Using point-of-care ultrasound to evaluate head and neck pathology is a relatively new and evolving entity. One of the more routine but common indications to perform this exam is to assess for and assist with incision and drainage of a peritonsillar abscess. However, there are other areas of interest such as the thyroid gland, parotid gland, and carotid artery. In addition, assessing for proper endotracheal tube location can now be done immediately following intubation using ultrasound techniques. While head and neck ultrasound may be intimidating to the novice sonographer, the technical skills needed to obtain and interpret these images are quite simple due superficial and easy-to-identify structures. Therefore, with minimal practice, one can become an expert in head and neck ultrasound. This chapter will review indications to perform a head or neck ultrasound, basic anatomy, image acquisition, normal ultrasound anatomy, and interpretation of pathology.
KeywordsPeritonsillar abscess Thyroid nodule Thyroid cyst Thyroiditis Carotid dissection Endotracheal tube placement Sialolithiasis
Carotid artery posterior to the tonsil: The carotid artery can be visualized posterior to the tonsil. In this case, it is noted posterior to a peritonsillar abscess (MP4 2283 kb)
Peritonsillar abscess: A large area of hypoechoic fluid represents a peritonsillar abscess (MP4 2153 kb)
Thyroid ultrasound: The thyroid gland will appear as a uniform, finely granular structure with the isthmus anterior to the trachea. On the left lateral side of the trachea (on the right of the screen) is the esophagus. Note the pulsatile carotid arteries bilaterally (MP4 788 kb)
Thyroid in a sagittal plane: Left lobe of the thyroid, a uniform and finely granular structure, is visualized her in a sagittal plane (MP4 589 kb)
Color Doppler of the thyroid gland: Normal vascular flow of the thyroid gland using color Doppler (MP4 343 kb)
Thyroid cyst: Thyroid cysts are a type of benign nodule that can be simple, colloid, or hemorrhagic in appearance (MP4 873 kb)
Thyroiditis: With any inflammatory state of the thyroid, there will be increased vascular flow as evidenced here by placing color Doppler over the thyroid gland (MP4 544 kb)
Trachea: The trachea will appear as an echogenic curved stripe with posterior acoustic shadowing (MP4 546 kb)
Correct ETT placement: With correct placement of an endotracheal tube, two curved parallel echogenic lines will be seen (MP4 1039 kb)
Parotid gland: The parotid gland is seen just below the skin with a homogenous, finely granular echotexture (MP4 507 kb)
Submandibular gland: Submandibular gland appears as a homogenous structure, similar to the parotid gland, just deep to the subcutaneous tissue (MP4 461 kb)
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