Nasal gliomas are rare benign congenital midline tumors composed of heterotopic neuroglial tissue with the potential for intracranial extension. They are commomly seen in newborns and children but rarely in adults. Preoperative diagnostic imaging is essential to delineate the exact site and extension of tumor and to plan the appropriate surgical approach. Endoscopic surgery is considered appropriate for the removal of intranasal glioma without intracranial extension. We experienced a case of nasophryngeal glioma in a newborn who had been presented with respiratory distress. The tumor was successfully removed by endoscopic surgery. So we report this rare case with the review of literatures.
Adult ; Child ; Diagnostic Imaging ; Endoscopes ; Glioma* ; Humans ; Infant, Newborn* ; Nasopharynx

OBJECTIVE: To measure the upper airway of obstructive sleep apnea-hypopnea syndrome by speed CT. We can predict the airway obstruction plane with the airway plane data and compliance in OSAHS patients. Through this measurement, we can provide assistance for clinical diagnosis and treatment. METHOD: This study randomly selected 82 patients diagnosed with OSAHS and 45 cases non-snoring healthy people as control group by the PHILIPS 256-slice CT. The zone volume, sagittal diameter, coronary diameter and cross-sectional area of the narrowest plane in nasopharyngeal area, velopharyngeal area, glossopharyngeal area, hypopharynx area in two groups of quiet respiration and Müller's status were measured. RESULT: In the OSAHS group underwent quiet breathing and Müller movement during CT scanning, the two states about nasopharyngeal coronary diameter, the hypopharynx sagittal diameter and cross-sectional area showed no significant difference, while other groups showed differences between the parameters (P<0.05). There was significant difference (P<0.01) in the velopharyngeal volume, tongue sagittal diameter and volume. Under Müller movement in the OSAHS group and the control group, the hypopharynx volume showed no significant difference. The nasopharyngeal coronary diameter and volume, velopharyngeal cross-sectional area and tongue sagittal diameter were different (P<0.05). The remaining set of parameters showed significant differences (P<0.01). Compared the airway compliance (Müller phase) of the OSAHS group and the control group,the parameters of each group were different (P<0.05), of which the nasopharyngeal sagittal diameter, velopharyngeal volume showed significant difference (P<0.01). Meanwhile, in the same plane, coronary diameter was greater than sagittal diameter (P<0.05) in both the OSAHS group and the control group. The pharyngeal volume measurement was basically consistent to the fiber endoscopy. CONCLUSION The obstruction plate of OSAHS patients is mostly in the velopharyngeal area and glossopharyngeal area measured with a high speed CT. The volume measurement of upper airway with speed CT can predict airway obstruction plate in patients with OSAHS.
Case-Control Studies ; Humans ; Hypopharynx ; Nasopharynx ; diagnostic imaging ; Pharynx ; diagnostic imaging ; Sleep Apnea, Obstructive ; diagnostic imaging ; Tomography, X-Ray Computed ; Tongue ; diagnostic imaging

Objective:To discuss the application of virtual endoscopy in the diagnosis of adenoid hypertrophy and the morphologic classification of adenoid. Methods:The clinical data of 97 children with adenoid hypertrophy admitted to Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University General Hospital from July 2022 to December 2022 were collected. The virtual endoscopic reconstruction of the nasopharynx was performed by cone beam computed tomography. The results of virtual endoscopic adenoid size measurement were compared with the results of nasopharyngeal CT median sagittal position and nasopharyngeal endoscopy. Virtual endoscopic classification of adenoid based on the size of the adenoids and their relationship with the torus tubarius. Results:The t-test results of the size of adenoids measured by virtual endoscopy and nasopharyngeal CT were t=1.699 and P=0.093, and the results of intra-group correlation coefficient（ICC） analysis were ICC=0.921 and P<0.01. The proportion of adenoids measured by virtual endoscopy and nasopharyngeal CT was highly consistent. The t-test results of the size of adenoids measured virtual endoscopy and nasopharyngeal endoscopy were t=1.543 and P=0.15, and the results of intra-group correlation coefficient（ICC） analysis were ICC=0.900 and P<0.01. The proportion of adenoids measured by virtual endoscopy and nasopharyngeal endoscopy was highly consistent. Among the 97 children, the morphological classification results of adenoids were 48 cases of overall hypertrophy type, 47 cases of central bulge type, and 2 cases of flat thickening type. Conclusion:The diagnosis of adenoid hypertrophy by virtual endoscopy has high accuracy, which not only avoids the invasive operation of traditional nasopharyngeal endoscopy, but also can observe the adenoid condition and its relationship with the torus tubarius from multiple angles. And, the morphological classification of adenoids using virtual endoscopy has guiding significance for perioperative preparation.
Child ; Humans ; Adenoids/surgery* ; Nasopharynx/diagnostic imaging* ; Adenoidectomy ; Endoscopy/methods* ; Hypertrophy/surgery*

