![]() ![]() Water-soluble contrast and barium studies remain the preferred studies for gross screening for perforations or false passages, functional disorders, and mucosal lesions. It is also better for identifying gas and retained foreign bodies this is especially useful in the evaluation of a potentially swallowed foreign body. It simultaneously allows a thorough evaluation of the other neck structures, including soft tissue injury that might be associated with pharyngeal tears, vascular injury, and cervical spine injuries, among others. Adjunctive magnetic resonance imaging (MRI) may be used selectively to evaluate the cisternal course of the vagus nerve and its brain stem nuclei.ĬT is the preferred modality for the study of pharyngeal trauma, as it can be performed more simply than MRI in the acute or immediate subacute clinical setting and provides superior cartilage detail and multiplanar images. Throat Pain, Referred Otalgia, Dysphonia, and Vocal Cord DysfunctionĬT is the preferred modality for these studies since it not only provides a good evaluation of the hypopharynx and larynx but also can easily be extended to include the upper thoracic cavity or intracranial structures in cases of potential vagus nerve dysfunction. In young patients, MR might be preferred because of the absence of ionizing radiation. As the initial biopsy results may be inconclusive or negative, MR may be used in an attempt to further characterize the lesion. A variety of sometimes unusual lesions, either benign or malignant, can be encountered in this clinical context. In most cases, a CT study is adequate for all of these tasks. This is discussed more fully in conjunction with laryngeal cancer in Chapter 206.Įvaluation of Submucosal or Peripharyngeal Masses of Uncertain Etiologyīoth CT and MR can be used to demonstrate the presence, nature, and extent of a submucosal mass lesion. This is discussed in more detail in conjunction with the larynx in Chapters 201 and 206.Įvaluating the Extent of Known Hypopharyngeal Cancer and Related Regional Lymph Node Metastases and Posttreatment Surveillance Most of the current usage is limited to cancer evaluation with fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET). The approach with radionuclide studies depends on the aim of the examination. There is little or no use for ultrasound in studying the hypopharynx except in practices that use this imaging to assess lymph node disease in patients with hypopharyngeal cancer. Specific problem-driven protocols for CT and MR are presented in Appendixes A and B. The hypopharynx is studied in essentially the same manner as the larynx therefore, the principles related to imaging of the hypopharynx with computed tomography (CT) and magnetic resonance (MR) should be reviewed in Chapter 201. ![]() HYPOPHARYNX: INTRODUCTION, NORMAL ANATOMY, AND FUNCTION
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