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Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is an uncommon histiocytic disease with idiopathic etiology and unique pathology. Extra-nodal RDD that occurs in the nasal cavity is extremely unusual and the characteristic clinical features are unknown. Herein, we report a case of nasal septum RDD, with intermittent epistaxis from the left nasal cavity, which led to collapse of the nasal bridge. The patient underwent surgical biopsy, and a diagnosis of nasal septum RDD was established. No further treatment was performed. An enlarged mass was found in the second postoperative year which was treated by surgical excision in the third postoperative year. To improve the current diagnostic and therapeutic approach of extra-nodal RDD, we incorporate previous reports from the literature to discuss the pathological characteristics, pathogenesis, clinical manifestations, diagnosis, and therapy for this rare disease. [ABSTRACT FROM AUTHOR]

Background/Objectives: Nasal morphology is a significant aspect of facial anatomy and is often used for forensic identification and aesthetic surgery. This study aims to compare nasal dimensions based on sex, facial index (FI), and nasal index (NI) using cone-beam computed tomography (CBCT) and 3D modeling. Methods: To observe differences in nasal dimensions by sex and analyze the relationships between facial shapes (FI) and nasal forms (NI), a total of 100 participants (50 males, 50 females) in their 20s were selected from Dankook University Dental Hospital. CBCT scans were performed, and 3D models were created using Mimics software (version 22.0). The measurement items included the alaria distance between (AL), the distance between N (nasion) and SN (subnasale), the distance between N (nasion) and PRN (pronasale), and the distance between SN (subnasale) and PRN (pronasale). A T-test was used for the sex-based analysis of the nasal dimensions, and the facial index- and nasal index-based nasal dimensions were analyzed using a one-way ANOVA with Scherffe's post hoc test. Additionally, all the statistical analyses were performed using SPSS software (version 23.0). Results: The results indicated that males generally have larger nasal dimensions than females. Additionally, the mesoprosopic facial type (round face) showed the largest nasal dimensions in the FI classification, while the platyrrhine nasal type (broad and short nose) exhibited the largest dimensions in the NI classification. Conclusions: This study demonstrates that the nasal size varies significantly with sex, facial shape, and nasal form. The findings can contribute to forensic identification and provide valuable data for clinical practices in facial reconstruction and nasal surgery. [ABSTRACT FROM AUTHOR]

Objective: Alar asymmetry in unilateral cleft lip (UCL) nasal deformity is a well-recognized clinical feature. However, there is a lack of comprehensive quantitative analysis of this asymmetry. This study compares the shape, volume, and axis rotation between the cleft and non-cleft ala in skeletally mature patients with UCL. Design: A retrospective comparative study utilizing three-dimensional rendered CT scans. Setting: Tertiary care pediatric institution. Patients, Participants: This study included 18 patients with UCL nasal deformity at skeletal maturity. Main Outcome Measure(s): Cleft and non-cleft side ala volume, surface area, and axis to the midsagittal plane. Results: The cleft-side ala was significantly lesser in volume by 27.3%, significantly lesser in surface area by 17.6%, and significantly greater in surface area to volume ratio by 14.6% than the non-cleft ala. The cleft-side ala was significantly greater by 43.1% horizontal axis to the midsagittal plane. In patients with primary rhinoplasty, the cleft-side ala had 28.0% less volume and 18.7% less surface area. In intermediate rhinoplasty, the cleft-side ala had 39.1% less volume and 23.5% less surface area than the non-cleft ala. Conclusions: Significant asymmetry exists between the cleft-side and non-cleft ala in patients with UCL. The cleft-side ala is significantly smaller in volume and surface area than the non-cleft ala. Additionally, the cleft-side ala demonstrates a significantly greater horizontal axis that contributes considerably to nasal asymmetry, supporting the need to restore a normal vertical axis to the clef-side ala. [ABSTRACT FROM AUTHOR]

The emergency of esophageal button batteries is recognized. Foreign bodies in the ear or nose are treated as comparatively nonemergent. We present the case of a child who presented with suspected pen-nib in the nostril to highlight the importance of investigation and intervention in unwitnessed nasal foreign body and review the literature regarding X-rays in these cases. Fifteen papers were identified as per search parameters; 3 papers recommend the use of plain radiographs for nasal foreign bodies. We propose that in unwitnessed pediatric nasal foreign body insertion, a facial X-ray should be considered, especially if suspecting a metallic foreign body. [ABSTRACT FROM AUTHOR]

We describe a case of nasal non-Hodgkin's lymphoma in a 79-year-old Chinese patient accompany with nasal myiasis. The first 2 biopsies in this case were false negative. Subsequently, nasal maggots developed in this patient. After removing all maggots under nasal endoscopy, the patient continued to have recurrent fever and was transferred to a higher hospital for further treatment, in which he received a third biopsy. Unfortunately, several hours after the biopsy, the patient died for severe nasal bleeding. The final biopsy result indicated the neoplasm of the left nasal cavity was non-Hodgkin's lymphoma. This case illustrates the importance of repeated biopsies for nasal non-Hodgkin's lymphoma if necessary. Nasal myiasis is a secondary disease of nasal non-Hodgkin's lymphoma in this case. [ABSTRACT FROM AUTHOR]

Objective: Nasal airway obstruction affects up to one-third of Americans and is one of the most common complaints by patients to otolaryngologists. Nasal airway obstruction and obstructive sleep apnea syndrome (OSAS) are closely related. The aim of this study was to use the 3D imaging software, ITK-SNAP as a platform to define a gold standard for anatomically accurate boundaries of the nasal airway in 3D CBCT and to create a more reliable and precise 3D CBCT segmentation of the nasal airway for assisting diagnosis, treatment, and monitoring of nasal airway obstruction and OSAS. Method and materials: After review of the literature to identify established parameters using CBCT and CT technology for the segmentation of the nasal airway, and the existing drawbacks, a gold standard for locating the anatomical boundaries of the nasal airway using CBCT is proposed. This new method aims at standardization of segmentation and quantification, allowing for more reliable comparison between studies. ITK-SNAP software was used to segment three CBCT samples of healthy patients aged 21 to 59 years, who were patients of record, with CBCT obtained for either orthodontic, endodontic, or prosthodontic treatment planning purposes. Results: The literature search identified 11 studies describing nasal airway parameters utilizing CBCT and CT. A great variation was detected on where the anatomical boundaries for the nasal airway were selected. A new standard in the identification of anatomical boundaries of the nasal airway is proposed for consistent segmentation and quantification using 3D CBCT by using the following landmarks: the inferior ANS-PNS border, the anterior nares border, the posterior sella-PNS border, and superiorly the border in alignment with the base of the skull (excluding the ostia, frontal, ethmoidal, and sphenoidal air cells). The three segmented samples were volumetrically measured, and statistically analyzed. The mean average Hounsfield unit intensity using the CBCT samples in this study was 629 with a standard deviation of 190. Conclusion: The literature indicates a lack of a gold standard using CBCT technology for the segmentation of the nasal airway. With the proposed standard in this study, it is possible to quantify the nasal airway volume and thereby its reduction. For the general dental practitioner, this is an important aspect during the evaluation of overall airway assessment. This information can be useful in the diagnosis and treatment of airway compromised dental patients. [ABSTRACT FROM AUTHOR]

