Computerized tomography in the evaluation of head and neck lesions

The development of computerized tomography (CT) has been called the most important contribution to medical diagnostic techniques since Roentgen discovered the X-ray in 1895. Over the past several years, the growth in technology and literature concerning computerized tomography has been rapid. CT is useful in evaluation of head and neck lesions such as lesions of the paranasal sinuses, the nasopharynx, base of skull, the larynx and neck areas. It is also useful in evaluation of intracranial complications of head and neck diseases. CT has added the horizontal plane in the evaluation of these lesions. The ease of obtaining CT scans and its non-invasiveness are advantages. The most important single feature of CT that distinguishes it from other radiographic techniques is the capability of imaging of soft tissue. CT demonstration of bone destruction is not superior to polytomography. The transaxial orientation of CT planes seems to be particularly useful in certain locations such as the pterygopalatine fossa. CT is an additional diagnostic tool, but it has limitations of other radiologic techniques in differentiating histologic types. In this series, one case of ethmoiditis resembled carcinoma. In another, radiation necrosis was indistinguishable from intracranial metastasis. As technology advances in the use of CT, its application in head and neck lesions will be increasing.