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1.
Article in Chinese | MEDLINE | ID: mdl-38973034

ABSTRACT

Objective:To explore the imaging features of rare tumors of nasal cavity and sinuses, and to improve the understanding of these diseases, thereby aiding clinical diagnosis and treatment. Methods:The CT and MRI findings of 79 cases of rare neoplasm of nasal cavity and sinuses confirmed by pathology were retrospectively analyzed, and the imaging features were summarized. Results:Among the 79 cases, there were 16 cases of neuroendocrine carcinoma, most showing expansive and infiltrative bone destruction without hyperosteogeny and sclerosis. The sphenoid sinus exhibited a "pigeon" shape. In 28 cases of malignant melanoma, MRI signals were diverse, typical signals were rare, but mixed signals were more common. In 12 cases of rhabdomyosarcoma, MRI enhancement mostly showed "grape-like" enhancement and partial ring enhancement; There were 10 cases of olfactory neuroblastoma, the lesions were consistent with the distribution area of olfactory mucosa, most of them were lobulated, marginal nodules, and "flower ring" enhancement, and 2 cases grew across intracranial and external, with multiple cystic lesions and surrounding flaky edema bands. In 5 cases of solitary fibrous tumor, Benign tumors had regular shape and uniform density, while malignant tumors had irregular shape and uneven density, The enhancement was obviously uneven and showed a "pattern" change. There were 2 cases of sarcomatoid carcinoma, both with lobed appearance, uneven density, lamellar low-density shadow, and osteolytic bone destruction. In 4 cases of schwannoma, the enhancement showed obvious inhomogeneous enhancement. One case showed cystic necrosis, one case showed calcification, and the surrounding structure was compressed without damage. There was 1 case of neurofibroma, with many cystic components, low signal separation and compartmentalized enhancement. One case of paraganglioma showed moderate enhancement in the arterial phase and progressive enhancement in the venous phase, accompanied by significant swelling bone destruction. Conclusion:Rare tumors of nasal cavity and paranasal sinuses have distinctive imaging features. CT and MRI can effectively show the extent of the lesions and the degree of infiltration into adjacent tissues and organs, which is helpful for early clinical diagnosis and staging. However, definitive diagnosis still depends on pathology and immunohistochemistry.


Subject(s)
Magnetic Resonance Imaging , Nasal Cavity , Nose Neoplasms , Paranasal Sinus Neoplasms , Tomography, X-Ray Computed , Humans , Nasal Cavity/diagnostic imaging , Nasal Cavity/pathology , Retrospective Studies , Magnetic Resonance Imaging/methods , Nose Neoplasms/diagnostic imaging , Nose Neoplasms/pathology , Paranasal Sinus Neoplasms/diagnostic imaging , Paranasal Sinus Neoplasms/pathology , Male , Rhabdomyosarcoma/diagnostic imaging , Rhabdomyosarcoma/pathology , Female , Carcinoma, Neuroendocrine/diagnostic imaging , Carcinoma, Neuroendocrine/pathology , Middle Aged , Paranasal Sinuses/diagnostic imaging , Paranasal Sinuses/pathology , Melanoma/diagnostic imaging , Melanoma/pathology , Adult , Solitary Fibrous Tumors/diagnostic imaging , Solitary Fibrous Tumors/pathology , Young Adult , Aged
2.
Article in Chinese | MEDLINE | ID: mdl-38973044

ABSTRACT

Objective:To study the clinical anatomy of the sphenopalatine foramina by dissecting the sphenopalatine foramina during Vidian nerve branch neurotomy. The anatomy and CBCT images of sphenopalatine foramen were analyzed to facilitate the navigational of clinical operation using CBCT images. Methods:From October 2017 to September 2023, 84 cases(168 sides) of Vidian nerve branch neurotomy in our department were collected. The clinical summary was made according to the anatomy of sphenopalatine foramen during the operation. Preoperative CBCT imaging findings of the sphenopalatine foramina were also studied. Results:The clinical anatomy of sphenopalatine foramen could be divided into four types: middle meatus type(1.19%), trans-meatus type(62.29%), superior meatus type(33.33%) and double foramen type(1.19%). The incidence of ethmoidal ridge was 98.81%. The distance from sphenopalatine foramina to posterior nasal canal were(14.63±2.66) mm to left and(14.65±2.63) mm to right, The position Angle ∠a of lower margin of sphenopalatine foramina were(62.36±10.05)° to left and(61.51±11.82)° to right, respectively. Axial CT images can be used to divide the sphenopalatine foramen into five levels: the upper edge of the sphenopalatine foramen level, the Vidian nerve level, the basal plate interaction level, the lower edge of the sphenopalatine foramen level and the pterygopalatine canal level. The agreement between endoscopic anatomy of sphenopalatine foramen and imaging navigation was 100%. Conclusion:The sphenopalatine foramina exhibit various anatomical types. The preoperative navigational CBCT reading can effectively identify the type of sphenopalatine foramina, guide the choice of surgical method, and help avoid serious complications. This has significant clinical application value.


