BACKGROUND: One nostril must be selected for nasotracheal intubation. In some cases, structural anomalies within the nasal cavity hinder the insertion of the tube or complications, such as epistaxis, develop. This study examined the possibility of using radiography to select the nostril that would induce fewer complications. METHODS: Four hundred and five patients who underwent nasotracheal intubation under general anesthesia were studied. A 7.0-mm internal diameter nasal right angle endotracheal (RAE) tube and 6.5-mm internal diameter nasal RAE tube were inserted into men and women, respectively. Complications were considered to have developed in cases in which insertion of the tube into the nasal cavity failed or epistaxis occurred. The tube was inserted into the other nostril for insertion failures and hemostasis was performed in cases of epistaxis. The degree of nasal septal deviation was determined from posteroanterior skull radiographs or panoramic radiographs; the incidence of complications was compared depending on the direction of the septal deviation and the intubated nostril. RESULTS: The radiographs of 390 patients were readable; 94 had nasal septum deviation. The incidence of complications for cases without nasal septum deviation was 16.9%, that for cases in which the tube was inserted into the nostril on the opposite side of the deviation was 18.5%, and that for cases in which the tube was inserted into the nostril with the deviation was 35.0%, showing a high incidence of complications when intubation is performed through the nostril with septum deviation (chi-square test, P < 0.05 ). CONCLUSIONS: Although there were no differences in the incidence rates of complications between intubation through the left nostril and that through the right nostril, radiological findings indicated that incidence of complications significantly increased when the tube was inserted into the nostril with the septum deviation.
Anesthesia, General ; Epistaxis ; Female ; Hemostasis ; Humans ; Incidence ; Intubation* ; Male ; Nasal Cavity ; Nasal Septum ; Radiography ; Radiography, Panoramic ; Skull

BACKGROUND: One nostril must be selected for nasotracheal intubation. In some cases, structural anomalies within the nasal cavity hinder the insertion of the tube or complications, such as epistaxis, develop. This study examined the possibility of using radiography to select the nostril that would induce fewer complications. METHODS: Four hundred and five patients who underwent nasotracheal intubation under general anesthesia were studied. A 7.0-mm internal diameter nasal right angle endotracheal (RAE) tube and 6.5-mm internal diameter nasal RAE tube were inserted into men and women, respectively. Complications were considered to have developed in cases in which insertion of the tube into the nasal cavity failed or epistaxis occurred. The tube was inserted into the other nostril for insertion failures and hemostasis was performed in cases of epistaxis. The degree of nasal septal deviation was determined from posteroanterior skull radiographs or panoramic radiographs; the incidence of complications was compared depending on the direction of the septal deviation and the intubated nostril. RESULTS: The radiographs of 390 patients were readable; 94 had nasal septum deviation. The incidence of complications for cases without nasal septum deviation was 16.9%, that for cases in which the tube was inserted into the nostril on the opposite side of the deviation was 18.5%, and that for cases in which the tube was inserted into the nostril with the deviation was 35.0%, showing a high incidence of complications when intubation is performed through the nostril with septum deviation (chi-square test, P < 0.05 ). CONCLUSIONS: Although there were no differences in the incidence rates of complications between intubation through the left nostril and that through the right nostril, radiological findings indicated that incidence of complications significantly increased when the tube was inserted into the nostril with the septum deviation.
Anesthesia, General ; Epistaxis ; Female ; Hemostasis ; Humans ; Incidence ; Intubation* ; Male ; Nasal Cavity ; Nasal Septum ; Radiography ; Radiography, Panoramic ; Skull

PURPOSE: To assess the width of the labial alveolar bone of the incisive canal and the width of the incisive canal on spiral computed tomographic images of the anterior portion of the maxilla. MATERIALS AND METHODS: Study materials included 38 CT scans taken for preoperative planning of implant placement. Axial cross-sectioned image entirely showing the incisive canal was selected and scanned with 600 DPI resolution. The width of the labial alveolar bone of the incisive canal at an orifice to the oral cavity, middle portion, and an orifice to the nasal cavity and the diameter of the incisive canal at the middle portion were determined by two specialist using Digora for Windows 2.1. The statistical analyses were carried out using SPSS 12.0.1. RESULTS: When the maxillary central incisors remained, the mean labial alveolar bone width were 6.81+/-1.41 mm, 6.46+/-1.33 mm, and 7.91+/-1.33 mm. When the maxillary central incisors were missed the mean width were 5.42+/- 2.20 mm, 6.23+/-2.29 mm, and 7.89+/-2.13 mm. CONCLUSIONS: The labial alveolar bone width at middle portion and an orifice to the nasal cavity were of no statistical significant difference according to presence of the maxillary central incisors (P>0.05). The width between oral cavity and nasal cavity, middle portion and to nasal cavity revealed statistically significant difference (P<0.05).
Alveolar Process ; Dental Implants ; Incisor ; Maxilla ; Mouth ; Nasal Cavity ; Radiography, Dental, Digital ; Specialization ; Tomography, X-Ray Computed

