المتخصصون في المجالات الطبية

March 10, 2026

At Mayo Clinic, the management of head and neck disease relies on high-resolution imaging and advanced surgical expertise to support accurate diagnosis and operative planning. Detailed visualization of complex anatomy — including the temporal bone — allows surgeons to develop tailored surgical strategies while reducing the need for exploratory intervention. Close collaboration between otolaryngologists and neuroradiologists across imaging and surgical services is central to optimizing patient outcomes.

Mallory J. Raymond, M.D., an otolaryngologist at Mayo Clinic in Jacksonville, Florida, says that on an average day, she sees as many as 25 patients, most of whom require imaging of the temporal bone and inner ear anatomy.

"High-quality imaging and expert interpretation of those images are critical," Dr. Raymond says. "But the close communication between the interpreting neuroradiologist and the head and neck surgeon is how we deliver an accurate diagnosis and develop a precise surgical approach."

Layered benefits of multidisciplinary collaboration for complex head and neck disorders

Photon-counting CT is considered a milestone in imaging technology. It combines superior anatomical detail and diagnostic specificity with meaningful reductions in patient radiation exposure compared with conventional CT.

Mayo Clinic uses photon-counting CT to image the temporal bone in better detail, and subspecialized neuroradiologists have the experience and expertise needed to interpret the advanced imaging. However, communication between neuroradiology and ENT specialists goes far beyond relaying those interpretations. It involves deep discussion before and after imaging, as well as prior to surgery.

"Expertise that exists in a silo will not lead to optimal patient outcomes," says John V. Murray Jr., M.D., a neuroradiologist at Mayo Clinic in Jacksonville, Florida. "Bringing everybody's subspecialized knowledge and experience to the table enables us to talk about a patient's unique circumstances and work through the challenges."

Drs. Murray and Raymond emphasize that collaboration is critical to clinical decision-making at each stage of care by enabling:

Guidance prior to photon-counting CT

Imaging and interpretation are more efficient and precise when the radiologist understands what the clinician is hoping to learn from the tests.

"The job of the radiologist is to provide value to the clinician and ultimately to the patient," Dr. Murray says. "To do this effectively, it's important to understand the concerns and questions of the referring clinician. Without this knowledge, radiologists are working with limited information, which makes it harder to deliver meaningful results."

Timely communication also benefits ENT patients. "We package interpretation, diagnosis and planning in one visit," Dr. Raymond says. "It requires quick interpretation and collaboration. But when patients come in for imaging, they can potentially leave with answers."

Diagnostic clarification

Diagnosing complex head and neck conditions is not always straightforward, no matter how advanced the imaging.

"Imaging is not 100% diagnostic, 100% of the time," Dr. Raymond says. Often, otolaryngologists rely on patterns of appearance in temporal bone imaging for guidance. If those patterns overlap and suggest more than one potential diagnosis, going back to the neuroradiologist to talk through those images, patterns and potential issues is crucial.

"An ENT and a neuroradiologist may not have the same level of expertise and experience as far as evaluating a patient or interpreting imaging," Dr. Murray says. "But when we put our expertise together, we can fill in the missing pieces of the puzzle and find the answer."

Surgical confidence

Advanced imaging and talking through the interpretation of that imaging can increase the confidence of the patient and the surgeon that the diagnosis is correct. Dr. Raymond says that confidence is especially vital before beginning an invasive procedure for conditions directly related to the temporal bone, such as:

• Otosclerosis. In the past, it was often not possible to confirm this diagnosis without exploratory surgery. Now, newer imaging and neuroradiology expertise can confirm the diagnosis through characteristic imaging findings and support the surgical approach.
• Superior semicircular canal dehiscence. The operation to address this syndrome is considered invasive and may require a craniotomy, so confidence in the diagnosis is essential.

"An important responsibility for neuroradiologists is to identify any factors that could complicate surgical procedures," Dr. Murray says. "Dr. Raymond possesses expertise in the surgical approach, and through our collaboration, we are able to identify potential surgical landmines that may present challenges during surgery."

Combining collaboration with advanced imaging

Photon-counting CT extends traditional physician collaboration by providing imaging data of unprecedented anatomical detail to support informed clinical decision-making. With expert understanding of the anatomy, neuroradiologists can provide quality interpretation of photon-counting CT scans and relay that interpretation to surgeons.

"When you have high-quality imaging on the front end, you are more likely to get the most accurate interpretation," Dr. Murray says. "Photon-counting CT has been a game changer in temporal bone imaging, allowing for visualization of minute anatomy and pathology, which was not possible in the recent past."

For fellows and residents, the combination of collaboration and advanced imaging provides an ideal environment for subspecialization within neuroradiology. Photon-counting CT is now the standard technique for imaging the temporal bones at Mayo Clinic.

"Our trainees spend time in the emergency department managing new complaints and issues," Dr. Raymond says. "They quickly learn the value of advanced imaging interpretation and multidisciplinary collaboration. Our culture of collaboration is pervasive in every aspect of our environment."

For more information

Refer a patient to Mayo Clinic.