Olfactory cleft stenosis and obstruction on paranasal sinus CT scan in pre-septo-rhinoplasty patients: normal variants or pathologic findings?

OBJECTIVE(S): To determine the frequency of olfactory cleft (OC) stenosis and obstruction on paranasal sinus CT scans in pre-septorhinoplasty of patients who had septal deviation, septopyramidal deformation or nasal obstruction without other sinonasal conditions. METHODS: This retrospective study included patients referred to our institution between December 2013 and December 2021 for septorhinoplasty due to nasal obstruction without other sinonasal or neurological conditions. All patients underwent preoperative paranasal sinus CT scan and olfactory testing. OC stenosis was quoted as none, partial, or total (less than 1/3 contact between nasal septum and ethmoid turbinates, 1/3-2/3, more than 2/3, respectively), as well as OC obstruction as none, partial, or complete (obstruction of less than 1/3 of OC, 1/3-2/3, more than 2/3, respectively). Radiologic evaluation was validated by near perfect interobserver agreement. RESULTS: A total of 75 patients (32 women, 43 men) with a mean age of 44.2 ± 15.64 (23-74) years were included, of which 36 were normosmic and 39 hyposmic. OC stenosis was partial in 58.7% (n = 44) of the patients, absent in 28% (n = 21), and total in 13.3% (n = 10), without difference between normosmic and hyposmic patients (p = .66). OC obstruction was absent in 52% (n = 39) and partial in 46.7% (n = 35), without difference between normosmic and hyposmic patients (p = .51). Only one normosmic patient had complete OC obstruction. CONCLUSION: OC partial stenosis and partial obstruction were frequent findings in pre-septorhinoplasty patients without respiratory mucosa disease and did not influence their olfactory status. Total stenosis and complete obstruction were rarer and require further investigation. CLINICAL RELEVANCE STATEMENT: Isolated partial olfactory cleft stenosis and obstruction should be considered normal variants, whereas the impact of complete olfactory cleft stenosis and obstruction on patient's olfactory status remains to be determined. KEY POINTS: • The incidence of olfactory cleft stenosis and obstruction in asymptomatic patients remains unknown, even though it is encountered in clinical practice. • Partial and total olfactory cleft stenosis occurred in 58.7% and 13.3% of the patients; partial obstruction occurred in half of the cases, but complete obstruction was extremely rare. • There are frequent findings of partial olfactory cleft obstruction and stenosis, but complete obstruction and total stenosis should be further investigated.

The synthesis and properties of Ca3 Sc2 Si3 O12 :Ce3+ (CSSG) phosphor are utilized for the development of human-centric lighting light-emitting diodes (HCL-LEDs).

In this study, cerium ion (Ce3+ )-doped calcium scandium silicate garnet (Ca3 Sc2 Si3 O12 , abbreviated CSSG) phosphors were successfully synthesized using the sol-gel method. The crystal phase, morphology, and photoluminescence properties of the synthesized phosphors were thoroughly investigated. Under excitation by a blue light-emitting diode (LED) chip (450 nm), the CSSG phosphor displayed a wide emission spectrum spanning from green to yellow. Remarkably, the material exhibited exceptional thermal stability, with an emissivity ratio at 150°C to that at 25°C reaching approximately 85%. Additionally, the material showcased impressive optical performance when tested with a blue LED chip, including a color rendering index (CRI) exceeding 90, an R9 value surpassing 50, and a biological impact ratio (M/P) above 0.6. These noteworthy findings underscore the potential applications of CSSG as a white light-converting phosphor, particularly in the realm of human-centered lighting.

Bremsstrahlung Produced by 5 keV Electrons Incident on Al2O3 and MgO Samples at Air Pressures of 30, 50, and 100 Pa.

Bremsstrahlung spectra produced by 5 keV electrons incident on Al2O3 and MgO targets at air pressures of 30, 50, and 100 Pa have been compared with results produced using pyPENELOPE, a program designed to simulate electron microscopy. The comparisons showed that the experimental results were in good agreement with the results simulated using pyPENELOPE, except near the Duane-Hunt limit, where the bremsstrahlung amplitudes were consistently greater than PENEPMA predicted. The discrepancies may be due to charging effects, which are not simulated by PENEPMA, the Monte Carlo code on which pyPENELOPE is based. If so, the phenomena could potentially impact the accuracy of energy dispersive X-ray spectrometry measurements.