Purpose Our aim was to assess the sinonasal magnetic resonance imaging (MRI) features of acute invasive fungal rhinosinusitis (AIFRS) in coronavirus disease (COVID)-associated mucormycosis (CAM) and to correlate these with histopathology and patient outcome in terms of duration of hospital stay and survival at 10 weeks. Methods Twenty patients with histopathologically confirmed sinonasal CAM underwent MRI (including postcontrast T1-weighted and diffusion-weighted imaging). Histopathological findings (presence of coagulative necrosis, granulomatous reaction, and fungal burden) were recorded and all patients were followed up at 6 and 10 weeks. Statistical analysis was done using chi-square test and Fischer's exact test. Results Enhancement patterns seen in our subjects included homogeneous, heterogeneous, and lack of contrast enhancement (LOC), with LOC being the most common (65%). Diffusion restriction was found in 90% patients. Statistically significant correlation was found between LOC pattern and presence of coagulative necrosis (p -value = 0.007), extent of fungal hyphae (p -value = 0.047), and duration of hospital stay (p -value = 0.004). Restricted diffusion was also seen to correlate with a high fungal load (p -value = 0.007). Conclusion Our study describes the MRI findings of AIFRS in CAM and highlights the imaging features which may be surrogate markers for coagulative necrosis and fungal burden. [ABSTRACT FROM AUTHOR]

Purpose: The neurotropism of SARS-CoV-2 and the consequential damage to the olfactory system have been proposed as one of the possible underlying causes of olfactory dysfunction in COVID-19. We aimed to aggregate the results of the studies which reported imaging of the olfactory system of patients with COVID-19 versus controls. Methods: PubMed and EMBASE were searched to identify relevant literature reporting the structural imaging characteristics of the olfactory bulb (OB), olfactory cleft, olfactory sulcus (OS), or olfactory tract in COVID-19 patients. Hedge's g and weighted mean difference were used as a measure of effect size. Quality assessment, subgroup analyses, meta-regression, and sensitivity analysis were also conducted. Results: Ten studies were included in the qualitative synthesis, out of which seven studies with 183 cases with COVID-19 and 308 controls without COVID-19 were enrolled in the quantitative synthesis. No significant differences were detected in analyses of right OB volume and left OB volume. Likewise, right OS depth and left OS depth were also not significantly different in COVID-19 cases compared to non-COVID-19 controls. Also, we performed subgroup analysis, meta-regression, and sensitivity analysis to investigate the potential effect of confounding moderators. Conclusion: The findings of this review did not confirm alterations in structural imaging of the olfactory system, including OB volume and OS depth by Covid-19 which is consistent with the results of recent histopathological evaluations. [ABSTRACT FROM AUTHOR]

Objective: Pneumatization of paranasal sinuses varies greatly between patients, and certain pneumatization variants have been associated with specific clinical conditions. The present research aimed to evaluate the presence of coexistence smaller maxillary and frontal sinus volume and narrow internal nasal valve angle and whether this association is significant. Methods: Sixty patients aged above 18 years old who underwent surgery for caudal septal deviation at the ear nose throat department of a tertiary care hospital between 2018 and 2021 were included in this retrospective cross-sectional study. The internal nasal valve angle was measured from reformatted coronal computed tomography scans. The maxillary sinus volume and frontal sinus volume were calculated using a workstation. The maxillary sinus and frontal sinus volumes were classified as narrow side and wide side according to the internal nasal valve angle measurements. The narrow- and wide-side maxillary sinus and frontal sinus volumes were compared within each other. Results: There was a statistically significant difference between the maxillary sinus volumes of the narrow internal nasal valve angle side and wide internal nasal valve angle side (mean ± SD: 14.47 ± 5.45 and 15.21 ± 5.31 mL, respectively, P = .014). There was a statistically significant difference between the frontal sinus volumes of the narrow internal nasal valve angle side and wide internal nasal valve angle side (median: 2.85 and 3.08 mL, respectively, P < .001). Conclusion: The maxillary sinus and frontal sinus volumes ipsilateral to the narrow internal nasal valve angle sides were significantly decreased. This coexistence may be significant. Further studies are needed to explain the significance of this association. [ABSTRACT FROM AUTHOR]

Introduction: Fishing can be problematic for the novice fisherman when the fishing hook sinks into the fisherman's body. The hook can often not be removed easily because of its specific structure. Case report: A 12-year-old boy had a fishing hook sunk into his nose after it was thrown towards his face; it inserted into the septum and right lower lateral cartilage of the nose due to inexperience in handling it by the victim. Discussion: The hook was extracted through the 'push through and cut off' method with no damage caused to the lower lateral cartilage, septum and the nasal skin. Deep insertion of the hook in the sensitive areas such cartilage of the nose can cause an irreversible complication if erroneously manipulated. Conclusion: This is the first report of technique of removed fishing hook with extra teeth from the nasal cartilage. Surgeon knowledge about the hook type and techniques of hook removal can help successful removal from the body without irreversible complication. [ABSTRACT FROM AUTHOR]

