Imaging of the paranasal sinuses and anterior skull base

Due to the complex anatomy of the anterior skull base and paranasal sinuses, radiologic diagnostics in this area are challenging. Magnetic resonance imaging (MRI) and computed tomography (CT) are the primary indicated modalities. Guidelines helping to select the appropriate modality have been published by the German Society of Head and Neck Radiology and the Society of Otorhinolaryngology. The present article presents an overview of the current radiologic procedures and their optimized implementation using clinical examples. These examples highlight the fact that a combination of at least CT and MRI is frequently required. Use of CT for intraoperative navigation is everyday practice in clinical routine. Occasionally, additional procedures such as angiography or myelography are necessary, particularly in cases of preoperative vascular diagnostics or embolization. Overall, evaluation of radiologic diagnostics in this area is complex; it requires experience and knowledge of the disease, as well as an understanding of the diagnostic procedures. Close collaboration between head and neck surgeons and radiologists is thus essential.