Analysis of the structure and luminescence properties of Zn2 GeO4 :Eu3+ according to Judd-Ofelt theory.

The preparation and characteristic of nanorod-like Zn2 GeO4 doped with Eu3+ or zinc germanate (ZGO):xEu3+ (x = 0 ÷ 0.05), which was synthesized using the hydrothermal method, are described. The influence of Eu3+ -doping ions on the structure and the optical properties of ZGO was also investigated. According to the photoluminescence spectra, ZGO:xEu3+ nanophosphors gave a red emission due to the 5 D0 →7 F2 emission of Eu3+ ions. In accordance with Judd-Ofelt theory, the intensity parameters for f-f transitions from the emission and absorption spectrum were determined. At the 5 D0 excited state of Eu3+ , total spontaneous emission probabilities (AR ), lifetimes (τR ), branching ratios (ßR ), and quantum efficiency (η) were calculated. The ZGO:xEu3+ (x = 0.02, 0.03, 0.04) phosphor showed the branch ratio ß (5 D0 →7 F2 ) > 60%, indicating that the phosphors prepared here have a promising potential as laser light. The sample with a concentration of 0.04Eu3+ achieved the highest quantum efficiency of 84%, suggesting that it has potential light-emitting diode applications.

Characterization of structural and optical properties of Mn2+ -doped Zn2 GeO4 nanorods as an efficient green phosphor for solid-state lighting.

A series of Mn2+ -doped zinc germinate ZGO:xMn2+ (x = 0-0.05) nanorods was synthesized successfully using a hydrothermal method. XRD revealed that crystal phases of the ZGO:xMn2+ were rhombohedral and in the R-3 space group. The Williamson-Hall equation was also used to explain the strain, nanocrystalline size, and stacking fault. Green LEDs were successfully fabricated by coating ZGO:Mn2+ nanorods onto UV-LED chips. For high color purity, CIE of the fabricated green LEDs were (0.2404, 0.5428), which made this material a promising candidate for fabrication of UV-based green LEDs.

Impact of rocuronium on intraoperative neuromonitoring vagal amplitudes during thyroidectomy.

PURPOSE: Neuromuscular blocking agents (NMBA) facilitate endotracheal intubation and reduce related laryngeal morbidity. However, NMBA interfere with intraoperative neuromonitoring amplitudes during thyroidectomy. The goal of this study was to evaluate the impact of rocuronium used for tracheal intubation on early intraoperative neuromonitoring vagal amplitudes observed during first thyroid lobe dissection. METHODS: This is an observational pharmacoepidemiological study with prospective data collection and retrospective analysis. During the study period, all consecutive patients who underwent thyroid surgery with neuromonitoring were included. Patients underwent endotracheal intubation either using a single dose of rocuronium (NMBA group) or without NMBA (NMBA-free group) according to the anesthesiologist's preference. RESULTS: Six hundred six patients were included (213 NMBA and 393 NMBA-free group patients). At V1, 39 patients (18%) in the NMBA group had an amplitude < 100 µV (need for curarization reversal in 30 patients) and 13 patients (3.3%) in the NMBA-free group (p < 0.001). In the remaining 554 patients, the mean V1 amplitude was significantly decreased in the NMBA group (544 versus 685 µV; p < 0.001). After exclusion of 25 patients with loss of signal types 1 and 2 during dissection, the difference between mean V1 and mean V2 was significantly lower in NMBA group patients (- 22 versus - 86 µV; p = 0.016). CONCLUSION: This study provides new data showing how NMBA used for tracheal intubation significantly decrease V1 amplitude baseline and modify amplitude variations from V1 to V2 values during the first thyroid lobe dissection. LEVEL OF EVIDENCE: Pharmacoepidemiological study.

[Understanding and caring for patients with smelly wounds]. / Prise en charge des troubles de l'odorat liés à la Covid-19.

Sudden loss of smell is a very common symptom that can be observed in two-thirds of patients with Covid-19, and may be the only symptom of this disease. A study has demonstrated that 80% of infected patients have sudden loss of smell without nasal obstruction. This suggests that anomalies of the olfactory epithelium are a key element of pathogenesis and local involvement. Management of odor disorders related to Covid-19 is still being debated. Share of experience of the ear, nose and throat team at the University Hospital of Nancy (54).

Full-field microsurface profilometry using image correlation without vertical scanning.

