnetic field generator (EMG) is generally stored with the brace and bracket (shown in fig. A special computer program processes this large volume of data to create two-dimensional cross-sectional images of your body. The patient is a 37-year-old man who smokes. The bone algorithm was used in all cases [15]. Scanning and registration protocols that enable accuracy StealthMerge ENT software that fuses different imaging modalities (CT, MRI) together for improved visualization Instruments that are designed and calibrated for use in image-guided surgery Benefits of image-guided surgery for ENT procedures CT scans in children should always be done with low-dose technique. Such speed is beneficial for all patients. He recently developed intermittent left-sided epistaxis. The paranasal sinuses are hollow, air-filled spaces located within the bones of the face and surrounding the nasal cavity, a system of air channels connecting the nose with the back of the throat. Uncomplicated sinusitis does not require radiologic imagery. Soft tissue, such as the heart or liver, shows up in shades of gray. Please type your comment or suggestion into the text box below. This study should be downloaded from the server or onto a CD to be taken to the OR. Sinonasal cancers are quite uncommon, with an annual incidence of less than 1:100,000 in the United States. The procedure itself should not be different from your point of view. The AAO-HNS website regarding surgical navigation was reaffirmed 12/8/2012: CT scan of the paranasal sinuses with Stealth protocol should be ordered prior to the patients surgery date. from the hard palate to above the end of the frontal sinuses, bone kernel (e.g. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ % These occur as the CT scanner's internal parts, not usually visible to you, revolve around you during the imaging process. With modern CT scanners, you may hear slight buzzing, clicking and whirring sounds. CT scan is one of the safest means of studying the sinuses. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Gantry Tilt: 15 to 20 degrees angulation of the gantry to the canthomeatal line or tilting the patient's chin toward the chest ("tucked" position). At the time of surgery, the system is taken to the OR and the CT scan can be viewed on the monitor while the surgeon inserts a special probe into the nose. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ When the ENT doctor orders a Landmark and 3D we will bill 76377 (3D) and 77011 (Landmarks). After a prolonged course of antibiotics, serial CT scans revealed resolution of the frontal abscess and sinusitis. Plain radiography, if used at all, should be reserved for patients with persistent symptoms despite appropriate treatment. H"BB^{NMMedC=q?oz-R. Uncomplicated cases of sinusitis are most often treated empirically based on findings from the history and physical examination. The technologist begins by positioning patients on the CT examination table. 21151 Pomerantz Family Pavilion Procedures and Techniques, Whether you're performing functional endoscopic sinus surgery (FESS) or operating in the skull base,meta-analyses on commercial image-guided navigation systems, like StealthStation ENT system, suggest a reduction in major complications during endoscopic sinus surgery compared with non-image guided procedures.1-3. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ All Rights Reserved A major advantage of CT is its ability to image bone, soft tissue, and blood vessels all at the same time. 256 Slice CT - Updated 01-25-2022 Sinus: Medtronic Sinus. Immunocompromised persons and smokers are at increased risk for serious sinusitis complications. Citardi MJ, et al. 70481- CT Orbits with contrast 3. Medications (specific to nursing) 1% lidocaine with 1:100,000 epinephrine. A radiologist, a doctor specially trained to supervise and interpret radiology exams, will analyze the images. 256 Slice CT - Updated 01-25-2022 Sinus: Head Boney Sinus (Flash Spiral) 256 Slice CT - Updated 01-25-2022 Sinus: Landmarx Sinus. CT is usually the first test ordered when a sinus tumor is suspected. Carver College of Medicine (2021), CT NCAP (neck, chest, abdomen and pelvis), left ventricular systolic and diastolic function, ultrasound-guided musculoskeletal interventions, gluteus minimus/medius tendon calcific tendinopathy barbotage, lateral cutaneous femoral nerve of the thigh injection, common peroneal (fibular) nerve injection, metatarsophalangeal joint (MTPJ) injection. They should not have repeated CT exams unless necessary. Weight 75-90kg: 120cc. Each IGS instrument should be registered and evaluated prior to utilization. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ He had left maxillary and frontal tenderness to palpation on examination. This is where the technologist operates the scanner and monitors your exam in direct visual contact. 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In some protocols we always want to give the maximum dose of 150cc, like when you are looking for a pancreatic carcinoma or liver metastases. However. RadiologyInfo.org is not a medical facility. Created for people with ongoing healthcare needs but benefits everyone. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America (RSNA) and the American College of Radiology (ACR), comprising physicians with expertise in several radiologic areas. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Image-guided navigation systems used in endoscopic sinus surgery have shown a reduction in the need for revision surgeries. It is imperative that the correct patient, study from the desired date and the appropriate anatomical study are selected. Magnetic resonance imaging (MRI) cannot define bony anatomy as well as CT. MRI is only used to differentiate soft-tissue structures, such as in cases of suspected fungal infection or neoplasm. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Auris Nasus Larynx. There are four pairs of sinuses, each connected to the nasal cavity by small openings. A typical CT of the paranasal sinus may be as follows: Typical indications include the following: The purpose of a CT scan of the paranasal sinuses is to visualize the possible presence of inflammatory or newly formed tissue in the context of the paranasal cavities. CT of the head with fiducials. CT Assessment of Sinuses Before FESS The radiologist's role is to report on five key 2014;82(6 Suppl):S95-105. Bone window views provide excellent resolution and a good definition of the complete osteomeatal complex and other anatomic details that. The CT protocols listed are generic versions of scan protocols and need to be modified for scanner make and model. You may feel a need to urinate. Straps and pillows may be used to help the patient maintain the correct position and to hold still during the exam. The IGS equipment requires positioning of a registration unit on the patient. 