OBJECTIVE: To elucidate the relationship between different cephalometric measurements and the severity of childhood OSAHS, then analyze the value of cephalometric measurements in predicting the severity of OSAHS in children. METHOD: Sixty-one patients received PSG examination and standard lateral neck roentgenography including cervical trachea. Cephalometric measurements include adenoid size, adenoidal-nasopharyngeal ratio, narrowest posterior airway space of nasopharynx, ratio of the narrowest posterior airway space of nasopharynx and trachea diameter. Statistical analysis was made to study the relationship between the data of Cephalometric measurements and PSG. RESULT: Cephalometric measurements were all associated with AHI and AI (P < 0.01). Only PAS/TD variable was entered in the stepwise linear regression equation. ROC curve analysis revealed that the optimal probability cut-off in predicting moderate and severe OSA using PAS/TD ratio was 0. 658, with the area under the curve being 0.799. The corresponding sensitivity and specificity were 81.8% and 76.5% respectively. There was no correlation between cephalometric measurements and LSaO2 (P > 0.01). CONCLUSION PAS/TD is useful and simple in predicting the severity of OSAHS in children, but no use in predicting the severity of arterial oxygen saturation.
Body Mass Index ; Cephalometry ; Child ; Child, Preschool ; Female ; Head ; diagnostic imaging ; Humans ; Male ; Nasopharynx ; diagnostic imaging ; Radiography ; Sleep Apnea, Obstructive ; diagnostic imaging

OBJECTIVETo investigate the prevalent area where the nasopharyngeal carcinoma (NPC) initially would develop most frequently in the nasopharynx.

METHODSFrom March, 1994 to June, 2003, the data of original micro-focus of 32 pathologically confirmed NPC were retrospectively reviewed, All cases were shown by CT to have stages T(0) or T(1) lesions.

RESULTSOn clinical examination, only 3 cases (9.4%) were found to have original micro-tumor in the recess, the other 29 cases (90.6%) had developed from the other regions including 20 (69.0%) from the roof and 9 cases (31.0%) from the posterior wall, all with the mucosa in the recess smooth and symmetrical. However, CT images showed that membrane of all the nasopharyngeal walls, including the recess, were normal in 24 cases (75.0%); except the micro-foci were observed on one side of the posterior wall in 5 cases (15.6%) but still with the recess normal, One lateral wall and/or the recess were involved with abnormal appearance in 3 cases (9.4%) who were clinically found to have NPC focus originated from the recess.

CONCLUSIONOur data suggest that the roof of nasopharyngeal cavity may be the area likely to develop the original NPC micro-focus, followed in frequency by the posterior wall, with the recess the least likely. The recess involvement observed in advanced lesions may be the extension of the NPC focus from the original site on the roof or the posterior wall of nasopharynx.