Subject(s)
Cone-Beam Computed Tomography , Endoscopy , Humans , Cone-Beam Computed Tomography/methods , Endoscopy/methods , Male , Female , Middle Aged , Sphenoid Bone/diagnostic imaging , Sphenoid Bone/anatomy & histology , Adult , Nasal Cavity/diagnostic imaging , Nasal Cavity/anatomy & histology
3.
Cir Cir ; 92(3): 287-297, 2024.
Article in English | MEDLINE | ID: mdl-38862105

ABSTRACT

OBJECTIVE: This study aimed to investigate the limitations, barriers, and complications in the early transition from the microscopic transsphenoidal approach (MTA) to the endonasal endoscopic approach (EEA) to the skull base in our institution. METHODS: Technical challenges, as well as clinical features and complications, were compared between MTA, EEA, and mixed cases during the early surgical curve. RESULTS: The period from the early learning curve was 1 year until the EEA protocol was used routinely. A total of 34 patients registered a resection using a transsphenoidal approach. Eighteen patients underwent EEA, 11 underwent MTA, and five underwent a mixed endonasal and microscopic approach. Non-significant differences were found in endocrine outcomes between the three groups. Patients with unchanged or improved visual function were higher in the EEA group (p = 0.147). Non-significant differences were found in terms of the extent of resection (EOR) between groups (p = 0.369). Only 1 (2.9%) patient in the whole series developed a post-operative CSF leaking that resolved with medical management, belonging to the EEA group (5.5%). CONCLUSIONS: The early phase of the learning curve did not affect our series significantly in terms of the EOR, endocrine status, and visual outcomes.


OBJETIVO: Investigar las limitaciones, las barreras y las complicaciones en la transición del abordaje transesfenoidal microscópico (ATM) al abordaje endonasal endoscópico (AEE) para la base del cráneo en nuestra institución. MÉTODO: Se compararon las características clínicas y las complicaciones entre ATM, AEE y casos mixtos durante la curva quirúrgica temprana. RESULTADOS: El periodo desde la curva de aprendizaje inicial fue de 1 año hasta que se utilizó el protocolo AEE de forma sistemática. Un total de 34 pacientes tuvieron una resección por vía transesfenoidal. A 18 pacientes se les realizó AEE, a 11 ATM y a 5 abordaje mixto endonasal y microscópico. Se encontraron diferencias no significativas en los resultados endocrinos entre los tres grupos. Los pacientes con función visual sin cambios o mejorada fueron más en el grupo AEE (p = 0.147). No se encontraron diferencias significativas respecto a la extensión de la resección (p = 0.369). Solo 1 (2.9%) paciente desarrolló una fístula de líquido cefalorraquídeo que se resolvió con manejo médico, perteneciente al grupo AEE (5.5%). CONCLUSIONES: La fase inicial de la curva de aprendizaje no afectó significativamente a nuestra serie en términos de extensión de la resección, estado endocrino y resultados visuales.


Subject(s)
Learning Curve , Humans , Female , Male , Middle Aged , Adult , Pituitary Neoplasms/surgery , Aged , Retrospective Studies , Microsurgery/methods , Sella Turcica/surgery , Postoperative Complications/etiology , Postoperative Complications/epidemiology , Nasal Cavity/surgery , Natural Orifice Endoscopic Surgery/methods , Neuroendoscopy/methods , Cerebrospinal Fluid Leak/etiology , Cerebrospinal Fluid Leak/epidemiology , Endoscopy/methods
4.
Article in Chinese | MEDLINE | ID: mdl-38858118

ABSTRACT

Objective:To summarize and analyze the clinical manifestations, diagnosis and management and prognostic features of solitary fibrous tumor(SFT) in nasal cavity, sinus and skull base. Methods:The clinical data of 12 patients with STF from nasal cavity, sinus and cranial base admitted to the Affiliated Hospital of Qingdao University from April 2014 to January 2022 were retrospectively analyzed, including 4 patients admitted to the department of Otolaryngology head and neck surgery and 8 patients admitted to the department of skull base surgery The clinical characteristics, diagnosis, management and prognosis were analyzed. Results:Twelve patients were included in this research, including 7 males and 5 females. All patients received surgical treatment, and 4 patients also received postoperative adjuvant chemoradiotherapy. After follow-up for 12-60 months, 4 patients with adjuvant radiotherapy and chemotherapy had a good prognosis, and among 8 patients who did not receive radiotherapy and chemotherapy, 6 patients had good prognosis and 2 patients showed relapse. Four patients with a history of recurrence of SFT after surgery were admitted to our hospital for surgical treatment, in which 1 patient had relapse after surgery, and none had metastasis. Nasal cavity and sinus to skull base SFT is rare. The most effective treatment for this disease is surgical resection, and postoperative adjuvant chemoradiation and long-term follow-up can achieve a better prognosis. En bloc resection is the key to treatment success.