Objective: The study addresses whether the growth of the nasal dorsum is disturbed by cleft treatments, for cleft lip only (CL) and cleft lip with cleft palate (CLP). Design: A total of 576 patients with cleft (278 CL, 298 CLP) and 333 individuals without orofacial clefts were retrospectively enrolled. Cleft lip only group was treated with a modified Millard technique combined with Tajima incision for rhinoplasty at 3 to 6 months. The CLP group underwent the same lip repair technique and then underwent a Sommerlad palatoplasty at 9 to 12 months. Lateral cephalometric radiographs of all individuals were taken to evaluate the nasal length and nasal dorsum height. Dunn test was used to analyze the difference (P <.001). Results: Compared with control, in CL, nasal bone angle and nasal dorsum angle increase by age similarly (5-18 years, P >.05); the total dorsum is significantly shorter (5-18 years, P <.001), while the upper nasal dorsum length is similar (except in 5-6 years), and the lower nasal dorsum is shorter (5-18 years, P <.001). In CLP, nasal bone angle develops insufficiently as children grow (8-18 years, P <.001); the nasal dorsum angle is notably smaller (5-18 years, P <.001); nasal bone length is not significantly different except 11 to 13 years (P <.05); nasal dorsal length is similar at skeletal maturity (17-18 years, P >.05), although it is shorter during 8 to 16 years (P <.05); the upper nasal dorsum is overdeveloped (14-18 years, P <.05), whereas the lower nasal dorsum is underdeveloped (5-18 years, P <.001). Conclusion: Treatments in both CL and CLP could be the important factors in disturbing the growth of cartilaginous portion of the nasal dorsum (including nasal tip) and the nasal dorsum height. [ABSTRACT FROM AUTHOR]

Third-party payers request objective confirmation of the nasal septum deviation (NSD) severity by computed tomography (CT) before authorizing financial support for septoplasty. Previous studies have provided contradictory results related to the link between obstruction severity and CT-measured angle of the NSD. The aim of this study was to investigate whether the diverse CT morphology of NSDs (including previously neglected types and shapes) could predict obstruction severity. The study included 225 patients with NSD. The CT morphology of the septum was analyzed using 5 different classifications of NSD that are commonly used in the clinical practice and research. The angle of NSD was also measured. Nasal obstruction was assessed by the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. A relationship between CT morphology and the angle of the NSD and NOSE scores was analyzed using appropriate regression models. Patients with NSDs located in the anterior part of the septum always have some degree of nasal obstruction, while those with posterior NSDs did not necessarily report obstruction symptoms no matter how complicated NSD they have. Regression analysis did not reveal any causal relationship between NOSE scores and CT morphology and the angle of NSD. The presence of spurs and whether they divide nasal passages have no statistically significant predictive effect on the obstruction severity. The CT morphology and the angle of the NSD could not predict severity of the nasal obstruction. Requesting CT examination just to objectively confirm nasal obstruction is not justified. [ABSTRACT FROM AUTHOR]

Aim: Our objective is comparing the physical examination and radiological imaging (lateral nasal x-ray and computed tomography (CT)) methods for diagnosis in patients admitted to the emergency department due to nasal trauma and referring them to the department of otolaryngology. Material and Methods: We retrospectively analyzed the physical examination and radiological imaging (lateral nasal radiography, paranasal CT) of 64 patients who were admitted to our hospital emergency department between October 2016 and October 2018 due to isolated nasal trauma and consulted to the department of otolaryngology and head and neck surgery. Results: Of the 64 patients who participated in the study, 51 were male and 13 were female. While nasal fracture was detected in 56 patients, nasal fracture was not observed in 8 patients. As a result of our study, the rate of detecting nasal fracture only by physical examination was 41%, 73.2% by lateral nasal radiography, and 85.7% by physical examination and lateral nasal radiography. With paranasal CT, nasal fracture was diagnosed in all patients. Paranasal CT was found to be statistically significantly more successful in detecting nasal fracture compared to physical examination and direct nasal radiograph findings (p = 0.002). Conclusion: As a result; physical examination and lateral nasal radiography provide useful information for diagnosis, but paranasal CT was the best diagnostic method in the diagnosis of nasal fracture. [ABSTRACT FROM AUTHOR]

Basal cell adenoma is a benign basaloid cell tumor involving salivary glands. It requires biopsy and histopathology to distinguish from pleomorphic adenoma, adenoid cystic carcinoma and basal cell adenocarcinoma. Present manuscript reports a case of an adult female with nasal mass, which was clinically and cytologically mimicking benign lesion and adenoid cystic carcinoma was confirmed only on surgical biopsy. The possible clinical dilemma between Basal cell adenoma and Adenoid cystic carcinoma is discussed in this case report. [ABSTRACT FROM AUTHOR]

Background: The functional significance of the posterior segment of the septum is not fully understood. Aims/Objectives: The purpose of this study was to evaluate the impact of posterior septum resection with varying extents on nasal airflow pattern and warming function, and to determine the appropriate resection extent on posterior septum without disturbing airflow pattern. Material and Methods: Three dimensional models were established from the nasal CT scan of a healthy female volunteer without nasal disease. The models included the normal, as well as 1 cm, 2 cm, and 3 cm extent of posterior septum resection by virtual surgery. Using computational fluid dynamics, the airflow characteristics such as average and peak airflow velocity, average wall shear stress, average temperature and turbulence kinetic energy were recorded and compared among the four models. Results: By comparison with the normal model, the virtual surgeries with varying extents of posterior septum resection (1 cm, 2 cm, and 3 cm), demonstrated little alteration on indices of the average and peak airflow velocity, average wall shear stress, airflow temperature and turbulence kinetic energy. However, a statistical difference of the abovementioned indices existed when compared between varying planes of the nasal cavity (p < .001), although this did not appear to be significantly influenced by the degree of posterior septectomy. Conclusions and significance: From an aerodynamics perspective, little disturbance on airflow pattern and warming function of nasal cavity could be detected with increasing resection of posterior septum (up to 3 cm). These results may imply that resection of the posterior septum (up to 3 cm) has little impact on nasal function. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the feasibility, effectiveness, and safety of computed tomography–assisted auricular cartilage grafting for treating alar base depression secondary to unilateral cleft lip. Design and Setting: For patients with obvious depression of the alar base, the difference in heights of the alar base and the piriform margin between the cleft side and the noncleft side were measured with computed tomography. If both were >3.0 mm, the cartilage was harvested postauricularly and subdivided into 2 to 4 pieces. A multiple layer graft was inserted under the depressed alar base. The procedure was performed from 2006 to 2013, and the follow-up period was 3 to 15 months. Participants: Chinese patients with alar base depression secondary to unilateral cleft lip were selected. Intervention: Suture and cartilage graft techniques. Main Outcomes Measures: Differences in bilateral alar base heights and piriform apertures. Results: There was no wound dehiscence, exposure of bone, or donor site morbidity. The difference in heights in the bilateral alar bases and piriform apertures decreased. There were no obvious scars in any of the cases. Conclusions: This technique has several advantages including ease of operation, minimal trauma, satisfactory outcomes, and useful references for operation provided by computed tomography. It is a superior alternative for reconstruction of secondary alar depression. [ABSTRACT FROM AUTHOR]

Objectives: The relative importance of the nasal valve relative to the remainder of the nasal airway remains unknown. The goal of this article was to objectively measure the shape of the nasal inlet and its effect on downstream airflow and nasal cavity volume using a physical model and a physiologic flow model. Methods: A patient who had isolated nasal valve surgery and had pre- and postoperative computed tomography scans available for analysis was studied. Nasal inlet shape measurements, computational fluid dynamics, and nasal volume analysis were performed using the computed tomography data. In addition, a physical model was used to determine the effect of nasal obstruction on downstream soft tissue. Results: The postoperative shape of the nasal inlet was improved in terms of length and degree of tortuosity. Whereas the operated-on region at the nasal inlet showed an only 25% increase in cross-sectional area postoperatively, downstream nonoperated sites in the nasal cavity revealed increases in area ranging from 33% to 51%. Computational fluid dynamics analysis showed that airway resistance decreased by 42%, and pressure drop was reduced by 43%. Intraluminal mucosal expansion was found with nasal obstruction in the physical model. Conclusion: By decreasing the degree of bending and length at the nasal valve, inspiratory downstream nonoperated sites of the nasal cavity showed improvement in volume and airflow, suggesting that the nasal valve could play an oversized role in modulating the aerodynamics of the airway. This was confirmed with the physical model of nasal obstruction on downstream mucosa. [ABSTRACT FROM AUTHOR]

Objectives: To compare 3-dimensional nasal symmetry in patients with UCLP who had either rotation advancement alone or nasoalveolar molding (NAM) followed by rotation advancement in conjunction with primary nasal repair. Design: Pilot retrospective cohort study. Materials and Methods: Nasal casts of 23 patients with UCLP from 2 institutions were analyzed; 12 in the rotation advancement only group (Iowa) and 11 in the NAM, rotation advancement with primary nasal repair group (New York). Casts from patients aged 6 to 18 years were scanned using the 3Shape scanner and 3-dimensional analysis of nasal symmetry performed using 3dMD Vultus software, Version 2507, 3dMD, Atlanta, GA. Cleft and noncleft side columellar height, nasal dome height, alar base width, and nasal projection were linearly measured. Inter- and intragroup analyses were performed using t tests and paired t tests as appropriate. Results: A statistically significant difference in mean-scaled 3-dimensional asymmetry index was found between groups with group 1 having a larger measure of asymmetry (4.69 cm3) than group 2 (2.56 cm3; P = .02). Intergroup analysis performed on the most sensitive linear measure, alar base width, revealed significantly less asymmetry on average in group 2 than in group 1 (P = .013). Conclusion: This study suggests the NAM followed by rotation advancement in conjunction with primary nasal repair approach may result in less nasal asymmetry compared to rotation advancement alone. [ABSTRACT FROM AUTHOR]

Craniosynostosis is caused by premature fusion of one or more cranial sutures, restricting skull, brain and face growth. Nonsyndromic craniosynostosis could disturb the proportions of face. Although morphometric diameters of nasal cavity in healthy children are already known, they have not been established yet in children with nonsyndromic craniosynostosis. The aim our study was to check whether diameters of bone structures of nasal cavity in children with nonsyndromic craniosynostosis measured in CT are within normal range. 249 children aged 0–36 months (96 with clinical diagnosis of nonsyndromic craniosynostosis and 153 in control group) were included into the study. The following diameters were measured on head CT scans: anterior bony width (ABW), bony choanal aperture width (BCAW), right and left posterior bony width (between bone sidewall and nasal cavity septum—RPBW and LPBW). The study group has been divided into 4 categories, depending on child’s age. The dimensions measured between bone structures of nasal cavity were statistically significantly lower in comparison to the control group. They did not depend on the sex for ABW, nor on age in groups 7–12 months and < 2 years for BCAW, RPBW and LPBW. The measured dimensions increased with age. In children with nonsyndromic craniosynostosis the diameter of pyriform aperture and bony choanal aperture were lower than in controls, what may be described as fronto-orbital anomalies. Morphometric measurements of anthropometric indicators on CT scans could be used as standards in the clinical identification of craniosynostosis type and may help in planning surgical procedures, particularly in the facial skeleton in children. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the reproducibility of a standardized image for personal identification (SIPI), used in the comparative analysis of paranasal sinuses, and test the effect of inaccurate reformation of the SIPI on suitability for comparative identification. Five raters with different professional backgrounds independently reformatted SIPIs from ten post-mortem head CTs. Inter-rater, intra-rater agreement as well angular deviations between reformatted SIPI images and reference SIPI images were calculated. Second, raters assessed the suitability of 70 accurately and inaccurately reformatted SIPIs for identification with a 4-point Likert scale. Inter-rater agreement as well as levels of significance regarding image suitability were calculated. Inter-rater agreement regarding reproducibility of SIPI reformation was excellent (inter-rater correlation coefficient (ICC) 0.9995, intra-rater ICC 0.9983). Deviation between the angular dimensions of the reformatted SIPIs and the reference SIPIs was ≤1° in 94% of all 300 measurements. Inter-rater agreement regarding the effect of inaccurate SIPI reformation on suitability for comparative identification was fair (ICC 0.6809). There was no statistically significant difference between raters' evaluation of image suitability (p=0.9755). This study shows that the standardized image for personal identification can be accurately reformatted by different raters with varying professional backgrounds. In addition, raters agree that inaccurately reformatted SIPIs are still suitable for comparative identification in the majority of cases. [ABSTRACT FROM AUTHOR]

Endoscopic surgery is performed on patients with chronic inflammatory disease of the paranasal sinuses to improve sinus ventilation. Little is known about how sinus surgery affects sinonasal airflow. In this study nasal passage geometry was reconstructed from computed tomographic imaging from healthy normal, pre-operative, and post-operative subjects. Transient air flow through the nasal passage during calm breathing was simulated. Subject-specific differences in ventilation of the nasal passage were observed. Velocity magnitude at ostium was different between left and right airway. In FESS, airflow in post-surgical subjects, airflow at the maxillary sinus ostium was upto ten times higher during inspiration. In a Lothrop procedure, airflow at the frontal sinus ostium can be upto four times higher during inspiration. In both post-operative subjects, airflow at ostium was not quasi-steady. The subject-specific effect (of surgery) on sinonasal interaction evaluated through airflow simulations may have important consequences for pre- and post-surgical assessment and surgical planning, and design for improvement of the delivery efficiency of nasal therapeutics. [ABSTRACT FROM AUTHOR]

