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 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 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

OBJECTIVE: The purpose of the study was to observe the CT imaging features of the frontal recess regional. METHOD: Eighty-two patients were undergone spiral computed tomography (CT). Then multiplanar reconstruction images were made using standard triplanar reconstruction protocol on a computer workstation. RESULT: The prevalence of agger nasi cell was 87.8% (144/164). One hundred and forty-five (89%, 145/164) uncinate processes had one superior attachment for each uncinate process. The others had two superior attachments for each uncinate process. The uncinate process' single superior attachment of into the surrounding structures was identified to have the following distribution: 90/164 (54.9%): to the lamina papyracea, 50/164 (30.5%) to the middle turbinate, and 5/164 (3.0%) to the skull base. Of all the frontal cells were identified in 144 (87.8%) sides of frontal recesses, the prevalence of type I II, type III IV, were 30.5% and 9.8% respectively. CONCLUSION T Agger nasi cell and uncinate process play an important role in endoscopic frontal sinus surgery.
Adolescent ; Adult ; Aged ; Child ; Female ; Frontal Lobe ; diagnostic imaging ; Frontal Sinus ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Nasal Cavity ; diagnostic imaging ; Tomography, X-Ray Computed ; Turbinates ; diagnostic imaging ; Young Adult

OBJECTIVE: To analyze the correlation between olfactory disorders and the morphology of nasal cavity in chronic rhinosinusitis (CRS). METHOD: One hundred and seventy-six patients with chronic rhinosinusitis and/or polyps were included. Olfactory function, the morphology of nasal cavity and nasal sinus, especially the morphology of olfactory cleft, were surveyed by T&T Olfactometer, nasal endoscope and computed tomography (coronal and horizontal position). All patients were divided into 5 groups by different olfaction level. Data was achieved by the scoring endoscopic appearances of Kennedy, and CT staging system of Lund-Mackey and analyzed by SPSS 11.5. RESULT: (1) Among all patients, 61.9% accompanied with hyposmia, 21% with anosmia , the other 17.1% with normal olfaction; (2) There was positive correlation between the scores of staging system of Lund-Mackey and the olfactory function level (P < 0.01) (3) There was positive correlation between the scores of endoscopic appearances of Kennedy and the olfactory function level (P < 0.05). CONCLUSION (1) Olfactory function were correlated with the severity of CRS; (2) As the determining methods of CRS, staging system of Lund-Mackey can be used to estimate the olfactory function generally and initially; (3) There was not significant difference between the scores of endoscopic appearances of Kennedy and the olfactory function level.
Adult ; Chronic Disease ; Endoscopy ; Female ; Humans ; Male ; Nasal Cavity ; diagnostic imaging ; pathology ; Olfaction Disorders ; diagnostic imaging ; pathology ; Paranasal Sinuses ; diagnostic imaging ; pathology ; Sinusitis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Objective: To identify the internal nasal valve (INV) and to evaluate its key parameters in the established 3D models of nasal cavity space via Mimics from CT images, in order to provide evidence for quantitative diagnosis of nasal valve compromise. Methods: A total of 32 Han adults without nasal diseases who underwent maxillofacial CT test in Shanghai Ninth People's Hospital from January 2015 to December 2018 were retrospectively recruited, including 16 males and 16 females, with the age ranged from 20 to 80 years (50% age<50 years old). Maxillofacial CT images were used to create 3D model of nasal cavity space. The INV was identified and the following parameters were measured: the angle between the INV and the nasal bone (θ_INV-B), unilateral cross-sectional area of the INV (A_INV-R, A_INV-L), total cross-sectional area of the INV (A_INV), unilateral height of the INV (H_INV-R, H_INV-L), unilateral nasal valve angle (α_INV-R, α_INV-L), and the sum of nasal valve angle (α_INV). The A_INV in our study was compared with the results of the previously adopted planes (Plane_C, perpendicular to the hard palate and Plane_B, plane perpendicular to the nasal bone). The parameters above were compared among genders, age and race groups. SPSS 26 and GraphPad Prism 9 software were used for statistical analysis and mapping of data. Results: The A_INV in our study was (214.87±52.94) mm², which was significantly less than that of Plane_C (254.97±47.80) mm² and Plane_B (226.07±57.36) mm². The measured parameters were as follows: θ_INV-B was (82.07±7.06)°; A_INV-R was (112.66±31.39) mm²; A_INV-L was (102.21±27.14) mm²; A_INV was (214.87±52.94) mm²; H_INV-R was (24.87±4.62) mm; H_INV-L was (24.35±4.86) mm; α_INV-R was (20.48±2.99)°; α_INV-L was (19.65±3.82)°; α_INV was (40.13±6.24)°. The A_INV-R was larger than A_INV-L (t=2.33, P<0.05); The H_INV, A_INV-R, A_INV-L and A_INV of males were more than those of females (t value was 5.77, 3.21, 2.91 and 3.52, respectively, all P<0.01). The A_INV of the young group (<50 years) was larger than that of the old group (t=2.83, P<0.01); The θ_INV-B was different between the Han people and the Caucasian (t=2.92,P<0.01). The α_INV of the Han people was larger than that of Caucasians (Z=-6.92, P<0.01), but the H_INV was smaller (Z=-3.89, P<0.01). Conclusion: The A_INV carried out in 3D models of nasal cavity space is significantly smaller than that obtained by the previous methods of CT evaluation. INV static parameters differ among genders, age and race groups.
Adult ; Female ; Humans ; Male ; Young Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Nasal Cavity/diagnostic imaging* ; Retrospective Studies ; China ; Nose ; Nasal Bone

OBJECTIVE: To investigate the nasal airflow-field in relation with the structure and function of the human nose. METHOD: The 3-D finite-element mesh is developed from Spiral- CT imaging scans of the 25 healthy volunteers' noses. Given three preconditions, the nasal air-flow is described by the Navier-Stokes and continuity equations at the inspiratory flow rate of 10 min, then the whole airflow patterns are obtained for further analysis. RESULT: (1) In 5 cases, the airflow passes mainly through the middle medial region in both sides in the nasal airway. In remaining 20 cases, the airflow passes mainly through the middle and ventral medial regions in one side in the nasal cavity while little air passes through middle medial regions in another the other side through which little air passes. (2) The differences of velocity in the nasal valve, middle and ventral medial regions of the nasal airway between mainly side and non maingnot-mainly side are of statistical significance, while those in the olfactory split, middle and inferior meatuses in both sides are of no statistical significance. (3) In the mainly side, the most rapid air speed occurred in the nasal valve , the second rapid velocity in the middle medial region and the third in the ventral medial regions, the slowest velocity in the olfactory split, middle and inferior meatuses. In notion- mainly side, the velocity in all regions is slow without statistical significance. CONCLUSION (1) At the inspiratory flow rate of 10 L/min, the middle and ventral medial regions act as the main airways in nasal cavity. (2) The airflow in nasal cavity can be directed effectively and reasonably by nasal valve, inferior turbinate, middle turbinate in turn, which may be consistent with the nasal cycle functionally.
Adult ; Asian Continental Ancestry Group ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Models, Biological ; Nasal Cavity ; diagnostic imaging ; Pulmonary Ventilation ; Tomography, X-Ray Computed