Subject(s)
Nasal Cavity , Skull Base Neoplasms , Solitary Fibrous Tumors , Humans , Male , Female , Nasal Cavity/pathology , Solitary Fibrous Tumors/therapy , Solitary Fibrous Tumors/diagnosis , Retrospective Studies , Skull Base Neoplasms/therapy , Prognosis , Skull Base , Middle Aged , Neoplasm Recurrence, Local , Nose Neoplasms/therapy , Nose Neoplasms/diagnosis , Adult , Paranasal Sinus Neoplasms/therapy
5.
Article in Chinese | MEDLINE | ID: mdl-38858115

ABSTRACT

Objective:To investigate the clinical characteristics of esthesioneuroblastoma and the efficacy of endonasal endoscopic surgery combined with radiotherapy/chemotherapy. Methods:The clinical and surgical data of 17 patients with esthesioneuroblastoma who underwent endonasal endoscopic surgery in our department from September 2009 to June 2023 were retrospectively analyzed. Results:Among all patients, the modified Kadish stage B was identified in 4 patients, C in 10 patients, and D in 3 patients. Ten of them underwent endonasal endoscopic surgery without neck dissection in one day, whose average operation time is (5.2±2.5) hours and average blood loss is (192±162)mL. Skull base reconstructions were performed in 15 patients, postoperative complications were observed in 3 patients, and negative margins were obtained in 13 patients. All 17 patients were followed up for an average of (49.7±40.2) months. Three patients died and 6 had recurrence and/or metastasis. The 1-year, 2-year and 5-year overall survival rates were 88.2%, 80.2%, and 80.2%, respectively, and the 1-year, 2-year and 5-year disease-free survival rates were 82.4%, 82.4%, and 50.8%, respectively. The 2-year overall survival rates of patients with negative and positive margins were 100% and 25%, respectively, while the 2-year disease-free survival rates were 61.5% and 25.0%, respectively. Conclusion:Endonasal endoscopic surgery combined with radiotherapy/chemotherapy can achieve satisfactory effect in esthesioneuroblastoma, and the prognosis of patients with positive margins is poor.


Subject(s)
Esthesioneuroblastoma, Olfactory , Nose Neoplasms , Humans , Esthesioneuroblastoma, Olfactory/surgery , Female , Male , Retrospective Studies , Middle Aged , Nose Neoplasms/surgery , Adult , Endoscopy/methods , Nasal Cavity , Survival Rate , Treatment Outcome
6.
Article in Chinese | MEDLINE | ID: mdl-38858120

ABSTRACT

NUT Carcinoma(NC) is a rare malignant tumor of unknown origin, which is highly aggressive. It is characterized by chromosome rearrangement accompanied by NUTM1 gene. The pathological manifestations were sudden and focal squamous in poorly differentiated or undifferentiated carcinoma. NUTM1gene rearrangement can be used to diagnose NC. The prognosis of NUT cancer is poor. Clinically, there is no established treatment plan. treatment options mainly comprise surgery, radiotherapy and chemotherapy. A 74-year-old patient with NC of the nasal cavity and sinuses was reported. Her clinical presentation was right nasal congestion with facial swelling. Sinus CT and MRI showed soft tissue density in the right nasal cavity and maxillary sinus with bone destruction. After admission, the patient underwent nasal endoscopic biopsy, and the postoperative pathological FISH staining showed BRD4/NUT fusion t(15, 19). The tumor was significantly reduced after two courses of sequential chemoradiotherapy. Two months later, the patient underwent a partial maxillary resection due to the rapid regrowth of sinusoidal mass, invading the hard palate. The patient died 2 months after surgery due to multiple organ failure resulted from tumor metastasis, with a survival time of 11 months. The clinical characteristics, diagnosis and treatment of this case were reported and related literature was reviewed.


Subject(s)
Nasal Cavity , Nose Neoplasms , Humans , Aged , Female , Nasal Cavity/pathology , Nose Neoplasms/therapy , Neoplasm Proteins/genetics , Nuclear Proteins/genetics , Oncogene Proteins, Fusion/genetics , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/therapy , Fatal Outcome , Carcinoma
7.
Open Vet J ; 14(5): 1182-1190, 2024 May.
Article in English | MEDLINE | ID: mdl-38938433

ABSTRACT

Background: Computed tomography (CT) is the gold standard for diagnosing canine nasal diseases. However, it cannot easily detect minor abnormalities in inflammatory diseases because they are not accompanied by obvious morphological changes. Aim: The present study aimed to compare the differences in normal CT findings of turbinate structure and mucosa between breeds to establish criteria for CT diagnosis of inflammatory diseases of the nasal cavity. Methods: CT data from 77 dogs of 5 breeds without nasal diseases were retrospectively studied. The nasal air percentage, which reflects the volume of the nasal turbinate structure and mucosa, was measured. The nasal turbinate mucosa was measured for contrast enhancement reflecting blood flow. Measurements were performed in the ventral and ethmoid turbinate (ET) regions. Comparisons were made between breeds and sections. Results: The air percentage in the ventral and ET regions was significantly different between breeds. Contrast enhancement was significantly different between breeds only in the ET. Moreover, different breeds had different correlations between body weight, age, nose length, and air percentage. Conclusion: In this study, reference values for normal CT findings of the nasal structure and mucosa were obtained, taking into account the breed, measurement section, and patient factors. The results showed that the volume of the turbinate structure and contrast enhancement of nasal mucosa differed depending on the breed. The measured values also differed depending on the cross-sections and patient factors.