A prospective single blinded interventional study was held in Otorhinolaryngology Clinic, Universiti Kebangsaan Malaysia Medical Centre in August 2010 until November 2012 to evaluate the functional outcome of septorhinoplasty objectively and subjectively. Objective assessment was done using rhinomanometry and subjective assessment using Nasal Obstruction Symptoms Evaluation (NOSE) scale and Health-Related Quality of Life Questionnaires (HRQOL) in Rhino Surgery. All measurements were taken preoperatively and 3 months postoperatively. A total of 29 patients were enrolled and completed the study. Septorhinoplasty was commonly performed in Malays and Indians and rare amongst Chinese, with age ranged from 18 to 54 years. Majority had no history of trauma. Twisted nose was the most common external nose abnormality followed by crooked and saddle nose. All patients had internal valve insufficiency. There were significant improvement of the total and of all the parameters in the NOSE scale post septorhinoplasty ( p < 0.05). Furthermore, there were significant improvement in total and in all parameters in HRQOL score post septorhinoplasty ( p < 0.05). There were improvements in the rhinomanometry data bilaterally during inspiration and expiration, but were not statistically significant ( p > 0.05). Significant correlations were noted in the improvement between the two subjective assessments (NOSE scale and HRQOL score). However, there was no significant correlation in the improvement between the subjective (NOSE scale and HRQOL score) with objective (rhinomanometry score) assessments. Septorhinoplasty improves the nasal airflow and quality of life of patients with nasal obstruction. [ABSTRACT FROM AUTHOR]

During septorhinoplasty, septal cartilage is frequently resected for various purposes but the L-strut is preserved. Numerous materials are inserted into the nasal dorsum during dorsal augmenation rhinoplasty without considering nasal structural safety. This study used a finite element method (FEM) to redefine the septal L-strut, to prevent collapse as pressure moved from the rhinion to the supratip breakpoint on the nasal dorsum and as the contact percentage between the caudal L-strut and the maxillary crest changed. We designed a 1-cm-wide L-strut model based on computed tomography data. At least 45% of the width of the L-strut in the inferior portion of the caudal strut must be preserved during septoplasty to stabilize the septum. In augmentation rhinoplasty, the caudal L-strut must either be preserved perfectly or reinforced to prevent collapse or distortion of the L-strut. The dorsal augmentation material must be fixed in an augmentation pocket to prevent movement of graft material toward the supratip breakpoint, which can disrupt the L-strut. We conducted a numerical analysis using a FEM to predict tissue/organ behavior and to help clinicians understand the reasons for target tissue/organ collapse and deformation. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Anatomic variation can potentially impact the surgical safety. Purpose: The purpose of this cross-sectional study was to assess the prevalence of ostiomeatal complex variations based on cone beam computed tomography (CBCT) images of the patients seeking rhinoplasty. Materials and Method: In this cross-sectional study, CBCT images of 281 patients including 153 female and 128 male with Mean±SD age of 26.97±7.38 were retrieved and analyzed for presence of variations of ostiomeatal complex and mucosal thickening. All CBCT images were acquired by NewTom VGi scanner with 15×15 field of view, as a part of preoperative recording of patients seeking rhinoplasty in an otolaryngology clinic. Chi- square test and Odds ratio were used for statistical analysis of the obtained data and p< 0.05 was considered to be statistically significant. Results: Agger nasi cells which were seen in 93.2% of the cases were the most common anatomic variation. It was followed by Haller cells (68%), concha bullosa (67.3%), uncinate process variations (54.8%), nasal sepal deviation (49.5%) and paradoxical curvature of middle turbinate (10%). Mucosal thickening were detected in 60.7% of the studied cases. Conclusion: Ostiomeatal complex variations and mucosal thickening are considerably prevalent among the patients seeking rhinoplasty. This study also revealed that CBCT evaluation of paranasal sinuses has comparable result in delineation of the sinonasal anatomy. [ABSTRACT FROM AUTHOR]

Background: Salivary and lacrimal side effects of radioiodine therapy have been carefully described. However, nasal side effects are rarely described. The objective of this study was to document the frequency of nasal side effects in comparison to the already well-documented lacrimal side effects and to determine contributing risk factors. Methods: A retrospective review of the medical records of 807 patients with differentiated thyroid cancer who received care at an academic medical center was conducted. Four hundred eleven patients who received treatment with radioactive iodine (RAI) were identified and included in the analysis. The frequency of both nasal and lacrimal side effects was ascertained. Factors that may have contributed to patients sustaining nasal damage after RAI therapy were also documented. These factors included radioactive iodine dose, method of preparation for receiving RAI therapy, and patient characteristics. Results: The mean dose of RAI administered was 109 mCi. Forty-three patients (10.5%) and 40 patients (9.7%) developed nasal and lacrimal side effects, respectively, following RAI treatment. The mean time of onset of nasal symptoms was 11 days, compared with 10 months for lacrimal symptoms. Radioiodine dose and body mass index were significantly positively and negatively correlated, respectively, with sustaining nasal side effects ( p values of 0.04 and 0.01, respectively). Similarly, both RAI dose and body mass index were significantly correlated, positively and negatively, respectively, with sustaining lacrimal side effects ( p values of 0.02 and 0.01). Preparation for treatment using a withdrawal protocol was associated with increased risk of both nasal and lacrimal side effects, compared with a recombinant human thyrotropin (rhTSH) protocol ( p values of <0.01 and 0.01). The odds ratios (95% confidence interval [CI]) for nasal and lacrimal side effects with recombinant rhTSH preparation were 0.22 [0.11-0.44] and 0.37 [0.18-0.76], respectively. Instructions to maintain adequate hydration and development of lacrimal symptoms were only associated with nasal symptoms in unadjusted analyses. Conclusions: Both nasal and lacrimal dysfunction occurred at an approximately 10% frequency. Although it cannot be determined whether acute nasal side effects are followed by long-term ramifications, these consequences of RAI could potentially add to the reasons to carefully evaluate the benefits and risks of RAI therapy on an individual basis. [ABSTRACT FROM AUTHOR]