Adult ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnostic imaging ; pathology ; Nasopharynx ; diagnostic imaging ; pathology ; Retrospective Studies ; Tomography, X-Ray Computed

Diagnosis, Differential ; Dyspnea, Paroxysmal ; etiology ; physiopathology ; Humans ; Infant, Newborn ; Male ; Meningocele ; complications ; diagnosis ; diagnostic imaging ; physiopathology ; Nasopharynx ; abnormalities ; diagnostic imaging ; Tomography, X-Ray Computed

OBJECTIVE: To explore the impact of nasopharynx and palatum durum on the pathogenesis and severity of OSAHS patients via CT scan, and to establish a foundation to select the suitable surgical procedures. METHOD: Thirty nine OSAHS patients diagnosed by PSG and 30 normal adults were included in this study. Successive CT scanning were undertaken from roof of nasopharynx to glottis and then the CT scan slices were reconstructed in sagittal plane through Efilm software. The parameters were measured in the midline of the nasopharynx,the longest section of the hard palate and then were analyzed by t test. RESULT: The subspinale-posterior nasal spine (A-PNS) of OSAHS patients were longer than those of normal adults. The posterior nasal spine-culminating point of nasopharynx (PNS-R) and posterior space of hard palate (PNS-B) of OSAHS patients were less than those of normal adults. A 95% confidence interval were calculated from the parameters of 30 normal adults. Among 39 OSAHS patients, the A-PNS in 6 patients were longer than the top limit of normal,the PNS-R in 10 patients and the PNS-B in 16 patients were less than the low limit of normal adults, 2 patients were seen the differences of both A-PNS and PNS, 5 were seen the differences of both PNS-R and PNS-B, and 1 were seen the differences of A-PNS and PNS-B. The AHI of 24 OSAHS patients with smaller nasopharynx and longer hard palate were larger than that of the other 15 OSAHS patients, meanwhile the SaO2 of the former patients were lower than the latter. CONCLUSION Though the narrow of the upper airway in OSAHS patients mainly attribute to the nasopharynx, the nasopharyngeal size and the length of hard palate are also involved in the pathogenesis and severity of OSAHS and should be considered when choosing the surgical procedures.
Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Nasopharynx ; diagnostic imaging ; Sleep Apnea, Obstructive ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

The diagnosis of hepatocellular carcinoma (HCC) is based on imaging studies particularly in high-risk patients without histologic confirmation. This study evaluated the prevalence and characteristics of false-positively diagnosed HCC in a liver resection cohort for HCC. A retrospective review was performed of 837 liver resection cases for clinically diagnosed HCC between 2005 and 2010 at our institute. High-risk patients with tumors > 1 cm with one or two image findings consistent with HCC and tumors < 1 cm with two or more image findings consistent with HCC with persistently increased serum alpha-fetoprotein (AFP) levels above the normal range with underlying inhibited hepatitis activity underwent liver resection. The false-positive rate was 2.2% (n = 18). Of the 18 patients, 7 patients (0.8%) were diagnosed with benign conditions (one each of hemangioma, inflammation, cortical adenoma, dysplastic nodule, angiomyolipoma, bile duct adenoma, and non-neoplastic liver parenchyme) and 11 patients (1.3%) were diagnosed with malignancies (cholangiocarcinoma [n = 6], hepatoblastoma [n = 2], and one each of lymphoepithelioma-like carcinoma, ovarian cystadenocarcinoma, and nasopharynx carcinoma metastasis). The clinical characteristics of pathologically diagnosed HCC patients were similar (P > 0.05) compared to non-HCC patients except for higher rate of history of alcoholism (P < 0.05) observed in non-HCC patients. Four of 18 non-HCC patients (22.2%) showed diagnostic discordance on the dynamic imaging study. Despite the recent progression in diagnostic imaging techniques, 2.2% of cases were false-positively diagnosed as HCC in a liver resection patient cohort; and the final diagnosis was benign disease in 0.8% of liver resection patients clinically diagnosed with HCC.
Adenoma ; Adenoma, Bile Duct ; Alcoholism ; alpha-Fetoproteins ; Angiomyolipoma ; Carcinoma, Hepatocellular* ; Cohort Studies ; Cystadenocarcinoma ; Diagnosis* ; Diagnostic Imaging ; Hemangioma ; Hepatitis ; Hepatoblastoma ; Humans ; Inflammation ; Liver* ; Nasopharynx ; Prevalence ; Reference Values ; Retrospective Studies

BACKGROUNDNasopharyngeal carcinoma (NPC) is endemic in Southern Asia. Radiation therapy remains the mainstay of treatment strategies for NPC. Although approximately 19% - 56% of patients develop a recurrent disease 5 years after their primary treatment, recognition of post-radiation changes and early detection of relapse are important in improving the outcome of NPC. Our aim was to analyze the post-radiation changes and recurrent diseases related to NPC using computed tomography (CT) scans and to investigate their relationship.

