🦷 CT SCAN NECK & ORAL CAVITY – STEP BY STEP

---

1️⃣ WHAT IS CT NECK / ORAL CAVITY?

CT Neck is a scan used to evaluate:

• Oral cavity (tongue, buccal mucosa, palate)
• Pharynx & larynx
• Salivary glands
• Lymph nodes
• Thyroid & soft tissues

👉 Best for tumor, infection & lymph node assessment

---

2️⃣ WHY DO CT NECK SCAN?

📌 Indications:

• Oral cancer (tongue, buccal mucosa) 🦷
• Neck swelling / lymphadenopathy
• Abscess / infection
• Trauma
• Salivary gland pathology
• Thyroid mass
• Airway obstruction
• Staging & follow-up of malignancy

👉 Contrast CT is most commonly used

---

3️⃣ PATIENT PREPARATION

• Explain procedure
• Remove:
  • Dentures
  • Metal chains
  • Hair pins
• Check history:
  • Surgery / cancer
• For contrast:
  • Creatinine level
  • Allergy history

👉 Ask patient not to swallow during scan (important)

---

4️⃣ PATIENT POSITIONING

🛏️ Standard:

• Supine position
• Head first
• Neck slightly extended

🎯 Alignment:

• Midline centered
• Chin slightly up
• Avoid tilt / rotation

👉 Immobilization important (avoid motion artifacts)

---

5️⃣ SCAN PLANNING

📍 Coverage:

• From skull base → thoracic inlet

📐 Planning line:

• Axial slices parallel to hard palate

👉 Include:

• Oral cavity
• Oropharynx
• Larynx
• Thyroid

---

6️⃣ SCAN PARAMETERS (Typical)

• kVp → 120
• mAs → 200–300
• Slice thickness:
  • 3–5 mm (routine)
  • 1 mm (thin slices / tumor staging)
• Pitch → ~0.8–1
• Rotation time → 0.5–1 sec

---

7️⃣ CONTRAST PROTOCOL 💉

• IV non-ionic contrast
• Dose: ~1–1.5 ml/kg

⏱️ Timing:

• Scan delay: 60–70 sec (venous phase)

👉 Important for:

• Tumor enhancement
• Lymph nodes
• Abscess detection

---

8️⃣ IMAGE RECONSTRUCTION

• Axial images (main)
• Coronal & sagittal (MPR)
• Soft tissue + bone algorithm

---

9️⃣ FILMING / DISPLAY

🧾 Routine:

• Axial soft tissue window
• Axial bone window
• Coronal & sagittal views

🎯 Window settings:

• Soft tissue → for mass / nodes
• Bone → for mandible / skull base

👉 Always label properly (R/L marker)

---

🔟 COMMON PATHOLOGY

🦷 1. Oral Cancer

• Irregular mass
• Enhancement after contrast
• Invasion to adjacent structures

---

🦷 2. Lymphadenopathy

• Enlarged nodes
• Necrosis (central hypodensity)

---

🦷 3. Abscess

• Fluid collection
• Peripheral rim enhancement

---

🦷 4. Salivary Gland Disease

• Parotid / submandibular swelling
• Stones (hyperdense)

---

🦷 5. Thyroid Lesion

• Enlargement / nodules

---

🦷 6. Trauma

• Mandible fracture
• Soft tissue swelling

---

1️⃣1️⃣ FINDINGS (HOW TO CHECK)

👉 Follow systematic approach:

1. Oral cavity
   • Tongue, floor of mouth
2. Pharynx & larynx
   • Airway patency
3. Lymph nodes
   • Size / necrosis
4. Salivary glands
   • Normal / enlarged
5. Thyroid
   • Normal / nodular
6. Bone
   • Mandible / skull base