Aim: Nasal bone is the most common broken bone of the face. Incorrect assessments of nasal trauma are frequently encountered in forensic evaluations. Here, we aimed to determine the reasons and frequency of erroneous assessments of nasal trauma in emergency department (ED). Methods: This is a cross-sectional multicentric study analyzing the Forensic Medical Department archive retrospectively. Epidemiologic features, type of fracture (depressed or non-depressed), and specialty of the doctor examining the cases in ED were studied. Forensic evaluation was reported by analyzing all radiologic examinations (CT and X-ray), medical records, and after repeated physical examination of nasal trauma by the forensic council, consisting of a forensic expert, a radiologist and an otolaryngologist. Nasal fracture was diagnosed when at least two of three physicians agreed. Results: A total of 535 cases (mean age 31.7 ± 14.4, 87.1 % males) were analyzed. The most common causes of injuries were assault (81.8 %), followed by traffic accident (15.3 %) and falls from a height (2.1 %). There were misdiagnoses in ten patients (1.9 %) and overdiagnosis in 135 (24.5 %). The possibility of fracture overdiagnosis was 13.5 times higher than missing it. General practitioners and emergency physicians have 19.7 times (95 % CI 5.5-22. 3) and 3.4 times (95 % CI 1.5-7.8) the tendency to report soft tissue nasal injuries as non-depressed fractures, respectively. Conclusion: We found that nasal fractures are rarely missed while the overdiagnosis was very common. Examination of patients by a general practitioner or an emergency physician without consultation with a specialist and using only plain radiographs were found to be independent parameters affecting overdiagnosis. [ABSTRACT FROM AUTHOR]

The article presents a case of a 60-year-old female due to slow, progressive right nasal obstruction for five months to discuss concomitant antrochoanal polyp and fungus ball in the unilateral maxillary sinus. Based on computed tomography, a soft-tissue density with calcifications in the right maxillary sinus and large mass occupying her right middle meatus was detected. She underwent right endoscopic sinus surgery (ESS).

Concha bullosa is an aerated turbinate in the nose. It is a common anatomic variant that can develop a mucocele if obstructed, which can further progress to become a mucopyocele if infected. A mucopyocele can expand and cause destruction of neighboring tissues. A review of the literature revealed only 10 cases previously reported. We describe 2 cases of mucocele and 2 cases of mucopyocele. [ABSTRACT FROM AUTHOR]

Nasolabial cysts are painless, submucosal, non-odontogenic jaw cysts presenting as soft tissue swellings in the maxillary anterior mucolabial fold lateral to midline, leading to elevation of nasal ala. Present case documents bilateral nasolabial cysts in a 69-year-old Asian female patient. In the present case, extraoral swelling of maxillary lip and elevation of nasal ala was observed on right side of the face. Intraorally, soft and fluctuant bilateral cysts were observed. Straw-colored fluid was aspirated from the right cyst. Radiographically, erosion of bone in a "cupping" fashion was observed in the region of left cyst. The cysts were enucleated using intraoral approach. Histopathology of the right-sided cyst revealed a cystic cavity lined by stratified squamous cells along with a few mucosal cells. At few places, stratified squamous and pseudostratified columnar epithelia with many cilia and goblet cells were also evident. Capsule was loosely arranged with fibrous tissue and chronic inflammatory infiltrate. Left-sided cystic specimen showed two or more layered stratified squamous lining epithelium with thin capsule. Diagnosis of bilateral nasolabial/nasoalveolar cysts was confirmed. [ABSTRACT FROM AUTHOR]

Nasal obstruction is one of the most distressing symptom of nasal and sinus disease. The nasal obstruction may be unilateral or bilateral or is intermittent ,progressive or persistent. The routine anterior and posterior rhinoscopy gives very little information as we can see the structure which lie directly in the line of sight and moreover the posterior rhinoscopy may not be possible in some cases. As a result , the early diagnosis of some unpleasant lesions remained elusive without nasal endoscopy. In addition, the diagnostic nasal endoscopy helps us in precise photo documentation of pre- and post treatment finding, which is unsurpassed or teaching .This study, thus, strongly recommend thorough endoscopic examination of nose and postnasal space especially when anterior and posterior rhinoscopy fail to reveal the cause of nasal obstruction. [ABSTRACT FROM AUTHOR]

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Conclusions: Despite being a single surgical channel this approach provides enough room and maneuverability for microscopic and endoscopic surgery of sellar lesions and the total septal preservation technique allows future reconstructions using the posterior nasoseptal flap. Objectives: To demonstrate the importance and feasibility of total nasal septum and anterior sphenoid preservation in transseptal approaches to the sella. Methods: Retrospective evaluation of 15 transseptal approaches for sellar lesions with or without suprasellar extensions operated under general anesthesia with a total septal preservation technique. Results: In all patients operated by this method a complete microscopic and endoscopic tumor removal was possible and an uneventful recovery was observed. Nasal congestion was mild and no episode of nasal bleeding, cerebrospinal leaks, visual loss, diabetes insipidus or death was observed. Breathing was considered normal or improved in all patients after removal of splints; this subjective sensation was confirmed at 1 month and 6 months follow-up visits. No external nose deformities or septal deviations were observed; nasal endoscopy demonstrated a preserved septum and anterior sphenoid wall anatomy on both sides of the nose at 1 month and 6 months follow-up visits. CT scans taken at 6 months after the procedure confirmed these clinical findings. [ABSTRACT FROM AUTHOR]

This prospective controlled study ascertained the contribution of flexible endoscopy (FE) for diagnosis of acute bacterial rhinosinusitis (ABRS) in a group of consecutive adult patients who had symptoms suggestive of ABRS and in whom sinus radiography (SRG) and FE were accomplished. We adopted for analysis the 2007 updated European guidelines on rhinosinusitis and computed the sensitivity and specificity of FE against SRG. Positive diagnosis was entertained when FE showed purulent material within sinus drainage area and/or SRG demonstrated air-fluid level, complete opacification, or at least 6 mm mucosal thickening. Of a total of 179 patients initially included in this study, 104 had clinical criteria compatible with guidelines for ABRS. Of them, 43 (41.3%) had positive FE and SRG, 17 (16.3%) had positive FE and negative SRG, and vice versa in 9 (8.7%); both modalities were negative in 35 (33.7%). FE yielded sensitivity of 82.7 ± 5.24% (95% CI: 72.41-92.97%) and specificity of 67.3 ± 6.50% (95% CI: 54.56-80.06%). Age, gender, symptom duration, pre-referral antibiotics, and treatment by primary/secondary physician were not associated with positive or negative diagnosis of ABRS. Of 75 patients who were excluded from the analysis, 33 (44%) had positive diagnosis of ABRS established by FE and/or SRG. The finding that clinical criteria had moderate predictive value (66.3%) highlights the need for objective measures for diagnosis of ABRS. In absence of feasible gold standard and considering that guidelines do not recommend SRG for routine diagnosis, FE serves as an indispensable ancillary tool for establishing ABRS. [ABSTRACT FROM AUTHOR]

