Radiological Imaging for Non-traumatic Paediatric ENT Conditions

Abstract

Head and neck pathology in the paediatric population is distinct from the adult population, requiring a different gamut of investigations, including those pertaining to radiology and a tailored differential given the patient’s age. Assessment should consider potential congenital aetiologies as well as acquired causes for the child’s symptoms, particularly related to neck infections. Neck masses are also common in children, are often benign, and can be categorised according to the location to help narrow the differential diagnosis. Paediatric airway disorders are another frequent ENT presentation where clinical assessment often plays a greater role in diagnosis than radiological investigations.

Imaging where indicated may include a plain radiograph, MRI, ultrasound or CT imaging, the latter often reserved in the acute setting to assess for infection-related complications or for bony assessment related to head and neck masses. Ultrasound assessment for neck masses can be a useful adjunct, although fine needle aspiration is less often considered in children. The risks and benefits of radiation exposure, the use of sedation or proceeding to sampling should all be considered carefully and often warrants a multidisciplinary approach.