The present study reports a case of inverted papilloma of the nasal cavity and infiltrating into the maxillary sinus. Inverted papilloma is an uncommon and locally aggressive benign tumor of the sinonasal region. The patient, 51- year-old male, presented with unilateral nasal obstruction and periodic swelling on the palate without pain. Enhanced CT scan revealed a heterogeneously enhancing solid mass in the nasal cavity and infiltrating into the right maxillary sinus, as well as an incidental, secondarily infected residual cyst in the periapical area of the right maxillary canine. The sinonasal mass was revealed as an inverted papilloma on histopathologic examination.
Diagnostic Imaging ; Humans ; Male ; Maxillary Sinus ; Nasal Cavity ; Nasal Obstruction ; Palate ; Papilloma, Inverted

OBJECTIVE: This study aims to compare the effects of fast and slow expansion on nasal cavity structure. METHODS: A total of 40 patients were selected and randomly divided into two groups. Cone-beam computer tomography (CBCT) was obtained before and after surgery and used for comparing the changes in nasal structure before and after treatment. RESULTS: Fast expansion had resulted in greater changes in the basilar and nasal bone arch extension structures than slow expansion. No significant difference at maxillary width and nasal parenchyma. CONCLUSIONS Rapid expansion therapy has more beneficial effects on nasal function.
Cephalometry ; Cone-Beam Computed Tomography ; Humans ; Maxilla ; diagnostic imaging ; Nasal Cavity ; Nose ; Palatal Expansion Technique

OBJECTIVETo explore the role of nasal mucosal lymphatic drainage in the pathogenesis of nasal polyps.

METHODSThere were 25 cases in the experimental group who had nasal polyps (which was further divided into Malm-1, Malm-2, Malm-3 level 3 subgroups) and 6 cases in the control group, including thyroid cancer and laryngeal cancer patients who had normal nasal structure. The nasal polyps in the experimental group and the middle turbinate in the control group were injected with a radionuclide and a radionuclide imaging technique was used to image the nasal mucosal lymphatics. The lymphatic drainage status of the nasal mucosa through the imaging results was analysed.

RESULTSThe T/NT ratio (radioactivity counting) of the region of interest (ROI) was 20. 66 +/- 1.89 in the control group and 29. 33 +/- 6.34 in the experimental group. The difference was significant (t = 3.275, P < 0.05). The T/NT ratio of the ROI was 24.40 +/- 3.19 in the Malm-1 level group, 29.31 +/- 3.39 in the Malm-2 level group, 39.21 +/- 3.15 in the Malm-3 level group. The differences of qualitative analysis were significant (F = 38. 980, P < 0.05). The quantitative analysis showed that at the injection site, signs of lymphatic development and drainage were not found in the control group or experimental group, but the phenomenon of contrast media retention existed at the injection site in the experimental group.

CONCLUSIONLymphatic drainage dysfunction exists in patients with nasal polyps, and it may play a role in the pathogenesis of nasal polyps.

Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Lymphatic System ; pathology ; Lymphography ; Male ; Middle Aged ; Nasal Cavity ; diagnostic imaging ; Nasal Polyps ; diagnostic imaging ; Radionuclide Imaging ; Young Adult

OBJECTIVETo investigate the anatomical interaction between uncinate process and agger nasi cell to better understand the anatomy of the frontal sinus drainage pathway by endoscopy, spiral computed tomography (CT) and sectioning.

METHODSTwenty-one skeletal skulls (forty-two sides) and one cadaver head (two sides) were studied by spiral CT together with endoscopy and collodion embedded thin sectioning at coronal plane. The sections with the thickness of 100 microm were stained with hemotoxylin and eosin.

RESULTSUnder endoscopy, a leaflet of bone to the middle turbinate, which is given off by uncinate process, forms the anterior insertion of the middle turbinate onto the lateral nasal wall. The middle portion of the uncinate process attached to the frontal process of the maxilla in all of the skeletal nasal cavities, as well as the lacrimal bone in 78.6% of the skeletal nasal cavities. On CT scans, the agger nasi cell is present in 90.5% of the skeletal nasal cavities. While the lateral wall of the agger nasi cell is formed by lacrimal bone, the medial wall of the agger nasi cell is formed by uncinate process. And the anterior wall is formed by the frontal process of the maxilla. The superior portion of the uncinate process forms the medial, posterior and top wall of the agger nasi cells. The superior portion of the uncinate extends into the frontal recess and may insert into lamina papyracea (33.3%), skull base (9.5%), middle turbinate, combination of these (57.2%).

CONCLUSIONSThe agger nasi cell is the key that unlocks the frontal recess.

Adult ; Frontal Sinus ; anatomy & histology ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; Nasal Cavity ; anatomy & histology ; diagnostic imaging ; Tomography, Spiral Computed ; Turbinates ; anatomy & histology ; diagnostic imaging

OBJECTIVE: To observe the CT three-dimensional imaging features of the frontal recess region with advanced three-dimensional reconstruction, and develop the real image of the important anatomical structures around the region to conduct surgery. METHOD: Thirty patients were undergone spiral CT by 16 line high speed spiral CT, and multiplanar reconstruction images using standard three-dimensional reconstruction protocol on a computer workstation. The structure of the frontal recess, the agger nasi cell and adhere style of the uncinate process were observed. The parameter of the important anatomic structure of frontal recess was measured precisely. RESULT: After the reconstruction, we get the three-dimensional model very close to the true state of the nasal cavity-sinuses cell, in which parts of the frontal recess can clearly identify the agger nasi cell, frontal cell and other important structures. In these patients, the height, width and depth of the agger nasi and frontal sinus were (9.45 ± 3.60)mm, (8.08 ± 3.37)mm, (26.98 ± 6.82)mm and (26.86 ± 9.45)mm, respectively. CONCLUSION This study tried to develop the standardized techniques and measurements from three-dimensional reconstructed images of the frontal sinus and to ascertain the usefulness of the frontal sinus in identification of patients. The project results in better preoperative patient counselling and in predicting postoperative improvement in clinical status.
Ethmoid Sinus ; diagnostic imaging ; Frontal Sinus ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Nasal Cavity ; Paranasal Sinuses ; diagnostic imaging ; Tomography, Spiral Computed ; methods

OBJECTIVETo evaluate the findings of computed tomography (CT) as objective markers of bone remodeling in rabbit models with chronic rhinosinusitis.

METHODSForty-eight rabbit models were established by vaccination of staphylococcus aureus. The rabbits were divided into 3 groups according to the time of infection: group A, B and C (4, 8, 12 weeks after infection), 16 rabbits in each group. Each group was subdivided into the medication administration team and the control team, 8 rabbits in each team. All the rabbits were examined by CT before vaccination to rule out the disease of nasal cavity and sinuses, and the CT images were used as the negative control. No interference was given to the control teams which were only examined again by CT when reached the end week. Dexamethasone sodium phosphate were administered to the medication administration teams 2 weeks before the end of experiment, and were examined by CT at the end. The images of both horizontal position and coronal position by reconstruction were obtained. The Hounsfield unit (Hu) of the bone which was the thickest position in each image were measured. The data was analyzed by SPSS 16.0 software. The Hu was analyzed statistically to compare the situation of the bone remodeling in different periods and administration in the rabbit models with CRS.

RESULTSAverage Hu (x±s) of normal rabbits was 810.0±99.7, average Hu at the end time: control team in group A was 964.0±84.6, medication administration team in group A was 833.0±92.5; control team in group B was 987.0±91.5, medication administration team in group B was 886.0±91.6; control team in group C was 1086.0±74.0, medication administration team in group C was 899.8±76.5. The Hu in all groups were higher than normal (t value were 2.747, 4.513 and 7.350 respectively, all P<0.05). No statistical difference was found between control teams of group A and B (t=0.423, P=0.667). The Hu in control team of group C was higher than group B (t=3.905, P=0.001); There was no statistical difference between medication administration teams of group A and B (t=0.892, P=0.384), and group B and C (t=0.886, P=0.385). The Hu of all medication administration teams in 3 groups were lower than all the control teams (t value were 2.717, 3.687, 8.379 respectively, all P<0.05).

CONCLUSIONSBone remodeling was found in rabbit models with rhinosinusitis, and the phenomenon was more obvious if the period was lengthened. The Hu could reflect the degree of bone remodelling. Glucocorticoids could depress the bone remodeling in the rabbit models with rhinosinusitis.

Animals ; Bone Remodeling ; Disease Models, Animal ; Nasal Bone ; diagnostic imaging ; Nasal Cavity ; Rabbits ; Sinusitis ; diagnostic imaging ; microbiology ; Tomography, X-Ray Computed

OBJECTIVETo sum up the characteristics of computed tomography of allergic fungal sinusitis (AFS) and to compare the CT changes with the findings in the operation. The diagnostic role of CT scan was discussed.

METHODSThe CT scans of 21 patients diagnosed as AFS were analyzed. The patients ranged from 15 to 50 years old,there were 17 males and 4 females. The CT was scanned with both bony and soft tissue windows. The preoperative examinations included nasal endoscopy, skin prick test, total serum IgE and nasal secretion smear. The findings in the operation were compared with the preoperative CT scans. Histopathology and fungal smear were done postoperatively.

RESULTSEndoscopy showed that all patients had polyps with wasfy yellow or inspissated white secretion. Nine cases (11 sides) showed yellow-to-brown material similar to peanut butter in the nasal cavities. Nasal CT scan demonstrated unilateral lesion in 10 cases (10 sides) and bilateral lesions in 11 cases (22 sides), who were all pansinus diseases. CT scan demonstrated a sheet areas of high-attenuation like "ground glass" within sinuses coupled with soft tissue image around them. Bone erosion of anterior skull base was encountered in 3 cases (4 sides). One case showed the intracranial extension. Twenty cases had conceived nasal endoscopic sinus surgeries. One case underwent endoscopic sinus surgery combined with coronal approach. The yellow-to-brown material (allergic mucin) was detected in the cavities of 17 cases. Four cases had green-to-brown secretion like mud. After follow-up of 6 months to 7 years, 14 cases were cured, 7 cases improved. Among them, 3 cases had to get revision surgeries because of recurrence 2 years after surgery.