OBJECTIVE: To compare computed tomography (CT) and magnetic resonance imaging (MRI) findings between two histological types of nasal hemangiomas (cavernous hemangioma and capillary or lobular capillary hemangioma). MATERIALS AND METHODS: CT (n = 20; six pre-contrast; 20 post-enhancement) and MRI (n = 7) images from 23 patients (16 men and seven women; mean age, 43 years; range, 13-73 years) with a pathologically diagnosed nasal cavity hemangioma (17 capillary and lobular capillary hemangiomas and six cavernous hemangiomas) were reviewed, focusing on lesion location, size, origin, contour, enhancement pattern, attenuation or signal intensity (SI), and bony changes. RESULTS: The 17 capillary and lobular hemangiomas averaged 13 mm (range, 4-37 mm) in size, and most (n = 13) were round. Fourteen capillary hemangiomas had marked or moderate early phase enhancement on CT, which dissipated during the delayed phase. Four capillary hemangiomas on MRI showed marked enhancement. Bony changes were usually not seen on CT or MRI (seen on five cases, 29.4%). Half of the lesions (2/4) had low SI on T1-weighted MRI images and heterogeneously high SI with signal voids on T2-weighted images. The six cavernous hemangiomas were larger than the capillary type (mean, 20.5 mm; range, 10-39 mm) and most had lobulating contours (n = 4), with characteristic enhancement patterns (three centripetal and three multifocal nodular), bony remodeling (n = 4, 66.7%), and mild to moderate heterogeneous enhancement during the early and delayed phases. CONCLUSION: CT and MRI findings are different between the two histological types of nasal hemangiomas, particularly in the enhancement pattern and size, which can assist in preoperative diagnosis and planning of surgical tumor excision.
Adolescent ; Adult ; Aged ; Female ; Hemangioma, Capillary/*radiography ; Hemangioma, Cavernous/diagnosis/*radiography ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Nasal Cavity/radiography ; Paranasal Sinuses/*radiography ; Retrospective Studies ; *Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo study the airflow in nasal cavity by reconstructing 20 volunteers' nasal cavity models and numerical simulation of the flow field in these nasal cavity models.

METHODSBased on the data from the CT images, 20 volunteers' nasal cavity models were reconstructed by the method of surface rendering. The flow field in these three-dimensional models were simulated with finite element method. Some of these volunteers were tested by means of acoustic rhinometry and the test results recorded. Comparisons were performed for the curves from acoustic rhinometry and the results of numerical simulations. The simulation results were explained with the fluid network theory.

RESULTSThe airflow distribution in the nasal cavity model could be acquired from the simulation results of the velocity plot. Main airflow would pass through the common nasal meatus in which flux accounted for 50% - 77% of overall flux. The pressure value at any point in the nasal cavity model could be obtained from the results of the pressure plot. The nasal airway resistance in the region of limen nasi accounted for 50% - 65% of overall nasal airway resistance. Comparing the test results with the simulation results the relation could be understood between the change of the cross-section area of nasal cavities and the plot of numerical simulation results of velocity and pressure in airflow field in the nasal cavity models.

CONCLUSIONSComparing the simulated results of the 20 volunteers' nasal cavity model it can be concluded that the distribution of airflow in nasal cavities is not stationary. The differences among everybody's nasal cavity structure lead to the different airflow distribution in the nasal cavities.

Adult ; Airway Resistance ; Computer Simulation ; Female ; Finite Element Analysis ; Humans ; Image Processing, Computer-Assisted ; Male ; Models, Anatomic ; Nasal Cavity ; anatomy & histology ; diagnostic imaging ; Radiography

In order to evaluate the calculation precision of the pencil beam (PB) algorithm and convolution-superposition(CS) algorithm for the situation with air cavity and small fields, we built a water phantom with an air cavity slab, in which the depth dose (DD) and off-axis ratio (OAR) for field 1cm x 1cm to field 7cm x 7cm were calculated by PB algorithms, CS algorithms and Monte Carlo (MC) simulation. The evaluation of algorithms by MC simulation was achieved by comparisons of DD with the spread penumbras of OAR curve self-defined as the width between isodose lines of 10% and 90%. It was shown that PB algorithm and CS algorithm both overestimated the DD but the degree overestimated by PB algorithm was more serious. The CS algorithm showed a better agreement with the MC simulation for the OARs, which spread to both laterals, while that was not predicted accurately by PB algorithm. It was indicated that PB algorithm and CS algorithm do not have high calculation precision whereas CS algorithms is relatively better for the situation with air cavity and small fields.
Algorithms ; Body Burden ; Computer Simulation ; Nasal Cavity ; diagnostic imaging ; Nasopharyngeal Neoplasms ; radiotherapy ; Nose Neoplasms ; radiotherapy ; Photons ; Radiography ; Radiometry ; methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Sensitivity and Specificity

