"Special Spaces" is a completely made-up term (not for dictations or for the Royal College exam)
There are 2 "Special Spaces" Categories:
1. Inferior orbital fissure
2. Sphenopalatine foramen
3. Pterygomaxillaryfissure
4. Foramen rotundum
5. Vidian/Pterygoid canal
6. Pterygopalatine canal (greater and lesser palatine foramina)
Homogeneous density:
-- 1.0 cm long axis for all, EXCEPT:
-- Level 1B and Jugulodigastric = 1.5 cm
-- Retropharyngeal - 0.8 cm
Heterogeneous density:
-- Level 2, think HPV+ oropharyngeal SCCa
-- Can be present in papillary thyroid carcinoma nodal mets
-- Look for irregular nodal margins
-- Peri-nodal fat must be otherwise clear--no inflammatory change or edema
Key to Level 2 = the posterior belly of the digastric muscle (especially when there is no IV contrast)
-- 1. Posterior Wall
-- 2. Pyriform Sinus (2)
-- 3. Post-cricoid
-- (4.) Posterior confluence of aryepiglottic folds
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