A full-field microprofilometry involving innovative image correlation was developed for profile measurement without vertical scanning. High-speed optical inspection has become critical for confirming precise dimensions in semiconductor fabrication such as microbumping in 3D stacked ICs and precision manufacturing. A digital micromirror device (DMD) is designed to serve as a point-light-source array in a quasiconfocal optical configuration and perform lateral scanning to minimize signal crosstalk between neighboring testing points. More importantly, multiple diffractive images are detected and measured with a prebuilt depth-correlated database to extract the height information of a tested surface. A 100-nm repeatability can be realized in the absence of a detector pinhole and without vertical scanning, thus achieving high-speed submicrometer-scale surface profilometry.

Optical Stark and Zeeman Spectroscopy of Thorium Fluoride (ThF) and Thorium Chloride (ThCl).

Experimentally and theoretically determined magnetic and electric dipole moments, bond distances, and vibrational spacings are used for a comparative study of the bonding in ThF and ThCl. Numerous bands in the visible electronic spectra between 16 400 and 18 800 cm-1 of supersonically cooled molecular beam samples have been detected using medium-resolution (Δν ≈ 0.1 cm-1) 2D spectroscopy. High-resolution (Δν < 20 MHz) field-free, Stark, and Zeeman spectroscopy of the detected [18.6]Ω = 3/2 - X2Δ3/2 band of ThF near 538.4 nm and the [18.2]Ω = 3/2 - X2Δ3/2 band of ThCl near 551.0 nm have been recorded and analyzed. Stark shifts and splitting were analyzed to produce | µâƒ—el| values of 1.453(7) D and 0.588(9) D for the X2Δ3/2 and [18.6]Ω = 3/2 states of ThF, respectively, and 2.022(35) D and 3.020(55) D for the X2Δ3/2 and [18.2]Ω = 3/2 states of ThCl. Zeeman splittings and shifts were analyzed to produce ge values of 1.038(4) and 1.079(4) for the X2Δ3/2 and [18.6]Ω = 3/2 states of ThF and 1.130(4) and 1.638(4) for the X2Δ3/2and [18.2]Ω = 3/2 states of ThCl. Analysis of ge values demonstrates that the X2Δ3/2 and [18.6]Ω = 3/2 states of ThF and the X2Δ3/2 state of ThCl are predominately 2Δ3/2 spin-orbit components, whereas the [18.2]Ω = 3/2 state of ThCl is an admixture of 2Δ3/2 and 2Π3/2 spin-orbit components. A molecular orbital description of the ground states is used to rationalize the observed | µâƒ—el|values for the ThX (X = F, Cl, O, and S) series and garner insight into the bonding mechanism. The dipole moments in the ground state of ThF and ThCl have been calculated using relativistic coupled-cluster methods. It is demonstrated that the systematic inclusion of electron-correlation contributions plays an essential role in obtaining accurate predictions for the dipole-moment values in ThF and ThCl.

Characterization of gas-phase thorium nitride.

Properties of gas-phase thorium nitride, ThN, have been experimentally determined from a combined optical and microwave spectroscopic study. An intense band near 555 nm has been assigned as the [18.0]1.5-X2Σ+ (0,0) transition and recorded at high resolution in the presence of static electric and magnetic fields. The observed optical Stark shifts were analyzed to determine permanent electric dipole moments, µâ†’el for the [18.0]1.5 and X2Σ+ states of 4.38 ± 0.02D and 5.11 ± 0.09D, respectively. Zeeman shifts were used to determine the magnetic g-factors. The pure rotational spectrum was recorded using a separated field optical pump/probe microwave repopulation scheme and analyzed to determine the bond length and 14N magnetic hyperfine and nuclear electric quadrupole parameters. A molecular orbital correlation diagram and ligand field electronic structure models are used to provide a qualitative interpretation of the electronic state ordering, magneto- and electro-static properties, and hyperfine interactions. Electronic structure calculations for the X2Σ+ state were performed, and results were compared with observations. Observed trends in µâ†’el for the ThX (X = N, S, O, F, and Cl) series are discussed.

[Chronic rhinosinusitis of adults: new definition, new diagnosis]. / Rhinosinusites chroniques de l'adulte : nouvelle définition, nouveau diagnostic.