Subject(s)
Tomography, X-Ray Computed , Turbinates , Animals , Dogs/anatomy & histology , Tomography, X-Ray Computed/veterinary , Retrospective Studies , Female , Turbinates/diagnostic imaging , Turbinates/anatomy & histology , Male , Nasal Mucosa/diagnostic imaging , Nasal Mucosa/anatomy & histology , Dog Diseases/diagnostic imaging , Nasal Cavity/diagnostic imaging , Nasal Cavity/anatomy & histology
8.
World J Surg Oncol ; 22(1): 163, 2024 Jun 22.
Article in English | MEDLINE | ID: mdl-38909260

ABSTRACT

Sinonasal malignant tumors are a group of uncommon malignancies that account for less than 1% of all tumors. These tumors often involve the maxillary sinus and nasal cavity, with less cumulative incidence in the ethmoidal sinus, sphenoidal sinus, and frontal sinus. The lack of consensus on the management of sinonasal malignancies is due to their rarity, diagnostic challenges, and the heterogeneity of treatments. In this paper, we present a case of endoscopic-assisted medial canthus incision combined with radiotherapy in the treatment of sinonasal malignant tumors, with the aim of providing valuable insights to clinicians on the management of these tumors.


Subject(s)
Endoscopy , Esthesioneuroblastoma, Olfactory , Nose Neoplasms , Humans , Esthesioneuroblastoma, Olfactory/surgery , Esthesioneuroblastoma, Olfactory/pathology , Esthesioneuroblastoma, Olfactory/diagnostic imaging , Endoscopy/methods , Nose Neoplasms/surgery , Nose Neoplasms/pathology , Nasal Cavity/surgery , Nasal Cavity/pathology , Nasal Cavity/diagnostic imaging , Prognosis , Male , Middle Aged , Female , Paranasal Sinus Neoplasms/surgery , Paranasal Sinus Neoplasms/pathology , Paranasal Sinus Neoplasms/diagnostic imaging
9.
Kobe J Med Sci ; 70(2): E56-E60, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38936878

ABSTRACT

Olfactory neuroblastoma (ONB) is an uncommon malignant tumor and is usually treated by a multidisciplinary approach includes surgery, radiotherapy, and chemotherapy. A 62 years-old male had a tumor in the nasal cavity and diagnosed as ONB with Kadish A stage. Anterior skull base surgery was performed as radical treatment. Since the surgical margin was negative, no postoperative radiotherapy was administered. 14 years after the surgery, bilateral otitis media with effusion (OME) was occurred, we found the recurrence tumor at bilateral retropharyngeal lymph node (RPLN) which surrounded the internal carotid arteries. Since these were unresectable, we planned chemoradiotherapy which was 70Gy of intensity modulated radiotherapy combined with two courses of carboplatin and etoposide. The tumor volume was reduced and bilateral OME were improved. He has been alive for 3 years after salvage treatment. Although ONB has a relatively good prognosis, it is known to often cause cervical lymph node metastasis. Grades III and IV of Hyams classification are considered high risk. This case, initial tumor was limited in the nasal cavity and its clinical classification was early stage, but Hyams classification was grade III. In reference to this case, considering that RPLN metastasis are difficult to radically resect at the salvage surgery, including this area in postoperative radiotherapy was considered an option.


Subject(s)
Esthesioneuroblastoma, Olfactory , Lymphatic Metastasis , Nasal Cavity , Nose Neoplasms , Humans , Male , Esthesioneuroblastoma, Olfactory/secondary , Esthesioneuroblastoma, Olfactory/pathology , Esthesioneuroblastoma, Olfactory/surgery , Middle Aged , Nose Neoplasms/pathology , Nasal Cavity/pathology , Skull Base/pathology , Skull Base/diagnostic imaging , Neoplasm Recurrence, Local/pathology , Chemoradiotherapy
10.
Sci Rep ; 14(1): 13817, 2024 06 15.
Article in English | MEDLINE | ID: mdl-38879680

ABSTRACT

The nasal cavity of living mammals is a unique structural complex among tetrapods, acquired along a series of major morphological transformations that occurred mainly during the Mesozoic Era, within the Synapsida clade. Particularly, non-mammaliaform cynodonts document several morphological changes in the skull, during the Triassic Period, that represent the first steps of the mammalian bauplan. We here explore the nasal cavity of five cynodont taxa, namely Thrinaxodon, Chiniquodon, Prozostrodon, Riograndia, and Brasilodon, in order to discuss the main changes within this skull region. We did not identify ossified turbinals in the nasal cavity of these taxa and if present, as non-ossified structures, they would not necessarily be associated with temperature control or the development of endothermy. We do, however, notice a complexification of the cartilage anchoring structures that divide the nasal cavity and separate it from the brain region in these forerunners of mammals.