METHODSCT scans of 510 pathologically proven NPC patients who have been followed up for more than 2 years after radiation were reviewed. The tumor's response to the radiation therapy and its relevance to recurrence were evaluated.

RESULTSFor patients who were followed up for more than 2 years, their CT scans-obtained within 3 months, during the 4th to the 6th month, and beyond 7 months after radiation therapy, showed a normal nasopharyngeal cavity with a slight thickening in the wall in 93.5%, 95.0% and 84.8% of the patients respectively. The degree of tumor regression had no significant relevance to the risk of recurrence within the initial 3 months (P = 0.094). During this term, the relapse rates in the cases in which the nasopharyngeal walls were displayed as normal, slightly or moderately thickening, or with obvious residual masses on CT scans were 7.1%, 11.7%, 23.5% and 23.1% respectively. The degree of tumor regression beyond 3 months after radiation therapy had a considerable reverse relevance to the risk of recurrence (P = 0.000). The relapse rates were 13.2%, 14.1%, 10.2% and 2.1%, respectively, in the cases with a normal and a slightly thickening nasopharyngeal wall during the 4th to the 6th month, the 7th to the 12th month, the 13th to the 24th month, and beyond 25 months after radiation. In contrast, the percents in cases with moderate or more aggressive thickening walls in the corresponding periods were 62.5%, 88.9%, 100% and 100%. Within 6 months after radiation therapy, shown by CT scans, the metastatic lymph nodes disappeared, markedly decreased, slightly decreased, or enlarged in 37.4%, 51.8%, 4.7%, and 0.4%, respectively, of the patients. During 6 to 12 months after radiation therapy, the proportions were 78.5%, 19.2%, 0.6% and 1.7% correspondingly. Beyond 12 months, the proportions were 83.7%, 7.9%, 0%, and 8.4%. The regression degree of the malignant nodes after radiation therapy showed a remarkable reverse relevance to the risk of recurrence in lymph nodes (P = 0.000). In the cases with disappearing, markedly decreased, slightly decreased, or enlarged malignant nodes within six months after radiation, the relapse rates were 2.9%, 4.5%, 12.5% and 100%, respectively.

CONCLUSIONSIf the nasopharyngeal walls are shown to remain moderately thick on a CT scan beyond 6 months after radiotherapy, the risk of relapse will increase. The baseline images taken within 3 months after radiotherapy and regular follow-up studies are the key to pick up the tumor recurrences in an earlier stage.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnostic imaging ; radiotherapy ; Nasopharynx ; diagnostic imaging ; pathology ; radiation effects ; Neoplasm Recurrence, Local ; Tomography, X-Ray Computed ; methods ; Treatment Outcome

Extramedullary plasmacytoma is a rare malignant plasma cell tumour. We report an extremely aggressive case of extramedullary plasmacytoma of the right maxillary sinus, which had metastasised to the brain and rib. A 56-year-old man presented with recurrent epistaxis and acute anaemia. Nasendoscopy revealed a medialised medial wall of the right maxilla and a mass occupying the whole nasopharynx. Magnetic resonance imaging revealed a right maxillary tumour with extension to the ipsilateral nasal cavity, nasopharynx, right sphenoid and ethmoidal sinuses. There was an extra-axial brain metastasis. There were metastases to the right parietal region and left eighth rib. Histopathology examination of the maxillary mass revealed abundant plasma cells with kappa-chain restriction. He was planned for four cycles of chemotherapy. Unfortunately, in view of the advanced stage of disease, he succumbed to his disease during the first cycle of chemotherapy.
Anemia ; complications ; Antineoplastic Agents ; therapeutic use ; Brain Neoplasms ; diagnosis ; pathology ; Fatal Outcome ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Maxillary Sinus ; diagnostic imaging ; pathology ; Maxillary Sinus Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Middle Aged ; Nasopharynx ; pathology ; Neoplasm Metastasis ; Plasmacytoma ; diagnosis ; diagnostic imaging ; pathology ; Radiography