Advances in head and neck imaging

The discovery of the X-ray in 1895 by Wilhelm Conrad Roentgen began the age of diagnostic imaging of the human body with all of its subspecialties, including that of head and neck radiology. Numerous eponymic projections were subsequently created to evaluate the skeleton and the overlying soft tissues. Several of those projections, such as the Water's view and Caldwell view, continue to be performed today in the evaluation of the head and neck with plain-film radiography. Fluoroscopy was introduced by the turn of the century and has continued to be the primary tool of functional evaluation of the upper pharynx, hypopharynx, and esophagus. Linear tomography was introduced in the 1930s and allowed evaluation of deeper tissues with detail not available by conventional radiography. Circular, elliptic, and hypocycloidal tomographic tube motions were introduced to evaluate different regions of the head and neck. Polytomography was especially helpful in the detailed evaluation of the temporal bones. CT and MRI were introduced in the 1970s and 1980s, respectively, and improved the capability of diagnostic radiology [1]. Additional progress in head and neck imaging has been made in the field of nuclear medicine. The advances in radiologic capability are used most often for the staging of primary head and neck carcinomas. Specifically, in squamous cell carcinoma, patient management is dependent on tumor staging, which relates to prognosis. New diagnostic capabilities can result in better patient outcomes related to the ability to select the most appropriate treatment protocol. Newer modalities have also made the diagnosis of infections and traumatic injuries easier and faster. The clinically important advances in head and neck radiology increase the sensitivity and specificity in the evaluation of neoplastic, inflammatory, and traumatic processes in the soft tissues of the head and neck.