Subject(s)
Fossils , Mammals , Skull , Turbinates , X-Ray Microtomography , Animals , Mammals/anatomy & histology , Fossils/anatomy & histology , Skull/anatomy & histology , Skull/diagnostic imaging , South America , Turbinates/anatomy & histology , Turbinates/diagnostic imaging , Biological Evolution , Nasal Cavity/anatomy & histology , Nasal Cavity/diagnostic imaging , Phylogeny
11.
BMC Oral Health ; 24(1): 533, 2024 May 04.
Article in English | MEDLINE | ID: mdl-38704542

ABSTRACT

INTRODUCTION: Orthognathic surgery can lead to sinus alterations, including sinusitis, attributed to the exposure of maxillary sinuses during Le Fort I osteotomy. Furthermore, being a hospital-based procedure, there is potential risk of complications arising from bacteria prevalent in such environments. This study evaluated maxillary sinusitis occurrence and the presence of multidrug-resistant bacteria in the nasal cavity before and after orthognathic surgery. METHODS: Ten patients with dentofacial deformities underwent Le Fort I osteotomy. Clinical evaluations using SNOT-22 questionnaire were performed, and nasal cavity samples were collected pre-surgery and 3-6 months post-surgery to quantify total mesophilic bacteria and detect Staphylococcus aureus, Acinetobacter baumannii, and Klebsiella pneumoniae. Cone Beam Computed Tomography (CBCT) was performed pre- and post-operatively, and the results were evaluated using the Lund-Mackay system. This study was registered and approved by the Research Ethics Committee of PUCRS (No. 4.683.066). RESULTS: The evaluation of SNOT-22 revealed that five patients showed an improvement in symptoms, while two remained in the same range of interpretation. One patient developed post-operative maxillary sinusitis, which was not detected at the time of evaluation by SNOT-22 or CBCT. CBCT showed a worsening sinus condition in three patients, two of whom had a significant increase in total bacteria count in their nasal cavities. The Brodsky scale was used to assess hypertrophy in palatine tonsils, where 60% of the subjects had grade 1 tonsils, 20% had grade 2 and 20% had grade 3. None of the patients had grade 4 tonsils, which would indicate more than 75% obstruction. Two patients harboured S. aureus and K. pneumoniae in their nasal cavities. Notably, K. pneumoniae, which was multidrug-resistant, was present in the nasal cavity of patients even before surgery, but this did not result in maxillary sinusitis, likely due to the patients' young and healthy condition. CONCLUSION: There was an improvement in signs and symptoms of maxillary sinusitis and quality of life in most patients after orthognathic surgery. However, some patients may still harbour multidrug-resistant bacteria, even if they are asymptomatic. Therefore, a thorough pre-operative assessment is essential to avoid difficult-to-treat post-operative complications.


Subject(s)
Cone-Beam Computed Tomography , Drug Resistance, Multiple, Bacterial , Maxillary Sinusitis , Nasal Cavity , Osteotomy, Le Fort , Humans , Female , Male , Nasal Cavity/microbiology , Nasal Cavity/diagnostic imaging , Maxillary Sinusitis/microbiology , Maxillary Sinusitis/diagnostic imaging , Adult , Young Adult , Acinetobacter baumannii/isolation & purification , Klebsiella pneumoniae/isolation & purification , Adolescent , Staphylococcus aureus/isolation & purification , Dentofacial Deformities/surgery , Dentofacial Deformities/microbiology , Postoperative Complications/microbiology , Postoperative Complications/diagnostic imaging
12.
JAMA Otolaryngol Head Neck Surg ; 150(7): 621-622, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38780970

ABSTRACT

An 18-year-old male with no significant medical history presented for evaluation of a nasal papule that was asymptomatic without any associated pain, pruritus, or bleeding with no changes for a year. What is your diagnosis?


Subject(s)
Nasal Cavity , Humans , Nasal Cavity/diagnostic imaging , Nasal Cavity/pathology , Nose Neoplasms/pathology , Nose Neoplasms/surgery , Male , Diagnosis, Differential , Female
13.
Vestn Otorinolaringol ; 89(2): 28-32, 2024.
Article in Russian | MEDLINE | ID: mdl-38805460

ABSTRACT

Dermoid nasal cysts (congenital nasal median heterotopias) are a rare congenital pathology in children. OBJECTIVE: Yo consider the clinical picture, methods of radiation diagnosis and to study the surgical results of a dermoid cyst of the nose according to the literature. MATERIALS AND METHODS: A retrospective review of medical histories with the diagnosis of "Dermoid cyst of the back of the nose and nasal cavity, epidermal cyst of the back of the nose, glioma, encephalocele" was conducted from 2017 to 2022 in the Pediatric Otorhinolaryngological Department of the National Medical Research Center for Otorhinolaryngology of the Federal Medical-Biological Agency of Russia. The case histories were analyzed by the nature of the lesion, the imaging techniques performed, the course of the operation and the results obtained. MATERIAL AND METHODS: A total of 16 medical histories were analyzed, the average age was 4.5 years (range 10 months - 15 years), over the past 5 years with a diagnosis of "Dermoid cyst of the nasal dorsum and nasal cavity, glioma, epidermal cyst of the nasal dorsum, encephalocele". All patients underwent magnetic resonance imaging (MRI) in the preoperative period, 14 patients also underwent computed tomography (CT). RESULT: Of these, 7 had a confirmed dermoid cyst with a fistula, 3 patients without a fistula, 3 patients had glioma, and 1 had encephalocele, 2 patients had an epidermoid cyst. A fistulous opening of the dermoid cyst of the nasal dorsum and nasal cavity was observed in the upper third of the nasal dorsum in 3 children, in the middle third in 2 patients and in the lower third in 2 children. The article presents a scheme for the characteristics of the lesion and the tactics of surgical treatment in comparison with the data of foreign authors. Intraoperatively, intracranial spread occurred in 6 patients. Various surgical approaches for intracranial proliferation and a corresponding literature review are also presented. Catamnestic follow-up ranged from 1 to 5 years (on average, 3.5 years), no relapses or postoperative complications were noted. CONCLUSION: Nasal median heterotopias are a rare congenital anomaly. Preoperative preparation should include CT and MRI to assess the lesion and exclude intracranial spread. The surgical approach depended directly on the localization of heterotopia and its spread. All patients had a good cosmetic result after the surgical treatment performed by us according to the author's method.


