Objective:To explore the relevant anatomical factors in the pathogenesis of chronic dacryocystitis based on CT radiomics. Methods:A retrospective analysis was conducted on the general data and sinus CT materials of 85 patients with chronic dacryocystitis（case group） admitted to our department from December 2020 to December 2023, and 85 individuals undergoing physical examination（control group） during the same period. The differences in anatomical parameters between the two groups were compared to study the morphological characteristics of the nasolacrimal duct in patients with chronic dacryocystitis. Univariate and multivariate logistic regression analyses were used to explore the relevant anatomical factors in the pathogenesis of chronic dacryocystitis. Results:There were statistically significant differences（P<0.05） in the proportion of combined nasal septal deviation, the distance between the anterior and posterior ridges of the lacrimal fossa, the angle between the long axis of the nasolacrimal duct and the projection on the midsagittal plane, the maximum transverse diameter of the bony nasolacrimal duct, the maximum cross-sectional area of the bony nasolacrimal duct, and the thickness of the frontal process of the maxilla between the two groups. There were no statistically significant differences（P>0.05） in whether there was a combined high-position nasal septal deviation, whether there was a combined non-high-position nasal septal deviation, and whether there was a combined pneumatized middle turbinate. Multivariate analysis showed that nasal septal deviation, the distance between the anterior and posterior ridges of the lacrimal fossa, the angle between the long axis of the nasolacrimal duct and the projection on the midsagittal plane, and the maximum cross-sectional area of the bony nasolacrimal duct are independent anatomical factors affecting the pathogenesis of chronic dacryocystitis. Conclusion:Nasal septal deviation, a large distance between the anterior and posterior ridges of the lacrimal fossa, a large angle between the long axis of the nasolacrimal duct and the projection on the midsagittal plane, and a small maximum transverse diameter of the bony nasolacrimal duct are important anatomical bases for the pathogenesis of chronic dacryocystitis, providing a basis for an in-depth understanding of the disease occurrence.
Humans ; Retrospective Studies ; Male ; Female ; Dacryocystitis/diagnostic imaging* ; Tomography, X-Ray Computed/methods* ; Nasolacrimal Duct/diagnostic imaging* ; Chronic Disease ; Nasal Septum/diagnostic imaging* ; Middle Aged ; Adult ; Radiomics

We present an extremely rare case of pleomorphic adenoma of the nasal septum in a 24-year old woman who went to consultation because of right nasal neoplasm. The radiologic discoveries by computerized tomography showed a tumor in the right nasal septum. Incisional biopsy was done, with a histopathological report of pleomorphic adenoma. Later, nasal endoscopy was used to remove the neoplasm and histology revealed pleomorphic adenoma of the nasal septum.
Adenoma, Pleomorphic ; diagnostic imaging ; surgery ; Catheter Ablation ; methods ; Cryotherapy ; methods ; Endoscopy ; Female ; Humans ; Nasal Septum ; diagnostic imaging ; surgery ; Nose Neoplasms ; diagnostic imaging ; surgery ; Rare Diseases ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To analysis the relationship between nasal septal deviation and the bulbous type concha bullosa(CB). METHOD: Analysis the paranasal sinus coronal plane CT scans of 972 patients,observe the incidence of nasal septal deviation and bulbous type concha bullosa and classify them into upper septal deviation and lower septal deviation. Measure the septal deviation angle and transverse diameter of the bulbous type concha bullosa, and a nalysis the relationship between nasal septal deviation and the bulbous type concha bullosa. RESULT: The incidences of bulbous type concha bullosa was 17.03% of 182 patients with nasal septal deviation and was 14.05% of 790 patients without nasal septal deviation. There was no statistically difference between them(P > 0.05). The incidences of bulbous type concha bullosa were 33.33% and 9.02% of the patients with upper septal deviation and lower septal deviation, and the difference was statistical (P < 0.01). The mean of the septal deviation angle was 14.55 degrees +/- 3.61 degrees, and the transverse diameter of the bulbous type concha bullosa was (5.93 +/- 1.88) mm in 20 patients with upper septal deviation and CB. The mean of the septal deviation angle was 13.36 degrees +/- 2.42 degrees, and the transverse diameter of the bulbous type concha bullosa was (4.86 +/- 1.40) mm in 11 patients with lower septal deviation and CB. There was no statistically difference between the septal deviation angle and the transverse diameter of bulbous type concha bullosa (P > 0.05). CONCLUSION There was a significant relationship between upper nasal septal devia tion and bulbous type concha bullosa, especially finding bulbous type concha bullosa in concave sides of nasal sep turn. But there was no significant relationship between the septal deviation angle and the size of the bulbous type concha bullosa.
Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; abnormalities ; diagnostic imaging ; Tomography, X-Ray Computed ; Turbinates ; abnormalities ; diagnostic imaging ; Young Adult

OBJECTIVE: To investigate the classification and distribution of external nasal fracture, and its influence to the nasal septum. METHOD: We randomly chose 60 patients who received nasal CT scan because of nasal trauma and diagnosed as external nasal fracture. We reviewed their CT data in PACS system with computer. RESULT: Of the 60 cases of nasal trauma, 90 sides got external nasal fracture, among which 58 sides (64.4%) had only nasal bone fracture, 16 sides (17.8%) had only maxillary frontal process fracture, and 16 sides (17.8%) had both. Half of these 60 patients got unilateral external nasal fracture, among whom 14 patients (46.7%) had traumatic nasal septum deviation meanwhile. The other 30 patients suffered from bilateral external nasal fracture, among whom 26 patients (86.7%) had traumatic nasal septum deviation. The difference between these two groups was statistically significant (P < 0.01). Moreover, 24 patients got fracture of either nasal bone or maxillary frontal process, 11 of whom (45.8%) got traumatic nasal septum deviation at the same time. The other 36 patients suffered fracture of both these two bones, 29 of whom (80.6%) had traumatic nasal septum deviation. The difference between these two groups was statistically significant (P < 0.01). We classified the nasal bone fracture as below: 16 patients with only unilateral external nasal fracture belonged to Type I, of whom 15 patients (25.0%) were type Ia with nasal bone or maxillary frontal process fracture and 1 patient (1.7%) fell into type Ib with fracture occurred on both of these two bones at the same side. Four patients suffered bilateral external nasal fracture belonged to type II, among whom 2 patients (3.3%) belonged to type IIa with nasal bone or maxillary frontal process fracture and 2 patients fell into type IIb with fracture of both of these two bones at different sides. The other 40 patients (66.7%) belonged to Tpye III, who suffered external nasal fracture accompanied with traumatic nasal septum deviation. CONCLUSION Traumatic nasal septum deviation was extremely concomitant in patients with external nasal fracture. It will be better to perform external nasal reconstructive surgery and plasty of nasal septum deviation by using the endoscope within 1 month for the patients whose symptom were serious or who cared a lot about the appearance.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Fractures, Bone ; classification ; diagnostic imaging ; pathology ; Humans ; Male ; Middle Aged ; Nasal Bone ; injuries ; Nasal Septum ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To compare the CT scan results in patients with deviation of nasal septum and normal adults and to explore its values in evaluating the state of nasal ventilation. METHOD: Twenty-six patients with deviation of nasal septum and 15 normal people were recruited in the study. The nasal airway from anterior nostril to posterior nostril was evaluated with PhlipsTomos scan AV Expander Elspiral scanner. The indexes of nasal ventilation was measured with the image-analysis software. The results of CT scan between patients with deviation of nasal septum and normal people was compared. RESULT: (1) There was obvious difference between patients with deviation of nasal septum and normal people in the NMCSA, IMCSA, DNCAT and DICAT. There was obvious difference between patients with deviation of nasal septum with obstruction in the opposite side and normal people in the ONMCSA and ODNCAT. There was obvious difference between patients with deviation of nasal septum without obstruction in the opposite side and normal people in the ODNCAT. (2) In the patients with deviation of nasal septum, between nasal minimal cross sectional area and inferior turbinate's maximum cross sectional area, there is obvious relation, r = -0.394, P < 0.05. CONCLUSION CT is one kind of objective inspection method in evaluating the state of nasal ventilation. With the measurement of the nasal morphology and functional index, we can understand the state of nasal ventilation more comprehensively. And with this, the treatment and diagnosis of disease with nasal obstruction will be more scientific.
Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Nasal Obstruction ; diagnostic imaging ; physiopathology ; Nasal Septum ; abnormalities ; diagnostic imaging ; Pulmonary Ventilation ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: The harvesting procedures on cadaver heads and a radioanatomic study of measuring dimensions of skull base by endoscopic endonasal approach were performed. The measurements could do help to design the nasoseptal mucoperiosteum and improve the rate of repair success. METHOD: The surgical procedures were demonstrated on cadaver heads specimens. Then 20 adult CT scans of sinus and skull base were calculated by workstations. The dimensions of three different skull base (the defect of anterior skull base/cribriform plate approach, sellar region/planum sphenoidale region and clivus region) of maximum areas, length and width, were measured. And with these data the nasoseptal flap were designed for providing enough area to cover the defect. The distance from the projection of sphenopalatine foramen to related area of skull base were plused for obtaining desired the length of nasoseptal flap. RESULT: The mean length from the projection of sphenopalatine to the anterior skull base, planum/sella area and clivus were 49.56 mm, 57.47 and 67.19 mm, respectively. The means of areas of anterior dural defect, transsellar defect and panclivectomy were 16.13 cm2, 14.03 cm2 and 13.12 cm2, respectively. The average length of the nasoseptal flap ranged between 64.71-65.93 mm, the width ranged between 28.57-30.95 mm with an average area of 22.95 cm2. CONCLUSION One side of nasal septal flap can provide enough area to reconstruct the anterior skull base and planum/sella area. In some cases, the flap can not completely cover the area of clivus region because of the limitation of its length.
Adult ; Endoscopy ; methods ; Humans ; Nasal Septum ; anatomy & histology ; diagnostic imaging ; transplantation ; Skull Base ; diagnostic imaging ; surgery ; Surgical Flaps ; Tomography, X-Ray Computed

OBJECTIVE: To explore the effect of septoplasty on the modality of inferior turbinate in patients with a deviated nasal septum. METHOD: Twenty-three patients with nasal septum deviation underwent septoplasty without turbinate surgery. All patients underwent CT imaging scans before and 3 months after the surgery. The thicknesses of the medial mucosa, lateral mucosa,and the cross-sectional areas of the inferior turbinate were measured and compared using the Wilcoxon signed rank test. P<0. 05 was considered statistically significant. RESULT: On the concave side of the septum, the thickness of the medial mucosa of the inferior turbinate was(5. 3+/-1.5) mm to (4. 1+/-1. 2) mm (P<0. 05), the thicknesses of the lateral mucosa of the inferior turbinate was(2. 5+/-0. 9) mm to (2.0+/-0. 9) mm (P>0. 05), and the cross-sectional area of the inferior turbinate was(139. 8 +/- 35.6) mm2 to( 110. 3 +/- 22.6)mm2 (P<0.05), pre- and post-operatively. On the convex side of the septum , the thickness of the medial mucosa of the inferior turbinate was(1.0 +/- 0. 6) mm to(4. 3 +/- 0. 6) mm (P>0. 05), the thicknesses of the lateral mucosa of the inferior turbinate was(1. 9+/-1. 1) mm to (1. 9+/-1.3) mm (P>0. 05), and the cross-sectional area of the inferior turbinate was(104. 5+/-15. 8)mm2 to(108. 3 +/- 20. 8)mm2 (P>0. 05), pre- and post-operatively. CONCLUSION The compensatory hypertrophic inferior turbinate may be self-adaptability in modality soon after septoplasty, thus surgeons must take it into consideration before performing turbinate surgery.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Rhinoplasty ; Tomography, X-Ray Computed ; Turbinates ; diagnostic imaging ; Young Adult

OBJECTIVE: To discuss the feasibility of endoscopic frontal sinus surgery in the nasal septum median path. METHOD: (1) Sixty adult cadaveric heads fixed with formalin were CT scanned,and were three dimensional reconstruction. (2) Thirty adult cadaveric heads were sawn along the sagittal line close to the side of the nasal septum, then the important anatomic marks were observed and measured. (3) Combined with CT and anatomical data, thirty adult cadaveric heads were operated in different degree, and the damage of nasal septum and fila olfactoria were detected in the same time. RESULT: (1) The roots of middle nasal concha were simulated in the endoscopic frontal sinus surgery. The operation time, operative procedures, markers foundation, endoscopic back of posterior border of frontal sinus foundation and attached to the symphysis with cribriform plate and the top of ethmoidal sinus were recorded. (2) The intersection