Chronic rhinosinusitis of adults: new definition, new diagnosis. The three-nose theory, which is based on evolution and development of the nose, seems useful for a better understanding of chronic rhinosinusitis (CRS). The nose seems in fact to be composed of three noses (one olfactory, one respiratory and one sinusal nose), each of them being able to be affected by specific diseases. The concept of chronic nasal dysfunction (CND) is based on standardized recording of nose and sinus symptoms, irrespectively of their aetiology. Clinical, endoscopic and CT-scan check up is then aimed to look for a specific disease of one or the other of the three noses (nasal polyposis, chronic respiratory rhinitis, sinusitis…) or for a disease affecting simultaneously the three noses (rhinosinusitis), each disease leading if necessary to specific additional tests (allergic tests, tooth check-up, immune balance tests…). This implies specific therapeutic options, the effectiveness of the choosed one being evaluated by comparing the standardized recordings of nose and sinus symptoms.

Rhinosinusites chroniques de l'adulte : nouvelle définition, nouveau diagnostic. Pour mieux comprendre la rhinosinusite chronique, il peut être utile de s'appuyer sur la théorie des trois nez, issue des connaissances sur l'évolution et le développement de l'organe nasal humain. Celui-ci apparaît comme un assemblage de trois nez différents (nez olfactif, nez respiratoire et nez sinusien) qui peuvent développer chacun des pathologies propres. Le concept de dysfonctionnement nasal chronique repose sur l'enregistrement standardisé des symptômes rhinosinusiens, indépendamment de leur étiologie. Le bilan clinique, endoscopique et tomodensitométrique a alors pour but de rechercher une pathologie spécifique à l'un ou l'autre des trois nez (polypose nasale, rhinite respiratoire chronique, sinusite…) ou une pathologie diffuse touchant les trois nez (rhinosinusite), qui dans chaque cas peut conduire si nécessaire à des investigations complémentaires (bilan allergologique, dentaire, immunitaire…). Il en découle des propositions thérapeutiques spécifiques, l'efficacité de celle retenue étant évaluée par comparaison des recueils de symptômes standardisés.

Enhancing the luminescence of Eu3+ /Eu2+ ion-doped hydroxyapatite by fluoridation and thermal annealing.

This paper reports a novel way for the synthesis of a europium (Eu)-doped fluor-hydroxyapatite (FHA) nanostructure to control the luminescence of hydroxyapatite nanophosphor, particularly, by applying optimum fluorine concentrations, annealed temperatures and pH value. The Eu-doped FHA was made using the co-precipitation method followed by thermal annealing in air and reducing in a H2 atmosphere to control the visible light emission center of the nanophosphors. The intensities of the OH- group decreased with the increasing fluorine concentrations. For the specimens annealed in air, the light emission center of the nanophosphor was 615 nm, which was emission from the Eu3+ ion. However, when they were annealed in reduced gas (Ar + 5% H2 ), a 448 nm light emission center from the Eu2+ ion of FHA was observed. The presence of fluorine in Eu-doped FHA resulted in a significant enhancement of nanophosphor luminescence, which has potential application in light emission and nanomedicine.

Fine-tuned evaluation of olfactory function in patients operated for nasal polyposis.

Given the forced-choice procedure of the identification test, patients with profound anosmia are more likely to have higher identification scores by chance than patients with hyposmia or normosmia. This may be a confusing factor when assessing the sense of smell, which alters the appreciation of real olfaction improvement. The aim of this study was to fine-tune the results of the identification Sniffin' Sticks test before and 6 weeks after surgery using the real identification score. A total of 133 patients underwent the Identification (I) and Threshold (T) tests the day before and 6 weeks after nasalization surgery. The scores of the identification test, called I G (global identification), were ranked from 0 to 16. Patients had to specify if their forced-choice answers were given either surely or randomly, called I H (hazard identification). The real score of identification I R was obtained as follow: I R = I G - I H. Patients with an immeasurable threshold according to the T test were more prone to give randomly correct answers. On the basis of I G scores, 43.6% of patients remained hypo-anosmic after surgery compared to 72.9% before surgery. Using I R scores, only 3.8% of patients remained anosmic (I R = 0) at 6 weeks after surgery. Hence, patients with real anosmia (I R = 0) were less prone to improve their olfaction than patients with I R > 0. The analysis of random factor when using identification test allows differentiating a real anosmia from a hyposmia. An I G ≤ 4 could be considered as a profound/real anosmia or a severe hyposmia. This procedure cannot, however, replace the forced-choice method in odor identification testing.

Precise optical surface profilometry using innovative chromatic differential confocal microscopy.

A broadband differential confocal method that exploits novel double-slit chromatic confocal microscopy was developed for one-shot microscopic 3D surface measurement. In situ automated optical inspection to generate microscopic surface profiles has become extremely important for ensuring strict geometric compliance in precision manufacturing. An innovative optical configuration was developed to generate a pair of orthogonally polarized incident light beams, and a pair of the conjugate light beams was detected using two slits of different widths at the corresponding conjugate imaging locations of the incident beams. A sub-micrometer depth measuring repeatability can be achieved for the one-shot reconstruction of 3D surface profiles.

The olfactory fascia: an evo-devo concept of the fibrocartilaginous nose.

PURPOSE: Evo-devo is the science that studies the link between evolution of species and embryological development. This concept helps to understand the complex anatomy of the human nose. The evo-devo theory suggests the persistence in the adult of an anatomical entity, the olfactory fascia, that unites the cartilages of the nose to the olfactory mucosa. METHODS: We dissected two fresh specimens. After resecting the superficial tissues of the nose, dissection was focused on the disarticulation of the fibrocartilaginous noses from the facial and skull base skeleton. RESULTS: Dissection shows two fibrocartilaginous sacs that were invaginated side-by-side in the midface and attached to the anterior skull base. These membranous sacs were separated in the midline by the perpendicular plate of the ethmoid. Their walls contained the alar cartilages and the lateral expansions of the septolateral cartilage, which we had to separate from the septal cartilage. The olfactory mucosa was located inside their cranial ends. CONCLUSION: The olfactory fascia is a continuous membrane uniting the nasal cartilages to the olfactory mucosa. Its origin can be found in the invagination and differentiation processes of the olfactory placodes. The fibrous portions of the olfactory fascia may be described as ligaments that unit the different components of the olfactory fascia one to the other and the fibrocartilaginous nose to the facial and skull base skeleton. The basicranial ligaments, fixing the fibrocartilaginous nose to the skull base, represent key elements in the concept of septorhinoplasty by disarticulation.

Assessment of quality-of-life outcomes after surgery for nasal polyposis with the DyNaChron questionnaire.

This prospective study assesses outcomes at 6 weeks and 7 months after radical ethmoid surgery in 65 patients with nasal polyposis using a new and detailed instrument, the DyNaChron questionnaire, which was filled in the day prior to surgery and at 6 weeks and 7 months after surgery at follow-up visits. Before surgery, the leading bothersome symptoms were olfactory disturbances (7.74 ± 2.81) and nasal obstruction (6.66 ± 2.28). After surgery (6th week and 7th month), there was a clear improvement of all symptoms including nasal obstruction, olfactory disturbances, anterior rhinorrhea, postnasal discharge, facial pain/headache and cough in comparison to baseline (p < 0.0001). Nasal obstruction was the most improved symptom (effect size of 2.24). At 7th post-operative month, the sense of smell continued to improve slightly. By contrast, the postnasal discharge score that was significantly improved at 6th post-operative week tended to worsen at 7 months (p = 0.0045). Before surgery, strong psychosocial impacts were observed in association with nasal obstruction and anterior rhinorrhea. The physical impacts of each symptom were proportionally correlated to the symptom score before and after surgery. The quality of life (QOL) related to each symptom was clearly better at 6 weeks and remained steady at 7 months after surgery. In conclusion, olfactory disorders and postnasal rhinorrhea were the main remaining symptoms after sinus surgery despite a global improvement of symptoms and quality of life. The earlier time point to stabilize QOL outcomes of endoscopic sinus surgery could be suggested at 6 weeks after surgery.

Olfactory neuroblastoma behavior inside and outside the olfactory cleft.

PURPOSE: Olfactory neuroblastoma (ONB) is a rare malignant tumor of the nose. The currently available evidence links this disease with cells of the olfactory epithelium. The detailed description of tumor site and its extension is the key of treatment. The aim of the present study was to describe the way ONB develops inside and outside the olfactory cleft. METHODS: Thirteen consecutive patients treated between 2004 and 2014 for ONB with unequivocal pathologic diagnosis, complete diagnostic imaging and endonasal endoscopy surgery were enrolled in this retrospective study. The site of origin and local extension of each tumor were studied in detail based on computed tomography/magnetic resonance imaging, surgical report, registered videotape of the surgery, and pathological reports. RESULTS: This series shows the behavior of a tumor arising either in the olfactory clefts (11 cases) or in the ethmoidal labyrinth (2 cases). When the setting begins with a tumor located in the olfactory cleft (below or in contact with the cribriform plate), the further step can be the extension to the ethmoidal labyrinth before intracranial or intraorbital extension. When tumors originate inside the ethmoidal labyrinths, the extension can first be into frontal sinus or orbital cavity. CONCLUSIONS: This fine anatomic and radiologic description shows the natural behavior of ONB inside and outside the olfactory cleft. As a consequence, the staging system developed by Kadish seems inadequate and Dulguerov's staging system could be improved. However, the preliminary proposed modification has to be evaluated in a prospective and large, multicenter cohort of patients.