The aim of the present investigation is to evaluate the effect of rapid maxillary expansion (RME) on the respiratory pattern. A clinical case is presented to describe how patients with atresic maxilla and respiratory problems can benefit from rapid maxillary expansion. The article highlights that the health professional, mainly the Orthodontist and the Otorhinolaryngologist, may use complementary exams to diagnose a mouth breather patient. [ABSTRACT FROM AUTHOR]

Abstract: Examining visual word recognition memory (WRM) with nose-referenced EEGs, we reported a preserved ERP ‘old-new effect’ (enhanced parietal positivity 300–800 ms to correctly-recognized repeated items) in schizophrenia ([Kayser, J., Bruder, G.E., Friedman, D., Tenke, C.E., Amador, X.F., Clark, S.C., Malaspina, D., Gorman, J.M., 1999. Brain event-related potentials (ERPs) in schizophrenia during a word recognition memory task. Int. J. Psychophysiol. 34(3), 249–265.]). However, patients showed reduced early negative potentials (N1, N2) and poorer WRM. Because group differences in neuronal generator patterns (i.e., sink-source orientation) may be masked by choice of EEG recording reference, the current study combined surface Laplacians and principal components analysis (PCA) to clarify ERP component topography and polarity and to disentangle stimulus- and response-related contributions. To investigate the impact of stimulus modality, 31-channel ERPs were recorded from 20 schizophrenic patients (15 male) and 20 age-, gender-, and handedness-matched healthy adults during parallel visual and auditory continuous WRM tasks. Stimulus- and response-locked reference-free current source densities (spherical splines) were submitted to unrestricted Varimax-PCA to identify and measure neuronal generator patterns underlying ERPs. Poorer (78.2±18.7% vs. 87.8±11.3% correct) and slower (958±226 vs. 773±206 ms) performance in patients was accompanied by reduced stimulus-related left-parietal P3 sources (150 ms pre-response) and vertex N2 sinks (both overall and old/new effects) but modality-specific N1 sinks were not significantly reduced. A distinct mid-frontal sink 50-ms post-response was markedly attenuated in patients. Reductions were more robust for auditory stimuli. However, patients showed increased lateral-frontotemporal sinks (T7 maximum) concurrent with auditory P3 sources. Electrophysiologic correlates of WRM deficits in schizophrenia suggest functional impairments of posterior cortex (stimulus representation) and anterior cingulate (stimulus categorization, response monitoring), primarily affecting memory for spoken words. [Copyright &y& Elsevier]

Abstract: Objective: To evaluate the presenting symptoms, imaging data, surgical treatment, and clinical outcomes associated with isolated sphenoid sinus disease. Patients and Methods: From July 2003 to February 2008, the authors performed surgery on 11 patients with isolated sphenoid sinus diseases. The presenting signs and symptoms, radiological studies, operative findings, and clinical outcomes were retrospectively reviewed and analyzed. Results: Five patients presented with a fungal process, three with sphenoid sinusitis, one with mucocele, one with an angiofibroma, and one with fibrous dysplasia. The most common presenting symptom was headache, followed by rhinorrhea and visual symptoms. Ten patients were treated endoscopically and one patient was treated with an external approach. Conclusion: Because of the proximity of the sphenoid sinus to important and vulnerable structures of the skull base, delay in diagnosis and treatment can lead to the development of serious intracranial and orbital complications. The presenting symptoms of patients with an isolated sphenoid sinus lesion are often vague and nonspecific, with headache being the only reliable finding. Endoscopic sinus surgery is a safe, effective, and direct approach to the sphenoid sinus. [Copyright &y& Elsevier]

Conclusions: In order to confirm these preliminary results, a prospective double-blind study has been instituted in Padova University ENT Section to compare the efficacy of sulphurous-arsenical-ferruginous thermal water nasal irrigations vs isotonic sodium chloride solution nasal irrigations after functional endoscopic sinus surgery for chronic sinusitis. Objectives: Despite their widespread use, much uncertainty exists about the indications and therapeutic mechanisms of nasal thermal water inhalations in the treatment of sinonasal chronic disease. The aim of the present study was to evaluate the effects of sulphurous-arsenical-ferruginous thermal water inhalations on nasal respiratory flow, mucociliary transport, nasal cytology, and chemo-physics of nasal mucus in a group of consecutive patients with chronic sinonasal disease. Patients and methods: Thirty-seven patients with chronic sinonasal disease underwent a 12-day course of sulphurous-arsenical-ferruginous thermal water warm vapour inhalations (38°C) followed by nasal aerosol of the same thermal water (7 microns micelle). Results: This preliminary study showed that a course of sulphurous-arsenical-ferruginous thermal water inhalations determined a significant improvement in nasal flow and reduction of nasal resistance; a statistically significant reduction of mean mucociliary transport time, from pathologic to physiologic values, has also been shown. Statistical analysis of our data confirmed that the presence of nasal bacteria was significantly reduced by thermal water inhalations. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 23-year-old woman with right-sided nasal obstruction with mucoid discharge for 3 years, linked to right-sided proptosis since the first year. Examinations showed polypoid mass in the nasal cavity, opacities in the right side and ipsilateral sinuses, and a bulbous concha filled with fungal mud. The lateral lamella was resected and the fungal debris was removed in surgery. The study noted that a small concha might harbor a disease if not addressed.