Subject(s)
Dermoid Cyst , Magnetic Resonance Imaging , Humans , Child , Female , Male , Child, Preschool , Dermoid Cyst/surgery , Dermoid Cyst/congenital , Dermoid Cyst/diagnosis , Retrospective Studies , Magnetic Resonance Imaging/methods , Infant , Tomography, X-Ray Computed/methods , Adolescent , Nose Neoplasms/surgery , Nose Neoplasms/congenital , Nose Neoplasms/diagnosis , Nose Neoplasms/diagnostic imaging , Russia , Nasal Cavity/abnormalities , Nasal Cavity/surgery , Nasal Cavity/diagnostic imaging , Treatment Outcome
14.
BMC Med Inform Decis Mak ; 24(1): 145, 2024 May 29.
Article in English | MEDLINE | ID: mdl-38811961

ABSTRACT

BACKGROUND: Nasal polyps and inverted papillomas often look similar. Clinically, it is difficult to distinguish the masses by endoscopic examination. Therefore, in this study, we aimed to develop a deep learning algorithm for computer-aided diagnosis of nasal endoscopic images, which may provide a more accurate clinical diagnosis before pathologic confirmation of the nasal masses. METHODS: By performing deep learning of nasal endoscope images, we evaluated our computer-aided diagnosis system's assessment ability for nasal polyps and inverted papilloma and the feasibility of their clinical application. We used curriculum learning pre-trained with patches of nasal endoscopic images and full-sized images. The proposed model's performance for classifying nasal polyps, inverted papilloma, and normal tissue was analyzed using five-fold cross-validation. RESULTS: The normal scores for our best-performing network were 0.9520 for recall, 0.7900 for precision, 0.8648 for F1-score, 0.97 for the area under the curve, and 0.8273 for accuracy. For nasal polyps, the best performance was 0.8162, 0.8496, 0.8409, 0.89, and 0.8273, respectively, for recall, precision, F1-score, area under the curve, and accuracy. Finally, for inverted papilloma, the best performance was obtained for recall, precision, F1-score, area under the curve, and accuracy values of 0.5172, 0.8125, 0.6122, 0.83, and 0.8273, respectively. CONCLUSION: Although there were some misclassifications, the results of gradient-weighted class activation mapping were generally consistent with the areas under the curve determined by otolaryngologists. These results suggest that the convolutional neural network is highly reliable in resolving lesion locations in nasal endoscopic images.


Subject(s)
Deep Learning , Endoscopy , Nasal Cavity , Nasal Polyps , Humans , Nasal Cavity/diagnostic imaging , Nasal Cavity/pathology , Nasal Polyps/diagnostic imaging , Nose Neoplasms/diagnostic imaging , Nose Neoplasms/pathology , Papilloma, Inverted/diagnostic imaging , Papilloma, Inverted/pathology , Diagnosis, Computer-Assisted , Diagnosis, Differential , Male , Middle Aged , Adult
15.
Int J Comput Assist Radiol Surg ; 19(7): 1385-1389, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38775903

ABSTRACT

PURPOSE: We present a novel method for augmented reality in endoscopic endonasal surgery. Our method does not require the use of external tracking devices and can show hidden anatomical structures relevant to the surgical intervention. METHODS: Our method registers a preoperative 3D model of the nasal cavity to an intraoperative 3D model by estimating a scaled-rigid transformation. Registration is based on a two-stage ICP approach on the reconstructed nasal cavity. The hidden structures are then transferred from the preoperative 3D model to the intraoperative one using the estimated transformation, projected and overlaid into the endoscopic images to obtain the augmented reality. RESULTS: We performed qualitative and quantitative validation of our method on 12 clinical cases. Qualitative results were obtained from an ENT surgeon from visual inspection of the hidden structures in the augmented images. Quantitative results were obtained by measuring a target registration error using a novel transillumination-based approach. The results show that the hidden structures of interest are augmented at the expected locations in most cases. CONCLUSION: Our method was able to augment the endoscopic images in a sufficiently precise manner when the intraoperative nasal cavity did not deform considerably with respect to its preoperative state. This is a promising step towards trackerless augmented reality in endonasal surgery.


