The nasal bones are paired oblong upper central facial bones placed side by side between the frontal processes of the maxilla, jointly forming the nasal ridge.
The nasal bones has two surfaces:
external surface attaches the procerus and nasalis muscles
internal, which is transv...
Nasal bone fractures are the most common type of facial fractures, accounting for ~45% of facial fractures, and are often missed when significant facial swelling is present.
Unsurprisingly, nasal bone fractures occur when the nose impacts against a solid object (e.g. fis...
The nasal cavity forms part of the aerodigestive tract.
The nasal cavity is formed by 1:
anteriorly: nasal aperture
laterally: inferior, middle and superior nasal conchae or turbinates
superiorly: cribiform plate of the ethmoid bone
inferiorly: palatal processes of the maxill...
The nasal conchae are long, narrow curled shelves of bone that protrude into the nasal cavity. The superior, middle and inferior conchae divide the nasal cavity into three groove-like air passages.
The conchae are located laterally in the nasal cavity and covered by pseudostratified columnar, c...
Nasal encephalocoeles are the herniation of cranial content in the nasal area. It is one of the causes of craniospinal dysraphism.
Nasal encephaloceles usually present at birth with symptoms of obstruction or other complications. It presents as an external swelling on the...
Nasal gliomas, also know as nasal glial heterotopia, are a rare congenital lesion composed of dysplastic glial cells which have lost their intracranial connections and present as an extranasal or intranasal mass.
Nasal gliomas are rare congenital lesions. These masses occur spora...
Nasal septal perforation may affect either the bony, or cartilaginous septum. Most commonly it affects the anterior septal cartilaginous area although with syphilis it characteristically affects the bony septum.
Symptoms include a nasal discharge, nasal congestion (loss o...
A not-very-useful mnemonic for the causes of nasal septum perforation is:
Say Water Coke Syrup Sugarwater Lemonade or Say Nothing
W: Wegener granulomatosis
N: non-Hodgkin T-cell lymphoma (NHL)
The nasion is the midline bony depression between eyes where the frontal and two nasal bones meet, just below the glabella. It is also known as the bridge of the nose.
It is one of the skull landmarks, craniometric points for radiological or anthropological skull measurement.
Naso-orbitoethmoid (NOE) fractures (also known as orbitoethmoid or nasoethmoidal complex fractures) are fractures which involve the central upper midface.
Naso-orbitoethmoid (NOE) fractures are caused by a high-impact force applied anteriorly to the nose and transmitted posteriorly t...
Nasolabial cyst (also known as nasoalveolar cyst or Klestadt`s cyst) is a rare non-odontogenic, soft-tissue, developmental cyst occurring inferior to the nasal alar region. The cyst is derived from epithelial cells retained in the mesenchyme after fusion of the medial and lateral nasal processes...
The nasolacrimal (drainage) apparatus consists of:
Tears produced by the lacrimal gland, accessory lacrimal glands of Krause Wolfring and Zeis, and Meibomian glands track medially along the eyelid margins and collect at the lacrimal lake at ...
The nasolacrimal duct is the terminal part of the nasolacrimal apparatus.
Then nasolacrimal duct is the inferior continuation of the lacrimal sac and is ~17 mm in length in total. There are two parts to the nasolacrimal duct:
intraosseous part (12 mm): lies within nasolacrimal c...
Nasolacrimal tumours, in other words tumours involving the nasolacrimal drainage apparatus, are uncommon, and have a variety of histologies.
Clinical presentation of nasolacrimal tumours are typically fairly non-specific, often resulting in delayed diagnosis 1. Typical pr...
This suture forms the fissure between the frontal process of maxilla and the lateral border of the nasal bone. The nasomaxillary sutures are paried.
The nasopalatine nerve (also known as the long sphenopalatine nerve) is a branch of the pterygopalatine ganglion.
exits the pterygopalatine ganglion in the pterygopalatine fossa
passes through the sphenopalatine foramen to enter the nasal cavity
passes along the roof of...
Nasopharyngeal carcinomas (NPC) are the most common primary malignancy of the nasopharynx. It is of squamous cell origin and some types of which are strongly associated with Epstein Barr virus (EBV).
Nasopharyngeal carcinomas account for ~70% of all primary malignancies of the nas...
Nasopharyngeal carcinoma is staged using the TNM staging system with derived stage groupings.
Primary tumour (T)
Tx: primary tumour cannot be assessed
T0: no evidence of primary tumour
Tis: carcinoma in situ
T1: tumour is confined to the nasopharynx
T2: tumour extends to soft...
A nasopharyngeal choristoma is a rare, non-neoplastic mass (type of choristoma) typically located in the lateral aspect of the nasopharynx without intracranial extension. These lesions are composed of fibrovascular tissue and fat. Resection is curative.
A mnemonic for causes of nasopharyngeal masses is:
S: squamous cell carcinoma
A: antrachoanal polyp
I: inverted papilloma
L: lethal midline granuloma
The nasopharynx forms part the pharynx, being the continuation of the nasal cavity superiorly, and the oropharynx inferiorly.
anteriorly: posterior nares and posterior margin of nasal septum 1,2
inferiorly: soft palate 2
superiorly: basi-sphenoid and basi-occiput 1...
There are several types of neck dissections which can classified as follows:
Radical neck dissection
Radical neck dissection is considered to be the standard basic procedure for cervical lymphadenectomy. All other procedures represent one or more alterations of this procedure. The dissection i...
Necrotising otitis externa (NOE), also known as malignant otitis externa, is a severe invasive infection of the external auditory canal (EAC) which can spread rapidly to involve the surrounding soft tissue, adjacent neck spaces and skull base.
Predisposing conditions for NOE include...
The nerve to stapedius arises from the facial nerve to supply the stapedius muscle. The facial nerve branch is given off in its mastoid segment, as it passes posterior to the pyramidal process.
Damage to this branch with resulting paralysis of stapedius leads to hypersensitivity to loud noises ...
Craniocerebral neuroblastoma metastases usually involve the calvaria, orbits, skull base and the dura.
Please refer to the article neuroblastoma for a general discussion on this entity.
periorbital ecchymosis "raccoon eyes"
palpable calvarial masse...
Orbital manifestations of neurofibromatosis type 1 (NF1) reflects a mix of CNS, musculoskeletal and ocular disease. Usually only one orbit is affected, commonly associated with ipsilateral extracranial disease.
NF1 manifests in the orbit in the following ways 1-5:
Non-decussating retinal-fugal fibre syndrome (NRFFS), also referred to as achiasma, is the isolated congenital absence of optic chiasm with unremarkable rest of the optic pathway and midline structures. Clinically, it typically presents as seesaw nystagmus since childhood. Diagnosis is usually m...
Bone marrow signal of the clivus changes predictably with age and is well assessed with midline T1 non-fat saturated, non-contrast images. As is seen in the rest of the body the proportion of yellow (fatty) marrow increases with age. Knowledge of these changes allows diagnosis of the abnormal cl...
This article lists examples of normal imaging of the head and neck and surrounding structures, divided by region and modality.
For normal spinal imaging, please see: normal spinal imaging
soft tissue: example 1
soft tissue: example 2
Norrie disease is a rare X-linked inherited cause of congenital bilateral blindness. It can present with a retinal mass (pseudoglioma) and cataracts. It is associated with developmental delay and hearing loss.
The nose, sometimes referred to as the external nose, is a feature of the face and is composed of soft tissues that extend externally from the skull. It is continuous posteriorly with the nasal cavity.
facial artery (from external cartoid artery) with anastomoses ...
A helpful mnemonic to remember the expected direction of nystagmus during caloric test is:
Following ear stimulation with water (left ear):
cold water (cooler than body temperature), a right-beating nystagmus (directed toward the opposite ear) results