Neuroimaging clinics of North America
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The petrous apex is the most medial portion of the temporal bone that cannot be directly examined on clinical examination. The referring physician completely relies on imaging and radiologic interpretation. ⋯ The location of the petrous apex also typically precludes safe percutaneous biopsy. Knowledge of the petrous apex anatomy, normal anatomic variations, and their differentiating features from pathologic entities is critical for accurate interpretation.
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Lymph nodes status is an important predictor of prognosis in head and neck squamous cell carcinoma, making accurate staging critical. The physical examination of the neck is highly inaccurate. ⋯ US features help differentiate benign from malignant nodes, aided by US-guided fine-needle aspiration for indeterminate cases. PET-CT is useful for staging the lymph nodes and detection of distant metastasis.