ct sinus landmark protocol

ct sinus landmark protocol

Fusion: Standalone, electromagnetic based ENT image guidance system. After watching this. You may feel a need to urinate. CT scans in children should always be done with low-dose technique. The patient was started on a four-week course of broad-spectrum antibiotics in combination with an oral steroid pulse. Sinuses - Landmark Protocol Indications o Pre-surgical planning Sequences Examples of appropriate cases listed by the academy include, but at not limited to: Distorted sinus anatomy of development, postoperative or traumatic origin, Extensive sinonasal polyposis: pathology involving the frontal, posterior ethmoid and sphenoid sinuses, Disease abutting the skull base, orbit, optic nerve or carotid artery, CSF rhinorrhea or conditions where there is a confirmed or suspected skull base defect. CT Sinus Scan. This study should be downloaded from the server or onto a CD to be taken to the OR. . 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. The technologist begins by positioning patients on the CT examination table. Some imaging tests and treatments have special pediatric considerations. 3 0 obj Different body parts absorb x-rays in different amounts. x@Qhm@0%\&'HD(qQCn,nG>ioR}lwlk~lo x8v?f\[/v]d\m~yKl;~L~~ncOxpb,}0Ng|n}08OSD_@@@@@t2?~axNO|vw7}0sgAew-xW q>6>w7Wrn sm@@@@@g>GnG?'@uX x[o~7|'l_/}@t_c_v@@@@@.5>O7ao/?FA?[c}R}qO?45}O,5G[?n{=]_T_Yo!ISK5h_|0x>h\_TAov/O}yiNn_)4X>y+OW? Cat Scan - Welcome to Landmark Medical Center CT is less sensitive to patient movement than MRI. o Process images with bone algorithm. Vreugdenburg TD, et al. This website does not provide cost information. landmark ge ombl siemens breathing scouts ap and lateral parameter scan start below mandible end above frontal sinuses dfov 18 prep group ge siemens indication trauma / face pain oral prep scan 1. non-contrast recon 0.625mm or 1.25mm axial recon - bone algorithm 1.25mm axial recon - standard algorithm `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ detect the presence of inflammatory diseases. Image 1: AxiEM System powerbox with cords for connecting to the base unit. 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). %PDF-1.4 7 0 obj Update my browser now. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ no financial relationships to ineligible companies to disclose. Sinus CT Imaging | CT Scan For ENT Concerns - SFENTA 5 0 obj The quality of the CT or CBCT scan is the most important aspect of creating NB: This article aims to frame a general concept of a CT protocol for the assessment of the paranasal sinuses. Leave them at home or remove them prior to your exam. Our CT techs do a Sinus CT with out contrast (70486). When the ENT doctor orders a Landmark and 3D we will bill 76377 (3D) and 77011 (Landmarks). necessary to evaluate the sinuses on CT. A CT scan generates images that can be reformatted in multiple planes. Localising olfactory pathology can present a challenge to the reporting radiologist. 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. /X4 Do 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. 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. CT of the Neck: Image Analysis and Reporting in the - RadioGraphics Sphenoid sinuses are normal. CT is beneficial in studying chronic disease of the paranasal sinuses, not least to assess whether it has spread to surrounding structures. A special CT scan of the sinus is done pre-operatively, and entered into the computerized system. He progressed to an acute sinusitis with associated fevers and left facial pressure, pain, and swelling. If neoplasia is suspected, the use of an intravenous contrast medium is indicated. . CT scan of the paranasal sinuses with Stealth protocol should be ordered prior to the patients surgery date. The technologist may ask you to hold your breath during the scanning. Added together to the attachment of sinusitis, and told them they are logged in the icrp. Disadvantages of MRI include high false-positive findings, poor bony imaging, and higher cost. It is the best imaging modality for sinusitis. The olfactory pathway is composed of peripheral sinonasal and central sensorineural components. inbqo@O[nF{su:t(//A (hA222=h)D'@/w8}{aaaEB[xxeqJyg-w3h7 . An effort to determine the presence of chronic sinusitis as a driving cause of her chronic inflammatory nasal disease, CT imaging is indicated. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ implants, specific indications. Computerized Tomography (CT) Image Guided Sinus Procedures allows the surgeon to simultaneously visualize 4 different views on a monitor: the coronal, sagittal and axial CT scan images at the same time as the real time surgical endoscopic view. Healthcare Professionals The CT protocol itself is based on certain technical parameters, and the patient wouldn't notice any difference between Stealth CT protocol and standard CT protocol. 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. SINUSITIS AFFECTS 31 MILLION AMERICANS 2. However, the technologist will always be able to see, hear and speak with you through a built-in intercom system. Three aspects of direct coronal imaging of the paranasal . 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{ Tell your doctor if there's a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you're taking, and allergies. CT imaging allows providers to have a more in-depth look at your sinuses to determine the cause of blockages. CT with fusion is a radiological technique used to enhance the images. Int Forum Allergy Rhinol. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ His nasal symptoms improved after he started taking decongestants and antibiotics, but a persistent headache prompted a visit back to his family physician. What is a stealth ct of sinuses? | HealthTap Online Doctor Commonly Used CPT Codes for CT | Harrison Imaging Centers . It is usually performed as a non-contrast study. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Learn how we can help 5.8k views Reviewed >2 years ago Thank Dr. Mazen Ghani agrees 4 thanks Immunocompromised persons and smokers are at increased risk for serious sinusitis complications. Sinusitis is one of the most common diseases treated by primary care physicians. CT Sinus Cat Scan Quick Reference Guide for Physicians. Image-guided surgery influences perioperative morbidity from endoscopic sinus surgery: a systematic review and meta-analysis. CT of the sinuses is now widely available and is performed in a relatively short time, especially when compared to. Rotating around you, the x-ray tube and electronic x-ray detectors are located opposite each other in a ring, called a gantry. CT Scan and Imaging Protocols | CTisus If you have a known allergy to contrast material, your doctor may prescribe medications to reduce the risk of an allergic reaction. Recognition and utilization of surgical landmarks is imperative for the surgeon. In emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. PDF .6 / 0/ 5 /-./ /./ / *-/ 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. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ A sinus ct looks at the bone and soft tissue of the several facial sinus cavities. This allows us to minimize radiation while providing a high tech three-dimensional image of the sinuses. What will I experience during and after the procedure? % <> This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Attachment of ct sinus, ct scans in the radiologist in both before. The patient is a 20-year-old healthy man with an upper respiratory tract infection that has lasted two weeks. "What will a CT scan of my sinuses reveal?" - Zocdoc This unit has both electromagnetic and optical capabilities. Masterson L, et al. The CT paranasal sinus protocolserves as an examination for the assessment of the study of the mucosa and bone system of the sinonasal cavities. Clinically and sinuses using landmarx protocol done without any general Brain (CTA) Brain (helical adult) CTA Carotid and Brain. The doctor may administer contrast material intravenously (by vein), so you will feel a pin prick when the nurse inserts the needle into your vein. Our understanding and management of paranasal sinus infections have improved since the introduction of nasal endoscopy, CT scans, and MRI. It is usually performed as a non-contrast study. ct of sinuses with fusion - Oral and Maxillofacial Surgery - MedHelp From the raw data, we reformat coronal, axial, and sagittal 2.5-mm-thick contiguous images with bone and soft-tissue algorithms. Web Privacy Policy | Nondiscrimination Statement. 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. Rhinology 49: 429-437, 2011. CT Assessment of Sinuses Before FESS The radiologist's role is to report on five key CT exams are generally painless, fast, and easy. <> stream Metal objects, including jewelry, eyeglasses, dentures, and hairpins, may affect the CT images. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ 70481- CT Orbits with contrast 3. The use of image-guided surgery in endoscopic sinus surgery: an evidence-based review with recommendations. Deviated Septum The nasal septum has cartilage and bone that divide your nose's nasal cavity in two. CT scanning is painless, noninvasive and accurate. PDF CT scanning protocol - Stryker Corporation SINUSES AND ORBITS CT FLANK FOR STONES 70486, 70450 CT Sinus and Head w/o contrast 74150, 72192 CT Abdomen and Pelvis w/o contrast 70486 CT . PDF NEURO PROTOCOLS - geiselmed.dartmouth.edu When the exam is complete, the technologist will ask you to wait until they verify that the images are of high enough quality for accurate interpretation by the radiologist. This places markers on the outside of the head to help surgeons accurately orient images to the patient. 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. This exam does not commonly require contrast material; however, in some situations your doctor may request that contrast material be given. Please contact your physician with specific medical questions or for a referral to a radiologist or other physician. It is imperative that the correct patient, study from the desired date and the appropriate anatomical study are selected. You may feel warm or flushed as the contrast is injected. This unit has a smaller footprint and at UIHC is utilized in the ASC. Leave jewelry at home and wear loose, comfortable clothing. 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. Surgical Navigation at UIHC is currently achieved with Medtronic Fusion IGS (Image Guided Surgery) system. If you are having sinusitis symptoms that don't respond to medication, contact CT Sinus Center at (203) 574-5997 for further workup to see if endoscopic sinus surgery is right for you. KOLAWOLE S. OKUYEMI, M.D., M.P.H., AND TERANCE T. TSUE, M.D. Does anyone have some insight on this? an optimal imaging protocol. The computer workstation that processes the imaging information is in a separate control room. These lines help ensure that you are in the correct position on the exam table. 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. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ After this treatment, his symptoms improved approximately 50 percent, and he received a limited CT scan of the sinuses. Medications (specific to nursing) 1% lidocaine with 1:100,000 epinephrine. Surgical 3D Head. In this article we will discuss: Basics of contrast enhancement. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. He has a history of bilateral nasal obstruction and facial pressure pain over a number of years. A large nasal mass was seen emanating from the right middle meatus with a smooth mucosal surface and prominent blood vessels. Ramakrishnan VR, et al. 2019; 46(4): 520-525. There are four pairs of sinuses, each connected to the nasal cavity by small openings. Ent and is a sinus medtronic protocol to successfully apply this without contrast. J Craniomaxillofac Surg. A person who is very large may not fit into the opening of a conventional CT scanner. endobj Figure 3A, 3B shows the CT appearance after FESS. 2006 Apr;116(4):564-72. 4 0 obj Mucosal thickening, polyps, and other sinus abnormalities can be seen in 40 percent of symptomatic adults; however, clinical correlation is needed to avoid overdiagnosis of sinusitis because of nonspecific CT findings. /G3 gs He appeared generally healthy on examination and had hyponasal speech. Contrast agents may be injected before scanning Contiguous, non-overlapping slices Constant slice thickness Axial slices The IGS instrumentation and registration protocols will vary with based on the brand and model of the system used. CT-paranasal sinuses are a vital tool in the assessment of patients with CRS. Navigation and non-navigation CT scan of the sinuses: comparison of the 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. With CT scanning, several x-ray beams and electronic x-ray detectors rotate around you. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Image 3: The equipment shown here is required for the positioning the Electromagnetic Field Generator (EMG seen in figure 4) within the space adjacent to the surgical field. The bone algorithm was used in all cases [15]. 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. Some CT exams use a contrast material to enhance visibility in the body area under examination. You may need a follow-up exam. 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. 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. Treon Plus: Infrared light based unit currently utilized at the VA in Iowa City. 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. Read More Created for people with ongoing healthcare needs but benefits everyone. CT is usually the first test ordered when a sinus tumor is suspected. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Speed is especially beneficial for children, the elderly, and critically ill anyone who finds it difficult to stay still, even for the brief time necessary to obtain images. 