CONCLUSIONSThe characteristic of a sheet area of high-attenuation like " ground glass" within sinuses coupled with soft tissue image around them in computed tomography of nasal sinus, accompanied with invasive expansion or bone erosion, has a diagnostic significance for AFS.

Adolescent ; Adult ; Female ; Fungi ; Humans ; Hypersensitivity ; diagnostic imaging ; Male ; Middle Aged ; Mycoses ; diagnostic imaging ; Nasal Cavity ; diagnostic imaging ; Paranasal Sinuses ; diagnostic imaging ; Sinusitis ; diagnostic imaging ; microbiology ; Tomography, X-Ray Computed ; Young Adult

Nuclear protein of the testis midline carcinoma (NMC) is a rare malignant tumor that is mostly located in the upper trachea,mediastinal midline,and paravertebral midline,and few literature has described the imaging features of NMC in the nasal cavity and paranasal sinuses. In this article we summarize the clinical,radiologic,and pathologic data of one case of pathologically confirmed NMC in the nasal cavity and paranasal sinus by focusing on its CT and magnetic resonance imaging features.
Humans ; Magnetic Resonance Imaging ; Nasal Cavity ; pathology ; Nose Neoplasms ; diagnostic imaging ; Nuclear Proteins ; Paranasal Sinus Neoplasms ; diagnostic imaging ; Paranasal Sinuses ; pathology ; Tomography, X-Ray Computed

OBJECTIVETo analyze the images from the segmenting CT in the space of nasal endoscope and to observe the benefits in applying the method in endoscopic sinus surgery.

METHODSFive patients with inverted papilloma and ten patients with chronic rhinosinusitis were enrolled. The images from the coronal CT were put in the ideal model of the nasal cavity, which had been designed by SketchUp software package, and the space of the model in the 0 degree rod-lens telescope was simulated and observed according to definite elevation angle between the endoscope and bottom of nasal cavity and the distance of the endoscope entering the nasal cavity. The surgical plan was designed and compared with the models of the intraoperative corresponding vision.

RESULTSThe anatomical form of the images from the coronal CT and the directions of the space in the visual field of the endoscope were correlative with the elevation angle between the endoscope and bottom of nasal cavity and the distance of the endoscope entering the nasal cavity. Based on the elevation angle and the entering distance of the endoscope, the images from the CT scan in the space of nasal endoscope were analysed according to the order, which were consistent with the findings in the intraoperative corresponding vision, providing the accurate directions of the space for the endoscopic sinus surgery.

CONCLUSIONSThe changes of the images of the CT scan in the space of the endoscope were consistent with the perspective law. To know the perspective law could grasp the directions of the space in the visual field of the endoscope and ensure the safety of the endoscopic surgery. The method was simple and feasible. The benefits of this technique were confirmed by clinician.

Adult ; Endoscopy ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Nasal Cavity ; diagnostic imaging ; Paranasal Sinuses ; diagnostic imaging ; Software ; Tomography, X-Ray Computed ; methods

OBJECTIVETo create a model from an adult cadaver's nasal cavity and verify whether it can be used to study the airflow dynamics in the nasal cavity and paranasal sinuses.

METHODS(1) The model was made by the material of transparent resin and Bengal gelatin according to a nasal cast of a cadaver. (2) The model was check by Acoustic Rhino-meter, CT scan and nasal endoscope, then compared with the normal. (3) To observe the smoke flow in the model and record it by a digital camera

RESULTSIt was succeeded in creating a model of the nasal cavity and paranasal sinus. The model was good at simulation and transparency. The structure of the model, the cross-sectional areas of the nasal passage and the CT scan results of the model were similar to the normal. The airflows in the model could be recorded by a digital camera. It showed that there were two types of airflows in the nose. The majority of airflows were found in the common and middle nasal meatus, the little part of the airflows passed through the upper of the nose like a parabola. There was an increasing proportion of airflows in the olfactory region when elevated the airflow rates. A relatively large vortex formed in the upper part of the nose, just behind the nasal valve, and another one was in the pharynx nasals.

CONCLUSIONS(1) The transparent resin and Bengal gelatin are suitable for making the model of the nose. The model can be used to study the airflows dynamics of the nasal cavity and paranasal sinuses. (2) The majority of inspired airflows go straightly to the pharynx nasals through the combined middle and inferior airways, a little part of inspired airflows through the olfactory region like a parabola. (3) The inspired airflows first arrived at the front position of the middle and inferior turbinate. The airflows can go into the maxillary sinus, a vortex can be see in the maxillary sinus during breath.

Computers, Analog ; Humans ; Models, Anatomic ; Nasal Cavity ; anatomy & histology ; diagnostic imaging ; Paranasal Sinuses ; anatomy & histology ; diagnostic imaging ; Tomography, X-Ray Computed