Subject(s)
Augmented Reality , Imaging, Three-Dimensional , Nasal Cavity , Humans , Imaging, Three-Dimensional/methods , Nasal Cavity/surgery , Nasal Cavity/diagnostic imaging , Endoscopy/methods , Surgery, Computer-Assisted/methods
16.
J Clin Neurosci ; 125: 38-42, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38744121

ABSTRACT

The nasal skull base is located into the deep position of nasal cavity and closely related to important nerves and vessels. The complete removal of tumors in this area poses a complex surgical challenge.In order to investigate the clinical efficacy of utilizing free middle turbinate mucosa (FMT), fascia lata, and pedicled nasal septum flap (known as the Hadad-Bassagasteguy flap, HBF) for the treatment of cerebrospinal fluid (CSF) rhinorrhea, a retrospective analysis was conducted on clinical data from 65 patients who underwent skull base reconstruction following endoscopic resection of nasal-skull base tumors. The selection of the repair material was based on the size and location of the defect. For defects less than 1.5 cm (n = 24), FMT was chosen, while for defects greater than or equal to 1.5 cm (n = 16), HBF was preferred. In cases where HBF was not available or not suitable (specifically, when the defect was located on the posterior wall of the frontal sinus), fascia lata was selected (n = 25). The repair outcomes of all 65 patients were summarized, and subsequently, a comparison was made between the use of fascia lata and HBF. The overall success rate for one-time repairs was 93.8 %. Specifically, the success rates for repairs using FMT, fascia lata, and HBF were 91.7 %, 96.0 %, and 93.8 %, respectively. Throughout the follow-up period, there were 2 cases of postoperative CSF leakage out of 24 patients who underwent FMT reconstruction, 1 case out of 25 patients who underwent fascia lata reconstruction, and 1 case out of 16 patients who underwent HBF reconstruction. The occurrence of postoperative complications, such as intracranial infection, lung infection, and epistaxis, was observed in both the fascia lata group and the HBF group. However, there were no statistically significant differences between the two groups. The transnasal endoscopic reconstruction of skull base defect using HBF, fascia lata, and FMT demonstrated satisfactory repair effects in managing CSF rhinorrhea. Generally, FMT has been found to be a dependable repair material for small defects measuring less than 1.5 cm, while in the case of larger defects equal to or exceeding 1.5 cm, both HBF and fascia lata can be utilized with comparable repair outcomes. The selection of fascia lata becomes a viable option when HBF is unavailable or not suitable.


Subject(s)
Cerebrospinal Fluid Rhinorrhea , Plastic Surgery Procedures , Surgical Flaps , Humans , Cerebrospinal Fluid Rhinorrhea/surgery , Female , Male , Middle Aged , Retrospective Studies , Adult , Plastic Surgery Procedures/methods , Aged , Skull Base/surgery , Fascia Lata/transplantation , Fascia Lata/surgery , Young Adult , Skull Base Neoplasms/surgery , Treatment Outcome , Adolescent , Endoscopy/methods , Nasal Cavity/surgery
17.
Int J Numer Method Biomed Eng ; 40(7): e3830, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38700070

ABSTRACT

This study aimed to explore the variability in nasal airflow patterns among different sexes and populations using computational fluid dynamics (CFD). We focused on evaluating the universality and applicability of dimensionless parameters R (bilateral nasal resistance) and ϕ (nasal flow asymmetry), initially established in a Caucasian Spanish cohort, across a broader spectrum of human populations to assess normal breathing function in healthy airways. In this retrospective study, CT scans from Cambodia (20 males, 20 females), Russia (20 males, 18 females), and Spain (19 males, 19 females) were analyzed. A standardized CFD workflow was implemented to calculate R-ϕ parameters from these scans. Statistical analyses were conducted to assess and compare these parameters across different sexes and populations, emphasizing their distribution and variances. Our results indicated no significant sex-based differences in the R parameter across the populations. However, moderate sexual dimorphism in the ϕ parameter was observed in the Cambodian group. Notably, no geographical differences were found in either R or ϕ parameters, suggesting consistent nasal airflow characteristics across the diverse human groups studied. The study also emphasized the importance of using dimensionless variables to effectively analyze the relationships between form and function in nasal airflow. The observed consistency of R-ϕ parameters across various populations highlights their potential as reliable indicators in both medical practice and further CFD research, particularly in diverse human populations. Our findings suggest the potential applicability of dimensionless CFD parameters in analyzing nasal airflow, highlighting their utility across diverse demographic and geographic contexts. This research advances our understanding of nasal airflow dynamics and underscores the need for additional studies to validate these parameters in broader population cohorts. The approach of employing dimensionless parameters paves the way for future research that eliminates confounding size effects, enabling more accurate comparisons across different populations and sexes. The implications of this study are significant for the advancement of personalized medicine and the development of diagnostic tools that accommodate individual variations in nasal airflow.


