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Position Statement: Imaging

Position Statement: Imaging

The American Academy of Otolaryngology Head and Neck Surgery endorses the ability of otolaryngologists to review and provide their expert interpretation of radiologic studies pertaining to the head and neck region with particular emphasis on the paranasal sinuses and temporal bones.

In order for otolaryngology-head and neck surgery residency programs to maintain their accreditation, all programs must strictly adhere to the requirements of the Accreditation Council for Graduate Medical Education (ACGME). Under the ACGME, otolaryngology – head and neck surgery residents “must demonstrate proficiency in data gathering and interpretation in areas” including “imaging studies of the head and neck.” In other words, the ACGME has a specific requirement that demands otolaryngology-head and neck surgery residents achieve mastery in head and neck imaging studies as a prerequisite to board certification. This requirement helps ensure otolaryngology-head and neck surgery residents possess the knowledge and expertise to accurately select, order, interpret and perform imaging studies.

In addition to otolaryngologist – head and neck surgeons needing to demonstrate a proficiency in head and neck imaging during specialty training, many complete Continuing Medical Education (CME) credits that often include courses on head and neck imaging. The AAO-HNS annually offers CME courses specifically tailored to meet the rigorous IAC CME accreditation standards for both initial accreditation and reaccreditation requirements. All of these factors demonstrate the extensive professional expertise our specialists have with performing and interpreting diagnostic imaging, thus helping ensure patients receive appropriate diagnostic imaging studies for the head and neck.

Otolaryngologists perform procedures on patients for whom they have ordered and interpreted imaging (e.g., relating to disorders involving the sinuses, neck, temporal bone). The clinical correlation that can be achieved between intraoperative findings and those on imaging is unsurpassed, both for the individual patient and as the surgeon gains practice experience; as expert as they are, radiologists rarely have such opportunities. In fact, surgeons must have a high level of radiographic interpretive skill (as opposed to merely reading the report) to successfully perform procedures for which imaging is integral to medical/surgical decision making, be it pre-operative or intra-operative with image guidance.

Otolaryngologists performing sinus surgery generally read sinus CTs themselves, because we are most knowledgeable about the relevant surgical anatomy and can correlate clinically to the patient. Otolaryngologists are trained to recognize the listed radiographic criteria for sinusitis, and in the case of in-office CT scan imaging, radiology consultation is not mandatory. Even when read by an independent radiologist, the reports often do not comprehensively describe the extent of the disease or the relevant anatomy.

In summary, otolaryngologists possess extensive professional expertise to perform and interpret diagnostic imaging.

Adopted 4/15/2020 

References:

  1. Lozada KN, Bernstein JM. Current Status of Radiology Training in Otolaryngology Residency Programs. JAMA Otolaryngol Head Neck Surg. 2018 Mar;144 (3):218-221.
  2. Position Statement: Intra-Operative Use of Computer Aided Surgery. AAO-HNS, Revised 3/2/14.
  3. Position Statement: Point-of-Care Imaging in Otolaryngology. AAO-HNS, Revised 9/28/13.

Important Disclaimer Notice (Updated 7/31/14)

Position statements are approved by the American Academy of Otolaryngology—Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal, medical, or business advice.