50, and 75% sinus-length landmark slices, as shown in Fig. {"url":"/signup-modal-props.json?lang=us"}, Macori F, Yap J, Murphy A, et al. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ What is CT (Computed Tomography) of the Sinuses? Vreugdenburg TD, et al. A special CT scan of the sinus is done pre-operatively, and entered into the computerized system. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Alternative Names. The MRI showed extension of the neoplasm into the medial anterior maxilla and septum (Figure 4). He underwent transfacial and endoscopic resection of the mass with postoperative radiation therapy. Endoscopic sinus surgery with and without computer assisted navigation: A retrospective study. It is usually performed as a non-contrast study. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ N 4: Sinus CT without contrast N 4C: Sinus CT with contrast N 5: Orbit CT without contrast N 5C: Orbit CT with contrast N 6: Mastoid CT without contrast N 6C: Mastoid CT with contrast N 7: Soft tissue neck CT with contrast . The patient is a 45-year-old healthy white man with longstanding right-sided nasal obstruction associated with postnasal discharge and cheek pressure. 74170, 72194, 76376 Ste nt Protocol Question of: diverticulitis, appendicitis, abscess, cancer, prior abdominal surgery. A CT scan may help detect sinusitis, evaluate sinuses filled with thickened sinus membranes, give additional information on tumors of the nasal cavity, diagnose inflammatory disorders, and plan for surgery by defining anatomy (12). At UIHC, this is equipment is kept in a mobile storage unit that can be positioned outside the room prior to the start of the case. If additional information is needed to determine the extent of soft tissue of the tumor, magnetic resonance imaging (MRI) may be helpful. The CT paranasal sinus protocol serves as an examination for the assessment of the study of the mucosa and bone system of the sinonasal cavities. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database. An advanced navigation protocol for endoscopic transsphenoidal surgery. Up to 40 percent of asymptomatic adults have abnormalities on sinus CT scans, as do more than 80 percent of those with minor upper respiratory tract infections.14. A computed tomography (CT) scan of the sinus is an imaging test that uses x-rays to make detailed pictures of the air-filled spaces inside the face (sinuses). This is especially true for soft tissues and blood vessels. <> stream End Location: 1 cm superior to Skull vertex. Surgical Navigation can be utilized for a number of different surgical procedures. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Advances in diagnostic imaging techniques (e.g., computed tomographic [CT] scan and magnetic resonance imaging [MRI]) have enhanced the understanding and management of sinusitis. What are the limitations of CT of the Sinuses? Your doctor can review these images on a computer monitor, print them on film or via a 3D printer, or transfer them to a CD or DVD. Keep reading to know what we look for in a CT scan of the sinuses. Use of bone anchoring device in electromagnetic computer-assisted navigation in lateral skull base surgery. A total of 31 children and 84 adults were included in the analysis. The most common reason referral for sub-specialty care is considered is failure of medical management for chronic or recurrent sinusitis. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ CT imaging allows providers to have a more in-depth look at your sinuses to determine the cause of blockages. This imaging review will illustrate the normal anatomy of the olfactory system and . The actual CT scan takes less than a minute and the entire process is usually completed within 10 minutes. A computed tomography scan (CT or CAT) of your sinuses uses X-ray technology and advanced computer analysis to create detailed pictures of the sinus. J Craniomaxillofac Surg. Who interprets the results and how do I get them? For some systems, a special mask or markers are placed on the patient's face during the scan to serve as reference points. With pediatric patients, a parent may be allowed in the room but may need to wear a lead apron to minimize radiation exposure. CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. He subsequently underwent a successful frontal sinus obliteration to prevent future episodes of frontal sinusitis. 256 Slice CT - Updated 01-25-2022 Head: Temporal Bones. Usually done without contrast. CT images of internal organs, bones, soft tissue, and blood vessels provide greater detail than traditional x-rays. Next-Generation Surgical Navigation Systems in Sinus and Skull Base Surgery. The American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS) endorses the use of image-guided surgery for procedures including4: Medtronic offers powered and manual instruments that are specially designed for a broad variety of FESS procedures. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ FIND RELIEF. Learn more about our additional products for FESS and their potential benefits for you and your patients. How the Test is Performed. After this treatment, his symptoms improved approximately 50 percent, and he received a limited CT scan of the sinuses. He appeared healthy on examination and had hyponasal speech. d ;w&$@B!Cp "**((((+.x,f_Ut:3==!(/3SzI"D!BHp!~"DC {Wgd\I-[lm/~{C}ac}8qF=zP+{{v!~aaak 7fyw]Z!B,X7x7b\ID@acO?) CT Protocols BRAIN WITHOUT CONTRAST Purpose: Evaluation of subdural hematoma, epidural hematoma, stroke, bleed, headaches, initial workup of acute or changing dementia, mental status changes, fractures, trauma, shunt malfunction, new onset of seizures (particularly in adults) hydrocephalus. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Check for errors and try again. 2016;126(1):51-59. Though the scanning itself causes no pain, there may be some discomfort from having to remain still for several minutes. A CT scan generates images that can be reformatted in multiple planes. A diagnosis via CT scan may eliminate the need for exploratory surgery and surgical biopsy. Although the standards discussed herein reflect the University of Iowa's head and neck protocols, reliance on any information provided herein is solely at your own risk. The University of Iowa does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on this web site. It's also the most reliable imaging technique for . The surgeon should ensure the desired patient, date of study, and anatomical location are obtained. Diagnostic imaging is generally used in cases of recurrent or complicated sinus disease. Laryngoscope. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{
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