A 68-year-old Chinese man presented with an eight-month history of pyrexia of unknown origin and chronic sinusitis despite multiple courses of antibiotics. He underwent extensive investigations, including workups for infections, chronic granulomatous diseases and malignancy. Nasal biopsies were performed twice under local anaesthesia, but did not show any evidence of malignancy. Eventually, the patient was diagnosed with natural killer (NK)/T-cell lymphoma, nasal variant, based on histopathological findings from harvested deep tissue obtained via functional endoscopic sinus surgery. This study highlights that, for patients presenting with pyrexia of unknown origin and nasal symptoms, NK/T-cell lymphoma must be considered as a differential diagnosis. Generous amounts of tissue should be harvested under general anaesthesia rather than limited tissue under local anaesthesia, in order to facilitate and ensure a definitive diagnosis.
Aged ; Anti-Bacterial Agents ; chemistry ; Biopsy ; China ; Humans ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; diagnostic imaging ; pathology ; Male ; Nasal Cavity ; pathology ; Nose Neoplasms ; complications ; diagnosis ; radiotherapy ; Prognosis ; Radiography ; Radiotherapy ; Sinusitis ; complications ; diagnosis ; Treatment Outcome

Chondrosarcomas are malignant tumors of cartilage that rarely involve the sinonasal region, and myxoid chondrosarcoma is a rare histologic variant of chondrosarcoma that usually occurs in the soft tissue of extremities. Although several case reports and results of small series of chondrosarcomas in the sinonasal region in children are available, myxoid type chondrosarcoma is extremely rare. We recently experienced a case of low grade myxoid chondrosarcoma involving the sinonasal cavity in a 10-year-old boy, and here we report its radiologic-pathologic findings. In this case, chondroid calcification on CT and septal and marginal enhancement on MRI suggested a chondrosarcoma. Whole body PET-CT demonstrated no definite metastatic lesion and a low peak standardized uptake value primary tumor. However, no definite distinguishing imaging features were observed that distinguished low grade myxoid chondrosarcoma from conventional chondrosarcoma.
Bone Neoplasms/*diagnosis/radiotherapy/surgery ; Child ; Chondrosarcoma/*diagnosis/radiotherapy/surgery ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Myxosarcoma/*diagnosis/radiotherapy/surgery ; Nasal Cavity/*pathology/*radiography/surgery ; Paranasal Sinuses/*pathology/*radiography/surgery ; Positron-Emission Tomography ; Rare Diseases ; Tomography, X-Ray Computed ; Whole Body Imaging

OBJECTIVETo study the clinical, radiologic and pathologic features, as well as differential diagnosis of teratocarcinosarcoma in nasal cavity and paranasal sinuses.

METHODSLight microscopic examination and immunohistochemical study was performed in 5 cases of sinonasal teratocarcinosarcoma. The clinical, radiologic and pathologic features were analyzed and the literature was reviewed.

RESULTSAll 5 patients were males and their age ranged from 34 to 43 years (mean age = 39 years). The clinical presentation was nasal obstruction, epistaxis and headache. Physical examination often revealed a polypoid mass with contact bleeding. Computed tomography showed a homogeneous nasal mass with obturation of sinuses. Cystic changes, calcification or ossification was not observed. Histologically, the tumor showed a heterogeneous admixture of components from the 3 germ cell layers, exhibiting various degrees of maturation. Squamous epithelium, smooth muscle cells, chondro-osseous tissue, intestinal or respiratory type epithelium, "fetal-type" clear cells and immature neuroepithelium were commonly seen. Immunohistochemical study demonstrated that the epithelial component expressed cytokeratin and epithelial membrane antigen, while the mesenchymal component variably expressed vimentin, smooth muscle actin and S-100 protein. On the other hand, the neuroepithelial component expressed neuron-specific enolase, synaptophysin and chromogranin, and the primitive component expressed CD99. The initial biopsy diagnosis included capillary hemangioma, olfactory neuroblastoma, craniopharyngioma and malignant mixed tumor. Follow-up information was available in all patients. Two of which had local recurrence and 1 had cervical lymph node metastasis.

CONCLUSIONSSinonasal teratocarcinosarcoma is a rare and highly malignant tumor occurring in sinonasal tract. It manifests mainly in adult males and is characterized by a complex admixture of teratomatous and carcinosarcomatous components. "Fetal-type" clear cells, squamous epithelium and immature neuroepithelium represent important histologic characteristics useful in diagnosis.

Adult ; Carcinosarcoma ; diagnostic imaging ; metabolism ; pathology ; radiotherapy ; surgery ; Follow-Up Studies ; Humans ; Keratins ; metabolism ; Lymphatic Metastasis ; Male ; Mucin-1 ; metabolism ; Nasal Cavity ; Neck Dissection ; Neoplasm Recurrence, Local ; Nose Neoplasms ; diagnostic imaging ; metabolism ; pathology ; radiotherapy ; surgery ; Paranasal Sinus Neoplasms ; diagnostic imaging ; metabolism ; pathology ; radiotherapy ; surgery ; Radiography ; Teratocarcinoma ; diagnostic imaging ; metabolism ; pathology ; radiotherapy ; surgery