point formed by the level of middle nasal concha and the vertical of middle nasal concha corresponded with the nasal septum was called the M point. The distance from the M point to the horizon of the nasal bone was (20.07 +/- 6.21) mm, the distance from the M point to the first fila olfactoria was (24.38 +/- 7.68) mm, the distance from the first fila olfactoria to the posterior edge of frontal sinus was (9.57 +/- 2.73) mm, the distance from the root of the middle nasal concha to posterior edge of frontal sinus was (5.38 +/- 1.23) mm, the anteroposterior diameter of frontal sinus fundus was (7.62 +/- 2.45) mm, the transverse diameter of frontal sinus fundus was (9.41 +/- 3.37) mm, the seesaw diameter of frontal sinus partition was (16.97 +/- 3.23) mm, the anteroposterior diameter of frontal sinus partition was (12.34 +/- 2.23) mm. (3) The operation time through the nasal septum path was 105 minutes which combined with CT and anatomical measurements. 0 degrees endoscopy could be used to observe the frontal part of the lateral, posterior and top wall, while nasal septum remove should be finished with 30 degree endoscopy. The bottom of frontal sinus can be exposed and removed with 0 degree endoscopy. 3 cases of cadaveric frontal sinus lateral wall can not be observed with 70 degree endoscopy. 30 cases of cadaveric frontal sinus,some of the top and the lateral wall, anterior and posterior wall could be observed with 70 degree endoscopy, nasal septum damage range was about 2.23 cm x 2.59 cm, and no fila olfactoria damage was found. CONCLUSION Endoscopic frontal sinus surgery in the nasal septum median path is a good way to find frontal sinus.
Endoscopy ; methods ; Feasibility Studies ; Frontal Sinus ; diagnostic imaging ; surgery ; Humans ; Nasal Bone ; diagnostic imaging ; surgery ; Nasal Septum ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

OBJECTIVE: To analyze the characteristic of chronic paranasal sinusitis CT scans and discuss the relationship between the anatomic variations in ostiomeatal complex (OMC) and the incidence of chronic sinusitis. METHOD: One hundred and ninety-seven cases diagnosis as sinusitis were selected and analyzed,whose age ranged between 4 and 74 years old. Several common anatomical abnormalities in ostiomeatal complex were evaluated through the observation of the coronal and axial plane CT scans of the paranasal sinusitis. RESULT: The incidence of anatomic variations in OMC concentrated in the age between 11-20. The incidence of chronic sinusitis also concentrated in the age between 11-20. Deviation of nasal septum, uncinate variations, inferior-turbinate hypertrophy were observed between the chronic sinusitis group and the none chronic sinusitis group,the correlation between deviation of nasal septum, uncinate variations, inferior-turbinate hypertrophy and chronic sinusitis were significant (P<0.05). CONCLUSION The occurrence of OMC variation is common. The anatomic variations may be one of the causes of chronic paranasal sinusitis, especially deviation of nasal septum, uncinate variations and inferior-turbinate hypertrophy. If these abnormalities were altered,it will have a great significance for the preservation and treatment of chronic paranasal sinusitis.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; diagnostic imaging ; Paranasal Sinuses ; diagnostic imaging ; Sinusitis ; diagnostic imaging ; Tomography, Spiral Computed ; Young Adult

OBJECTIVE: To investigate the features of nasal septum cellule in computed tomographic (CT) images and its clinical significance. METHOD: CT scans data of nasal septum in 173 patients were randomly obtained from January 2001 to June 2005. Prevalence and clinical features were summarized in the data of 19 patients with nasal septum cellule retrospectively. RESULT: (1) Nineteen cases with nasal septum cellule were found in 173 patients. (2) All nasal septum cellule of 19 cases located in perpendicular plate of the ethmoid bone, in which 8 cases located in upper part of nasal septum and 11 located in middle. (3) There were totally seven patients with nasal diseases related to nasal septum cellule, in which 3 cases with inflammation, 2 cases with bone fracture, 1 case with cholesterol granuloma, 1 case with mucocele. CONCLUSION Nasal septum cellule is an anatomic variation of nasal septum bone, and its features can provide further understanding of some diseases related to nasal septum cellule.
Adolescent ; Adult ; Aged ; Ethmoid Bone ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Nasal Bone ; diagnostic imaging ; Nasal Septum ; diagnostic imaging ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult