0:00

Well, I hope you've enjoyed this exhaustive

0:03

and somewhat whirlwind tour of the various lesions

0:08

of the Sino nasal cavity.

0:10

A few take home messages.

0:12

CT scanning really rules with regard to the typical

0:15

and routine and evaluation of inflammatory disease

0:20

and is quite nice at defining the anatomy

0:23

of the sino nasal cavity as is required

0:27

for those individuals undergoing functional

0:30

endoscopic sinus surgery.

0:32

The evaluation of patients before and

0:34

after functional endoscopic sinus surgery requires you

0:37

to understand the anatomic variants that are present,

0:41

the potential areas of catastrophe

0:43

or pitfalls, which include the optic nerve walls,

0:47

the carotid walls, the laminate preparation,

0:49

and the cribriform plate,

0:51

and understanding what potential complications can occur

0:54

after endoscopic science surgery.

0:56

With regard to the complications of sinusitis,

1:00

we usually will employ MR.

1:02

And contrast enhanced CT scan

1:05

for looking at the intracranial orbital

1:08

and vascular complications that can arise secondary

1:11

to sinusitis.

1:13

I spent a good amount of time talking

1:16

to you about fungal sinusitis

1:17

because it's an interesting topic

1:19

and it also is a infection that can lead to

1:24

severe morbidity and mortality for the individual.

1:27

When there's aggressive invasive fungal sinusitis,

1:31

most cases are sapr prophetic growth.

1:33

It's just there versus a fungus ball versus allergic

1:37

fungal sinusitis.

1:39

We then shifted our focus and talked about neoplasms

1:44

and in most cases prior to surgery,

1:47

patients will get both an MR

1:49

and a CT to define the soft tissue anatomy by MR

1:53

and the bony anatomy by ct.

1:56

And we also have to be concerned about spread

2:00

to the tega palatine fossa

2:03

and the distribution of the fifth granial nerve.

2:06

Second division perineural spread can lead to

2:10

positive margins at resection.

2:12

If we don't define it in advance on our imaging, remember

2:16

that many of these tumors look alike.

2:19

They're gonna be low in signal intensity on T two weight

2:22

imaging and will show contrast enhancement.

2:26

Don't be as concerned about arriving at the

2:29

histologic diagnosis.

2:30

For the most part,

2:32

the diagnosis is made via a biopsy endoscopically

2:36

with tumor that is readily available

2:39

and tissue that's readily attainable

2:41

by the endoscopic sinus surgeon.

2:43

And with that, I'd like

2:44

to wish you all good luck in interpreting your Cy Nasal

2:48

imaging studies, and I hope this has been useful for you.

2:52

Thank you very much for your attention.