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. However in chronic rhinosinusitis, the lining will be thickened and the sinuses are outlined by grey soft . CPT for ENT: Stereotactic Computer Assisted Navigation This results in more detail. The CT scanner is a large doughnut-shaped machine. CT scanning is painless, noninvasive and accurate. You may need to remove any piercings, if possible. He had left maxillary and frontal tenderness to palpation on examination. Although mucosal thickening is seen in more than 90 percent of sinusitis cases, it is very nonspecific.68 Air-fluid levels and complete opacification are more specific for sinusitis but are seen in only 60 percent of sinusitis cases.6 Interpretation of plain radiographs can vary widely among different observers, and there is a high rate of false-negative results.2,9, Radiographs of the sinuses in infants aged three years or younger are not useful because of false opacification from undeveloped sinuses.10 Other important limitations of plain radiographs include poor visualization of ethmoid air spaces and difficulty differentiating between infection, tumor, and polyp in an opacified sinus.2, Because clinical judgment is sufficient to diagnose sinusitis in a majority of cases, and empiric treatments are inexpensive and safe, only a small percentage of patients who develop recurrent or complicated sinusitis are candidates for imaging studies. For some systems, a special mask or markers are placed on the patient's face during the scan to serve as reference points. It is usually performed as a non-contrast study. Unable to process the form. If the exam uses iodinated contrast material, your doctor will screen you for chronic or acute kidney disease. To help ensure current and accurate information, we do not permit copying but encourage linking to this site. 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. 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. J Laryngol Otol. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Such speed is beneficial for all patients. Department of Otolaryngology Like traditional x-rays, it produces multiple images or pictures of the inside of the body. 256 Slice CT - Updated 01-25-2022 Sinus: R/O Mass. Laryngoscope. This content is owned by the AAFP. It's also the most reliable imaging technique for . A: Stereotactic computer assisted navigation (SCAN), also known as image guidance, is typically used by otolaryngologist - head and neck surgeons when performing functional endoscopic sinus surgery (FESS) and skull base approaches. ENT Navigation Solutions CT sinus fusion protocol, axial view. Midline septal mass and notable HRCT imaging of acquired cholesteatoma: a pictorial review This study should be downloaded from the server or onto a CD to be taken to the OR. PDF Ct Sinus Landmarx Protocol citydata - Amazon Web Services <> They should not have repeated CT exams unless necessary. Int Forum Allergy Rhinol. Ct head protocols 1. . University of Iowa All Rights Reserved To help answer those questions we have put together our protocols that we thought might prove useful. You can return to your normal activities immediately. Because of the progression of his headaches, a maxillofacial and head CT scan was obtained, revealing acute sinusitis with frontal epidural abscess (Figure 2). Intra-Operative Use of Computer Aided Surgery. Image-guided surgery with theStealthStation ENT Navigation Systemcan be used to surgically navigate tumors and lesions affecting the anterior and lateral skull base. Alternatively, 4% cocaine (no more than 4 ml) may be used for pre-surgical vasoconstriction and to assist with hemostasis. However, the benefit of an accurate diagnosis far outweighs the risk involved with CT scanning. Start Location: 1 cm inferior to Skull base. Cedars-Sinai 's S. Mark Taper Foundation Imaging Center has a team of specialists . The radiation dose for this procedure varies. CT Brain Special Protocols | Cedars-Sinai CT of the head with fiducials. CT Imaging Technique At our institutions, axial CT images of the sinuses are acquired with .625-mm collima - tion. 2014;82(6 Suppl):S95-105. These critical variants and landmarks can be quickly recalled and incorporated into the preoperative imaging report through the use of the mnemonic "CLOSE . In the emergency department setting, CT is performed to investigate acute infectious or inflammatory symptoms and chronic processes. Or, they may be over the weight limitusually 450 poundsfor the moving table. . Face/Sinus. Although air-fluid levels and complete opacification of a sinus are more specific for sinusitis, they are only seen in 60 percent of cases. Surgeon and OR staff ensure the appropriate equipment are available and present in or near the OR room prior to transport of the patient to the OR. In neoplastic, inflammatory and infectious disorders, a CT scan of the paranasal sinuses is performed to demonstrate bony erosions, osteolytic lesions, and calcifications. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Ct sinus with and without contrast | HealthTap Online Doctor `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ A diagnosis via CT scan may eliminate the need for exploratory surgery and surgical biopsy. PDF Neuroradiology CT Protocols - North Star Radiology Paranasal sinuses CT anatomy - W-Radiology Anterior ethmoid sinuses exhibit no mucosal disease. 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). CT Scan of the Paranasal Sinuses - Medscape /XObject <>>> (see below) Oxymetazoline HCL nasal spray, 0.05%. Image-guided navigation systems used in endoscopic sinus surgery have shown a reduction in the need for revision surgeries. 2013; 149(1):17-29. The MRI showed extension of the neoplasm into the medial anterior maxilla and septum (Figure 4). Protocol specifics will vary depending on CT scanner type, specific hardware and software, radiologist and perhaps referrer preference, and patient factors, e.g. You also may have a metallic taste in your mouth. Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical imaging test. A noncontrast CT scan is usually sufficient, except for complicated acute sinusitis (e.g., periorbital cellulitis or abscess). Illustrated by: Timothy McCulloch, MD, Copyright The University of Iowa. This is accomplished through: Benefits of image-guided navigated surgery include improvements in visualization, enabling surgeons to work within complex sinus anatomy and optimize surgical strategies for their patients.5-9. Weight > 90kg : 150cc. Radiology department of the Rijnland Hospital in Leiderdorp, the Netherlands. Medtronics Fusion Navigation System With few exceptions, neck CT should be performed with intravenous contrast material . In general, intravenous contrast material is not necessary. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Optimal contrast enhancement is important for a succesful diagnostic CT-scan. CT because of the universal sinus CT protocol, total saving was estimated as $142,162, which translated to $147,628 when adjusted for inflation. CT Sinus Scan - Los Angeles | Cedars-Sinai How the Test is Performed PDF Cpt Code and Guidelines for Ct Scans Schedule 203-878-2341 Fax 203-878-3429 Our CT scanner uses cone beam technology to focus just on the sinuses. Home CT paranasal sinus (protocol) | Radiology Reference Article The surgeon should ensure the desired patient, date of study, and anatomical location are obtained. The Preoperative Sinus CT: Avoiding a "CLOSE" Call with - PubMed Risk factors for complicated infections include prolonged tobacco use and chronic occupational exposure to wood dust, nickel, or chrome pigment. Doctors do not generally recommend CT scanning for pregnant women unless medically necessary because of potential risk to the unborn baby. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ World Neurosurg. Ct head protocols - SlideShare `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Peter M. Som, Hugh D. Curtin. For a CT scan of the sinuses, the patient is most commonly positioned lying flat on the back. This will pass. Alternative Names. 50, and 75% sinus-length landmark slices, as shown in Fig. Any of these conditions may increase the risk of an adverse effect. These occur as the CT scanner's internal parts, not usually visible to you, revolve around you during the imaging process. The Radiology Assistant : CT contrast injection and protocols To the left of the picture are inputs for the EGM cords (shown in figure 4). Otolaryngol Clin North Am. A CT of the sinus can help your physician to assess any injury, infection or other abnormalities. Please type your comment or suggestion into the text box below. RadiologyInfo.org, RSNA and ACR are not responsible for the content contained on the web pages found at these links. 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). With pediatric patients, a parent may be allowed in the room but may need to wear a lead apron to minimize radiation exposure. 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. The preferred initial procedure is a coronal CT image (13). 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.

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