Subject(s)
Hydrodynamics , Humans , Male , Female , Adult , Airway Resistance/physiology , Retrospective Studies , Tomography, X-Ray Computed , Middle Aged , Nasal Cavity/physiology , Nasal Cavity/diagnostic imaging , Nasal Cavity/anatomy & histology , Computer Simulation , Cambodia , Spain
18.
Sci Rep ; 14(1): 10715, 2024 05 23.
Article in English | MEDLINE | ID: mdl-38782960

ABSTRACT

The large nose adorned by adult male proboscis monkeys is hypothesised to serve as an audiovisual signal of sexual selection. It serves as a visual signal of male quality and social status, and as an acoustic signal, through the expression of loud, low-formant nasalised calls in dense rainforests, where visibility is poor. However, it is unclear how the male proboscis monkey nasal complex, including the internal structure of the nose, plays a role in visual or acoustic signalling. Here, we use cranionasal data to assess whether large noses found in male proboscis monkeys serve visual and/or acoustic signalling functions. Our findings support a visual signalling function for male nasal enlargement through a relatively high degree of nasal aperture sexual size dimorphism, the craniofacial region to which nasal soft tissue attaches. We additionally find nasal aperture size increases beyond dental maturity among male proboscis monkeys, consistent with the visual signalling hypothesis. We show that the cranionasal region has an acoustic signalling role through pronounced nasal cavity sexual shape dimorphism, wherein male nasal cavity shape allows the expression of loud, low-formant nasalised calls. Our findings provide robust support for the male proboscis monkey nasal complex serving both visual and acoustic functions.


Subject(s)
Sex Characteristics , Animals , Male , Nasal Cavity/anatomy & histology , Nasal Cavity/physiology , Nose/anatomy & histology , Animal Communication , Acoustics , Skull/anatomy & histology , Vocalization, Animal/physiology , Female
19.
Sci Rep ; 14(1): 11779, 2024 05 23.
Article in English | MEDLINE | ID: mdl-38783070

ABSTRACT

Most terrestrial mammals have a vomeronasal system to detect specific chemicals. The peripheral organ of this system is a vomeronasal organ (VNO) opening to the incisive duct, and its primary integrative center is an accessory olfactory bulb (AOB). The VNO in seals is thought to be degenerated like whales and manatees, unlike otariids, because of the absence of the AOB. However, olfaction plays pivotal roles in seals, and thus we conducted a detailed morphological evaluation of the vomeronasal system of three harbor seals (Phoca vitulina). The VNO lumen was not found, and the incisive duct did not open into the oral cavity but was recognized as a fossa on the anteroventral side of the nasal cavity. This fossa is rich in mucous glands that secrete acidic mucopolysaccharides, which might originate from the vomeronasal glands. The olfactory bulb consisted only of a main olfactory bulb that received projections from the olfactory mucosa, but an AOB region was not evident. These findings clarified that harbor seals do not have a VNO to detect some chemicals, but the corresponding region is a specialized secretory organ.


Subject(s)
Nasal Cavity , Olfactory Bulb , Phoca , Vomeronasal Organ , Animals , Vomeronasal Organ/metabolism , Vomeronasal Organ/anatomy & histology , Phoca/metabolism , Phoca/anatomy & histology , Nasal Cavity/anatomy & histology , Nasal Cavity/metabolism , Olfactory Bulb/metabolism , Olfactory Bulb/anatomy & histology , Mucus/metabolism , Olfactory Mucosa/metabolism , Olfactory Mucosa/anatomy & histology , Male , Smell/physiology , Female
20.
AAPS PharmSciTech ; 25(5): 117, 2024 May 28.
Article in English | MEDLINE | ID: mdl-38806874

ABSTRACT

Eugenol (Eug) holds potential as a treatment for bacterial rhinosinusitis by nasal powder drug delivery. To stabilization and solidification of volatile Eug, herein, nasal inhalable γ-cyclodextrin metal-organic framework (γ-CD-MOF) was investigated as a carrier by gas-solid adsorption method. The results showed that the particle size of Eug loaded by γ-CD-MOF (Eug@γ-CD-MOF) distributed in the range of 10-150 µm well. In comparison to γ-CD and ß-CD-MOF, γ-CD-MOF has higher thermal stability to Eug. And the intermolecular interactions between Eug and the carriers were verified by characterizations and molecular docking. Based on the bionic human nasal cavity model, Eug@γ-CD-MOF had a high deposition distribution (90.07 ± 1.58%). Compared with free Eug, the retention time Eug@γ-CD-MOF in the nasal cavity was prolonged from 5 min to 60 min. In addition, the cell viability showed that Eug@γ-CD-MOF (Eug content range 3.125-200 µg/mL) was non-cytotoxic. And the encapsulation of γ-CD-MOF could not reduce the bacteriostatic effect of Eug. Therefore, the biocompatible γ-CD-MOF could be a potential and valuable carrier for nasal drug delivery to realize solidification and nasal therapeutic effects of volatile oils.


Subject(s)
Administration, Intranasal , Drug Carriers , Drug Delivery Systems , Eugenol , Metal-Organic Frameworks , Powders , Metal-Organic Frameworks/chemistry , Powders/chemistry , Humans , Eugenol/chemistry , Eugenol/administration & dosage , Eugenol/pharmacology , Administration, Intranasal/methods , Drug Delivery Systems/methods , Drug Carriers/chemistry , Particle Size , Cell Survival/drug effects , Molecular Docking Simulation/methods , gamma-Cyclodextrins/chemistry , Drug Stability , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/pharmacology , Cyclodextrins/chemistry , Nasal Cavity/metabolism
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