Chemically Bonded Plasmonic Triazole-Functionalized Au/Zeolitic Imidazole Framework (ZIF-67) for Enhanced CO2 Photoreduction.

The design of functionalized metallic nanoparticles is considered an emerging technique to ensure the interaction between metal and semiconductor material. In the literature, this interface interaction is mainly governed by electrostatic or van der Waals forces, limiting the injection of electrons under light irradiation. To enhance the transfer of electrons between two compounds, close contact or chemical bonding at the interface is required. Herein, a new approach was reported for the synthesis of chemically bonded plasmonic Au NPs/ZIF-67 nanocomposites. The structure of ZIF-67 was grown on the surface of functionalized plasmonic Au NPs using 1H-1,2,4-triazole-3-thiol as the capping agent, which acted as both stabilizer of Au nanoparticles and a molecular linker for ZIF-67 formation. As a result, the synthesized material exhibited outstanding photocatalytic CO2 reduction with a methanol production rate of 2.70 mmol h-1 g-1 cat under sunlight irradiation. This work emphasizes that the diligent use of capping agents, with suitable functional groups, could facilitate the formation of intimate heterostructure for enhanced photocatalytic CO2 reduction.

Direct Z-scheme mediated SmVO4/UiO-66-NH2 heterojunction nanocomposite for the degradation of antibiotic tetracycline hydrochloride molecules under sunlight.

The use of tetracycline hydrochloride (TCH) for veterinary, human therapy, and agriculture has risen in the past few decades, making it to become one of the most exploited antibiotics. However, TCH residue in the environment is causing issues related to the evolution of antibiotic-resistant bacteria. To address such a problem, photodegradation offers a potential solution to decompose these pollutants in wastewater and thereby mitigates negative environmental impacts. In this context, the research focuses on the use of the rare-earth metal oxide samarium orthovanadate (SmVO4) with nanorod structure, coupled with UiO-66-NH2 for the photocatalytic degradation. Their photocatalytic activity to degrade antibiotic TCH molecules is explored under simulated solar light irradiation. The integration of UiO-66-NH2 with SmVO4 enhanced the light absorption, recombination resistance, carrier lifetime (from 0.382 to 0.411 ns) and specific surface area (from 67.17 to 246 m2/g) of the composite system as confirmed from multiple analyses. The obtained results further indicated that SmVO4/UiO-66-NH2 nanocomposites could form a direct Z-scheme based heterojunction. Such mechanism of charge transfer leads to the effective degradation of TCH molecules up to 50% in 90 min under solar light, while it is degraded only 30% in the case of bare-SmVO4 nanorods. In this work, the incorporation of UiO-66-NH2 positively influences photoelectrochemical properties and improves the overall photoredox properties of SmVO4 for the degradation of complex compounds like antibiotic TCH molecules. Therefore, UiO-66-NH2 can be proposed as an effective material to sensitize the rare-earth based photocatalytic material.

Descriptive analysis of recurrences of nasal intestinal-type adenocarcinomas after radiotherapy.

BACKGROUND: Despite adjuvant radiotherapy, rates of recurrences of endoscopically operated nasal intestinal-type adenocarcinomas (ITAC) have not been improved in successive series. To better understand how to improve local control, we aimed to investigate the site of local recurrences of ITACs. METHODS: Retrospective study in a reference center in sinonasal malignancies. For all patients with a local recurrence, radiotherapy plans were retrieved and compared to the delineation of local recurrences. RESULTS: Of 63 patients, 54 underwent adjuvant radiotherapy of which 14 (25.9%) had a local recurrence. Eleven of them had their onset in an optimally irradiated area. Difficulty to dissect the cribriform plate and/or the lateral lamina was reported for 11 patients with local recurrences in the operative reports (p <0.0001). CONCLUSIONS: Most of recurrences arose in an optimally irradiated area. A close cooperation between surgeons and radiotherapists is required to define areas at risk and adapt treatment.