A 21-month-old boxer dog was presented with clinical signs caused by nasopharyngeal obstruction. A mineralised mass in the nasopharynx was identified by radiography. Computed tomography allowed accurate anatomical localisation of the cystic lesion and identification of an ossified wall. Surgical removal of the mass by a ventral approach resulted in complete resolution of clinical signs. Histopathological examination strongly suggested that the cyst was derived from remnants of Rathke’s pouch. [ABSTRACT FROM AUTHOR]

The aim of the study was to estimate the sensitivity and specificity of endoscopy and the diagnostic value of clinical criteria for acute bacterial rhinosinusitis (ABRS). The hospital records of 117 consecutive patients who had symptoms compatible with ABRS and who underwent sinus radiography and flexible nasendoscopy were retrieved. A positive diagnosis was entertained when radiography demonstrated air fluid level, complete opacification or at least 6 mm mucosal thickening and/or endoscopy revealed purulent material within the drainage area of the sinuses. Using a modified version of the Hui and Walter procedure, the sensitivity and specificity of nasendoscopy was calculated against sinus radiography, a standard reference test, with known estimated sensitivity (76%) and specificity (79%). The findings show that 40 patients (34%) had positive endoscopy and radiography. Twenty patients (17%) had positive endoscopy and negative radiography, and vice versa in 15 (13%). In 42 patients (36%) both modalities were negative. Endoscopy yielded a sensitivity of 80% (95% CI, 0.55–1.00) and a specificity of 94% (95% CI, 0.33–1.00). Although estimates seem better than those of radiography, the confidence intervals are quite wide and no firm conclusion is drawn. Neither single nor combination of symptoms, concurrent with two major and one minor factor advocated by the AAO-HNS Task Force on Rhinosinusitis, were associated with a positive diagnosis of ABRS. The data suggest that endoscopy is no less effective than radiography in predicting ABRS, also that clinical criteria are of rather limited diagnostic value, and thus should be supported by other diagnostic tests. Endoscopy is recommended as a first line diagnostic tool for the diagnosis of ABRS in routine ENT practice. If the outcome is negative, radiography may follow. [ABSTRACT FROM AUTHOR]

Many methods have been used to identify unknown persons. The most common is the study of fingerprints, which is one of the few methods in which data can be stored and retrieved in a precise and cost-effective manner. The asymmetry of the frontal sinuses has stimulated several attempts to identify persons by analyzing measurements of the sinuses obtained from plain x-ray films. However, an objective and reproducible method has not been achieved. The objective of this paper is to report on a method of making standardized measurements of the frontal sinuses on radiographs and storing the resultant information in a computer databank. To test the system, the author made new measurements on 100 x-rays and entered the results into a computer databank that contained information on earlier measurements of the same 100 x-rays and on 400 others. With the aid of the databank, the author was able to rapidly and accurately match each new measurement with the earlier measurement. The author concludes that such a system is a simple and cost-effective method of establishing the identification of unknown persons for whom frontal sinus x-rays exist. [ABSTRACT FROM AUTHOR]

The article describes the case of inferior turbinate angiofibroma (AF) in a 49-year-old Hispanic male. Topics include stromal fibrous tissue with vascular structures according to biopsy, angiography of the external carotid artery branches to the internal maxillary artery, and incidence of extranasopharyngeal AFs in women.

The article describes the case of a 21-year-old male who presented to a clinic with a 3-year history of progressive right-sided nasal obstruction. Topics covered include the findings of the patient's physical examination and computed tomography scan, the most commonly diagnosed sites of schwannomas and the requirements for a definitive diagnosis of schwannoma.

Abstract: Osteopetrosis is a rare genetic disorder caused by osteoclast failure. This disorder ranges widely in severity. Its most severe forms are characterized by a deficient bone resorption that prevents the enlargement of bone cavities, impairing the development of bone marrow and leading to hematological failure. This is a study of a case report of osteopetrosis revealed by a neonatal choanal imperforation. A review of the literature on the pathology of osteopetrosis is also presented. A new born girl was admitted for a respiratory failure and a feeding difficulty. Clinical examination showed a right choanal imperforation that was confirmed with a computerized tomography. A surgical act was arranged for later on. Three months after, she was admitted for exploration of hepatosplenomegaly. On examination she had hypertelorism, depressed nasal bridge, exophthalmia and a bilateral choanal imperforation. The hemogram showed anemia and thrombocytopenia. On the skeleton radiography the bones were uniformly sclerotic with a corticomedullary differentiation loss, confirming the diagnosis of osteopetrosis. Molecular biology found a novel homozygous mutation in the TCIRG1 gene. The evolution was marked by the recurrence of the choanal atresia despite the surgical treatment. [Copyright &y& Elsevier]

• Developing regression equations for predicting external nasal shape. • Using three-dimensional craniofacial models acquired from CT images. • Introducing sex and age as important factors for predicting nose. The nose is a valuable facial feature for facial recognition and approximation. We propose the use of regression functions to predict nasal profiles comprising the structures around the piriform aperture using CT-based 3D models. We examined craniofacial reconstruction models acquired from computed tomographic images of Korean adults (188 males and 201 females). Eighteen measurements using 16 craniometric landmarks were measured on 3D craniofacial models. We conducted a descriptive analysis with comparisons according to sex, and simple linear regression analyses to obtain regression functions. Using multiple regression analyses with sex and age as independent variables, multiple regression equations were developed with coefficient of determination R2 ranging from 0.314 to 0.724, meaning that the equations for known sex and age were better for the prediction of nasal profiles than equations that assumed only known sex. These equations are useful and practical for reconstructing nasal profiles in forensic analyses. [ABSTRACT FROM AUTHOR]

Rhinoliths are calcareous concretions that are formed by the deposition of salts on an intranasal foreign body over a number of years. We describe a rare case of rhinolithiasis, whereby a small foreign body has been lodged in a man's nasal cavity for over 80 years. He presented to the ear, nose and throat clinic with a sore throat and an incidental finding of a rhinolith was made which was confirmed by x-ray. This was managed conservatively. [ABSTRACT FROM AUTHOR]

Cavernous haemangiomas arising in the paranasal sinuses are very rare. Even though the lesion is benign in nature, its imaging features are non-specific, leading to an incorrect pre-operative diagnosis in most patients. We present a case of a maxillary sinus cavernous haemangioma in a young male. The clinical presentation and imaging characteristics of this entity are reviewed. [ABSTRACT FROM AUTHOR]

Abstract: Although CT scans are being increasingly used for diagnosis and management for choanal atresia, we present a case in which this exam led to a misdiagnosis of encephalocele. This occurred because the nasal roof can be unossified until one year of age, a physiological variation, known as chondrocranium. As nasal malformations can be associated, this child underwent surgical procedure, and the absence of encephalocele was identified only intra-operatively. The purpose of this case-report is to stress the presence of chondrocranium as a variation of anatomy, and that diagnosis of choanal atresia should be performed with radiological and endoscopic exams associated. [Copyright &y& Elsevier]